Reversible And Irreversible Effects Of Drug Abuse

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REVERSIBLE AND IRREVERSIBLE EFFECTS OF DRUG ABUSE

CHAPTER TWO

REVIEW OF LITERATURE

INTRODUCTION

Our focus in this chapter is to critically examine relevant literatures that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.

Precisely, the chapter will be considered in three sub-headings:

Conceptual Framework
Theoretical Framework
Empirical Review

2.1 CONCEPTUAL FRAMEWORK

Drug Abuse

A drug is defined as a substance (and often an illegal substance) that causes addiction, habituation on a marked range in consciousness (Merriam-Webster Collegiate Dictionary, 1993). The definition includes drugs such as heroin, cocaine, baxuco (a cocaine product), opium, cannabis and psycho-tropic substances as described in Mbatia (1994). Drugs can further be defined as simply chemicals that can change something in the body's chemistry or internal makeup. We use drugs in foods like vitamins. But these are both necessary and beneficial. We use drugs as prescribed by doctors. Drugs are harmful or even fatal if they are used for purposes not intended, or in the wrong way (Van, Cleave, Byrd, & Revell, 1987). Many people use the terms 'drug use' 'substance abuse' and 'drug abuse' interchangeably. However, the term 'drug' is mainly used to refer to 'medicine', while substance abuse may include chemicals other than drugs, i.e., gasoline, cleaning fluids, glue, and other chemicals (Hendrikz, 1986). There is a common misconception that drug abuse has to do primarily with illegal drugs such as cocaine, marijuana, and heroin; or with illicit use of prescriptions and medication. There are many types of drugs that may be abused. For example, chloroquine and aspirin are drugs which are commonly abused and they may be fatal. Chloroquine is at times used by girls for abortion. Some people are said to combine aspirin and alcohol for a stronger drink. Also youths abuse substances such as gasoline, cleaning fluids, glue and other chemicals. Therefore not all abused chemicals are drugs. Drug abuse is defined as the use of a mood-altering drug to change the way one feels. Drugs may be abused by inhaling, sniffing, swallowing, or injecting into oneself. The drug may be legal or illegal, all the same it may be used for legitimate or medical reasons (Van, Cleve, Byrd, & Revell, 1978). A drug or substance is considered abused if it is deliberately used to induce physiological or psychological effects (or both), and for a purpose other than for therapeutic purposes. The drug used should contribute to health risks, disruption of psychological functioning, adverse social consequences, or some combinations of these (Kauffaman, 1989). In this article, a drug is defined as any chemical which, when inhaled or taken in the body through injection or by mouth, may adversely affect ones ability to think and make valid judgemems, and adversely affect one's sexual behaviour. It is also defined as any substance other than food that is purposely introduced into the body to alter normal functions. Such substances include cocaine in all its forms, opium in all its forms, bhang and marijuana.

Overview of Drug Abuse in Nigeria

The history of drug abuse in Nigeria predates the early trends of civilization which took place as man settled down from being a gatherer to a farmer. Some of the early crops he cultivated include intoxicants such as wine (alcoholic) and strong tobacco, as well as opium, and other harder substances. The introduction of Islam in the north and Christianity in the south reduced this trend. Contemporary Nigeria witnessed drug abuse since the return of the World War II Veterans who fought in Malaysia and Burma (Myanmar). On return, after the war, they brought with them concealed contents of Cannabis (Indian hemp) as souvenirs. Subsequently, there was a sporadic and illegal cultivation of cannabis as a widespread farm product. History has it that between the period 1960’s and 1970’s drug trafficking rate was low, as it was only dominated by derivatives and cannabis. By and large, the 1980’s brought with it the emergence of wide varieties of substance into Nigeria that included Cocaine, Heroin, and Hallucinogens etc. This trend is still prevalent in Nigeria today because a considerable number of her youths have improvised other useful drugs to like caffeine, and antipyretics by abusing them. This happens in spite of the growing religious activities in the country. This tremendous increase made the government to respond by establishing the National Drugs Law Enforcement Agency, and National Agency for Food and Drugs Administration and Control.

Determinants Of Drug Abuse

Majority of today's youth faces conflicts that they can barely handle in a very young age. Modernization has brought many social changes in the society. Children are being taken for granted, usually by parents who both work and have no time for their children. Another factor is the issue of broken family, peer pressure, and many other issues that would make a youth feel inferior of himself/herself. Youth like these seeks a way to express themselves and unfortunately, this search for self–expression has often lead to deviant practices such as joining gangs, engaging in pre-marital sex and engaging in substance abuse. Stephen (1997) wrote that growing numbers of children are being neglected, abused, and ignored. Without change, the dark specter of generational warfare could become all too real. Stephen (1997) further continues that child-care advocates reports that up to 15% of 16-to 19-year-olds are at risk of never reaching their potential and simply becoming lost in society. In other recent studies, the research shows that family and peer influence, individual characteristics including behaviour and personality can also be considered as factors that influence children and adolescent to engage in substance abuse (Johnston, O'Malley & Bachman, 2003). There are several ways to determine if a youth is at-risk of substance abuse. Christle, et al (2002) cited that researchers have identified a number of demographic and behavioural characteristics of youth that contribute to their risk of involvement with substance abuse. These include ethnic minority status; aggressive, antisocial behaviour; difficulties in school and school failure (including educational disabilities). These risk factors are common denominators in the backgrounds of youth who require a variety of human services like child welfare services. Most research had placed little emphasis on neighbourhood norms in studies of youth substance use. Previous research on teenagers’ smoking, drinking, and drug use has focused on imitative behaviour with respect to classmates and friends. These studies have used various strategies to assess the effects of social context on substance use: the demographic composition of the teenager’s school or neighbourhood as a proxy for the prevalence of smoking (Johnson and Hoffman, 2000); friends’ behaviour as reported by the teen; individual teenagers’ reports about whether their (best) friends smoke and what their friends would do if the teenager smoked around them; teenagers’ estimates of the percentage of other students in their grade who engage in the behaviour of interest. Most studies of this type ignore that friends select each other based on shared values (but see Case and Katz, 1991) and that teenagers may not accurately perceive the prevalence of substance use (Kawaguchi, 2004). On the latter point, for example, Perkins and colleagues (Perkins, 2002; Perkins, Haines, and Rice, 2005) show that college students overestimate campus drinking, and that misperceptions of drinking strongly predict individual behaviour. It is important to ask how teenagers are affected by the attitudes and behaviour of adults as compared to peers. Adults and peers likely matter to teens in different ways. Whereas the threat of adult sanction may be an important mechanism linking adult attitudes and behaviour to teen behaviour, the risk of social exclusion may be the driving force behind peer effects. Unfortunately, the theoretical and data demands for modelling neighbourhood and peer effects simultaneously are high, requiring a design that takes account of teens’ choices about peers as well as sufficient numbers of cases for each combination of neighbourhood and school or peer group (Kim et al., 2006). Few, if any, studies manage to do this. Given data constraints and the lack of research on how adult neighbours influence teen substance use, our analysis focuses on the influence of adults. Substance use among teens varies significantly by teens’ race/ethnicity, gender, and family structure, as well as by their parents’ attitudes and behaviours with respect to substance use (see USDHHS 1994, and Tyas and Pederson, 1998 on adolescent smoking). Smoking, drinking, and drug use tend to be more common among white teenagers than African American and Hispanic teens (Johnston, O’ Maley, and Bachman, 2001), among teens who live in single-parent households (Hoffmann, 2002; Kirby, 2002), and among teens whose parents’ smoke, drink, or use drugs (Anderson and Henry, 1994). Furthermore, youth who believe that their parents are indifferent to smoking and/or drug use are also more likely to use these substances, regardless of their parents’ use of these substances (Newman and Ward, 1999). Across race/ethnic groups, boys are more likely than girls to drink and use marijuana (Wallace and Bachman, 1991), but girls are at least as likely if not somewhat more likely to smoke cigarettes (Gruber and Zinman, 2001). By contrast, socioeconomic status is not well correlated with teens’ substance use (Gruber and Zinman, 2001).

