PAUL ANDREW BOURNE, B.Sc. (Hons), Dip Edu.
INTRODUCTION
Drug use among our nations’ youth has become the focus of concern in our schools. With the widespread availability and enormous variety of drugs, serious implications are placed on the society. Kleber (1994) confirmed that the use and abuse of drugs is a critical issue in most societies and it is associated with social and economic consequences. The desire to pursue this study is based on prevailing concern of the prevalence of substance use among Jamaican adolescents. Substance abuse prevalence among adolescents has sparked widespread concerns that put millions of users at increased risk for ill-health, poor academic performances, delinquency, traffic accidents and illicit sexual practices. Substance abuse and misuse has touched all major aspects of society and has regulated the relations between the classes, gender age and races. The purpose of this paper is to find out whether knowledge of the ill-effect of substance use does decrease the prevalence of use among adolescents. Information obtained may serve as a guide in planning programmes for schools in identifying strategies to address and reduce the problem of substance use among youths in schools.
The National Institute on Drugs (2003) reported that, during the last twenty years there has been an immense upsurge in illicit drug use among youths. In response to such problem, the researcher conducted a cross-sectional survey in which data was collected in three corporate area schools to examine whether knowledge of the ill-effects of substances does have an impact on adolescents substances use.
Through this study an insight will be gained into the prevalence level of substance use among youths in Jamaica and other parts of the world. This study has incorporated materials based on the knowledge and experiences gained by expert researchers on the topic. The information gathered will be used to compare and contrast with data gathered by the researcher in three corporate area schools.
The majority of substance users begin taking drugs at an early age. Early drug use strongly predicts abuse and dependence into adulthood. Patton, McMorris, Toumbourou, Hemphill, Donath and Catalano (2004) confirmed that early substance use among adolescents impacts on the health, leads risky sexual behaviour and intentional and unintentional injuries. Taking drugs while the body is in its developmental stage interrupts the normal maturing process and compounds the dangers posed to the users.
Disheartening though it may seem adolescents continue to exhibit a craving for substances thus subjecting themselves to greater health risks. One may ask the question, why do so many youngsters continue to put themselves at risk? One answer might be cultural. They live in a society that is drug-dependent. Younger children are often unaware of the dangers involved in substance use. When younger children see parents and siblings using substances, they may erroneously perceive that drug taking is a normal acceptable behaviour. Buelow (1995) posited that children from homes in which alcohol or other substances are used are at risk for a wide range of developmental problems. He continued that, family affiliation and relationships are crucial through each stage of the child’s development. Parenting then seems to play a significant role in adolescent substance use.
Board and Feinberg (1995) stated that despite the warnings on the cigarette box that it is harmful to health adults continue to use it to cope with or relieve stress. Adults drink to socialize, stay calm and relax. Coffee is used as a morning stimulant and marijuana is popularized by the Rastafarian religion as medicine. To an extent then, teenager substance use is a mere reflection of adult behaviour.
The use of drugs frequently begins in adolescent and very often persists into adulthood which sometimes results in serious negative consequences. Studies have shown that a single dose of a drug can lead to death or permanent injury.
Adolescents use drugs for various reasons. The culture is a part if the reason adolescents get involved in substance use. They see adults smoke and drink to socialize and or relieve stress. The society, which has become modernized, tends to allow adolescents greater latitude for non-conforming behaviour. At times open rejection of authority is tolerated and regarded as a normal part of gaining independence from parents. Adolescents who strive to have a sense of belonging sometimes get involved with both legal and illegal drugs. Unfortunately, they often do not see the link between their actions today and the consequences tomorrow.
Adolescence is frequently regarded as a period of physical and psychological changes. During this period risk taking increases and adolescents tend to explore new behaviours and roles involving risk taking. For most adolescents substance use reflects their curiosity and it is usually a covert behaviour, disguised from parents and authority figures. This makes it extremely necessary for adolescents to be made aware of the facts in drug use. Millions of adolescents are at risk of becoming substance abusers. It therefore means that continuous programmes are needed in our schools for early identification and treatment.
The breath and depth of substance use and abuse by adolescents are indeed daunting. Lerner and Garlambas (1998) noted that the use and abuse of illegal/illicit drugs and other unhealthy substances (example inhalants) by adolescents is extensive. They found that alcohol, cigarette and tobacco were widely used.
