Stakeholder’s Views on Substance Abuse and the Development of Effective and  Sustainable Interventions in Nigeria:      Fi...
ABSTRACTBackground: In Nigeria, substance abuse has gradually become a cause for concern due to thealarming increase in th...
TABLE OF CONTENTSABSTRACT                                                                          2ACKNOWLEDGEMENT       ...
ACKNOWLEDGEMENTSOur special thanks go to the Chairman of the Board of Trustees of Freedom Foundation, Dr. TonyRapu and the...
ACRONYMNSNAFDAC    National Agency for Food and Drug Administration and ControlNDLEA     National Drug Law Enforcement Age...
1. BACKGROUND INFORMATION   1.1.    IntroductionSubstance abuse, a public health and social problem has gradually become a...
substance abuse in Nigeria. This has been attributed to inadequate funding and low governmentinterest; uneven distribution...
2. Determining stakeholders’ views and opinions on the strategies for developing effective       and sustainable substance...
2. RESULTS AND FINDINGSOut of the 74 stakeholders who attended the Consultative Forum, an approximate number of 29persons ...
All study     Stakeholders that have     Stake holders that have                                          participants    ...
The second point of view centred on the belief that substance abuse was not a new problem inthe country and that the incid...
2.1.4. Views on populations vulnerable to substance abuse:                                                                ...
There was a strong consensus that substance abuse had so many health implications. The mostcommon health implication menti...
i.   Education and awareness promotion ii.   Addressing risk factors and increasing protective factors for substance abuse...
must work harder. If drug users need to be jailed, then let that be done to ensure security of livesand property”.Supply R...
2.2.2. Views on strategies for developing effective and sustainable substance abuse           interventionsStakeholders re...
A smaller group of stakeholders however had a different opinion about research and policydevelopment. A psychiatrist argue...
3. DISCUSSION AND CONCLUSIONThis study was aimed at providing information that as much as possible reflects stakeholders’v...
Therefore, having earlier noted the importance of understanding the views of stakeholders andalso getting them involved in...
REFERENCES1) United Nations Office on Drugs and Crime. World Drug Report. New York : United   Nations Publications, 2011.2...
10) Oshodi, OY; Aina, OF and Onajole, AT. Substance use among secondary school students   in an urban setting in Nigeria: ...
FREEDOM FOUNDATION                   24 HENRY ADEFOWOPE CRESCENT,                         AWUSE ESTATE, OPEBI,            ...
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In Nigeria, substance abuse has gradually become a cause for concern due to the alarming increase in the consumption of psychoactive substances over the years. This has therefore warranted the need to find an effective and sustainable solution to the problem before its gets out of hand. A stakeholders’ consultative forum on substance abuse which attracted important stakeholders in the field was convened in March 2011 and issues bordering on substance abuse in Nigeria and the development of effective and sustainable intervention were discussed and decisions on the way forward taken. Taking into consideration that stakeholders play important roles at the various stages of planning, implementation and evaluation of substance abuse interventions, it is important to understand their views on issues relevant to the development of these interventions. The researchers therefore conducted this study with the aim of providing information on stakeholders’ views about substance abuse in Nigeria, as well as their opinions on the strategies for developing effective and sustainable substance abuse interventions in the country; in view that it would serve as a framework for making decisions on issues related to the development of substance abuse control interventions in Nigeria and also for conducting further studies on issues highlighted in the study.