EFFECTS OF DRUG ABUSE

People abuse substances such as drugs, alcohol, and tobacco for varied and complicated reasons, but it is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospitals and emergency departments through direct damage to health by substance abuse and its link to physical trauma. Jails and prisons tally daily the strong connection between crime and drug dependence and abuse. Although use of some drugs such as cocaine has declined, use of other drugs such as heroin and “club drugs” has increased. Substance use and abuse is in the forefront of societal problems. It is a pervasive problem, affecting directly or indirectly the overwhelming majority of persons. The deleterious impact of alcohol and drugs is devastating. The involvement of some children and adolescents in substance abuse often lead to different consequences. Such consequences include physiological, psychosocial and legal aspects. It is noted that the physiological effect of drug abuse depends on the drugs that has been used. Substance abuse undermines physical health. For example, chronic alcohol abuse is associated with diseases of the liver, central nervous system, and heart. Often, as in the case of the brain disorder Korsakoff's syndrome, the damage resulting from alcohol abuse is irreversible. Additional health problems stemming from the use of other substances are well documented (Colby, 2004)). Well-known examples are lung cancer caused by smoking, and pervasive central nervous system damage resulting from the inhaling of solvents, cardiovascular disease and neurological damage (NCCDPHP, 2000). In addition, many substances are toxic in excessive doses, resulting in numerous acute and chronic effects on physical health, potentially leading to permanent disability or death. Finally, substance abuse increases the risk for acquiring other health-related problems, such as HIV, sexually transmitted diseases, or trauma secondary to accidents while under the influence of psychoactive substances (NCCDPHP, 2000). Mental health disorders often occur with substance abuse. Co-morbidity is relatively common, with up to one third of individuals with psychiatric disorders reporting a lifetime history of substance abuse disorders as well. In some instances, psychiatric disorder precedes or even contributes to the development of substance abuse, whereas in others, emotional and behavioural disturbances arise within the context of alcohol and drug use problems. A large body of research has delineated the disproportionate representation of psychological dysfunction in substance abusers. Included are problems in personality, mood, self esteem, coping, behaviour, and social functioning. Once again, some of these psychological difficulties may be evident prior to the onset of substance abuse, although psychological functioning often worsens over time in individuals with substance use disorders (McWhirter, 2004). In addition, children and adolescents who are involved in substance abuse may also be affected in terms of their educational status. Abuse of specific substances may also contribute to relatively unique psychological presentations, such as the a-motivational state that has been linked to chronic marijuana use. Other psychological effects of substance abuse are directly linked to the biological impact of psychoactive substances (such as anxiety and irritability stemming from withdrawal) and the behaviours that result from dependence on drugs and alcohol (such as craving and preoccupation with obtaining desired substances). Young people who persistently abuse substances often experience an array of problems, including academic difficulties, health-related problems (including mental health), poor peer relationships, and involvement with the juvenile justice system. Additionally, there are consequences for family members, the community, and the entire society. Declining grades, absenteeism from school and other activities, and increased potential for dropping out of school are problems associated with adolescent substance abuse. Hawkins, Catalano, and Miller (1992) cite research indicating that a low level of commitment to education and higher truancy rates appear to be related to substance use among adolescents. Cognitive and behavioural problems experienced by alcohol- and drug-using youth may interfere with their academic performance and also present obstacles to learning for their classmates (Bureau of Justice Statistics, 1992). Injuries due to accidents (such as car accidents), physical disabilities and diseases, and the effects of possible overdoses are among the health-related consequences of youth substance abuse. Disproportionate numbers of youth involved with alcohol and other drugs face an increased risk of death through suicide, homicide, accident, and illness. The Drug Abuse Warning Network (DAWN) study -- in a representative sample of hospitals throughout the United States -- reports trends in people seeking emergency department treatment related to illegal drug use or nonmedical use of legal drugs. Preliminary 1994 estimates indicate drug-related emergency department episodes for youth ages 12 to 17 increased by 17 percent from 1993 to 1994. This increase was greater than for any of the older age groups reported. Significantly, emergency department visits related to marijuana/hashish for youth ages 12 to 17 increased 50 percent between 1993 and 1994 (McCaig, 1995). Ninety-one youth between the ages of 12 and 17 died of drug abuse in 1993 (Office of Applied Studies, 1994).