It will be expected in this study to achieve the following objectives: To investigate the prevalence level of substance use and abuse of different drugs, to identify the substances being used, to examine the reasons for substance use, its availability and adolescents knowledge of the effect of substance use, to discover when and where the users were introduced to the substances, to examine any relationship to age, gender, socioeconomic status and geographic location to the use of substances and to further expose the dangers involved with substance use.
LITERATURE
The use of psychoactive substances, that is, substances which alter the behavioral responses of an individual to or within the environment (PIOJ, 2000), or ‘substance use’, as such activities are more commonly known, is not a phenomenon that is in anyway new to mankind. Even in countries which now denounce their use, substances like tobacco and alchohol continue to experience heavy use on a global scale. (Anderson, 1995) This is due in part to the legality of these substances, despite the array of ill-effects that various societies have associated with their use. However there are other substances which most societies have deemed as being ‘illicit drugs’ which despite the fact that they are illegal still seem to attract large numbers of users in many countries. The World Drug Report (2000), estimated that of some 180 million people worldwide, 4 per cent of the people aged 15 years and above consumed drugs in the late 1990s. This figure includes 144 million using marijuana, 29 million people consuming amphetamine type stimulants, 14 million using cocaine, 13 million abusing opiates, and 9 million were addicted to heroin.
In more recent times however, expressions of concern over the number of adolescents who are engaging in the use of various substances has grown tremendously. Drugs can be categorized into “hard and “soft drugs”. Most teenagers become involved in substance use with the “soft drug” such as alcohol, marijuana, tobacco or nicotine. Papalia, Olds and Feldman (2001) defined soft drugs as gateway substances because their use often leads to use of addictive substances such as crack and heroin. Studies indicate that it is during the younger years that the use of such substances begins, and even suggest that in today’s world, if an individual has not begun to use tobacco, alchohol or an illicit substance during this period, it is unlikely that they ever will. Young people in most countries tend to use these products to a greater extent and in riskier ways than even older people do (World Youth Report, 2003).
Factors influencing substance use among adolescents
There is much speculation as to the reasons behind adolescence substance use/abuse. Young people today have grown up in a world which is increasingly becoming more tolerant of some forms of drug use. For example, the initial pleasure and euphoria associated with some drugs are not linked with harm and addictive behaviour (Keenan ). In many cultures alcohol is nothing more than a savory complement to a tasty meal, a pleasant way to relax or part of a religious ritual. In some environment alcohol use is portrayed as a normal part of life. In Spain and Hungary for instance, champaign use signifies wealth, World Health Organization (WHO, 1995). In our society it is often used to celebrate a joyous occasion in the family or at work. Guinness is associated with strength, power and skill and beer and Smirnoff ice are linked with maleness. The initial use of alcohol by young people (especially boys) symbolizes an entry into the adult world. Being able to “hold his liquor” is a mark of “manhood” which gains him respect from his peers (Ministry of Education Youth and Culture (MOYEC1991).
Images of substance abuse in its various forms continue to pervade print and broadcast media. In many western cultures, the use of some substances has become accepted in mainstream popular culture which in itself is largely driven by youth cultures. Hayes, Smart, Toumbourou and Sanson (2004) cited that culture helps to form adolescents’ alcohol consumption. According to them, in countries where a permissive attitude towards alcohol use exist, consumption rates among adolescents were higher than in countries where the social climate towards youth alcohol use was less favourable.
There are also other intrapersonal factors which contribute to the use of these substances by young people such as the perception of the normality of substance use due to high levels of use by peers. An individual may feel pressured to fit in and engage in activities that their friends are doing. Consequently, youths who have friends who use drugs are more likely to use drugs. Studies indicate that, poor parent-child relations put adolescents at increased risks for drug use. The family environment serves as a model for drug use among adolescents. Parents and sibling drug use may be viewed as either acceptable or inappropriate behaviour by teens. Living in communities where drug use is prevalent not only normalizes the act of using it but makes accessibility easier. Adolescents who have low self-esteem and negative attitudes are at increased risks for substance use (McDowell and Futris, 2002).
