Prevalence and Patterns of Psychoactive Substance Use Among Undergraduates at a Nigerian Tertiary Institution

Prevalence and Patterns of Psychoactive Substance Use Among Undergraduates at a Nigerian Tertiary Institution | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Patterns of Psychoactive Substance Use Among Undergraduates at a Nigerian Tertiary Institution Chinaza Miracle Anyanwu, Ekene Mary Nnagha, Walter Agbor Ogar, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8545465/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Psychoactive substance use among undergraduates is a growing public health issue of concern, with significant implications on academic performance, health and overall well-being. Psychoactive substance use can lead to long-term addiction, impaired cognitive function, and increased risk of mental disorders, making it a critical issue for university students. This study assessed prevalence and factors associated with psychoactive substance use among undergraduates at a selected Nigerian Tertiary Institution. A descriptive cross-sectional study was conducted using a structured questionnaire to collect data from 320 randomly selected undergraduate students through a multistage sampling technique. Descriptive and inferential statistics were used to analyze the data, and a statistically significant p-value was set at < 0.05. 176 (55%) of the respondents were male, with mean age of 22.82 ± 3.372 years. 35.5% of respondents used psychoactive substances to relieve stress, while 6.5% used psychoactive substances due to parental influence. Alcohol (73.6%) was the commonest substance used; Drinking (57.1%) was the commonest consumption route. Age (p < 0.015), Gender (p < 0.046), Year of study (p < 0.009), and Average monthly income (p < 0.001) were significantly associated with increased psychoactive substance use. The use of psychoactive substances among undergraduates is alarmingly prevalent and must be effectively addressed. This research underscores the need for targeted interventions aimed at reducing substance use, with a focus on mental health support, peer education, drug abuse prevention campaigns, and stricter enforcement of campus policies on substance abuse. Additionally, preventive strategies should address the underlying psychosocial factors driving substance use, including academic stress, social influences, and economic challenges. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 INTRODUCTION The use of psychoactive substance is an alarming and increasing public health and social problem worldwide. Psychoactive substances alter mental functions such as perception, consciousness, cognition, mood, and emotions when consumed or administered into the body. Psychoactive substances are part of a larger class of psychoactive chemicals, including Alcohol and Nicotine. The misuse of these substances, which encompasses harmful or hazardous consumption patterns, is a growing concern, particularly among younger populations. 1 According to the World Drug Report 2021, approximately 275 million people used drugs worldwide in the preceding year, with another 36 million persons diagnosed with substance use disorders globally. 1 In 2019 alone, about 180,000 deaths were directly linked to substance use disorders, while another half million deaths were attributed to illicit drug use. The United Nations Office on Drugs and Crime in 2014 estimated that about 1 in 20 individuals worldwide, aged 15 to 64, had used an illicit psychoactive substance within the previous 12 months; that estimated to about 250 million individuals out of which, 1 in 10 of these individuals struggled with drug use. According to the same data, approximately 40 individuals per 1 million, or 183,000 individuals died from drug-related causes in 2012. 2 Substance abuse varies across different regions across the globe. A national survey of 2810 students in the UK in 2018 reported that 56% of the respondents had used drugs and 39% currently use them. Cannabis was the most frequently taken drug (94% of respondents who said that they had used drugs) and was the most likely to have been used regularly. 3 Monitoring the Future follow-up report on the use of psychoactive substances among university students in the United States revealed a trend in binge drinking (30.4%) and alcohol consumption (76.4%) within the past 12 months among young adults aged 19–22 in 2021 4 ; as well as a surge in the past year use of alcohol (84%) and historically high levels of cannabis (42%) and hallucinogens (9%) past year use among young adults aged 19–30 in 2023. According to Monitoring the Future 2023 report on substance use behaviors and attitudes of adolescents and young adults in the United States, Alcohol has remained the most reportedly used substance over the years. 5 Studies in Sudan found the overall prevalence of substance use to be 31% and the most common substance was tobacco followed by cannabis, tranquilizers and alcohol. The commonest reason for initiating substance use was curiosity. 6 Another study carried out among Ethiopian undergraduates found more substance use among children of uneducated parents, and that older students were 2.4 times more likely to use substances than younger students. 7 In a study carried out in University of Uyo, the prevalence of psychoactive substance use was 27.5% and was more in females (37.7% ) than males (18.2% ). Peer group influence (94.3%), stress (70.5%), curiosity (58.7%), were the most common factors perceived to be associated with the use of psychoactive substances among undergraduates. A prevalence of 20–40% and 20.9% of drug abuse was reported among students and youths respectively and drugs that are commonly used are stimulants, depressants, Narcotics and Hallucinogens. 8 Stimulants, like caffeine and cocaine, block the reuptake of neurotransmitters such as serotonin and dopamine, leading to increased energy, anxiety, and panic. Depressants, such as benzodiazepines and barbiturates, enhance GABA production, impairing memory and cognitive function. Narcotics, including codeine and heroin, stimulate endorphins to reduce pain and induce euphoria. Hallucinogens, like marijuana and ecstasy, mimic serotonin and epinephrine, altering perception and mood. According to some studies, these substances are misused due to the belief that they relieve stress and anxiety, induce sleep, ease tension, relax and help its users forget their problems. 9 Misuse of these psychoactive substances has been a major problem within the university system, largely because of its negative impact on students’ academic performance, health and social lives. Factors associated with substance misuse among undergraduate students may be linked to students’ transition from a restricted secondary school to an autonomous university life, and the growing appeal of a liberal campus environment. 10 For young people to change their behavior, especially undergraduates, it is essential to understand the consequences of substance misuse and abuse, including adverse health and social problems. Therefore, this shows the necessity of planning and formulation of preventive strategies to curtail the use of psychoactive substance by undergraduates. METHODS Study Setting, Sampling and Data Collection: The study was conducted from June till August, 2024 at the University of Calabar, Nigeria with an estimated student population of 40,645 students. A descriptive cross-sectional study was utilized. Cochran formula was used to calculate the minimum sample size; with a z of 1.96 and a sampling error set at 5%. To compensate for improperly filled questionnaires, a nonresponse rate of 10% (29) was added to the minimum sample size. Using Cochran formulae n = Z 2 pq/d 2 where n = sample size Z =Standard normal deviation = 1.96 at 95% confidence level P = proportion of target population estimated to have desired characteristics is 0.25; according to (Johnson et al. 2017) 8 . d = degree of precision (5%) q = 1-P= 1-0.25 = 0.75 using the Cochran formula: (1.96)2 x 0.25x 0.75 (0.05) 2 = 0.7203 0.0025 = 288 Sample size = 288 Assuming a 10% non-response, the minimum sample size will be adjusted with the formula: N__ 1 - 0.1 = n__ 0.9 where n =288 288 0.9 = 320 A multi-stage sampling technique method was used to select eligible undergraduates. Inclusion criteria were undergraduates at University of Calabar with a valid school identification card while exclusion criteria were undergraduates who did not consent to the study. Data collection was done using a using a semi-structured questionnaire adapted from European School Survey Project on Alcohol and Other Drugs (ESPAD) master-questionnaire self-administered format. Information included socio-demographic and academic information of the respondents, questions on prevalence and patterns of psychoactive substance, the types and reasons for use among the respondents. The questionnaire was distributed among undergraduates in the early hours of the day around the lecture halls to enable full participation by the target population. The instrument was pre-tested on 20 undergraduates in one of the faculties, to ensure that the contents were adequately understood. Response rate was 100%. Statistical analysis: Before analysis, all returned questionnaires were checked manually to ensure that the responses were in order. Data obtained from this study was analyzed using the Statistical Product and Service Solutions (SPSS) version 25.0. The data was presented in form of tables and analyzed as descriptive frequencies, percentages ad cross tabulations. For inferential statistics, the chi-square test was used to test for associations between the use of psychoactive substances and sociodemographic factors at 5% significance level. Ethical consideration: We obtained ethical clearance approval from the University of Calabar Teaching Hospital Health Research Ethics Committee (UCTH/HREC/33/Vol.III/343). All human-related procedures were performed in accordance with relevant institutional guidelines and regulations, and in compliance with the ethical principles of the Declaration of Helsinki. During data collection, the aim of this study was briefly explained to all participants, informed consent was gotten, and their anonymity and confidentiality were protected throughout the study. RESULTS Socio-demographic characteristics of respondents The socio-demographic characteristics of the 320 students that participated in the study showed that 79.7% were between 20–29 years old, with a mean age of 22.82 ± 3.372 years. Males made up 55% of the respondents, while females made up 45%. The majority (46.9%) were Pentecostal. Most respondents (61.3%) lived off-campus. The Igbo ethnic group was the most represented (38.1%). The average monthly income of most respondents was between 10,000 and 20,000 (28.1%) (see Table 1). ---TABLE 1 HERE--- Table 1: SOCIO-DEMOGRAPHICS CHARACTERISTICS OF THE RESPONDENTS Prevalence and patterns of psychoactive substance The prevalence and patterns of psychoactive substance use among the 320 respondents revealed that 231 (72.2%) of respondents have used psychoactive substances while 89 (27.8%) have not used before (presented in Fig. 1 ). ---FIGURE 1 HERE--- Figure 1 : Prevalence of Psychoactive substance use among undergraduates Among the 231 respondents that have used psychoactive substances, alcohol was the most commonly used substance (72.8%, 58.4%, and 44.2% used at least once in their lifetime, last 12 months, and 30 days, respectively), with wine being the most used in the last 30 days (55.0%). Other commonly used drugs include cigarettes (18.2%, used at least once in their lifetime), marijuana (14.2%, used at least once in their lifetime), and caffeine (21.8%, used at least once) (See Table 2). ---TABLE 2 HERE--- Table 2: NUMBER OF OCCASIONS THAT PSYCHOACTIVE SUBSTANCES WERE USED AMONG RESPONDENTS (n = 231) Table 3 shows the age of first use of different psychoactive substances among respondents ---TABLE 3 HERE--- Table 3: AGE OF FIRST USE OF DIFFERENT PSYCHOACTIVE SUBSTANCES AMONG RESPONDENTS (n = 231) Among those who have ever used the different psychoactive substance before, those who had use inhalants (62.5%), Codeine or cough syrup abuse (44.8%) and Alcoholic beverages (44.0%) have more respondents with early onset of drug use (≤ 17 years) compared to cigarettes (31.0%), Marijuana or cannabis (12.5%) and Cocaine (36.4%) (shown in Table 3). Drinking (57.1%), mixing of cocktail (19.0%), and smoking (17.3%) were the common modes of administration of these substances (presented in Fig. 2 ). ---FIGURE 2 HERE--- Figure 2 : Mode of consumption of Psychoactive substances used Friends (36.8%) and clubs/bars (39.4%) were the common sources of these drugs (presented in Fig. 3 ). ---FIGURE 3 HERE--- Figure 3 : Sources of Psychoactive substances Additionally, 49.1% of respondents had no friends using substances, while 50.1% had at least one friend using substances (See Fig. 4 ). ---FIGURE 4 HERE--- Figure 4 : Number of friends that use psychoactive substances Types of psychoactive substances used Figure 5 shows the types of psychoactive substance use among the 231 respondents that have used psychoactive substances. The result indicates that the most commonly used substance was alcoholic beverages, with 73.6% of respondents reporting use. Cannabis was used by 22.2% of respondents, followed by Tobacco products (20.0%), sedatives and sleeping pills (13.0%), any prescription drug (12.1%), Amphetamine (9.5%), Inhalant (8.7%), Opioids (7.4%) and Hallucinogen (6.9%). ---FIGURE 5 HERE--- Figure 5 : Types of psychoactive substances among respondents Reasons for psychoactive substance use Figure 6 shows the reasons for psychoactive substance use among the 231 respondents that have used psychoactive substances. The most common reasons reported by the respondents for using psychoactive drugs were stress relief (35.5%), emotional issues (24.8%), socializing (24.7%), peer pressure (20.8%), curiosity (19.9%), academic pressure (17.5%), and to deal with depression (17.3%). ---FIGURE 6 HERE--- Figure 6 : Reasons for using psychoactive substances The relationship between the use of psychoactive substance and socio-demographic factors of respondents The results of Table 4 showed the relationship between the use of psychoactive substances and socio-demographic factors of the respondents. From the result of the analysis, A significant (p < 0.05) association was found between age group (p = 0.015), gender (p = 0.046), year of study (p = 0.009) and average monthly income (p < 0.001) and the use of psychoactive substances. Respondents aged 20 years and above (74.8%) were more likely to use psychoactive substances than those below 20 years (58.0%). Also, a higher percentage of males (76.7%) use psychoactive substances in comparison to the females (66.7%). Additionally, students in their second year of study and above (74.6%) were more likely to use psychoactive substances than first year students (54.1%). Finally, a higher percentage of students with an average monthly income of more than 50,000 (85.7%) had a higher percentage of psychoactive substance use compared to those with lower incomes. There was no significant association between place of residence during academic session (p = 0.077) and the use of psychoactive substances among respondents. ---TABLE 4 HERE--- Table 4: THE RELATIONSHIP BETWEEN THE USE OF PSYCHOACTIVE SUBSTANCE AND SOCIO-DEMOGRAPHIC FACTORS OF THE RESPONDENT DISCUSSION The prevalence of psychoactive substance use among undergraduates in our study was 72.2%, which is notably higher than reported results in studies conducted in Southern Brazil and Ethiopia (41.5% and 53.6% respectively). 11,12 These differences can be attributed to cultural differences, levels of substance availability, or varying definitions of substance use across populations. A similar study in South Africa reported a prevalence of 62.7%, closely aligning with our findings. 13 In the context of Nigeria, our study's prevalence rate is comparable to findings from Lagos (71.58%) but lower than that reported in Imo (84.5%). 