Transmission of HIV/AIDS primarily occurs through exposure to body fluids of an infected person during sexual contact or through sharing of unsterile drug-injection equipment. Another primary means of transmission is from mothers to infants during pregnancy or the birth process. Many substance-abusing youth engage in behaviour that places them at risk of contracting HIV/AIDS or other sexually transmitted diseases. This may include the actual use of psychoactive substances (particularly those that are injected) or behaviour resulting from poor judgment and impulse control while experiencing the effects of mood-altering substances. Rates of AIDS diagnoses currently are relatively low among teenagers, compared with most other age groups. However, because the disease has a long latency period before symptoms appear, it is likely that many young adults with AIDS were actually infected with HIV as adolescents. Although alcohol-related traffic fatalities for youth have declined, young people are still overrepresented in this area. In 1995 alone, more than 2,000 youth (ages 15 to 20) were killed in alcohol-related car crashes (National Highway Traffic Safety Administration, 1997). These limited examples illustrate the catastrophic health-related consequences of substance abuse among adolescents. Besides personal and family distress, additional healthcare costs and loss of future productivity place burdens on the community. Mental health problems such as depression, developmental lags, apathy, withdrawal, and other psychosocial dysfunctions frequently are linked to substance abuse among adolescents. Substance-abusing youth are at higher risk than nonusers for mental health problems, including depression, conduct problems, personality disorders, suicidal thoughts, attempted suicide, and suicide. Marijuana use, which is prevalent among youth, has been shown to interfere with short-term memory, learning, and psychomotor skills. Motivation and psychosexual/emotional development also may be influenced (Bureau of Justice Statistics, 1992). Substance-abusing youth often are alienated from and stigmatized by their peers. Adolescents using alcohol and other drugs also often disengage from school and community activities, depriving their peers and communities of the positive contributions they might otherwise have made. In addition to personal adversities, the abuse of alcohol and other drugs by youth may result in family crises and jeopardize many aspects of family life, sometimes resulting in family dysfunction. Both siblings and parents are profoundly affected by alcohol- and drug-involved youth (Nowinski, 1990). Substance abuse can drain a family's financial and emotional resources (Bureau of Justice Statistics, 1992).

In a related vein, the social and economic costs related to youth substance abuse are high. They result from the financial losses and distress suffered by alcohol- and drug-related crime victims, increased burdens for the support of adolescents and young adults who are not able to become self-supporting, and greater demands for medical and other treatment services for these youth (Gropper, 1985). There is an undeniable link between substance abuse and delinquency. Arrest, adjudication, and intervention by the juvenile justice system are eventual consequences for many youth engaged in alcohol and other drug use. It cannot be claimed that substance abuse causes delinquent behaviour or delinquency causes alcohol and other drug use. However, the two behaviours are strongly correlated and often bring about school and family problems, involvement with negative peer groups, a lack of neighbourhood social controls, and physical or sexual abuse (Hawkins et al., 1987; Wilson and Howell, 1993). Possession and use of alcohol and other drugs are illegal for all youth. Beyond that, however, there is strong evidence of an association between alcohol and other drug use and delinquent behaviour of juveniles. Substance abuse is associated with both violent and income-generating crimes by youth. This increases fear among community residents and the demand for juvenile and criminal justice services, thus increasing the burden on these resources.

Gangs, drug trafficking, prostitution, and growing numbers of youth homicides are among the social and criminal justice problems often linked to adolescent substance abuse. The DUF study found the highest association between positive drug tests of male juvenile arrestees and their commission of drug-related crimes (e.g., sales, possession). However, a substantial rate of drug use also was found among youth who committed violent, property, and other crimes (National Institute of Justice, 1996). Other data support the concern for drug-involved youth in the juvenile justice system. The Survey of Youth in Custody, 1987 (Beck, Kline, and Greenfeld, 1988) found that more than 39 percent of youth under age 18 were under the influence of drugs at the time of their current offense. More than 57 percent reported using a drug in the previous month. In another study of 113 delinquent youth in a State detention facility, 82 percent reported being heavy (daily) users of alcohol and other drugs just prior to admission to the facility, 14 percent were regular users (more than two times weekly), and 4 percent reported occasional use (DeFrancesco, 1996). A study conducted in 1988 in Washington, D.C., found youth who sold and used drugs were more likely to commit crimes than those who only sold drugs or only used drugs. Heavy drug users were more likely to commit property crimes than nonusers, and youth who trafficked in drugs reported higher rates of crimes against persons. Youth in this sample were most likely to commit burglary or sell drugs while using or seeking to obtain drugs. About one-fourth of the youth also reported attacking another youth to obtain drugs. However, among the youth in this sample, the majority who committed crimes did not do so in connection with drugs (Altschuler and Brounstein, 1991).

The negative effect of drug is also referred to as drug abuse. Drug abuse is therefore defined as the excessive consumption of a drug by any individual. Drug abuse results when there is self injection or from the approved medical in a manner that deviates from the approved medical usage. Drug abuse is involved in the following:

1. Excessive use of drugs and use of unprescribed drugs.

2. Use of hard drugs.

Short-Term Consequences

Short-term consequences of drug use are relatively easy to establish through true experimental designs. For instance, establishing the direct physiological affect of a substance such as alcohol on reaction time can be accomplished with this method. Other more innovative approaches have also been developed such as the balanced placebo design (Marlatt et al., 1988). In this design, the expectancy effects of using a drug can be separated from the true pharmacological effects of the drug. Other more naturally occurring tragic short-term consequences include overdoses, car crashes due to alcohol or other drugs, and increased aggression and confrontational acts.

Long-Term Consequences

experimental control over the types of drugs used and the duration of their use is not possible. Therefore, it is difficult to establish how such use influences functioning later in life. For instance, it is not ethical to randomly assign one group of sixth graders to smoke one joint of marijuana every day and another matched group of sixth graders to never smoke marijuana to determine how the two groups differ in their level of functioning later in life. Therefore the only alternative is to follow the naturally unfolding development of individuals over time and repeatedly assess their drug use and their evolving biopsychosocial maturation. In order to establish causal inferences for long-term drug use consequences four assumptions must be met. First, there must be a reliable association between drug use and the outcome or consequence. Second, drug use must temporally precede the consequence. Third, the drug use must make a change in the consequence. Using both baseline and outcome measures of the consequence to show that drug use contributes unique variance above and beyond the specific stability effect. Finally, it is important to show that these relationships are not spurious and due to third-variable factors. This final assumption is not always possible to satisfy, and represents an inherent limitation in consequence research. However, using complex multivariate models that explicitly include alternate predictors of the outcomes is a powerful, but still not definite, approach to use to determine the plausible causal inferences of drug use on later consequences.

Long-term drug use consequences are far more difficult to establish than are those that are considered short-term. The primary reason for this is that true

Many short-term and long-term consequences of drug use have been investigated. This section reviews and categorizes findings in three broad areas, health consequences, psychological consequences, and social consequences. Since these domains encompass such a wide range of topics and human behaviors, this review is not exhaustive. Rather, specific areas within each domain are selectively reviewed. The review on health consequences includes HIV-sexual risk behaviors, healthservice utilization, and morbidity/mortality statistics. The section on psychological consequences focuses on suicidality, depression, anxiety, and psychosis. The section on social consequences is focused on interpersonal relationships. Specifically, antisocial behavior (theft and violent crime), interpersonal relationships (marital satisfaction, divorce, parenting), and workplace involvement (absenteeism, job satisfaction and stability) will be reviewed. Since both short-term and long-term consequences are important to consider, both cross-sectional and prospective studies are included in the following review.