The influence of peers on adolescent substance use
Adolescence is a turbulent period of stress and conflict. Erikson confirmed that adolescents go through a period called “identity crisis”, a time of storm and stress (Gormly 1997). Lerner and Galambos (1998) contend that adolescent is a developmental period of challenges and changes. Accordingly, the developmental process presents a set of problems and risks with which adolescents have to grapple. Cermak (2000-2005) remarked that during this time curiosity fuels the desire to find new relationships and to experience the world beyond the confines of the home. Their desire is to explore the world. The youths have a sense of invulnerability and live in the here and now. Information on long-term detrimental effects of alcohol and substance use often does not have much impact on them. The response to the challenge of marijuana experimentation may be motivated particularly by the desire to satisfy their curiosity of the world. The initial substance use is often so intriguing that the risks and consequences are often ignored.
It is at the adolescent stage that the individuals begin to develop a philosophy of life. They rely on peers for direction and validation (Keenan). Santrock 2000 reinforced that the adolescents now crave the support from the peers and seek to establish autonomy from parents. Parents and adults are perceived as hostile. The peer group influence becomes strong as it gives a sense of belonging thus supporting Maslow’s need hierarchy. Peer rejection at this level can be devastating.
The influence of peers on adolescents risk behaviour can be subtle. For instance the group may not compel the youngster to drink or smoke but may allude to him being a baby or “too soft” if he does not participate in the activities. Those who subscribe to the adolescent sub-culture approach believe that drug use depends entirely on the adolescents group of friends. Apple (2001) supports this view by stating that the association of marijuana users with other users increases their dysfunction behaviour. While it is quite normal for teens to spend more time with their peers increased association with marijuana users is another phenomenon that needs to be addressed. It is characteristics that substance users become withdrawn from peers who do not use marijuana and seek affiliation with others of similar energetic functioning. Group attitudes which correspond to the somatic and psychic effects of regular marijuana use become part of the subculture which reflects and supports drug use.
Adolescent substance use and parenting
Parental influence on adolescents varies. Stanton purports that parents who exhibit a high level of interest by interacting with their adolescents can increase the influence they have on who their teenagers choose for friends. Teenagers who have higher levels of family bonding are more likely to have friends who do not use substances (Bahr, Marcos and Maughan 1995). It has further been shown that adolescents who do not do drugs or alcohol tend to come from families who are less likely to use drugs McBroom (1994).However, an antithesis to the adolescents’ subculture theory proposes that drug use in youth develops because they see their parents taking psychoactive drugs such as tranquilizers or stimulants. Flannery, Vazsony and Rowe (1996) also associated drug use among adolescents to poor parenting practices. The study indicated that adolescents from families where drinking was prevalent were no more at risk to substance use than adolescents who were in families not affected by substances. In support of those views Howard, Boyd and Zucker (1994) cited in Annual Review (1998) announced that parents’ substance abuse can influence the behaviour of their children substance use as well as the cognitive development. Adolescents are a part of what is sometimes described as a “pill-popping society” in which drugs are thought to be the solution to problems. Lennard, Epstein, Bernstein and Ransom 1971 as an addition to this perspective, note that:
Individuals evolve into a way of life in which the regulation of
personal and interpersonal problems is accomplished through
the ingestion of drugs… relabeling as medical problems a wide
range of human behaviour, which in the past had been viewed
as falling within the bounds of normal trials and tribulations of human existence.
It is therefore assumed that because young people are brought up in households where they are witnessing the use of these drugs by their parents they begin to share similar points-of-view with respect to the use of drugs. However, they use illegal drugs instead of, and sometimes along with those which are medically prescribed, thus it can be inferred that drug use by children is but a “juvenile manifestation” of adult behaviour.
Stantrock (2000) emphasized the theory of Bandura and Skinner (Social Learning theory) that environmental experiences and situational influences impact on behaviour. This theory was supported to an extent by a study conducted by Denise Kandel where she concluded that parental influence varies with the parental drug involved, the illegal drug used by adolescents, the sex of the parent and the sex of the child. On the other hand, she stated that, though delinquent behaviour may be present in the child’s household, peer behaviour is the important determining factor in adolescent drug use and once this behaviour is present within the peer group then the behaviour of the parents becomes important.
The Mental Health Weekly (1999) recorded that the behavioural and emotional problems of youths increase the risk of abuse of tobacco, alcohol and other illegal substances. According to the study, youths who display problematic behaviour such as stealing or physical aggression were four times more likely to have used marijuana or an illegal substance than others who were not aggressive.