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Stakeholders' views full report

  1. 1. Stakeholder’s Views on Substance Abuse and the Development of Effective and Sustainable Interventions in Nigeria: Findings from a Consultative Forum Dr Rose Azuike* Research, Monitoring and Evaluation Unit, Freedom Foundation Dr Alexander Oni Substance Abuse Rehabilitation and Resource Centre, Freedom Foundation Dr Osasuyi Dirisu Substance Abuse Rehabilitation and Resource Centre, Freedom Foundation January, 2012 *Correspondence to: r.azuike@freedomfoundationng.org
  2. 2. ABSTRACTBackground: In Nigeria, substance abuse has gradually become a cause for concern due to thealarming increase in the consumption of psychoactive substances over the years. This hastherefore warranted the need to find an effective and sustainable solution to the problem beforeits gets out of hand. A stakeholders’ consultative forum on substance abuse which attractedimportant stakeholders in the field was convened in March 2011 and issues bordering onsubstance abuse in Nigeria and the development of effective and sustainable intervention werediscussed and decisions on the way forward taken. Taking into consideration that stakeholdersplay important roles at the various stages of planning, implementation and evaluation ofsubstance abuse interventions, it is important to understand their views on issues relevant to thedevelopment of these interventions. The researchers therefore conducted this study with the aimof providing information on stakeholders’ views about substance abuse in Nigeria, as well astheir opinions on the strategies for developing effective and sustainable substance abuseinterventions in the country; in view that it would serve as a framework for making decisions onissues related to the development of substance abuse control interventions in Nigeria and also forconducting further studies on issues highlighted in the study.Method: A mixed methods study involving analyses of information from open discussions heldat the Stakeholder’s Consultative Forum on Substance Abuse and a complementary survey of 74Forum attendees was conducted. Data analysis involved thematic analysis of the data from theopen group discussions and open-ended questions in the survey questionnaire; a statisticalanalysis of data from the closed questions in the survey questionnaire and an integrativeconsideration of the qualitative and quantitative findings.Results: Substance abuse was generally viewed as a chronic problem which had eaten deep intothe Nigerian society. Stakeholders’ views however varied on issues such as how they perceivedthe act of substance abuse, the magnitude of the problem, factors that influence substance abuse,the vulnerable populations as well as on the implications of the problem. Stakeholders who hadworked directly with persons with substance abuse disorders generally had more liberal viewsabout substance abuse than those who had not worked with these persons. Furthermore, threemajor strategies for developing effective and sustainable substance abuse interventions inNigeria were identified from stakeholders’ responses. These focused on encouragingcollaboration amongst stakeholders; advocacy and community sensitization; and research, policydevelopment and implementation.Conclusion: Stakeholders’ responses have not been considered in this report as being eithercorrect or incorrect but are rather seen as viewpoints that as much as possible reflectsstakeholders’ views on substance abuse and on the development of effective and sustainableinterventions in Nigeria. Although stakeholders had varying positions on the issues consideredin the study, a general appraisal of stakeholder responses indicate that despite the gloomy state ofsubstance abuse in Nigeria, the potential to develop and implement effective and sustainablesubstance abuse interventions in the country exists. It is therefore expected that the results ofthis study would provide a framework for making decisions on issues related to the developmentof substance abuse interventions in Nigeria and for conducting further studies on issueshighlighted. 2
  3. 3. TABLE OF CONTENTSABSTRACT 2ACKNOWLEDGEMENT 4ACRONYMS 5 1. BACKGROUND INFORMATION 6 1.1.Introduction 6 1.2.Study aim and objectives 7 1.3.Methods 8 2. RESULTS AND FINDINGS 9 2.1.Stakeholders’ views on substance abuse in Nigeria 9 2.1.1. Views on the act of substance abuse 9 2.1.2. Views on the magnitude of substance abuse 10 2.1.3. Views on the factors that influence substance abuse 11 2.1.4. Views on populations vulnerable to substance abuse 12 2.1.5. Views on the implications of substance abuse 12 2.2.Stakeholders’ views on the development of effective and sustainable substance abuse interventions 13 2.2.1. Views on effective approaches to substance abuse 13 2.2.2. Views on strategies for developing effective and sustainable substance abuse interventions 16 3. DISCUSSION AND CONCLUSION 18REFERENCES 20 3