Health

Various short-term health consequences associated with drug use have been established (over-doses, aggression, accidents). Long-term consequences have been more difficult to adequately test as the physiological mechanisms are more difficult to determine. The use of cigarettes is associated with cancer, emphysema, and heart disease. Cigarette smoking is responsible for over 400,000 deaths per year. Alcohol use is responsible for over 400,000 alcohol-related traffic crash deaths per year and over 25,000 people die from cirrhosis of the liver (National Institute on Alcohol Abuse and Alcoholism, 2004). Illicit drug use is associated with many health consequences including death (suicide, homicide, motor-vehicle injury) HIV infection, pneumonia, violence, and hepatitis. Overall, it is estimated that illicit drug use resulted in approximately 17,000 deaths in 2000 (Mokdad et al., 2004). Drug abuse is often an important determinant or correlate of sexual risk behaviors (Tapert et al., 2001; Testa and Collins, 1997). Drugs are used to enhance the sexual experience or the engagement in sexual behaviors helps to support the costs of drugs. Drug use has consistently been found to significantly increase sexual and other risk behaviors in many diverse populations. For instance, in a large community-based sample of male Latinos, Locke et al., (in press) found that drug use predicted more partners, more pregnancies, and more HIV testing. Further, another study (Newcomb et al., 2003) found that drug use mediated the influence of physical and emotional abuse on sexual risk behaviors in a large community sample of Latinas. Overall, behavior associated with drug abuse is now the single largest factor in the spread of HIV infection in the United States. In the United States, an estimated one-third of HIV/AIDS cases are related to injecting drug use. The use of drugs injected or not, can affect decision making—particularly about engaging in unsafe sex—that can endanger one’s health and the health of others (National Institute on Drug Abuse, 2003). Ellickson et al., (2004) studied the adult behavioral, socioeconomic, and health outcomes of adolescent and young adult marijuana users in a large prospective community sample. They identified several groups of individuals: those who abstained from marijuana use, early high users, stable light users, steady increasers, and occasional light users. Growth mixture analysis was conducted on six-waves of data on marijuana users collected over a 10-year period. After controlling for gender, race-ethnicity, household composition, and parental education, they found that the early high users had significantly poorer overall health than all other groups. Further, they had significantly lower earnings and lower educational attainment than all but the stable light users. Abstainers outperformed all other groups by age 29 in the domains of educational achievement, overall health, and life satisfaction. Those who abuse drugs often have higher levels of health service utilization than those who do not (Newcomb and Bentler, 1987). Palepu et al., (2003) examined emergency department utilization in a longitudinal study of HIV-infected persons with a history of alcohol problems. They found that substance abuse treatment was significantly related to decreased emergency room visits. However, the effect may be different for different substances, and may not be entirely linear. Cherpitel (2003) examined health service utilization in the US using two large national surveys conducted in 1995 and 2000. It was found that those reporting any health services utilization were less likely to report heavy drinking, two or more alcohol problems, and symptoms of alcohol dependence. Heavy or problem drinking was not predictive of health services utilization. After controlling for demographic characteristics and health insurance coverage, illicit drug users were almost twice as likely compared with nonusers, to report ER utilization, and one and a half times more likely to report primary care utilization in the 2000 survey, even though drug use was not significantly predictive of health services utilization in 1995.

Mental Health

A few longitudinal studies have examined the mental health consequences of drug use in general community populations, and varied findings have emerged (e.g., Kandel et al., 1986; Newcomb and Bentler, 1987; 1988). Some have reported causal relationships between drug use and deteriorated emotional health (e.g., Dackis and Gold, 1983; Newcomb and Bentler, 1987; 1988). Vaillant’s (1995, 1993) highly cited, yet controversial study of male college students yields some interesting findings. He found that those who abused alcohol were five times more likely to report being severely depressed than those who did not. Vaillant’s assertion that alcoholism is rarely the result of depression, but it is often a major causative factor, supports other views in the literature (e.g., Schuckitt, 1986), but it is disconcerting that he based this on such a small sample (N = 14). Further, while this is considered a community study, it is of males from Harvard University and therefore is not representative of the college-aged population. Overall, though accepted as common knowledge, evidence for causal relationships between early drug use and later deficits in emotional development is “hard to verify scientifically” (Newcomb and Bentler, 1988, p. 64). For example, adequate controls for preexisting conditions and important confounds may not have been made. Another longitudinal prospective study found a reciprocal effect between substance involvement and psychological distress (dysphoria and suicidal ideation), with substance use serving as both a predictor and outcome of psychological distress. Specifically, Newcomb et al., (1999) found that as an individual progressed through adulthood, psychological functioning was impaired by substance problems experienced four years earlier. In addition, they found that substance involvement was influenced by earlier psychological distress. Christoffersen et al., (2003) also found that suicide risk was associated with prior drug addiction in a prospective register-based study of Danish children. Newcomb et al., (1993) used prospective data from a community sample of 487 participants who were assessed 4 times over 12 years, beginning when they were young adolescents. They found that teenage polydrug use had few direct or unique effects on adult mental health, whereas increased polydrug use exacerbated later psychoticism, suicide ideation, and other indicators of emotional distress. Specific drug use in adolescence and changes in usage patterns into young adulthood predicted later psychopathology. Pencer and Addington (2003) also found that substance use was related to higher positive psychotic symptoms. Locke and Newcomb (2001) found several reciprocal relationships between alcohol use and dysphoria for both men and women over a 16-year period from adolescence to adulthood. For women, dysphoria during young adulthood had serious consequences, leading to alcohol-related problems and use of alcohol at work during adulthood. Also, alcohol involvement in young adulthood led to specific aspects of dysphoria in adulthood. For men, alcohol involvement during late adolescence led to depression as measured by the CES-D in adulthood, and depression scale scores in late adolescence led to alcohol involvement in adulthood. Also, suicidal ideation during late adolescence predicted use of alcohol at work in adulthood.

In a longitudinal study of adolescents, Shedler and Block (1990) found that those who had engaged in some drug experimentation were the best-adjusted of all participants. Those who frequently used drugs were maladjusted, and displayed interpersonal alienation, poor impulse control, and manifest emotional distress. If an adolescent had not experimented with any drug by age 18, they were relatively anxious, emotionally constricted, and lacking in social skills. Further, several studies have reported apparently positive effects from moderate alcohol use, including greater positive affect, stress reduction, and limited improvements in cognitive performance (Baum-Baicker, 1985; Kandel et al., 1986; Newcomb and Bentler, 1987, 1988; Newcomb et al., 1986).