14 This may indicate significant regional variation within Nigeria regarding substance use patterns among university students. Alcohol emerged as the most frequently used psychoactive substance in our study, with a prevalence of 73.6% and a recent use rate of 55% in the past 30 days. This trend aligns with findings from similar studies conducted in Germany with 84.7% of respondents with reported alcohol use 15 , 79.1% lifetime use amongst undergraduates in Johannesburg 16 and 80.6% in Western Cape, South Africa 13 although, binge drinking patterns were more frequent in latter countries compared. A study in Lagos with a prevalence of 71.58%, reported that alcohol consumption was prevalent among undergraduates due to its social acceptability. 17 Cigarettes (18.2%), marijuana (14.2%), and caffeine (21.8%) were also reported as commonly used substances in our study. Comparatively, a study among university students in South-Western Nigeria found a similar pattern, with cigarettes (23.5%), and marijuana (17.9%) being frequently used substances after alcohol. 18 Also, the use of caffeine was notably higher in our study than in others with 13.5% among university students in south western Nigeria and Uyo − 12.6%. 8,17 These comparisons reflect the growing trend of energy drink consumption and its association with academic pressure among students. 19 Our study also reported high early onset of use for psychoactive substances (< 18 years) like inhalants, codeine, and alcohol which identified early initiation of drug use among adolescents. This is comparable to studies done at Ethiopia where 46.2% of students initiated substance use before the age of 18; with alcohol being the most common early-onset substance. 12 For substances like inhalants and alcohol, it is often linked to curiosity, peer pressure, and emotional challenges during adolescence; and emphasizes the need for targeted interventions for children and adolescents to prevent substance use; as early drug use is often associated with increased risks for developing substance use disorders later in life. In terms of modes of usage, drinking (57.1%) was the most common, followed by mixing cocktails (19.0%) and smoking (17.3%) in our study. This pattern aligns with the predominant use of alcohol in our setting and this resonates with similar trends reported in studies conducted at universities in Ibadan and Lagos, with 78% and 75.5% of respondents respectively reported to have consumed psychoactive substances by drinking. 17,20 Prevalence of smoking, particularly cannabis, was reported at 21% at University of Lagos which is higher compared to the 8.2% prevalence of smoking cannabis in our study. The rising trend of cocktail mixing in social settings and prescription drug misuse for recreational purposes is a concerning pattern, particularly at parties and social events; as demonstrated in our study findings. A systematic review by Weyandt et al. (2020) revealed that young individuals aged 18–25 were more likely to misuse prescription drugs by mixing alcohol, benzodiazepines or other illicit drugs for recreational use. 21 From our study. the primary sources of psychoactive substances were clubs/bars (39.4%) and friends (36.8%); which indicate that peer influence plays a role in increased accessibility to psychoactive substances. 22 This aligns with previous research reporting peer pressure and social networks as significant predictors of substance use among university students in India. 23 Our findings also revealed a split among respondents regarding their friends' substance use, with 49.1% indicating they had no friends using substances, while 50.1% reported having at least one friend who does. This division may influence individual choices, thus, emphasizing the importance of social context in understanding substance use behaviors. A significant association was found between the use of psychoactive substances and some socio-demographic factors like Age (p = 0.015*), Gender (p = 0.046*), Year of study (p = 0.009*), and Average monthly income (p < 0.001). Respondents who were 20 years and above had a higher prevalence (74.8%) of psychoactive substance use compared to those below 20 years (58.0%); with significant age association, which is similar to a study conducted among undergraduates at Ataye, Ethiopia and Imo, Nigeria. 14,24 The reason for this could be that this age group face similar pressures, including peer influence, academic stress, and the transition to adulthood, which drive the increased prevalence of substance use. Concerning gender association, our study reported a significantly higher prevalence of psychoactive substance use (76.7%) amongst males than females (66.7%), with significant association with the male gender, which is similar to a study done among undergraduates in South-Western Nigeria. 25 Although gender disparity exists in some literature 8,26 , our findings show that males are more likely to engage in substance use than females; and reasons may be attributed to peer influence, cultural acceptance of substance use among males, and a tendency for males to engage in riskier behavior. Our findings showed that undergraduates in their second year of study and beyond (74.6%) had significantly higher prevalence of psychoactive substance use compared to first-year students (54.1%); with significant association with study year. A similar study conducted among students in mainland China showed that students in higher grades are more likely to misuse substances than students in lower grades. 27 Likewise, a study done among undergraduates in Ekiti, Nigeria showed that students in their fourth year of study were more likely to misuse substances, compared to first year students. 28 This may suggest that as students advance in studies, substance use behavior may tend to increase, driven by social and academic pressures. It can also be attributed to increased exposure to the university environment and peer pressure over time. Furthermore, socio-economic factors, including income and employment status, have been found to influence substance use patterns in various populations. A self-reported study among United States undergraduates in 2016 revealed that high socioeconomic status students were more likely to use psychoactive substances than their other peers. 29 Additionally, a study by Rakić et al. ( 2014 ) that assessed the correlation between psychoactive substance use among adolescents in Novi Sad, Serbia and sociodemographic factors reported that adolescents who had more pocket money were more likely to smoke cigarettes and consume alcohol than their peers. 30 A similar study conducted among undergraduates in South-Western Nigeria also reported a significant association between psychoactive substance use and high socioeconomic status. 25 This may suggest that student from affluent families or high-income earning students often face more peer pressure in social settings, contributing to increased psychoactive substance use. It may also suggest that as wealthier students can conveniently afford psychoactive substances, lower-income students may not have the financial means to abuse substances, even if they are inclined to do so. This aligns with our study findings where financial stability can be linked to increased psychoactive substance use. Our study has some strengths and limitations. Firstly, it focuses on a specific and vulnerable population which are undergraduates, thereby providing targeted insights for intervention. It also captures both the prevalence and patterns of psychoactive substance use, offering a comprehensive view of the issue, which can guide for more effective prevention and treatment programs. The use of anonymous self-administered surveys likely encouraged more honest responses. Additionally, the findings can serve as a baseline for future research, allowing for the tracking of behavioral trends over time, as it raises awareness on an important public health issue, potentially influencing policy and future research efforts. Conversely, as part of the study limitations. the sample size may not fully represent the entire undergraduate population, which could limit the generalizability of the findings. Additionally, the reliance on self-reported data introduces the possibility of bias, as some students may have underreported or exaggerated their substance use, potentially affecting the accuracy of the results. Furthermore, the cross-sectional design