Abstract. Substance use among Nigerian adolescents has increased significantly in the past decade, highlighting the need to implement evidence-based, effective prevention programs as one strategy to help reverse this trend. This study aimed to identify profiles of adolescent substance use and parenting and school correlates of these profiles to inform preventive interventions. Latent class analysis identified four distinct use patterns in 2,004 adolescents (46% male; M = 14.8 years) attending public and private schools in Lagos. Low levels of use distinguished the Low Use class (92.1% of the sample), while use of alcohol, cigarettes, and codeine defined the Alcohol Use class (2.9%). Moderate to high use of tramadol and codeine without a prescription differentiated the Nonmedical Use class (2.8%), and high use of most substances defined the High Use class (2.1%). Males, older youth, and private school students engaged in the riskiest substance use. Students in the Low Use class compared to students in the High Use class were more likely to attend public schools and had parents who solicited less information from them but were more disapproving of substance use. Students in the Low Use class relative to students in the Alcohol Use class also were more likely to attend public schools and had parents who solicited less information but knew more about their child’s activities. These findings suggest that tailored preventive interventions with parents and adolescents could be useful and that more research is needed to understand how the private school context confers risk for substance use.
Drug misuse is a global problem. Markets that supply illegal drugs often span international borders. However, each country has different primary drugs of use, populations that are using and consequences of use. The policy approach of each country to addressing substance use disorders can be characterized along a continuum between purely public health approaches and purely law enforcement approaches. Historically, a law enforcement approach has been the primary strategy in much of the world. However, there is a growing movement towards use of a public health approach. This article provides four case examples, Ukraine, Philippines, Nigeria and Peru, where there is movement to develop addiction public health infrastructure. The work varies by country, but includes regulatory changes, workforce development and resource allocation all of which are supported by the United Nations Office on Drugs and Crime (UNODC) and multi-national organizations that provide training and technical assistance, funded primarily by the European Union and United States governments. All four countries highlighted have barriers to moving towards a more public health approach which may include popularity of the law enforcement approach, turbulent government environments, and economics of being a drug producing nation. However, whether starting from the top down with changed policies, such as Ukraine or from the bottom up with training community members as in the Philippines, each country provides an example of how donor resources can be applied to make the transition towards a more humane and evidence-based approach to addressing substance use disorders. Key Messages While the primary approach to addressing drug use has focussed resources on law enforcement for over 100 years, many countries are adopting elements of a public health approach including prevention and treatment of the harms of drug use including substance use disorders. There is a growing global movement to make policy towards drugs and drug users more humane and evidence-based. Donor nation resources can be applied in a variety of combinations to improve care and outcomes for people who use drugs in low- and middle-income countries.
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