Antisocial Behavior

Although there is a clear correlation between drug use and criminality, several problems contribute to uncertainty as to how they are causally related in the general population. First, a focus on only clinical samples (e.g., Hanlon et al., 1990), adults in the criminal justice system (Harrison, 1992; Innes and Greenfeld, 1990), or adolescent samples (e.g., Apospori et al., 1995) limits the generalizability of the results to community samples of adults. Nevertheless, the association between drug abuse and criminal behavior and delinquency in the general population has been examined (e.g., Kaplan, 1995). Second, cross-sectional data prohibit the elucidation of the causal relation between drug abuse and criminal behavior. Third, many previous studies have examined specific types of drug use and not polydrug use, which might more likely be related to criminal behavior as it suggests a more deviant lifestyle of drug abuse. Therefore, whether drug problems precede criminality or criminal behaviors precede drug problems continues to be debated (Kaplan and Damphousse, 1995). Finally, the potential influence of other contributing or explanatory factors, such as social support and social conformity, have received little attention. Brook et al. (2003) tested associations between marijuana use and several domains of behavior 2 years later in a community-based sample of 1,151 male and 1,075 female Colombian adolescents. Findings suggest that time 1 adolescent marijuana use was associated with increased risks for time 2 adolescent difficulty in a variety of domains including violent experiences. The findings suggest that early adolescent marijuana use is associated with an increase in problem behavior during later adolescence. Newcomb et al. (2001) used prospective data to test the associations between drug abuse and crime in a community sample of 470 adults. Polydrug problems in early adulthood predicted both criminal behavior and polydrug problems in adulthood. Consequences of drug problems as a young adult included arrests and convictions for drug-related offenses, property damage, and driving under the influence of other drugs. Predictors of later polydrug problems included thefts, driving under the influence of alcohol and other drugs, arrests and convictions for drug-related offenses, and a lack of support for drug problems. Theoretical implications of these findings are discussed.

Interpersonal Relationships

The two key consequence areas relative to interpersonal relationships that have been studies are parenting practices and workplace behaviors.

Impact on Adult Parenting Practices

“The presence of substance abuse in an adult may or may not be an indicator that he or she is a dysfunctional parent” (Mayes, 1995 p. 101). Most work involving the influence of drug use on parenting looks at treatment or clinical samples. A few community studies have found associations between drug use and poor parenting. Newcomb and Loeb (1999) found poor parenting to be associated with a cluster of adult deviant behaviors that included polydrug problems and crime. Overall, it appears that drug-using parents are more likely to live unconventional lifestyles and endorse nonconventional values, and these values influence their role and functioning as parents (Kandel, 1990). For instance, substance using parents have displayed poor parenting skills, provided inadequate supervision of their children, and disciplined their children in a lax or coercive manner (Vaillant and Milofsky, 1982). The relationships between alcohol use and relational quality are well documented. For instance, high levels of family dysfunction are related to alcohol use (McKay et al., 1992), and alcoholic couples have been characterized by interpersonal violence (Quigley and Leonard, 2000) and sexual dissatisfaction (O’Farrell et al., 1997). Spouses of alcoholics expressed greater dissatisfaction in all areas of family functioning than alcoholics (Suman and Nagalakshmi, 1995). This dissatisfaction may be reflected in the finding that both marital dissatisfaction and divorce rates are as much as seven times greater in alcoholics than the general population (Schafi et al., 1975). Medora and Woodward (1991) studied loneliness in alcoholics, finding significant negative relationships between the number of years alcohol was consumed and self-esteem, marital satisfaction, and loneliness. The relationship between alcohol use and relationship satisfaction may not be entirely linear. Under some circumstances, alcohol use has adaptive consequences (Steinglass, 1981) and has been associated with increased marital satisfaction. For example, Jacob et al. (1983) found that high alcohol consumption was associated with high levels of marital satisfaction in the spouses of steady drinkers, but not binge drinkers. An indirect effect or consequence of drug use may be difficulty in intimate relationship functioning among adult children of drug-using parents. Newcomb and Rickards (1995) found that parent drug-use problems predicted poor family support, and family support was strongly associated with good adult intimate relations for both men and women. Furthermore, for men, more parent drug-use problems reduced dyadic adjustment, increased dependence, and had a specific effect on reducing dating competence. For women, parent drug-use problems had no direct effects on adult intimacy or relationship variables.

Workplace

A large percentage of people in the workforce drink. Data from the National Household Survey on Drug Abuse (SAMHSA, 1998) indicated that almost 64% of full-time employed adults (26–34 years old) used alcohol in the past month. Those who use alcohol heavily are more likely to have increased absenteeism, and to have had at least three employers in the last year (SAMHSA, 1997). Several relationships have been found between alcohol use and employment. Those who endorse an escapist drinking style drink more alcohol in response to work stress (Grunberg et al., 1999). Moderate levels of consumption are associated with increased income, while heavy drinking may be detrimental to income levels (Mullahy and Sindelar, 1992). It is often hypothesized that alcoholics would have a less stable pattern of employment due to the adverse consequences of heavy drinking. In fact, failure to fulfill major role obligations (work, school, and home) is a criterion (DSM-IV) for alcohol abuse. The direct association between alcohol use and the hours/weeks worked, length of employment and/or job loss specifically due to drinking problems has not been widely studied (Mullahy and Sindelar, 1992). Low job satisfaction has been shown to be associated with alcoholism (Hingson et al., 1981). Galaif et al. (2001) found that polydrug problems were both predictors and consequences of work adjustment. Individuals abusing drugs were more likely to experience an erratic job pattern, less likely to adhere to societal norms, experience a less satisfying career, and have smaller support networks. Overall, mixed results have been found regarding the association between drug use and work adjustment. Some investigations have documented inconsistent work histories, unemployment, work stress, absenteeism, tardiness, low quality work, job instability, work performance problems, and problems with job satisfaction among drug and alcohol users (Ames and James, 1987; Kandel, et al., 1986; Newcomb, 1988). Others have not found adverse effects on work adjustment (e.g., unemployment, job satisfaction, work performance) as a result of substance use (Bachman et al., 1984; Newcomb, 1988). Still, some researchers dispute the belief that drug use is a serious problem in the workplace (Newcomb, 1994b). Tam et al. (2003) found that childhood adversity experiences were precursors to later alcohol and drug use in a sample of homeless adults. Subsequently, regular substance use was negatively associated with labor force participation and social service utilization.