  4. 4. ACKNOWLEDGEMENTSOur special thanks go to the Chairman of the Board of Trustees of Freedom Foundation, Dr. TonyRapu and the Executive Director of Freedom Foundation, Mrs. Tenidola Awoyemi for providing theplatform for organizing the Stakeholders Consultative Forum on Substance Abuse held in March,2011 in Lagos, Nigeria. Our sincere gratitude goes to the individuals and organizations thatsupported the Consultative Forum both financially and morally. We would also like to thank allstakeholders who participated in the Consultative Forum and also took their valuable time tocomplete the survey questionnaire. 4
  5. 5. ACRONYMNSNAFDAC National Agency for Food and Drug Administration and ControlNDLEA National Drug Law Enforcement AgencyNGO Non-Governmental organizationUNODC United Nations Office on Drugs and CrimeUNODCCP United Nations Office for Drug Control and Crime Prevention 5
  6. 6. 1. BACKGROUND INFORMATION 1.1. IntroductionSubstance abuse, a public health and social problem has gradually become a cause for concern inAfrica and indeed in Nigeria. In Nigeria, the consumption of illegal drugs and the harmful use ofother psychoactive substances such as alcohol, pharmaceutical drugs, inhalants and solvents haveincreased at an alarming rate over the years. Available report indicates that Nigeria is currentlythe highest consumer of cannabis and amphetamine in Africa (1). An analysis of the World Drugreports over a ten-year period (2001 – 2011) showed that the estimated annual prevalence ofcannabis consumption among persons aged 15 to 65 years increased from about 8.7% to 14.3%;while that of amphetamine consumption increased from 1.2% to 1.4% (2; 1). The same trendwas also reported for cocaine and opiates with annual prevalence of consumption rising from1.0% and 0.3% respectively to 0.7% for both substances (2; 1).Although the National Drug Law Enforcement Agency (NDLEA) is charged with theresponsibility of controlling drug trafficking and abuse in Nigeria (3), and the National Agencyfor Food and Drug Administration and Control (NAFDAC) has the responsibility of regulatingand controlling the production, distribution, importation, exportation and consumption of legalpsychoactive substances and chemicals (4), a common feature of the existing substance abusestrategy is the emphasis placed on reducing the supply of illegal drugs through the imposition ofstiff penalties for illegal drug trafficking (5), as well as controlling the production, distribution,importation and exportation of legal psychoactive substances and chemicals (4). Minimal effortshowever have been made by these government agencies to control the consumption of thesepsychoactive substances and/or also reduce the harm associated with their use.While the government has made some effort to prevent or control the consumption ofpsychoactive substances by conducting ad hoc media campaigns, developing policies andestablishing a few public substance abuse treatment centres (6; 7; 8); local and international non-governmental organizations (NGOs) have been largely responsible for controlling theconsumption of psychoactive substances in Nigeria through the establishment of treatmentcentres and homes and the development and implementation of interventions focused onpreventing substance abuse, as well as reducing the harm associated with their use (7; 8). Theseinterventions however have been apparently ineffective as evidenced by the rising trends in 6
  7. 7. substance abuse in Nigeria. This has been attributed to inadequate funding and low governmentinterest; uneven distribution of interventions, poor coordination and networking amongstakeholders, limited information, limited number of treatment centres and unsupportive socialenvironment (7; 8).The emerging trend in substance abuse and the apparent lack of interventions/ ineffectiveness ofexisting interventions in Nigeria has warranted the need to find an effective and sustainablesolution to the problem before its gets out of hand. However, for substance abuse interventions tobe effective and sustainable, contributions from key stakeholders are required at the variousstages of planning, implementation and evaluation (9). It is therefore in this light that a non-governmental organization (NGO), Freedom Foundation, organized a stakeholders’ consultativeforum, tagged “Developing Effective and Sustainable Substance Abuse Intervention”. TheForum which was held in March, 2011 in Lagos, Nigeria, was aimed at bringing together the keyplayers in the control of substance abuse in the country to deliberate and take decisions on theway forward in the fight against substance abuse in the country. The Forum attracted a total of 74stakeholders comprising NGO executives and project/program management staff, governmentofficials, academicians/researchers, health professionals, social workers as well as independentconsultants. 