of the study only captures substance use behavior at a specific point in time, making it difficult to account for any changes or trends over a longer period. CONCLUSION Undergraduates who participated in the study reported high prevalence of psychoactive substance use. Among the proportion who used psychoactive substances, it was reported to be used more to relieve stress (35%), emotional issues (24.8%) and socialization (24.7%) and common sources were clubs/bar (39.4%) and friends (36.8%). Additionally, demographic factors like age, gender, year of study and socioeconomic status were found to influence substance use behavior. The findings highlight a critical public health issue that requires the attention of institutions, health professionals, and policymakers in order to address underlying biopsychosocial factors precipitating substance abuse, and implementing feasible institutional interventions. Declarations Funding Declaration: The authors received no financial support for this research, authorship nor publication of the article. Ethical Approval: All human-related procedures were performed in accordance with relevant institutional guidelines and regulations, and in compliance with the ethical principles of the Declaration of Helsinki. Ethical approval was obtained from the University of Calabar Teaching Hospital Health Research Ethics Committee (UCTH/HREC/33/Vol.III/343). Consent to participate and publish: Written and verbal informed consent was gotten from respondents to participate and publish prior to data collection, and their anonymity and confidentiality were protected throughout the study. Clinical Trial number: Not applicable. Conflict of Interest: The authors declare no conflict of interest. Data Availability Statement: The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Authors’ contribution: C.M.A was responsible for conceptualization, manuscript writing, preparing figures, methodology and reviewing the manuscript. E.M.N was responsible for manuscript writing, preparing figures, methodology, reviewing and editing the manuscript. W.A.O was responsible for manuscript writing, preparing figures and methodology. S.L.H was responsible for manuscript writing. References World Health Organization. N.d. Drugs Psychoactive. World Health Organ Retrieved June 28, 2024 https://www.who.int/health-topics/drugs-psychoactive United Nations Office on Drugs and Crime. 2014. World Drug Report 2014 Exsum Embargoed.pdf. www.unodc.org. 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Drug Alcohol Depend. 2018;186:201–6. 10.1016/j.drugalcdep.2017.12.047 . Soremekun RO, Oluwakemi E, Omole OC, Adeyemi, and Abayomi M. Oshatimi. Assessment of Use of Psychoactive and Other Non-Prescription Drugs among Students of Selected Tertiary Institutions in Ekiti State South West Nigeria - A Baseline Study. Heliyon. 2021;7(2):e06232. 10.1016/j.heliyon.2021.e06232 . Martin CC. High Socioeconomic Status Predicts Substance Use and Alcohol Consumption. Undergraduates Subst Use Misuse. 2019;54(6):1035–43. 10.1080/10826084.2018.1559193 . Rakić DušicaB, Rakić B, Milošević Z, and Ivan Nedeljković. The Prevalence of Substance Use among Adolescents and Its Correlation with Social and Demographic Factors. Vojnosanit Pregl. 2014;71(5):467–73. Tables Tables 1 to 4 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8545465","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":591696771,"identity":"ba553d19-47c1-4e6c-b96a-cac2e0db7e8a","order_by":0,"name":"Chinaza Miracle Anyanwu","email":"","orcid":"","institution":"University of Calabar","correspondingAuthor":false,"prefix":"","firstName":"Chinaza","middleName":"Miracle","lastName":"Anyanwu","suffix":""},{"id":591696777,"identity":"d9b23fa8-c0fb-45d6-8985-5dd3c3b05c29","order_by":1,"name":"Ekene Mary Nnagha","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwklEQVRIiWNgGAWjYJACZiCWAzEOPCBFizFYSwIpWhIbQCyitJhLNz9+XVBjkz4/7PBDoC12croNBLRYzjlmZj3jWFruxttpBkAtycZmBwhoMbiRYGbMw3Y4d+PsBJCWA4nbCGtJ/2bM8+9/uuHs9A/EaskxfszbdiBBXjqHaFtyyph5+5INN0jnFBxIMCDKL+mbP/N8s5OXn52++cOHCjs5glqAgE0CrBes0oCwchBg/gAi5RuIUz0KRsEoGAUjEAAAh4VHDjCsnOIAAAAASUVORK5CYII=","orcid":"","institution":"University of Calabar","correspondingAuthor":true,"prefix":"","firstName":"Ekene","middleName":"Mary","lastName":"Nnagha","suffix":""},{"id":591696778,"identity":"66f636c9-e28c-4468-9738-3d219c49744a","order_by":2,"name":"Walter Agbor Ogar","email":"","orcid":"","institution":"University of Calabar","correspondingAuthor":false,"prefix":"","firstName":"Walter","middleName":"Agbor","lastName":"Ogar","suffix":""},{"id":591696779,"identity":"2eadaa5d-5f51-4b33-8acb-cbc2ec18228d","order_by":3,"name":"Samson Lubem Hemen","email":"","orcid":"","institution":"University of Calabar","correspondingAuthor":false,"prefix":"","firstName":"Samson","middleName":"Lubem","lastName":"Hemen","suffix":""}],"badges":[],"createdAt":"2026-01-07 22:53:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8545465/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8545465/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102832330,"identity":"f4b4f578-3c1b-4f52-a470-f4c0c4dde1e0","added_by":"auto","created_at":"2026-02-17 10:12:14","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":132456,"visible":true,"origin":"","legend":"\u003cp\u003ePrevalence of Psychoactive substance use among undergraduates\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/66ede8c063c22d354077ef2c.png"},{"id":102832348,"identity":"cb671814-2c01-426c-a472-0bc236430cdc","added_by":"auto","created_at":"2026-02-17 10:12:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51018,"visible":true,"origin":"","legend":"\u003cp\u003eMode of administration of Psychoactive substance\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/e443430ffdb34d2327b27413.png"},{"id":102832361,"identity":"a3458bd0-da04-420a-8c74-7a863dcfdf11","added_by":"auto","created_at":"2026-02-17 10:12:25","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":47335,"visible":true,"origin":"","legend":"\u003cp\u003eSources of Psychoactive substances used\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/488274e9bdac21deab9a926c.png"},{"id":102832362,"identity":"e338cb57-c1a0-4854-95ed-73a293c26a77","added_by":"auto","created_at":"2026-02-17 10:12:25","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":90783,"visible":true,"origin":"","legend":"\u003cp\u003eNumber of friends that use Psychoactive substances\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/e43c7a2b716334d459b201cf.png"},{"id":102832333,"identity":"3a7255be-2528-47f1-b82e-8ad6c09e48e8","added_by":"auto","created_at":"2026-02-17 10:12:14","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":83767,"visible":true,"origin":"","legend":"\u003cp\u003eTypes of Psychoactive substances used among respondents\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/708a43a76b52a7ccd0109769.png"},{"id":102832334,"identity":"12e928d4-a1fd-497a-86a0-991f24cc5008","added_by":"auto","created_at":"2026-02-17 10:12:15","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":121827,"visible":true,"origin":"","legend":"\u003cp\u003eReasons for Psychoactive substances use among respondents.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/0947ca9b5e240f2dfadb8220.png"},{"id":106399451,"identity":"73da9e90-69b2-45d3-8cf5-f3c2f9b42c30","added_by":"auto","created_at":"2026-04-08 08:29:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1202732,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/c230aad2-6585-428a-9b01-749beef26609.pdf"},{"id":102832351,"identity":"382f48fb-71ac-423e-a081-f9657ced9433","added_by":"auto","created_at":"2026-02-17 10:12:21","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":50155,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-8545465/v1/741f5bcd34eb7b3d438dd291.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003ePrevalence and Patterns of Psychoactive Substance Use Among Undergraduates at a Nigerian Tertiary Institution\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe use of psychoactive substance is an alarming and increasing public health and social problem worldwide. Psychoactive substances alter mental functions such as perception, consciousness, cognition, mood, and emotions when consumed or administered into the body. Psychoactive substances are part of a larger class of psychoactive chemicals, including Alcohol and Nicotine. The misuse of these substances, which encompasses harmful or hazardous consumption patterns, is a growing concern, particularly among younger populations.