Prevention And Intervention Strategies for Drug Abuse

Dependence on the support of others begins at conception, but even as people become increasingly self-sufficient, they continue to require assistance from others in one form or another throughout life. Young people struggling to become social beings and unique individuals at the same time are in particular need of the various forms of social support. When that support is missing, the resulting isolation from others increases the potential for progression from normal youthful dissonance toward more dangerous consequences that can include death or lifelong social and emotional disturbances and sometimes tend to get involve in different things that may even try to make worst of their situation such as substance abuse (Colby, 2004). In response to the increasing numbers of at-risk youth, numerous programs have been developed to cope with problem.

Here are some basic examples of approaches. Stephen (1997) states that positive reinforcement is one of the approaches that works well on at-risk youth. He states that children crave attention more than anything else, especially positive attention. "A baby who is cuddled, talked to, and stimulated in the first six weeks of life is much more likely to be intelligent and well adjusted than a baby ignored and simply fed and cleaned up in silence. Later, the child who is rewarded with praise for accomplishments is much more likely than others to become optimistic and achievement oriented" (Stephen, 1997). He also states that one extinguishes unacceptable behavior by ignoring it and eliminating the child's ability to gain attention. On the other hand, pats on the back, awards, and ceremonies to celebrate accomplishments are particularly effective in fostering pro-social behavior and giving at-risk youth a stake in society, helping them overcome lack of hope and lack of faith in the future. He then suggested that using positive reinforcement must become a way of life for parents, teachers, and others. Teaching positive reinforcement to potential parents has been successful in reducing the at-risk population. Parent education can offer information and skills to assist the parent-to-be with incentives to learn and use good child-rearing practices. A similar program, Healthy Families America, was launched in 1992 by the National Committee to Prevent Child Abuse to help establish home visitation programs, service networks, and funding opportunities so all new parents can receive the necessary education and support regarding proper child rearing so as to prevent the involvement of children in risky matters such as substance abuse (Stephen, 1997). Stephen (1997) also states that mentoring is one the effective ways to prevent or stop children or adolescents to engage in abusing substances. He cites the, leaders in Kansas City that are on a quest to recruit, train, and assign 30,000 mentors - one for every at-risk child in the city. Zimmerman, et al (2002) states that, researchers have suggested that natural mentors may play a vital role in adolescent development. Young people often attribute their safe passage through the tumultuous years of adolescence to the influence of significant non-parental adults such as teachers, extended family members, or neighbours. Zimmerman, et al (2002) has found empirical support for the proposition that having a natural mentor may play a vital role in the lives of adolescents. It has also found out that having a natural mentor was also associated with lower levels of problem behaviour, and youth with natural mentors had more positive attitudes toward school across the range of friends' negative school behaviours. However, natural mentors had somewhat larger direct effects on school attitudes than they did on problem behaviours. Nevertheless, having a natural mentor may play a vital role in the lives of adolescents. “Respondents with natural mentors reported lower levels of problem behaviour, including marijuana use and nonviolent delinquency, than did those without mentors. This was true even after we adjusted for demographic variables and known risk factors such as problem behaviour norms and friends’ problem behaviours. Having a mentor partially offset the effect of these negative peer influences, providing evidence of a compensatory effect” (Zimmerman, et al, 2002). In addition, they suggested that programs that create settings that provide opportunities for youth to interact with non-parental adults may help adolescents foster the development of natural mentoring relationships. McWhirter (2004) states that, programs are now appearing in schools and community centers to provide attitudes and skills necessary to resolve conflict among children and adolescents non-violently. Models have been developed by the American Bar Association and the Justice Department, as well as by educators. He further states that “one of the best models involves training school staff - teachers, administrators, custodians, bus drivers, and cafeteria workers - in creative nonviolent conflict-resolution methods.” He concluded that older students are also taught these techniques, and they in turn teach younger students, turning peer pressure into a positive rather than negative force. Community school programs are also effective because most youth spend their time at school. Stephen (1997) gave some examples of successful Community school programs. One of the programs is in Missouri, where 6,000 volunteers keep 675 schools open for extra hours. Another examples are the Boys’ and Girls’ Clubs that offer mentoring in New Jersey schools and the Safe Haven programs in New York that provide safe environments and positive after-school tutoring and enrichment programs. Another program that is effective in the prevention of children and adolescents in substance abuse is the Life-skills training. Life-skills training have been defined as the formalized teaching of requisite skills for surviving, living with others, and succeeding in a complex society. It is reported that life-skills training was "proposed as the treatment of choice" when applied to prevention with adolescents. In addition, life skills which assist in the development of an adolescent's self-efficacy “include the ability to solve problems, to communicate honestly and directly, to gain and maintain social support, and to control emotions and personal feelings.” Life-skills programs vary in the types and quality of services they provide. McWhirter (2004) stated that “essential components of any life-skills curriculum are based on the development of fundamental, generalized interpersonal skills.” Successful life-skills programs appeared to have similar core elements. Effective programs addressed developmental needs, health promotion/problem prevention, and high-risk groups. This program involves adventures as a self-esteem enhancer. The overall goal of adventure-based activities and programming appears to be the enhancement of participants' self-esteem or self-concept. Accordingly, adventure programming activities and experiences include excitement, risk taking, cooperation and competition, trust, communication, physical, mental, and emotional challenges, physical activity, problem-solving and creativity, group and individual skill development, and fun. With all these prevention programs, children and youth initiative is obviously an important factor for at-risk recovery.

2.2 THEORETICAL FRAMEWORK

Theories and Reasons Behind Drug Abuse Drugs can act as hallucinogen (Msambichaka, et.. al., 1994). Youths want to become 'high', or be in a state of euphoria and feel "cool". The users attribute the use of drugs to forgetting their social-economic problems, and other social distress. This justification may be dangerous due to the fact that with the current economic and social problems, more youths may abuse drugs which may lead to creating a 'drug culture', and the problems associated with drugs. Drugs are said to increase performance and endurance as in cases of athletes. Several athletes have been caught and found guilty of using drugs to facilitate their performance. One such incidence was that of Diego Maradona, a soccer player from Argentina who used drug in soccer, and was banned from the 1994 world soccer cup games.

Gilmer (1973) provides three theories of drug abuse as: chane;ine; social systems, interactional behaviours, and personality variations.

1. Changing social systems theory: At social level, drug abuse is a response to pressures generated by social change. For example, one sociological theory holds that drug addiction among lower-class youth is a result of failure to get ahead in current social climate, 'withdrawal from the system through drugs', or turning to drugs to show opposition to the lifestyles of the 'established' generation.

2. Interactional theory: The theory holds that opportunities for a person to use drugs are generated by his/her association with users. Thus a person finds support and varying reinforcers from his peers, and becomes a member in the group. Interactional theories include conforming to peer group expectations where drug usage is part of the expected behaviour, along With certain tasks in music, clothes, and leisure activities.