1.2. Aim and objectivesTaking into consideration that stakeholders play important roles at the various stages of planning,implementation and evaluation of substance abuse interventions, it is important to understandtheir views on issues relevant to the development of these interventions. It is on that premise thatthe researchers conducted this study whose main aim is to provide information on stakeholders’views about substance abuse in Nigeria, as well as their opinions on the strategies for developingeffective and sustainable substance abuse interventions in the country; in view that it would serveas a framework for making decisions on issues related to the development of substance abusecontrol interventions in Nigeria and also for conducting further studies on issues highlighted inthe study.This study specifically focused on; 1. Obtaining a general understanding of stakeholders’ views on substance abuse in Nigeria. 7
  8. 8. 2. Determining stakeholders’ views and opinions on the strategies for developing effective and sustainable substance abuse interventions in the country. 1.3. MethodsThis was a mixed methods study comprising analyses of information from open discussions heldat the Stakeholder’s Consultative Forum on Substance Abuse and a complementary survey of asample of stakeholders who attended the Consultative Forum. The open discussions lasted forapproximately three hours and covered issues such as the magnitude of substance abuse inNigeria, its implications, vulnerable populations, factors associated with substance abuse,emerging issues and strategies for developing effective and sustainable substance abuseinterventions. The complementary survey was done using semi-structured questionnaires and itsaim was to collect demographic information of participants, obtain input on key issues from alarger number of the Consultative Forum participants and also confirm findings from the opendiscussions.Data analysis involved thematic analysis of the data from the open group discussions and open-ended questions in the survey questionnaire, a statistical analysis of data from the closedquestions in the survey questionnaire and an integrative consideration of the qualitative andquantitative findings. 8
  9. 9. 2. RESULTS AND FINDINGSOut of the 74 stakeholders who attended the Consultative Forum, an approximate number of 29persons made contributions during the open discussions sessions while 62 stakeholderscompleted the survey questionnaire resulting in a survey response rate of 84%. 56% of thesurvey respondents were females and 44% males. 45% were single, 52% were married and 3%were widowed. Close to half (46%) of the respondents were from the non-profit sector, 32%were from the public sector and 22 % were from the private sector. Over one-third of the surveyrespondents (n=23; 37%) had worked directly with drug- and alcohol-dependent persons. 2.1. Stakeholders’ Views on Substance Abuse in Nigeria 2.1.1. Views on the act of substance abuse:Of the 62 stakeholders surveyed, 35 (56%) were of the view that substance abuse was a self-inflicted problem, 16 (26%) believed that it was caused by external factors; while 11(17%)believed that substance abuse could either be self-inflicted or caused by external factors. 37(60%) viewed substance abuse as a voluntary act, 5 (8%) viewed it as an involuntary act; while20 (32%) believed that substance abuse could either be voluntary or involuntary. Somedifferences were observed in the pattern of responses between stakeholders that had workeddirectly with drug/alcohol-dependent persons and those that had not. A greater proportion ofstakeholders who had worked directly with drug/alcohol-dependent persons had more liberalperception of the act of substance abuse than those who had not worked with them. For instance,56% of stakeholders who had not worked with drug/alcohol-dependent persons’ perceivedsubstance abuse as being a self-inflicted problem; while only 26% of stakeholders that hadworked with them perceived substance abuse as being a self-inflicted problem. See table 1 fordetails 9
  10. 10. All study Stakeholders that have Stake holders that have participants worked directly with never worked directly with (n=62) drug/alcohol dependent drug/ alcohol dependent persons (n=23) persons (n=39) [No (%)] [No (%)] [No (%)]Stakeholders that think that substance 35 (56) 6 (26) 22 (56)abuse is a self-inflicted problemStakeholders that think that substance 16 (26) 5 (22) 11 (28)abuse is caused by external factorsStakeholders that think that substanceabuse could either be self-inflicted or 11 (18) 12 (52) 6 (15)caused by external factorsStakeholders that think that substance 37 (60) 12 (52) 29 (74)abuse is a voluntary actStakeholders that think that substance 5 (8) 2 (9) 3 (8)abuse is an involuntary actStakeholders that think substanceabuse could either be voluntary or 20 (32) 9 (39) 7 (18)involuntaryTable 1: Stakeholders’ views on the act of substance abuse 2.1.2. Views on the magnitude of substance abuse:During the open discussions, there was a general consensus that substance abuse is a chronicproblem that