Factors associated with psychoactive substance use among adolescent in Rupandehi district of Nepal: a mixed method approach.

Research Report.

ABSTRACT: Background : The use of the psychoactive substance is a common public health problem among adolescent in developed as well as developing countries. Every year billion productive age people suffered from this problem globally and Nepal is also no exception. This study aimed to examine the status of psychoactive substance use and the associated factors to initiate psychoactive substance use in adolescent in Rupandehi district of Nepal. Methods : This study adopted the mixed-method approach (qualitative and quantitative). In the first phase, we explored the reasons for use of psychoactive substance from various perspectives of wider stakeholders. Thereafter, guideline for the quantitative design was finalized considering findings of the qualitative study. The quantitative study was conducted among grade XI to XII School students age 15 to 19 years in both rural and urban settings and public and private schools of Rupandehi district, Nepal. Results : The study shows that nearly one -fifth school going adolescents use some types of psychoactive substances. The most used substances were either alcohol or drugs or both. Among the alcohol users, 12.1% of school going adolescents had hazardous effects and dependence. Similarly, among the drug users, 10.2% of school going adolescents reported intermediate, substantial and server effects. The major associated factors of using psychoactive substances were influences of the senior members of the family, poor care and support from family, the problem in family relation, education status of the parents, peer pressure and socio-cultural practices. The local availability of the substances, supportive physical, social and cultural environment, occupation, income and financial condition of the family, financial crisis and unnecessary access to the financial resources were the other crucial factors. Conclusion: Peer pressure, peers use psychoactive drugs, sex, and types of family are significantly associated factors were also working as reinforcing factors for using psychoactive substances. In spite of the intensive implementation of various intervention programs for preventing the usage of the psychoactive substances among youths and adolescents, we do not see an encouraging response. The study points to the very strong relationship among the peer group members and direct influence of their habits in each other. Peers and family-based intervention would be among the effective strategies for preventing usage of psychoactive substances among adolescents in Rupandehi district of Nepal. Keyword : Alcohol use, psychoactive substance use, drugs, abuse, tobacco use