\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAccording to the World Drug Report 2021, approximately 275\u0026nbsp;million people used drugs worldwide in the preceding year, with another 36\u0026nbsp;million persons diagnosed with substance use disorders globally.\u003csup\u003e1\u003c/sup\u003e In 2019 alone, about 180,000 deaths were directly linked to substance use disorders, while another half million deaths were attributed to illicit drug use. The United Nations Office on Drugs and Crime in 2014 estimated that about 1 in 20 individuals worldwide, aged 15 to 64, had used an illicit psychoactive substance within the previous 12 months; that estimated to about 250\u0026nbsp;million individuals out of which, 1 in 10 of these individuals struggled with drug use. According to the same data, approximately 40 individuals per 1\u0026nbsp;million, or 183,000 individuals died from drug-related causes in 2012.\u003csup\u003e2\u003c/sup\u003e Substance abuse varies across different regions across the globe. A national survey of 2810 students in the UK in 2018 reported that 56% of the respondents had used drugs and 39% currently use them. Cannabis was the most frequently taken drug (94% of respondents who said that they had used drugs) and was the most likely to have been used regularly.\u003csup\u003e3\u003c/sup\u003e Monitoring the Future follow-up report on the use of psychoactive substances among university students in the United States revealed a trend in binge drinking (30.4%) and alcohol consumption (76.4%) within the past 12 months among young adults aged 19\u0026ndash;22 in 2021\u003csup\u003e4\u003c/sup\u003e; as well as a surge in the past year use of alcohol (84%) and historically high levels of cannabis (42%) and hallucinogens (9%) past year use among young adults aged 19\u0026ndash;30 in 2023. According to Monitoring the Future 2023 report on substance use behaviors and attitudes of adolescents and young adults in the United States, Alcohol has remained the most reportedly used substance over the years.\u003csup\u003e5\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eStudies in Sudan found the overall prevalence of substance use to be 31% and the most common substance was tobacco followed by cannabis, tranquilizers and alcohol. The commonest reason for initiating substance use was curiosity. \u003csup\u003e6\u003c/sup\u003e Another study carried out among Ethiopian undergraduates found more substance use among children of uneducated parents, and that older students were 2.4 times more likely to use substances than younger students.\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn a study carried out in University of Uyo, the prevalence of psychoactive substance use was 27.5% and was more in females (37.7% ) than males (18.2% ). Peer group influence (94.3%), stress (70.5%), curiosity (58.7%), were the most common factors perceived to be associated with the use of psychoactive substances among undergraduates. A prevalence of 20\u0026ndash;40% and 20.9% of drug abuse was reported among students and youths respectively and drugs that are commonly used are stimulants, depressants, Narcotics and Hallucinogens.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eStimulants, like caffeine and cocaine, block the reuptake of neurotransmitters such as serotonin and dopamine, leading to increased energy, anxiety, and panic. Depressants, such as benzodiazepines and barbiturates, enhance GABA production, impairing memory and cognitive function. Narcotics, including codeine and heroin, stimulate endorphins to reduce pain and induce euphoria. Hallucinogens, like marijuana and ecstasy, mimic serotonin and epinephrine, altering perception and mood. According to some studies, these substances are misused due to the belief that they relieve stress and anxiety, induce sleep, ease tension, relax and help its users forget their problems.\u003csup\u003e9\u003c/sup\u003e Misuse of these psychoactive substances has been a major problem within the university system, largely because of its negative impact on students\u0026rsquo; academic performance, health and social lives. Factors associated with substance misuse among undergraduate students may be linked to students\u0026rsquo; transition from a restricted secondary school to an autonomous university life, and the growing appeal of a liberal campus environment.\u003csup\u003e10\u003c/sup\u003e For young people to change their behavior, especially undergraduates, it is essential to understand the consequences of substance misuse and abuse, including adverse health and social problems. Therefore, this shows the necessity of planning and formulation of preventive strategies to curtail the use of psychoactive substance by undergraduates.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy Setting, Sampling and Data Collection:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted from June till August, 2024 at the University of Calabar, Nigeria with an estimated student population of 40,645 students. A descriptive cross-sectional study was utilized. Cochran formula was used to calculate the minimum sample size; with a z of 1.96 and a sampling error set at 5%. To compensate for improperly filled questionnaires, a nonresponse rate of 10% (29) was added to the minimum sample size.\u003c/p\u003e\n\u003cp\u003eUsing Cochran formulae\u003c/p\u003e\n\u003cp\u003en = Z\u003csup\u003e2\u003c/sup\u003epq/d\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003ewhere n = sample size\u003c/p\u003e\n\u003cp\u003eZ =Standard normal deviation = 1.96 at 95% confidence level\u003c/p\u003e\n\u003cp\u003eP = proportion of target population estimated to have desired characteristics is 0.25; according to (Johnson et al. 2017)\u003csup\u003e8\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003ed = degree of precision (5%)\u003c/p\u003e\n\u003cp\u003eq = 1-P= 1-0.25 = 0.75\u003c/p\u003e\n\u003cp\u003eusing the Cochran formula:\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e(1.96)2 x 0.25x 0.75\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e(0.05)\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e= \u0026nbsp; \u003cu\u003e0.7203\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e0.0025 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; = 288\u003c/p\u003e\n\u003cp\u003eSample size = 288\u003c/p\u003e\n\u003cp\u003eAssuming a 10% non-response, the minimum sample size will be adjusted with the formula:\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eN__\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e1 - 0.1\u003c/p\u003e\n\u003cp\u003e= \u0026nbsp;\u003cu\u003e\u0026nbsp; \u0026nbsp; n__\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003cp\u003ewhere n =288\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e288\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003cp\u003e= 320\u003c/p\u003e\n\u003cp\u003eA multi-stage sampling technique method was used to select eligible undergraduates. Inclusion criteria were undergraduates at University of Calabar with a valid school identification card while exclusion criteria were undergraduates who did not consent to the study.