The Brown University (2002) noted that behavioural disorder may predict teen substance abuse. From the 619 teens studied 61 were diagnosed with attention-deficit/hyperactivity disorder (ADHD). Alcohol dependence was remarkably higher in the ADHD group. Given such findings, it is perhaps reasonable to suggest that there is a “common developmental progression in at least some teenagers, from conduct disorder to use of alcohol, tobacco and marijuana and finally to alcohol dependence”.
General patterns of substance abuse
Research on the matter has frequently indicated that alchohol, tobacco and marijuana are the substances most frequently used by adolescents across the globe. According to the 2003 United Nations World Youth Report (WYR),
The first substances used are generally tobacco, alcohol and, in some communities, inhalants; the age of first use is usually lower in developed countries. The use of substances… almost always increases with age, so among students the highest rate of use is generally recorded in the last two years of secondary school, continuing into early adulthood in most countries. In almost all regions boys are more likely than girls to use all substances (exceptions are the non-medical use of medications in a number of countries and alcohol and tobacco use in several European countries) and are more likely to use them in risky ways. Rates of alcohol and tobacco use by students in Europe appear to be the highest in the world, and figures indicate that illicit drug use rates are highest among students in Australia and North America.
In most cases the prevalence of the use of these substances seems to be partly attributed to their availability. In many western cultures many young people grow up in an environment where alchohol consumption is a seemingly normal part of everyday life. Despite attempts to restrict its use by those under a certain age, a large percentage of school age youth engage in the drinking of alchohol at least occasionally. Most surveys reveal that most people have tasted at least one alchoholic drink by the age of 18, though many actually start much earlier. (Anderson, 1995).
As stated before Europe has the highest rates of substance abuse and particularly alchohol use among adolescents worldwide. In 30 European countries, 61 per cent of grade 10 students reported having used alcohol in the past 30 days, compared with 40 per cent in the United States World Youth Report (WYR, 2003). In a survey done in Europe by the WHO, 1995 on the health behavior of school-age children (HBSC), the prevalence of experimentation in three age groups, children aged 11, 13 and 15 was examined. The survey revealed that those who had never tasted alchohol by age 15 were actually in the minority. Across the age groups, more students in Wales and Scotland reported having tasted alchohol than in all other countries, but, by age 15 the variation between the children in the different countries was not very great. Of the 11 countries, which include Austria, Belgium, Canada, Norway, Poland, Spain, Sweden, Scotland and Wales, only Norway showed a prevalence of experimentation less than 90 per cent.
It was also discovered from the study that males were more prone to experimentation than females at the age of 11 but that there was no substantial differences between the genders at 15. The HBSC survey further examined weekly use of alchohol by age and gender. At age 11 the proportion of weekly drinkers was relatively low for all respondents, but were substantially higher at age 15. The percentage of 15 year old boys who drank at least weekly ranged from 10 per cent in Poland to 47 per cent in Wales. Females were the least likely to drink weekly, but similarly to the males, the prevalence to do so increased with age. Reports from many regions indicated the growing use of alchohol to the point of intoxication. Intoxication among youths within the noted age groups was not an uncommon occurrence. By the age of 15, 42-74 per cent of males, and 24-70 per cent per cent of females reported having been drunk at least once.
Separate studies published in 2001 by the WHO showed that approximately 65 per cent of adolescents, that is, 14- to 19-year-olds in Australia and Canada reported having used alcohol in the last year. In Africa, though alcohol consumption is said to be the most troubling substance-related issue affecting the general population, rates of use by youths appear to be significantly lower than in Western countries. Several studies during the past decade have found that among students, between 8.8 per cent (10- to 14-year-olds in Lesotho) and 42 per cent (those attending secondary school in Kenya) were current users. Current-use figures from the past decade are largely unavailable for South-East Asia; however, a study of children and youth aged 10-17 years in Nepal found that 17 per cent had used alcohol in the past year and 9.2 per cent in the past month. In a study of vocational students in Thailand, alcohol use in the past three months was reported by 92.5 per cent of males and 80.5 per cent of females. Survey reports indicate that 70 per cent of senior high school students in Japan and 80 per cent in China had used alcohol at least once. In all regions, use increases with age. Also, a noticeable trend which emerged from some of these studies was that in developed countries, females are about as likely as males to be current users, while in developing countries males are more likely to be current users.