has eaten deep into the Nigerian society. Two major views were however identifiedfrom the survey response.The first and most common view on the extent of substance abuse was that the incidence andprevalence rates were unacceptably high and were still on the increase. It was also believed thatthe perpetrators were becoming less hidden. According to one of the survey respondents, Substance abuse in Nigeria is in a deplorable state as this issue is rampant in schools, from secondary to tertiary level. It is now the order of the day at bus terminals, market places, prisons and even on the streets of Mushin, Lagos Island, Okokomaiko, Ajegunle, etc.A school administrator further noted that “unlike back in the days when students secretly abuseddrugs like indian hemp, it is no longer done secretly and some of these students even boast of it”. 10
  11. 11. The second point of view centred on the belief that substance abuse was not a new problem inthe country and that the incidence and prevalence rates had been grossly understated andunderestimated due to the lack of adequate awareness and information on the problem. 2.1.3. Views on the factors that influence substance abuse:On the factors that influence substance abuse, it was unanimously agreed during the opendiscussion session that peer pressure was a major factor. Other factors highlighted by asignificant number of stakeholders were poverty and unemployment. Very few stakeholdersmentioned availability of drugs and ineffective policies.Stakeholders’ views about the level of influence of socio-demographic factors on substanceabuse were assessed. The factors assessed include age, sex, marital status, peer pressure, poverty,unemployment and level of education. Results of the survey indicate that over 80% of studyparticipants perceived peer pressure as having a high influence on substance abuse. Theproportion of stakeholders who perceived the other socio-demographic factors assessed ashaving a high influence on substance abuse are as follows; poverty (69%), unemployment (56%),level of education (27%), age (24%), sex (23%) and marital status (11%). Generally, all of thesocio-demographic factors assessed were perceived as having some level of influence onsubstance abuse. However some stakeholders perceived the following socio-demographic factorsas having no influence on substance abuse; age (6%), sex (10%), marital status (22%) and levelof education (3%).Factors Level of influence on substance abuse High Medium Low None No (%) No (%) No (%) No (%)Age 15 (24) 39 (63) 4 (6) 4 (6)Sex 14 (23) 33 (53) 9 (15) 6 (10)Marital Status 7 (11) 15 (24) 44 (71) 22 (35)Peer Pressure 54 (87) 5 (8) 3 (5) 0 (0)Poverty 43 (69) 15 (24) 4 (65) 0 (0)Unemployment 35 (56) 15 (24) 12 (19) 0 (0)Level of Education 17 (27) 34 (55) 9 (15) 3 (5)Table 2: Stakeholders’ perception of the influence of the socio-demographic factors below on substance abuse 11
  12. 12. 2.1.4. Views on populations vulnerable to substance abuse: Stakeholders had differing perceptions Figure 1: Stakeholders perception about the age group vulnerable to substance abuse about the populations vulnerable to 60 substance abuse in Nigeria. While majority Proportion of stakeholders 50 were of the opinion that the vulnerable 40 population were the youth, a few persons 30 felt that everyone was vulnerable to 20 substance abuse irrespective of their age. 10 The latter group argued that substance 0 abuse was common in different population Children Adolescents Young Adults Older adults (0-10) (11-17) (18-25) (26 & above) groups and could be initiated at any age depending on the combination of substanceabuse etiologic factors inherent in an individual or those to which an individual had beenexposed to. One of the stakeholders’ gave this example: Adolescents and young adults due to peer pressure abuse hard drugs such as cannabis; older adults due to stress and other health issues abuse drugs such as analgesics and steroids while the abuse of alcohol and cigarettes are common in every age group for various reasons.The survey findings on the other hand, showed that 42% of survey participants were of theopinion that the vulnerable population were youth in the 11-17 age group and 52 % of the surveyparticipants indicated youth in the 18-25 age group. The remaining 8% indicated other agegroups. 2.1.5. Views on the implications of substance abuse:Stakeholders’ views with respect to the implications of substance abuse in Nigeria fell into threethemes namely health, social and economic implications. Stakeholders focused more on thehealth and social implications. Only two stakeholders highlighted the economic implications ofsubstance abuse. 12