\u003c/p\u003e\n\u003cp\u003eData collection was done using a using a semi-structured questionnaire adapted from European School Survey Project on Alcohol and Other Drugs (ESPAD)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003emaster-questionnaire self-administered format. Information included socio-demographic and academic information of the respondents, questions on prevalence and patterns of psychoactive substance, the types and reasons for use among the respondents. The questionnaire was distributed among undergraduates in the early hours of the day around the lecture halls to enable full participation by the target population. The instrument was pre-tested on 20 undergraduates in one of the faculties, to ensure that the contents were adequately understood. Response rate was 100%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore analysis, all returned questionnaires were checked manually to ensure that the responses were in order. Data obtained from this study was analyzed using the Statistical Product and Service Solutions (SPSS) version 25.0. The data was presented in form of tables and analyzed as descriptive frequencies, percentages ad cross tabulations. For inferential statistics, the chi-square test was used to test for associations between the use of psychoactive substances and sociodemographic factors at 5% significance level.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe obtained ethical clearance approval from the University of Calabar Teaching Hospital Health Research Ethics Committee (UCTH/HREC/33/Vol.III/343). All human-related procedures were performed in accordance with relevant institutional guidelines and regulations, and in compliance with the ethical principles of the Declaration of Helsinki. During data collection, the aim of this study was briefly explained to all participants, informed consent was gotten, and their anonymity and confidentiality were protected throughout the study.\u0026nbsp;\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic characteristics of respondents\u003c/h2\u003e \u003cp\u003eThe socio-demographic characteristics of the 320 students that participated in the study showed that 79.7% were between 20\u0026ndash;29 years old, with a mean age of 22.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.372 years. Males made up 55% of the respondents, while females made up 45%. The majority (46.9%) were Pentecostal. Most respondents (61.3%) lived off-campus. The Igbo ethnic group was the most represented (38.1%). The average monthly income of most respondents was between 10,000 and 20,000 (28.1%) (see Table\u0026nbsp;1).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e---TABLE 1 HERE---\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;1: SOCIO-DEMOGRAPHICS CHARACTERISTICS OF THE RESPONDENTS\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence and patterns of psychoactive substance\u003c/h2\u003e \u003cp\u003eThe prevalence and patterns of psychoactive substance use among the 320 respondents revealed that 231 (72.2%) of respondents have used psychoactive substances while 89 (27.8%) have not used before (presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e---FIGURE 1 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: Prevalence of Psychoactive substance use among undergraduates\u003c/p\u003e \u003cp\u003eAmong the 231 respondents that have used psychoactive substances, alcohol was the most commonly used substance (72.8%, 58.4%, and 44.2% used at least once in their lifetime, last 12 months, and 30 days, respectively), with wine being the most used in the last 30 days (55.0%). Other commonly used drugs include cigarettes (18.2%, used at least once in their lifetime), marijuana (14.2%, used at least once in their lifetime), and caffeine (21.8%, used at least once) (See Table\u0026nbsp;2).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e---TABLE 2 HERE---\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;2: NUMBER OF OCCASIONS THAT PSYCHOACTIVE SUBSTANCES WERE USED AMONG RESPONDENTS (n\u0026thinsp;=\u0026thinsp;231)\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;3 shows the age of first use of different psychoactive substances among respondents\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e---TABLE 3 HERE---\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;3: AGE OF FIRST USE OF DIFFERENT PSYCHOACTIVE SUBSTANCES AMONG RESPONDENTS (n\u0026thinsp;=\u0026thinsp;231)\u003c/p\u003e \u003cp\u003eAmong those who have ever used the different psychoactive substance before, those who had use inhalants (62.5%), Codeine or cough syrup abuse (44.8%) and Alcoholic beverages (44.0%) have more respondents with early onset of drug use (\u0026le;\u0026thinsp;17 years) compared to cigarettes (31.0%), Marijuana or cannabis (12.5%) and Cocaine (36.4%) (shown in Table\u0026nbsp;3). Drinking (57.1%), mixing of cocktail (19.0%), and smoking (17.3%) were the common modes of administration of these substances (presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e---FIGURE 2 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e: Mode of consumption of Psychoactive substances used\u003c/p\u003e \u003cp\u003eFriends (36.8%) and clubs/bars (39.4%) were the common sources of these drugs (presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e---FIGURE 3 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e : Sources of Psychoactive substances\u003c/p\u003e \u003cp\u003eAdditionally, 49.1% of respondents had no friends using substances, while 50.1% had at least one friend using substances (See Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e---FIGURE 4 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: Number of friends that use psychoactive substances\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eTypes of psychoactive substances used\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the types of psychoactive substance use among the 231 respondents that have used psychoactive substances. The result indicates that the most commonly used substance was alcoholic beverages, with 73.6% of respondents reporting use. Cannabis was used by 22.2% of respondents, followed by Tobacco products (20.0%), sedatives and sleeping pills (13.0%), any prescription drug (12.1%), Amphetamine (9.5%), Inhalant (8.7%), Opioids (7.4%) and Hallucinogen (6.9%).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e---FIGURE 5 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: Types of psychoactive substances among respondents\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eReasons for psychoactive substance use\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e shows the reasons for psychoactive substance use among the 231 respondents that have used psychoactive substances. The most common reasons reported by the respondents for using psychoactive drugs were stress relief (35.5%), emotional issues (24.8%), socializing (24.7%), peer pressure (20.8%), curiosity (19.9%), academic pressure (17.5%), and to deal with depression (17.3%).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003e---FIGURE 6 HERE---\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e: Reasons for using psychoactive substances\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003eThe relationship between the use of psychoactive substance and socio-demographic factors of respondents\u003c/h2\u003e \u003cp\u003eThe results of Table\u0026nbsp;4 showed the relationship between the use of psychoactive substances and socio-demographic factors of the respondents. From the result of the analysis, A significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) association was found between age group (p\u0026thinsp;=\u0026thinsp;0.015), gender (p\u0026thinsp;=\u0026thinsp;0.046), year of study (p\u0026thinsp;=\u0026thinsp;0.009) and average monthly income (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the use of psychoactive substances. Respondents aged 20 years and above (74.8%) were more likely to use psychoactive substances than those below 20 years (58.0%). Also, a higher percentage of males (76.7%) use psychoactive substances in comparison to the females (66.7%). Additionally, students in their second year of study and above (74.6%) were more likely to use psychoactive substances than first year students (54.1%). Finally, a higher percentage of students with an average monthly income of more than 50,000 (85.7%) had a higher percentage of psychoactive substance use compared to those with lower incomes. There was no significant association between place of residence during academic session (p\u0026thinsp;=\u0026thinsp;0.077) and the use of psychoactive substances among respondents.