Objective This cross-sectional study aimed to assess the prevalence and awareness of drug and substance abuse among undergraduates in four southwestern universities in Nigeria. Methods The sample of 400 students included 100 male and female students in the 15- to 29-year age range from each of the four selected universities in southwest Nigeria between December 2019 and June 2020. Descriptive statistics and Pearson chi-square tests were used for data analysis using the statistical package for social sciences (SPSS). Results Four hundred students satisfied the inclusion criteria and suitably completed the questionnaire. Most respondents were in the 15- to 19-year and 20- to 24-year age groups and were female (68%). Drug and substance abuse prevalence was 45.7%; one in every four students abused substances despite an aggregate risk awareness level of 94.6%. Alcohol and cigarettes—legally and socially accepted substances—were the most abused (61.5% and 54.5%, respectively). Codeine-containing syrup and tramadol topped the list of drugs, ranking higher than cannabis. The major motive was to ‘get high’ and numb emotional problems caused by predominantly socioeconomic and societal factors. Conclusion The study showed a notable prevalence of drug and substance abuse across the selected universities in southwest Nigeria.
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