  13. 13. There was a strong consensus that substance abuse had so many health implications. The mostcommon health implication mentioned by stakeholders was HIV/AIDS. Other healthimplications highlighted were Hepatitis B and C and mental health issues such as depression,psychosis and schizophrenia.The social implications of substance abuse highlighted by stakeholders focused on security oflives and property. Stakeholders believed that substance abuse was associated with increasedlevel of insecurity in the country and some highlighted criminal activities such as armed robberyand rape.The economic implications of substance abuse were seen from the perspective of financial lossesto individuals, organizations and the country as a whole. Some of the instances of financiallosses given include; financial costs incurred by individuals in the treatment of substance abuseand its associated problems; loss of valuable manpower by organizations and financial losses tothe country through money laundering. 2.2. Stakeholders’ Views on the Development of Effective and Sustainable Substance Abuse Interventions 2.2.1. Views on effective approaches to substance abuseDuring the open discussions, the responses obtained on the effective approaches to substanceabuse fell into two major categories namely; demand reduction and supply reduction.Stakeholders’ views however were focused more on demand reduction. However, the surveyrevealed that while only 4% of stakeholders indicated that demand reduction was a moreeffective approach and 1% indicated supply reduction, over 90% were of the view thatcombining demand and supply reduction strategies was a more effective way of tacklingsubstance abuse.Demand ReductionUnder demand reduction, responses were focused on substance abuse prevention and thetreatment substance abuse disorders.Two major views on prevention of substance abuse were identified. They include; 13
  14. 14. i. Education and awareness promotion ii. Addressing risk factors and increasing protective factors for substance abuseOn the issue of education and awareness promotion, there was a general consensus that bothstrategies were effective in preventing substance abuse. A common view was that there was needfor mass awareness promotion and that substance abuse education needed to be directed towardsyouths. It was also noted that NGOs had a massive role to play in this instance.A few stakeholders however were of the view that addressing risk factors such as poverty andunemployment and/or increasing protective factors would be an effective way of preventingsubstance abuse. According to a youth program manager, One of the best approaches to substance abuse prevention is to tackle pressure areas and also establish youth friendly centres where young people could express themselves and receive appropriate counselling.According to another stakeholder, “the availability of jobs for all will go a long way in helpingreduce substance abuse among our youths”. Some stakeholders also noted that increasing youthengagement through activities like sports was an effective approach to substance abuseprevention.Another strategy for demand reduction highlighted during the open discussions was treatment ofsubstance abuse disorders. Most proponents of treatment emphasized rehabilitation of personswith substance abuse disorders. Some stakeholders highlighted the need to establish moretreatment centres in Nigeria, as well as make treatment and rehabilitation easily accessible andaffordable. As noted by a psychologist, “about 7-10% of adolescents are in need of treatment butonly a small number; usually those individuals with co-existing substance use and psychiatricdisorders receive treatment”. No stakeholder mentioned the issue of punishing or incarceratingpersons with substance abuse disorders.Analysis of the survey on the other hand indicated that 73% of the stakeholders were of the viewthat rehabilitation was a more effective approach and 27% believed that combining rehabilitationwith punishment was a more effective approach. No stakeholder viewed punishment as aneffective approach on its own. See table 3 for details. One stakeholder however suggestedincarceration in his comments on the survey questionnaire; “NDLEA and other security agents 14
  15. 15. must work harder. If drug users need to be jailed, then let that be done to ensure security of livesand property”.Supply ReductionMost of the stakeholders’ views obtained were focused on developing and enforcing laws andpolicies on drug manufacturing and trafficking. A stakeholder stated that “legislation directed atcontrolling manufacture, distribution, prescription, price, time of sale and consumption ofsubstances needs to be put in place”. In addition to legislation, other supply reduction strategiessuggested include eradication of drug plants, prosecution of illegal drug manufacturers andtraffickers by the NDLEA and the introduction of age restrictions on the purchase of alcohol. All study Stakeholders that have Stake holders that have participants worked directly with never worked directly with (n=62) drug/alcohol dependent drug/ alcohol dependent persons (n=23) persons (n=39) [No (%)] [No (%)] [No (%)]Stakeholders that think that rehabilitation isthe more effective way to treat drug/alcohol 45 (73) 