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e---TABLE 4 HERE---\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;4: THE RELATIONSHIP BETWEEN THE USE OF PSYCHOACTIVE SUBSTANCE AND SOCIO-DEMOGRAPHIC FACTORS OF THE RESPONDENT\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe prevalence of psychoactive substance use among undergraduates in our study was 72.2%, which is notably higher than reported results in studies conducted in Southern Brazil and Ethiopia (41.5% and 53.6% respectively).\u003csup\u003e11,12\u003c/sup\u003e These differences can be attributed to cultural differences, levels of substance availability, or varying definitions of substance use across populations. A similar study in South Africa reported a prevalence of 62.7%, closely aligning with our findings.\u003csup\u003e13\u003c/sup\u003e In the context of Nigeria, our study's prevalence rate is comparable to findings from Lagos (71.58%) but lower than that reported in Imo (84.5%).\u003csup\u003e14\u003c/sup\u003e This may indicate significant regional variation within Nigeria regarding substance use patterns among university students.\u003c/p\u003e \u003cp\u003eAlcohol emerged as the most frequently used psychoactive substance in our study, with a prevalence of 73.6% and a recent use rate of 55% in the past 30 days. This trend aligns with findings from similar studies conducted in Germany with 84.7% of respondents with reported alcohol use\u003csup\u003e15\u003c/sup\u003e, 79.1% lifetime use amongst undergraduates in Johannesburg\u003csup\u003e16\u003c/sup\u003e and 80.6% in Western Cape, South Africa\u003csup\u003e13\u003c/sup\u003e although, binge drinking patterns were more frequent in latter countries compared. A study in Lagos with a prevalence of 71.58%, reported that alcohol consumption was prevalent among undergraduates due to its social acceptability.\u003csup\u003e17\u003c/sup\u003e Cigarettes (18.2%), marijuana (14.2%), and caffeine (21.8%) were also reported as commonly used substances in our study. Comparatively, a study among university students in South-Western Nigeria found a similar pattern, with cigarettes (23.5%), and marijuana (17.9%) being frequently used substances after alcohol.\u003csup\u003e18\u003c/sup\u003e Also, the use of caffeine was notably higher in our study than in others with 13.5% among university students in south western Nigeria and Uyo \u0026minus;\u0026thinsp;12.6%.\u003csup\u003e8,17\u003c/sup\u003e These comparisons reflect the growing trend of energy drink consumption and its association with academic pressure among students.\u003csup\u003e19\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOur study also reported high early onset of use for psychoactive substances (\u0026lt;\u0026thinsp;18 years) like inhalants, codeine, and alcohol which identified early initiation of drug use among adolescents. This is comparable to studies done at Ethiopia where 46.2% of students initiated substance use before the age of 18; with alcohol being the most common early-onset substance.\u003csup\u003e12\u003c/sup\u003e For substances like inhalants and alcohol, it is often linked to curiosity, peer pressure, and emotional challenges during adolescence; and emphasizes the need for targeted interventions for children and adolescents to prevent substance use; as early drug use is often associated with increased risks for developing substance use disorders later in life.\u003c/p\u003e \u003cp\u003eIn terms of modes of usage, drinking (57.1%) was the most common, followed by mixing cocktails (19.0%) and smoking (17.3%) in our study. This pattern aligns with the predominant use of alcohol in our setting and this resonates with similar trends reported in studies conducted at universities in Ibadan and Lagos, with 78% and 75.5% of respondents respectively reported to have consumed psychoactive substances by drinking.\u003csup\u003e17,20\u003c/sup\u003e Prevalence of smoking, particularly cannabis, was reported at 21% at University of Lagos which is higher compared to the 8.2% prevalence of smoking cannabis in our study.\u003c/p\u003e \u003cp\u003eThe rising trend of cocktail mixing in social settings and prescription drug misuse for recreational purposes is a concerning pattern, particularly at parties and social events; as demonstrated in our study findings. A systematic review by Weyandt et al. (2020) revealed that young individuals aged 18\u0026ndash;25 were more likely to misuse prescription drugs by mixing alcohol, benzodiazepines or other illicit drugs for recreational use.\u003csup\u003e21\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFrom our study. the primary sources of psychoactive substances were clubs/bars (39.4%) and friends (36.8%); which indicate that peer influence plays a role in increased accessibility to psychoactive substances.\u003csup\u003e22\u003c/sup\u003e This aligns with previous research reporting peer pressure and social networks as significant predictors of substance use among university students in India.\u003csup\u003e23\u003c/sup\u003e Our findings also revealed a split among respondents regarding their friends' substance use, with 49.1% indicating they had no friends using substances, while 50.1% reported having at least one friend who does. This division may influence individual choices, thus, emphasizing the importance of social context in understanding substance use behaviors.\u003c/p\u003e \u003cp\u003eA significant association was found between the use of psychoactive substances and some socio-demographic factors like Age (p\u0026thinsp;=\u0026thinsp;0.015*), Gender (p\u0026thinsp;=\u0026thinsp;0.046*), Year of study (p\u0026thinsp;=\u0026thinsp;0.009*), and Average monthly income (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eRespondents who were 20 years and above had a higher prevalence (74.8%) of psychoactive substance use compared to those below 20 years (58.0%); with significant age association, which is similar to a study conducted among undergraduates at Ataye, Ethiopia and Imo, Nigeria.\u003csup\u003e14,24\u003c/sup\u003e The reason for this could be that this age group face similar pressures, including peer influence, academic stress, and the transition to adulthood, which drive the increased prevalence of substance use.\u003c/p\u003e \u003cp\u003eConcerning gender association, our study reported a significantly higher prevalence of psychoactive substance use (76.7%) amongst males than females (66.7%), with significant association with the male gender, which is similar to a study done among undergraduates in South-Western Nigeria.\u003csup\u003e25\u003c/sup\u003e Although gender disparity exists in some literature\u003csup\u003e8,26\u003c/sup\u003e, our findings show that males are more likely to engage in substance use than females; and reasons may be attributed to peer influence, cultural acceptance of substance use among males, and a tendency for males to engage in riskier behavior.\u003c/p\u003e \u003cp\u003eOur findings showed that undergraduates in their second year of study and beyond (74.6%) had significantly higher prevalence of psychoactive substance use compared to first-year students (54.1%); with significant association with study year. A similar study conducted among students in mainland China showed that students in higher grades are more likely to misuse substances than students in lower grades.\u003csup\u003e27\u003c/sup\u003e Likewise, a study done among undergraduates in Ekiti, Nigeria showed that students in their fourth year of study were more likely to misuse substances, compared to first year students.\u003csup\u003e28\u003c/sup\u003e This may suggest that as students advance in studies, substance use behavior may tend to increase, driven by social and academic pressures. It can also be attributed to increased exposure to the university environment and peer pressure over time.\u003c/p\u003e \u003cp\u003eFurthermore, socio-economic factors, including income and employment status, have been found to influence substance use patterns in various populations. A self-reported study among United States undergraduates in 2016 revealed that high socioeconomic status students were more likely to use psychoactive substances than their other peers.\u003csup\u003e29\u003c/sup\u003e Additionally, a study by Rakić et al. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) that assessed the correlation between psychoactive substance use among adolescents in Novi Sad, Serbia and sociodemographic factors reported that adolescents who had more pocket money were more likely to smoke cigarettes and consume alcohol than their peers.\u003csup\u003e30\u003c/sup\u003e A similar study conducted among undergraduates in South-Western Nigeria also reported a significant association between psychoactive substance use and high socioeconomic status.\u003csup\u003e25\u003c/sup\u003e This may suggest that student from affluent families or high-income earning students often face more peer pressure in social settings, contributing to increased psychoactive substance use. It may also suggest that as wealthier students can conveniently afford psychoactive substances, lower-income students may not have the financial means to abuse substances, even if they are inclined to do so. This aligns with our study findings where financial stability can be linked to increased psychoactive substance use.\u003c/p\u003e \u003cp\u003eOur study has some strengths and limitations. Firstly, it focuses on a specific and vulnerable population which are undergraduates, thereby providing targeted insights for intervention. It also captures both the prevalence and patterns of psychoactive substance use, offering a comprehensive view of the issue, which can guide for more effective prevention and treatment programs. The use of anonymous self-administered surveys likely encouraged more honest responses. Additionally, the findings can serve as a baseline for future research, allowing for the tracking of behavioral trends over time, as it raises awareness on an important public health issue, potentially influencing policy and future research efforts. Conversely, as part of the study limitations. the sample size may not fully represent the entire undergraduate population, which could limit the generalizability of the findings. Additionally, the reliance on self-reported data introduces the possibility of bias, as some students may have underreported or exaggerated their substance use, potentially affecting the accuracy of the results. Furthermore, the cross-sectional design of the study only captures substance use behavior at a specific point in time, making it difficult to account for any changes or trends over a longer period.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eUndergraduates who participated in the study reported high prevalence of psychoactive substance use. Among the proportion who used psychoactive substances, it was reported to be used more to relieve stress (35%), emotional issues (24.8%) and socialization (24.7%) and common sources were clubs/bar (39.4%) and friends (36.8%). Additionally, demographic factors like age, gender, year of study and socioeconomic status were found to influence substance use behavior. The findings highlight a critical public health issue that requires the attention of institutions, health professionals, and policymakers in order to address underlying biopsychosocial factors precipitating substance abuse, and implementing feasible institutional interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u0026nbsp;\u003c/strong\u003eThe authors received no financial support for this research, authorship nor publication of the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u0026nbsp;\u003c/strong\u003eAll human-related procedures were performed in accordance with relevant institutional guidelines and regulations, and in compliance with the ethical principles of the Declaration of Helsinki. Ethical approval was obtained from the University of Calabar Teaching Hospital Health Research Ethics Committee (UCTH/HREC/33/Vol.III/343).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate and publish:\u0026nbsp;\u003c/strong\u003eWritten and verbal informed consent was gotten from respondents to participate and publish prior to data collection, and their anonymity and confidentiality were protected throughout the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial number:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u0026nbsp;\u003c/strong\u003eThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution:\u0026nbsp;\u003c/strong\u003eC.M.A was responsible for conceptualization, manuscript writing, preparing figures, methodology and reviewing the manuscript. E.M.N was responsible for manuscript writing, preparing figures, methodology, reviewing and editing the manuscript. W.A.O was responsible for manuscript writing, preparing figures and methodology. S.L.H was responsible for manuscript writing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. N.d. Drugs Psychoactive. World Health Organ Retrieved June 28, 2024 \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/health-topics/drugs-psychoactive\u003c/span\u003e\u003cspan address=\"https://www.who.int/health-topics/drugs-psychoactive\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnited Nations Office on Drugs and Crime. 2014. World Drug Report 2014 Exsum Embargoed.pdf. www.unodc.org. 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Vojnosanit Pregl. 2014;71(5):467\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 4 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8545465/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8545465/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePsychoactive substance use among undergraduates is a growing public health issue of concern, with significant implications on academic performance, health and overall well-being. Psychoactive substance use can lead to long-term addiction, impaired cognitive function, and increased risk of mental disorders, making it a critical issue for university students. This study assessed prevalence and factors associated with psychoactive substance use among undergraduates at a selected Nigerian Tertiary Institution.\u003c/p\u003e \u003cp\u003eA descriptive cross-sectional study was conducted using a structured questionnaire to collect data from 320 randomly selected undergraduate students through a multistage sampling technique. Descriptive and inferential statistics were used to analyze the data, and a statistically significant p-value was set at \u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003e176 (55%) of the respondents were male, with mean age of 22.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.372 years. 35.5% of respondents used psychoactive substances to relieve stress, while 6.5% used psychoactive substances due to parental influence. Alcohol (73.6%) was the commonest substance used; Drinking (57.1%) was the commonest consumption route. Age (p\u0026thinsp;\u0026lt;\u0026thinsp;0.015), Gender (p\u0026thinsp;\u0026lt;\u0026thinsp;0.046), Year of study (p\u0026thinsp;\u0026lt;\u0026thinsp;0.009), and Average monthly income (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly associated with increased psychoactive substance use.\u003c/p\u003e \u003cp\u003eThe use of psychoactive substances among undergraduates is alarmingly prevalent and must be effectively addressed. This research underscores the need for targeted interventions aimed at reducing substance use, with a focus on mental health support, peer education, drug abuse prevention campaigns, and stricter enforcement of campus policies on substance abuse. Additionally, preventive strategies should address the underlying psychosocial factors driving substance use, including academic stress, social influences, and economic challenges.\u003c/p\u003e","manuscriptTitle":"Prevalence and Patterns of Psychoactive Substance Use Among Undergraduates at a Nigerian Tertiary Institution","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-17 10:10:25","doi":"10.21203/rs.3.rs-8545465/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6ca1baa8-9476-4df4-8d7e-8f77516e5237","owner":[],"postedDate":"February 17th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T08:28:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-17 10:10:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8545465","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8545465","identity":"rs-8545465","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}