Tobacco is often the first substance used by children and youth, with an estimated 20 per cent of young smokers worldwide beginning before the age of 10. A report prepared by a Swedish organization in 2000 indicated that an average of 37 per cent of grade 10 students in 30 European countries had smoked at least one cigarette in the past 30 days. The average incorporated widely different national rates ranging from 16 per cent in Cyprus to 67 per cent in Greenland. Two recent studies revealed that among grade 10 students in North America, rates of past-30-day use were 26 per cent in the United States and 29.9 per cent in Ontario, Canada. Rates of use within the last 30 day are reportedly close 20 per cent in Costa Rica, Jordan and South Africa, and 10 per cent or less in Barbados, China, Sri Lanka, Venezuela and Zimbabwe (WYR 2003).
Marijuana (or ganja as it is sometimes called) is the illicit substance most commonly used by youth in the majority of the world’s region, with its use accounting for the vast majority of illicit drug use by young people, representing about 90 per cent of all illicit drug use among students in Australia and the United States and almost 95 per cent in Europe, for example. In several countries, including Australia, Canada, France, Ireland, the United Kingdom and the United States, marijuana use is seemingly quite commonplace, with more than 25 per cent of all secondary school students reporting past-year use. Data averaged from over 200 surveys of American secondary school and college students between 1967 and 1972 by the National Commission on Marijuana and Drug Abuse reports an increase from 10 to 16 per cent among junior high school students, from 15 to 40 per cent in senior high school students and an increase from 22 to 50 per cent in college students (Josephson and Carroll, 1974).
Much smaller numbers of young people use illicit substances other than marijuana. However, the use of other substances is seemingly more prevalent in North America than in Europe. However available data suggest that Amphetamine-type stimulants (ATS), including drugs such as Ecstasy and methamphetamine, are the most commonly used illicit substances after marijuana, though there have been no reports of lifetime prevalence being higher than 10 per cent anywhere. Methamphetamine is currently the leading substance of concern in South-East Asia, partly owing to its easy and inexpensive production. A study in Thailand found that 29 per cent of vocational students (39 per cent of males and 18 per cent of females) had used methamphetamine.
Inhalants such as glue, nail polish, cigarette lighter fluid, hairspray, paint thinner, gasoline/petrol, correction fluid and amyl nitrite are inexpensive and easy to purchase in all regions and therefore collectively constitute the drug of choice for especially vulnerable young children worldwide. Among 40 countries supplying lifetime prevalence data during the 1990s, 16 reported rates of lower than 5 per cent, 15 reported rates of between 5 and 10 per cent, and 10 reported rates of 10 to 20 per cent. Rates in poorer communities and among indigenous peoples can be much higher. For example, in Sao Paulo, Brazil, nearly 24 per cent of 9- to 18-year-olds living in poverty had tried inhalants. More than 60 per cent of youth have reported use of inhalants in several Native communities in Canada and the United States. In Africa, inhalants and marijuana appear to be the illicit substances most commonly used by youth, falling just short of the numbers using alcohol and tobacco. (World Youth Report, 2003).
Cocaine, however does not seem to be as popular a drug among adolescents as some of the other aforementioned substances. Cocaine and heroine use among school-age children appears to be quite low in Europe and Canada. (World Health Organization, 1995) The same can be said for the use of heroin by injection; rates among school-age youth tend to be relatively low (less than 2 per cent, though 4.3 per cent of Australian students aged 15-16 years recently reported using opiates). Rates of heroin smoking are usually higher, however. In Europe, for example, Latvia, Poland, and Romania have reported rates of 5 to 8 per cent—the highest in the region for grade 10 students. (World Youth Report, 2003).
There is also the practice of using non-prescription medicines, or “over the counter drugs” for non-medical purposes. In countries such as Belgium and Greece Pharmaceuticals such as tranquilizers are preferred to illicit drugs (World Health Organization, 1995).
Substance use in the Caribbean
Substance use is an issue which is just as prevalent in the Caribbean as anywhere else in the world, and which like everywhere else has become increasingly significant in recent years. Reports made at the drug seminar held in Trinidad and Tobago in November of 1986 indicated that amongst the continued high levels of alchohol and tobacco use are increasingly high rates of marijuana use, as well as growing reports of the use of ‘hard’ substances such as cocaine. However substance abuse trends in the Caribbean have tended to be more or less consistent with trends existing in other regions of the world, especially in regard to certain substances.