3. Theory of personality: The theories focus on psychological need, for example:, escape behaviour. Gilmer (1973) argues that one popular view of marlJ~ is that it is a relatively safe way to escape from reality. A related view holds that people with severe insecurity have underlying emotional problems and neurotic conflicts that predispose them to turn into drugs.

2.3 EMPIRICAL REVIEW

Njers and Ngesu (2014), conducted a study on causes and effects of drug abuse among secondary school students in Dagoretti Division, Niaribi west District- Kenya. In their study they noticed that there are major factors which are compelling students to drug abuse like for seeking happiness accounted for 24% in this study, other reasons are peer pressure and curiosity in school children also contributed and was represented by 18% and 16% respectively. They further added that peer culture is also facilitating the behavior of drug use. Their finding implies that students who are expose to drugs by their friends, so they become more curios to an extent of taking such drugs. Finally they become addicted to consuming drugs.

Kasundu et al (2012), investigates Factors contributing to Drug abuse among the youth in Kenya: A case Study of Bamburi Location.Their study resulted that, the cause of drug abuse in Bamburi is the availability of drugs. They added further about the causes of drug abuse in Bamburi, such as friends’ influence, for releasing strain, easily accessible and parental influence. They also mentioned other factors which help increasing the cause of drug abuse. These factors are increase unemployment rate, high poverty ratio and reasonable cost of drugs.

Halady(2002) as cited by Fareo (2012), who gave the difference causes of drug abuse in youth in Nigeria. He argues that, the youth take drug for the first time as experiment curiosity. Happiness and pleasure then motivate him to continue. Another cause discussed by the author was absence of parental control. Normally parents have little time to monitor their sons and daughters, so their children most of their time with peers. Due to such peer they start and increase the drug use, as a result they become drug abuser. The author further added that, the increasing poverty and family burden has driven parents to send their children for earning to generate income. So during working their children are expose to drug taking.

Namayanja (2011), conducted a study on Challenges of Drug Abuse among the youth. The author mentioned different causes of drug abuse among the youth in Kwempe Division. In his study many participants reported that we desire to taste, some participants were introduced to drugs by their friends and cousins. The author further added that depression is a major cause of drug abuse mostly participants reported that they were feeling stressed, worry, unrest and and affected by domestic problems. The author further mentioned that biological factors are also one of the causes of drug abuse and further added that mostly participants related different stories to their drug use. Some of the participants told that it helps in sleeping. Other revealed that it gives them courage to do things. In addition with biological factors, availability of drugs is also a cause of drug abuse. The author mentioned that many participants indicated that we buy them from pour local shops and it is easily in our reach and at affordable price.

Chesang (2013), conducted a study on Drug Abuse among The Youth in Kenya. The author stated that there are different causes of drug abuse among youth. Many adults are dragged to drugs by their friends and some learn this from those who are already involved in this practice. The author further added that frustration and emotional stress due to the fear of success can also lead to drug abuse. Usually this stress starts from schooling age. According to the author different observer believe that parents are responsible for putting extra pressure on the children for getting high grads duo to which they fell more pressure and stress, so they children start taking drugs.

Amosum et al (2010), conducted a study on some causative of substance abuse among selected secondary school students in Ibadan, Nigeria. Their study resulted that all adults are different from each other in their make-up and in the way they face some situation or some dangerous event occurring in their surroundings. Every individual has the ability to face stress, tension, pain and unfavorable condition so these determine that whether the individual will become drug abuser or not, the author argued that drug abuser are weak and not able to face such stress and tension so for feel better they take drugs to escape from such situation.

According to World Health Organization report (2013), there are different reasons for drug abuse. Like for physical needs which plays an important role in initiation of the non-medical uses of drugs for pain reliever, sedatives, curiosity and enjoyment. The report further added about the reasons of drug use in Manalia city, where curiosity and result of enjoyment motivate youth to drug use. Other factor which plays an important role for drug use like for relieving cold, stress and hunger.

According to National Institute on Drug Abuse (2014), there are different reasons for which people taking drugs like for feeling good. Mostly people take drugs for pleasure and have different feeling. For example cocaine, when someone uses it they feel powerful, self-confident and energetic. The next reason mentioned by NIDA is to feel better because mostly people are feeling stressed and socially anxious. Other reason mentioned by NIDA is to do better. People take drugs for their best performance. Initially it may be good but regular use of drugs can be harmful. The NIDA further added that curiosity is also a major cause of drug abuse. Mostly of the adults are vulnerable because of their friend’s influence.

Jiloha (2009), conducted a study on Social and cultural aspects of drug abuse in adolescents. The author stated that parental influence is one of the causes of drug abuse. He stated that a child of smoker is likely to become a smoker. When a child is growing in such a family where most of the members are smokers, so the chances of smoking among the adults are high. The author added that, in India most of the adults smoke because their favorite actors and models are smokers and they copy them. The author added that the availability of is a significant factor. Drugs are easily available and adults can easily access to drugs and sometimes it is provided by their friends.

Arshad et al (2015), conducted a study on Alcoholism among Youth: A case Study in Kual Lampure. The authors stated that there are various reasons that lead to alcoholism in Kual Lampure. They concluded that, availability of alcohol is the leading factor by which youth are involved in alcoholism. According to the authors most of the respondents feels that they are drinking alcohol because it is available in their country. The authors further added that, there are some interpersonal problems like family problems, stress and peer influence which lead to alcoholism.

In the following passage the impact of drug abuse is discussed. These impacts are extracts from referred literature.

Njeru and Ngesu (2010), conducted a study on causes and effects of drug abuse among secondary school students in Dagoretti Division, Niaribi west District- Kenya. They found that drug abuse cause poor performance among the youth and mostly respondents believe that it develops aggressive behavior. The authors further added that in most cases drug abuse can lead to withdrawal and even violent behavior. Students who are drug abusers are unable to concentrate on their studies.

Matao (2013),conducted a study on Cause, Effect and Remidial measure of Drug Abuse Among the Children of Tanzania. The author stated that the impact of drugs on youth is more severe than elders, specifically when their weight is less than 50 kilogram. Their growth can be retarted by taking alcohol and tobacco, and other drugs. They forget about their classes, doing homework. It also effects the harmonic change in the body which create a negative impact on their growth specially height and weight. The author further added that drugs can have a negative impact on the menstrual period in young girls and low sperm count in young boys. Most of the time drug abusers are involved in rapes, crimes, robberies etc.

