GLOBAL RISK AND PROTECTIVE FACTORS ASSOCIATED WITH DRUG USE AMONG YOUTHS.

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Drug misuse is harmful, and overuse of drugs is a global issue. Adolescence is usually when drug use starts. Many risk and protective variables are associated with drug misuse. Drug misuse is a widespread issue; in 2016, 5.6% of people worldwide between the ages of 15 and 64 took drugs at least once. It has been demonstrated that younger individuals use most drugs at higher rates than older persons do. In several ASEAN (Association of Southeast Asian Nations) nations, drug usage is also on the rise, particularly among young men between the ages of 15 and 30. The 2013 Global Burden of Disease (GBD) research demonstrated the elevated burden of drug addiction among adolescents and young adults. Furthermore, addiction to alcohol and other drugs accounts for around 14% of the overall health burden among young males. Cannabis is the drug of choice for those with substance use problems, who are also more likely to be younger individuals and die from them. Teenagers are the demographic most vulnerable to addiction.

Adolescence is the crucial time to start using drugs, and young people between the ages of 18 and 25 use drugs at the highest rate. Adolescents are particularly prone to drug misuse currently due to their strong inclinations towards experimenting, curiosity, vulnerability to peer pressure, rebellion against authority, and low self-worth. The fundamental developmental process throughout adolescence entails a shift in the relationship between the individual and the many tiers of the environment to which the young person is used. Diversity in adolescence is encouraged by variations in the kind and timing of these relationships, which can serve as sources of danger or protection at this stage of life. All these elements are essential to support young people in realising their full potential and achieving optimal health during the transition to adulthood. Drug abuse hinders the development of critical thinking and the acquisition of essential cognitive abilities, which hinders a successful transition to adulthood. Drug-abusing adolescents have also been linked to decreased general health and well-being, as well as increased incidence of mental and physical disorders.

Teenagers are more likely to take drugs if they have risk factors and no protective variables. Early mental and behavioural health issues, peer pressure, inadequate educational facilities, poverty, inadequate parental supervision and connections, a dysfunctional family structure, a lack of opportunity, loneliness, gender, and drug accessibility are a few risk factors. High self-esteem, grit, religion, peer pressure, self-control, parental supervision, academic proficiency, anti-drug use laws, and a strong neighbourhood affiliation are among the protective variables.

Drug-related substances in this context refer to narcotics, opioids, psychoactive substances, amphetamines, cannabis, ecstasy, heroin, cocaine, hallucinogens, depressants, and stimulants. Drugs of abuse can be either off-label drugs or drugs that are medically prescribed.

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Risk factors

Individual traits: Adolescent drug addiction was significantly positively correlated with high impulsive features. When compared to the non-impulsive group, the impulsivity characteristic alone was an independent risk factor that raised the likelihood of taking any drug by two to four times. Marijuana drug addiction is strongly correlated with rebellious tendencies. An indicator of a young person's likelihood of participating in dangerous behaviour is their rebelliousness. However, most impacted responders had trouble controlling their emotions, according to research done on 112 young people receiving detoxification for opiate dependence. Early onset of emotional regulation impairment led to early onset of opioid dependence. In addition, case-control research including young people in outpatient treatment discovered that teenagers abusing cannabis had notable alexithymia characteristics in contrast to the control group. The teenagers in question had a significant level of difficulty in identifying emotion (DIF), a crucial component in diagnosing alexithymia. About cannabis addiction, the adjusted odds ratio for DIF was 1.11 (95% CI, 1.03–1.20) overall.

Harmful growth exposure: Adolescent drug misuse has also been demonstrated to correlate with a history of maltreatment in the past positively. Despite data being restricted to females, research discovered that a history of physical abuse in the past is linked, through a Path Analysis, to teenage drug misuse. Nevertheless, data from different research that concentrated on foster care indicated that any abuse might lead to a prevalence of cannabis use as high as 85.7% for lifetime use and as high as 31.7% for use during the previous three months. The research also discovered important latent factors, with r2 values of 73.6 and 68.1%, respectively, that explained the results of drug abuse: chronic physical maltreatment (factor loading of 0.858) and chronic psychological maltreatment (factor loading of 0.825). Another research study provided insight into individuals residing in child welfare services (CWS). Through longitudinal assessments, research showed that after 36 months, the percentage of CWS patients who used marijuana rose from 9 to 18%. There is proof that children in these shelters may have had a bad childhood as a result.

Comorbidity: Adolescents with illnesses who require ongoing medical pain management are more likely to abuse opioids. Despite the severity of their pain, teenagers with disorder symptoms may be more susceptible to drug usage.

Individual's perception: The substance's low cost and the presence of drug sellers near schools were contributing factors to juvenile accessibility. The perception of drug accessibility and law enforcement initiatives have also been connected. During all times, young perceptions of lax enforcement of drug laws in the neighbourhood predicted a rise in marijuana usage during the next assessment period. Furthermore, the chance of regular cannabis use among adolescents is increased by their overall screen time. The mean total screen time for individuals who reported using cannabis daily was 12.56 hours. In contrast, the mean for those who did not disclose using cannabis was 6.93 hours. Teens who spent more time texting, watching TV shows and movies, playing video games, and using the internet were substantially more likely to use cannabis regularly.