Alchohol related problems far exceeded problems related to any other psychoactive drug found in the Caribbean region. The psychological effects of drinking extend to almost every sector of society. The prevalence of alcoholism in the region is between 5 to 10 per cent according to reports and surveys from the countries, and this is related to high levels of consumption of alcoholic beverages. The increase in the production of alchohol especially beer is undoubtedly a contributory factor in this increase in consumption. (PIOJ, 2000).
The past 30 to 40 years have seen an increase in its use by children and adolescents at earlier ages, in greater quantities and with greater frequency. A number of studies have been done which have looked at patterns of substance use and abuse in the Caribbean region among adolescents attending school. A school survey on drug use done in Trinidad and Tobago in 1993 showed that 91 per cent of students had used alchohol, 46.7 per cent had used tobacco, and 6.9 per cent had used marijuana, while only 1.0 per cent had tried cocaine. A previous study had been done in 1991 in Trinidad in which 1,603 secondary students between the ages of 14 and 18 years were surveyed. The study reported usage levels of 84 per cent for alchohol, 35 per cent for tobacco, 8 per cent for marijuana and 2 per cent for cocaine. (PIOJ, 2000, p. 20).
In Belize a 1992 survey of students indicated that 57.3 per cent had used alchohol, 24.3 per cent tobacco, 4.75 per cent marijuana, 1.5 per cent cocaine/crack, and 2.6 per cent diazepam (Valium). In addition to this the study also found that three quarters of the tobacco users had started by age 14, more than half of the marijuana users had started by age 16, that males were more likely to use illicit drugs and that the differences by sex tended to be larger for marijuana and cocaine . Sedative use and alcohol use showed no significant gender differences. Some of the reasons that were given for initial drug use in this survey include peer pressure, experimentation and family influences.
In Jamaica various researchers have reported on patterns of substance abuse since 1987, with most of the surveys being done either among school students or in communities. A recent evaluation conducted by the Ministry of Education, Youth and Culture on drug use among students from grades 7 to 11 found that some 53.5 per cent reported having used alchohol before in their lifetime. A 1995 survey of students in all age schools reported that alchohol was the most commonly used substance followed by tobacco, marijuana and inhalants. Though this survey found that marijuana was the most commonly used illicit drug, the use of crack and cocaine had increased steadily and significantly since 1987. Another survey in the same year, with secondary students in grades 9 to 11, in the metropolitan area of Jamaica, indicated that use of all the substance report on in the 1987 national school survey had increased,. The lifetime and current use of other substances such as tranquilizers, amphetamines, psychedelics and opiates had also increased. Other surveys conducted in 1996 and 1997 showed similar trends in substance use, with alchohol being the most widely used, followed by tobacco and then marijuana. However the survey done 1997 revealed high levels of non- prescription drug use such as Paracetamol (85.7 per cent) and aspirin (76.6 per cent). The survey also yielded other findings which show drug use being higher among male students and children of professionals was higher than among females, rural students and children of non-professionals.
Differences in substance use between genders
Findings from the many surveys and studies conducted on patterns of substance use/abuse among adolescents, frequently established that there is a tendency for levels of substance use to differ between males and females. This tendency for one sex to engage in the use of a substance to a greater degree than the other seems however, to be largely determined by the substance in question, so that while males tended to abuse substances more heavily in most cases, there were other cases in which females engaged in use of the particular substance at levels equal to, and sometimes even higher than the males.
In the case of alchohol consumption, the findings from a number of studies conducted in different regions seem to concur that, on a general basis, males have the tendency to consume more alchohol than females; that is they consume alchohol in larger quantities and with greater frequency than do females. For instance in the aforementioned HBSC survey done in a number of countries in Europe, it was found that boys tended to start experimenting with alchohol at an earlier age than did females, and though use of alchohol by both genders increased with age, females still tended to drink less often than males. Findings indicated that males regardless of age consumed much greater quantities of alchohol more frequently, and where more likely to drink till intoxicated. This situation is apparently not isolated to Europe Studies done in the Caribbean show similar findings, as a study done by Barry Chevannes for UNESCO in 1988 indicated that in general, women do not drink as much or as frequently as the men. The National Adolescent Students Drug Survey done for the Planning Institute of Jamaica in 1998 and compiled in 2000 by Dr Ken Garfield Douglas indicated that males were two times more likely to have used alchohol than females, with this pattern being observed throughout the grade levels. Interestingly though is that one in every five females surveyed were current drinkers of alchohol, and that though adult males drank more than adult females , young males and females consume similar quantities.