Kasundoet al (2012), investigate Factors contributing to Drug abuse among the youth in Kenya: A case Study of Bamburi Location. They argued that the effect of drugs may change from person to community. In their study many respondents agreed on loss of appetite, poor health and sometimes death. Mostly people believed that crime rate is also high among the drug users. Their study concluded that there is high dropout rate among those students who are drug abusers. Most of the young drug abusers are involved in petty jobs from which they can afford to buy drugs which are easily available to everyone. The authors further added that the impacts of drug abuse on homosexuality and rape cases have been increased. Prostitution among the young girls has also increased in order to earn money and buy drugs for themselves. Pregnancy at early age is also increased among school going adults.

Sahu and Sahu (2012), conducted a study on Substance Abuse and Consequences. The authors stated that young people are taking drugs, often experience a variety of problems like academic difficulties, Health problems, poor relationship and involvement in crimes. The author further added that certain drugs can affect human central nervous system, which can lead to different health and behavioral problems. Road accidents, body fracture and over dose of prescribed drugs are possibly negative result of drug abuse. AIDS a fetal disease, where most of its affectees are drug abusers and is caused by unsterile syringes. The author added more about the impacts of drug abuse and stated that sometimes drug abuse creates more problems for the parents and mostly young abusers sold utensil of domestic use in order to buy drugs.

Namyanja (2011), conducted a study on Challenges of Drug Abuse among the youth. The author stated that there is high rate of suicide among those adults who are alcoholics and other drug abusers. The author gave the reason and stated that the use of drug cause changes in human brain chemistry. The author mentioned another impact of drug abuse and argued that excess of drugs use increase the chance of suicides.

Chesang (2013), conducted a study on Drug Abuse among The Youth in Kenya. The author stated different effects of drugs specially alcohol which is available in drinks like beer, wine, brandy and whisky. It lowers the brain activity and excessive use of alcohol can kill tissues including muscles and brain cells. It can also bring changes in the behavior of the user. The author added about the impact of tobacco and stated that it is the drug which leads to the start of other fetal drugs. It causes certain disease like lung disease, heat attack and cancer. The excess use of cannabis can become the center part of their lives. The author added about another drug Cocaine, which is normally injected and snored. The impact of Cocaine is sleeplessness, increase in sexual desire etc. It has also a negative impact on human health and creates stomach problem, liver and lung damage.

According to National Institute on Drug Abuse (2014), there are different impacts of specific drugs which are abused like nicotine, which can be found in cigarette. It increases risk of cancer and cardiovascular disease. Alcohol use can damage brain and different body organ but usually brain is vulnerable to be affected.Marijuana is another form of drug that affects human body very severely. Among there impacts high rate of heart beat and damage to lungs are common.

The following passage Remedy of Drug Abuse is discussed. These remedies are the extract from referred literature.

Jiloha (2009), conducted a study on Social and cultural aspects of drug abuse in adolescents. The author stated that curing youth from drug abuse needs a special focus. Knowing adult situation will explain that how much he is affected and how drugs became his integral part. The author added that in treatment process family and community support in crucial. Assistance programs, counseling on drug abuse and recovering resources must be offer in schools. Health insurance should be encouraged in order to obtain coverage from drug abuse and mental health service. Environmental change should be promoted and reduce the number of sign board which is advertising alcoholic beverages. The elder should be a role model for their adults.

Arshad et al (2015), conducted a study on Alcoholism among Youth: A case Study in Kual Lampure. In their study the author mentioned that there is a need of change in government policies regarding the drug use. Government should impose high tax on alcohol. Then it will automatically influence the drinkers. The seller should have license and without license there must a heavy fine. There should be awareness program on the effects of alcohol from the ministry of health. The authors further added that there must be different campaign where people and media transmit the negative consequences of alcoholism.

According to World Health Organization report (2013), drug abuse can be restricted by giving special attention to youth, reducing the availability of drugs, providing education on drug abuse, awareness among parents and motivating adults on the negative consequences of drugs through awareness campaign.

Amosum et al (2010), conducted a study on some causative of substance abuse among selected secondary school students in Ibadan, Nigeria. They mentioned that Kenya government has started National Campaign against Drug Abuse in early 2001. They are responsible for coordinating activities regarding drug abuse. They have started different campaign against drug abuse along with different organizations. Its initial mandate is to spread public education and develop an action plan to control drug abuse. The authors further added that parents should support their children. Parents should teach their children about the danger of drugs. The authors further added that there should be easy curriculum for children where the must not feel stressful. There should be specific rules regarding drug abuse. There is a need of initiating rehabilitation programs for drug addicted persons. There should be consistency in all the government programs regarding the drug abuse.

Namayanja (2011), conducted a study on Challenges of Drug Abuse among the youth. In his study most of the participants reported that they were using drug in bushes and hilly areas where they were hidden from people. The author mentioned that adults should be given appropriate information about the effects of drug abuse. There is a need of proper monitoring in rural areas because in rural areas drugs are easily available. Adults should be encourage to take active participation in all seminars regarding the supply of drugs.`

Fareo (2012), who gave the difference causes of drug abuse in youth in Nigeria. In his study he suggests that there is a need of family education. Parents must give their children awareness about drugs. Children must be given valves and parents must have a family relationship with their children. Parents must inform their children about the negative consequences of drugs. The author further added that there should be counseling centers for drug control and such center must be in every community. The author further added about the remedy of drug abuse in youth, there must be such curricula where education on drug abuse should be given priority at all level of education. There should be campaign against drug abuse in order to reduce the uses of harmful drugs.

Kasundu et al (2012), investigates Factors contributing to Drug abuse among the youth in Kenya: A case Study of Bamburi Location. The author suggest that schools from primary to secondary, high and universities level, all should conduct sessions and seminars on the negative consequences of drug abuse. Students must be given full information on drugs and it should be provided in their curriculum. There should be youth group in each community which will initiate different activities should be start in each community. The government institution must be free of corruption and police should be influenced to handle drugs dealers and small distributors. Policy regarding drugs must be stick and must be implemented.

Matao (2013), conducted a study on Cause, Effect and Remedial measure of Drug Abuse Among the Children of Tanzania: A case study of Hananasifu Ward in Kinondoni District in Dar es Salaam Region. The author gave different suggestion through which we can quite drug abuse among the youth. He argue that children should be taught by their parents that how to selects yours best friends. Adults should know about the dangerous consequences of drugs physically and mentally. Adults must be kept busy in their study and not letting them to their surrounding freely. The author further added that parent should quite their quarrels, separation and divorce because it can play an important role in initiation of drugs in their childhood. Parent should give full time to their children. The author further added that there should be comprehensive knowledge on drug abuse in schools. Children should teach how to keep themselves busy in sports and other healthy activities. The laws on drug abuse strike and must be implemented properly. The author further added that most of the time people in the community know the sellers so they should identify them and take them to court and help the victims by taking him to the hospital.

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