Protective factors

Individual traits: Research has shown that specific personal characteristics can prevent teenagers from becoming drug addicts. Youth with opioid addiction who exhibit high levels of mindfulness, as assessed by the 25-item Child Acceptance and Mindfulness Measure, or CAMM, proceed towards injectable drug usage more slowly. Furthermore, it was shown that marijuana usage was negatively correlated with the social phobia feature.

Individual's attitude: Strong anti-substance beliefs and a strong desire to preserve one's health were associated with a higher likelihood of protection against drug misuse.

Family factors

Risk factors: Numerous studies have documented the biological components that underlie drug misuse in teenagers. Studies on epigenetics are significant since they can offer a clear picture of the possible prenatal variables that may be addressed sooner. Adolescent drug misuse in later life is indirectly linked to expectant mums who use tobacco and alcohol. Furthermore, the dynamic interaction between parents and their offspring may significantly impact a child's development. When compared to the other component, the mother's psychological influence over her children's involvement in substance addiction was twice as strong.

In contrast, a study elucidated an indirect risk factor for drug misuse among youth: a lower parental educational attainment was found to indicate a higher likelihood of future drug usage by decreasing the youth's perception of danger. Parental negligence may potentially be a factor in this issue. The most frequent causes of neglect were the absence of parental monitoring, children's unrestrained use of pocket money, and the existence of family members who were substance abusers.

Protective factors: Even though the maternal characteristics were demonstrated to be risk factors when the paternal figure armed himself with enough information, the opposite impact was observed. According to research, fathers who are well-informed and conscious of their surroundings are more likely to shield their teenage kids from drug misuse. Some of the protective elements in this situation can include guidance and assistance.

Community factors

Risk factors: According to a 2017 study, peer drug abusers and teenage drug abusers are positively correlated. Peer groups using synthetic substances were expected to have a considerably higher chance of becoming lifetime marijuana users by a factor of 2.5 (p < 0.001). This element acted as peer pressure for young people since they subliminally wanted to fit in with others. Marijuana usage is also influenced by accessibility and participation in both scheduled and unstructured activities.

Protective factor: One crucial protective factor that might keep teenagers from doing drugs is strong religious beliefs that are interwoven throughout society. Furthermore, the degree of school connectivity and the availability of adult support are significant factors in drug use.

Conclusion

The possibility of drug usage rises when more people believe that there are little to no damaging dangers connected to drugs. On the other hand, a higher perceived danger continues to be a deterrent to marijuana consumption. Nevertheless, a different study found that the perceived availability of the substance was a more significant predictor of drug usage among adolescents. When considering the broader picture, these perspectives support one another and might influence drug usage. On the other hand, different research found that there was a tendency towards a decline in the perception of drug danger as drug use increased. As drug use among adults increases, young people may come to view drug use as normal and unproblematic.

Moreover, the overall amount of time spent in front of a screen increases the risk of drug usage in adolescents. Numerous investigations have demonstrated how screen time negatively impacts mental health and contributes to teenage substance use because of the widespread availability of online material that supports substance use. Teens with many medical conditions who use opioids for pain treatment have a higher risk of abusing them later in life. According to a qualitative investigation of general practitioners' perspectives on the danger of opioid abuse in individuals with pain, the default therapy for pain management involves the use of opioids. Misuse is not a primary worry for them. Adolescents should carefully decide whether to utilise opioids for pain relief.

Family structures were shown to have both positive and negative relationships with drug misuse among teenagers within the family factor domain. Paternal knowledge was repeatedly proven to be a protective factor against substance misuse, as reported in one research. If a father has enough information, he can act as his family's guardian, keeping an eye on and shielding his kids from harm. Though statistically insignificant, the scientists also noted a similar impact of paternal psychological control. Parenting style is related to this concept, and the authors contended that parenting style may significantly impact the outcomes being examined. Although this association was previously noted in an earlier literature review, a recent study found that the influence of negligent parenting practices leads to poorer substance abuse outcomes. However, it was pointed out in different research that rather than the parenting style per se, the teenagers' opinion of a neglectful parenting style increased their odds (OR 2.14, p = 0.012) of developing alcohol abuse. Families have a significant impact on teenagers' likelihood of abusing drugs. Therefore, parents must be involved in any intervention aimed at preventing teenage drug use or reducing current substance use. This includes fostering better parent-child communication and ensuring parents monitor their kids' whereabouts.  

Lastly, drug misuse among teenagers is also a result of communal influences. The relationship between peer pressure and drug misuse among teenagers may be explained by peer selection and peer socialisation processes. Strong religious convictions that are incorporated into society, according to another study, are fundamental in keeping teenagers from abusing drugs. Most faiths downplay any behaviour that may have negative implications on one's health, such as drug addiction. Spiritual beliefs may, therefore, aid in the protection of teenagers. Religious groups might employ this subject, which has been well shown in several studies, as part of their interventions to address the problem of teenage drug misuse.  

To your health,

Nwabekee.

Reference

Nawi, A.M. et al. (2021) 'Risk and protective factors of drug abuse among adolescents: A systematic review', BMC Public Health, 21(1).

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