For marijuana, the trend was similar in the sense that it was consistently reported that males consumed more marijuana than females. A survey done in 1994 by the Neuroscience, Adolescent Development and Drug Research Program in the Faculty of Medical Science, at the University of the West Indies (Mona Campus) reported use of marijuana by 25 per cent of the males respondents, compared to 2.5 per cent of female respondents. The survey conducted for the PIOJ in 1998, made a similar report, that more males (37.3 per cent) than females (18.4) reported having smoked marijuana during their lifetimes.
The survey also found that males had considerably higher rates of use for most other substances. The use of ‘ganja tea’, crack, cocaine, tranquilizers, amphetamines, psychedelics and opiates was more prevalent in males than in females, with these prevalence rates being one and a half to four times as high. (PIOJ, 2000).
Both of the above-mentioned surveys done in Jamaica reported similar patterns of male versus female use for tobacco, with a greater proportion of males having used or still using tobacco than females. The World Youth Report 2005 reported that in most countries boys are more likely than girls to smoke. Studies from Denmark, France, Greenland, Ireland, Norway and the United Kingdom reported the reverse with females being more likely than males to consider themselves smokers (World Health Organization, 1995).
Substance use and religion
According to Wallace and Brown et al. (2003) one plausible yet under-examined explanation as to why adolescents abstain from drug use is that of religiosity. They note that past research has shown that young people who are highly religious are less likely to use alcohol than those who are less religious. However, the authors address the study from a racial perspective, that is, the extent to which religiosity affects abstinence from substance abuse in white youth and black youth? Though the study specified the results in terms of black adolescents and white adolescents, it demonstrated that religiosity on a whole had a positive effect on the abstinence of adolescents from substance abuse. It should be noted however, that the chances of this happening were higher for black adolescents than for white. This can be attributed to black adolescents being more religious than white ones (Wallace, Brown, et al., 2003).
This view has been supported by the American Psychological Association which reported from a study that when adolescents perceive religion as being important in their lives, it is likely that they will lower their rates of cigarette smoking, heavy drinking and marijuana use. (Alcoholism & Drug Abuse Weekly, n.d., p.4).
The article also notes, as a precursor to this information that, previous research conducted has shown that religion was an important aspect in the lives of adolescents who were facing a lot of stress. The study found that adolescents who viewed religion as meaningful part of their life and a way by which they can cope with problems were half as likely to engage in substance abuse as those who were not. Califano (2002) also supports this view as he writes that adolescents who do not consider religious beliefs important are almost three times more likely to drink and smoke, four times more likely to use marijuana, and seven times more likely to use illicit drugs.
The MTF study, which was conducted under a research grant to the University of Michigan from the National Institute on Drug Abuse in 1998 assessed both the prevalence of alcohol use and the prevalence of getting drunk among 8th, 10th, and 12th graders. In examining the relationship between the use of alchohol and religion for this group it was found that the students’ religious commitment, determined by how important religion is to the student and how often he or she attends religious services was negatively associated with the prevalence of drinking and being drunk. For example, only 40 per cent of 12th graders with a high degree of religious commitment reported having drunk any alcohol in the past 30 days, compared with 60 per cent of students with a low religious commitment.
Though this may be the case, with respect to the Jamaican context where the religion of Rastafarianism has grown increasingly pervasive, it is fitting to inquire if these results will be similar for adolescents in these households, as members of this religion use the marijuana plant (marijuana) as a sacrament which “is used as a medium of communication and union between God and man” (Lowe, 1986, p.32). However, information about the extent to which adolescents who subscribe to Rastafarianism and the prevalence of substance abuse among them was not forthcoming.
Adolescent substance use versus the awareness of the effects
Alchohol, tobacco, marijuana and other illicit drugs are associated with a wide variety of physiological, social and economic problems, and in most cases contribute directly or indirectly to them. Each of the many substances which are used and in many cases abused have their short and/or long term effects that impact negatively upon the user, his family friends and society in general. The use of addictive substances is a common indicator of further deviant behaviour associated with numerous negative outcomes. Affiliated with these adverse consequences are “psychiatric co-morbidity and sucidiality, mortality from drug-related traffic crashes, risky sexual practices and substantial direct health care cost” (Winters 1998). Such behaviours bring to the forefront the social and economic ramifications of substance use.
Yet the substances continue to be used by a large number of people, and in particular a large number of adolescents. Studies indicate that most adolescent substance use starts out as experimentation, usually due to curiosity, availability and peer group pressure, while some others begin use due to a belief that this may provide relief from personal problems (WHO,1995). Wray (1994) confirmed that the initiation of substance use and early stages of abuse has its root in adolescence. This is a vulnerable stage and teenagers tend to feel that they are indestructible and immune to the problem of others. They do not perceive the link between their present actions and future consequences.
It is believed that most adolescents, when they first start using various substances are either for the most part unaware of the possible negative repercussions, or disregard them, due to the belief that such effects are remote. Levinson (2002) describes adolescence as a period characterizes by poor impulse control, immature decision-making, and submission to peer pressure, and according to the World Youth Report 2003, “Young people are characterized by their relative inexperience, their lack of knowledge of risk factors and of consequences such as overdosing, and often their general lack of concern.” The idea that adolescents are unaware of the possible short and long term effects of substance use may explain why most initiatives aimed at curbing substance use place such importance on the educating of adolescents and in some cases, pre-adolescents on the wide range of possible negatives.
Take for instance, the smoking of tobacco. Ninety per cent of all adult smokers begin to smoke at a young age, that is, before age 19. Many studies indicate that these young smokers do not understand the nature of addiction, the difficulty of breaking the cigarette habit, and that smoking cigarettes poses serious hazards to their health; nor do they know that, as research has shown, cigarette smoking can be a gateway drug habit for adolescents that can lead them to use of other drugs (Levinson, 2002). This then may help account for the large numbers of adolescent smokers. It is postulated, however that if young people are kept away from smoking, few will pick up the habit as adults. Brody, the New York Times reporter on personal health, advises parents to reinforce anti-smoking messages in the children at an early age. Brody contends that fostering involvement in sports, particularly competitive sports, can help prevent smoking because youngsters can be reminded that smoking interferes with lung function and impairs their performance. She advises that because young people are not likely to worry about the long term health consequences of smoking, its immediate negative effects be stressed: Stained teeth; a noxious odor that permeates the hair, clothes, skin and breath; lack of physical endurance; and the expenditure of money that could be spent on other things.
Awareness of the ill effects of smoking is not unpopular in Jamaica. The NCDA (2002) reported that a minimum of 8 out of every 10 persons interviewed were aware that smoking had negative consequences on the health, that secondary smoke can cause lung cancer and that smoking can harm the unborn baby. The Planning institute of Jamaica’s report on patterns of substance abuse among post primary, that is, secondary students compiled in 2000 showed that over 75 per cent of students ranging from grade 9 to 13 perceived regular cigarette smoking as a serious risk. This may explain in part the decrease in lifetime use of cigarettes among this reported by the same study. Significant decreases in lifetime and current use were also reported for alchohol and cocaine (PIOJ, 2000).
The question has been raised about whether or not students have enough and correct information about the dangers of alchohol and cigarette use and would they be curious to try it if they did. There are those who say that knowledge about drugs and their effects does not prevent use, yet studies have found that beliefs and attitudes, which in themselves can be influenced by knowledge, does seem to influence behaviour in respect to substance use. O’Malley, Johnston, and Bachman (1998) reported that the beliefs and attitudes of adolescents toward drinking showed a close association with drinking behavior; and though researchers have not shown definitively whether changes in beliefs and attitudes actually play an active role in changing drinking behavior, numerous analyses reported elsewhere, have supported the hypothesis that changes in attitudes and beliefs may have contributed to changes in the trends associated with both marijuana and cocaine use. It is therefore very likely that attitudes and beliefs similarly play an important role in determining alcohol-related behaviors.
This is supported by findings reported by the PIOJ on patterns of substance abuse among secondary students made in 2002. It was found that there was an inverse relationship between attitude and perception of harmfulness of certain substances such as cocaine and actual practice in terms of current use.
Despite our socio-political perspective about substance use among young adults, are our male marginalized or are they ‘substancesatized”?