17 (74) 28 (72)dependent persons.Stakeholders that think that punishment/incarceration is the more effective way to 0 (0) 0 () 0 (0)treat drug/alcohol dependent persons.Stakeholders that think that combiningrehabilitation and punishment is a more 17(27) 6(26) 11(28)effective way to treat drug/alcohol dependentpersons.Stakeholders that think that demand reductionis the more effective way to control substance 4 (6) 0 (0) 4 (10)abuse.Stakeholders that think that supply reductionis the more effective way to control substance 1(100) 0 (0) 1 (100)abuse.Stakeholders that think combining demandand supply reduction is a more effective way 57 (92) 10 (43) 12 (31)to control substance abuse.Table 3: Stakeholders’ views on effective approaches to substance abuse 15
  16. 16. 2.2.2. Views on strategies for developing effective and sustainable substance abuse interventionsStakeholders responses focused on three major themes: collaboration amongst stakeholders;advocacy and community sensitization; and research, policy development and implementation.The most common theme identified from stakeholders’ responses was a strong consensus on theneed for collaboration amongst relevant stakeholders and organization. A university lecturerstated that there was a need to form a coalition of relevant stakeholders. She further argued that acoalition will result in a “common and stronger voice” and that the government and donoragencies would be more inclined to listen to their advocacy messages.Majority of stakeholders emphasized the need for advocacy and community sensitization throughthe media, in the schools as well as grass roots campaign. Proponents of this view argued thatsince substance abuse had not been given adequate attention and that the key decision makers inthe problem were yet to recognize it as a public health problem, advocacy and communitysensitization was an appropriate way of drawing attention to the problem and consequentlydeveloping effective and sustainable substance abuse interventions.While majority of stakeholders highlighted the need for policy development and implementation,a fraction of them noted that research findings needed to be integrated into policy developmentand implementation. As stated by a stakeholder who is a Public Health Researcher, We need to know the effect substance abuse has had, the persons involved, the extent of involvement and the seriousness of existing laws. Armed with this information, we can then adopt workable policies that can sustainably tackle this menace not partially, but if possible, permanently.A HIV Project Coordinator however noted that a lot of stakeholders in Nigeria relied more ondata from other countries for the development of interventions which were sometimes noteffective because they were not culturally competent. She therefore called for a closer look atstudies conducted in the country.In addition to the call for research studies, a government official highlighted the need to ensurethat findings from research studies were properly disseminated and utilized by the relevantdecision makers. 16
  17. 17. A smaller group of stakeholders however had a different opinion about research and policydevelopment. A psychiatrist argued that research studies were available and a lot more werebeing conducted but that it was necessary to systematically review what was available. A fewother stakeholders further argued that policies were already in place but were not effective forvarious reasons. According to a stakeholder working in a managed care organization, The various policies for addressing this problem and indeed all other problems in Nigeria exist. Why they fail to work is the same reason why all other sectors of this country have failed; square pegs in round holes.This group of stakeholders called for the effective implementation of policies for controllingsubstance abuse. Some policies suggested include, designating specific locations for the sale ofalcohol as well as putting age restrictions on the purchase of alcohol so as to limit the rate ofalcohol consumption in general and cut off supply of the substance to under aged personsrespectively. 17
  18. 18. 3. DISCUSSION AND CONCLUSIONThis study was aimed at providing information that as much as possible reflects stakeholders’views on substance abuse and on the development of effective and sustainable interventions totackle substance abuse in Nigeria. Stakeholders’ responses are therefore not perceived in thisreport as being either correct or incorrect but are considered as viewpoints.The general perception that the magnitude of substance abuse in the country is quite enormoussupports international and local study reports which show that the prevalence of substance abusein Nigeria is high and has rapidly increased over the years (10; 11; 1). Despite the generalconsensus on the magnitude of substance abuse in the country, stakeholders have varying viewson issues such as the act of substance abuse, vulnerable populations, factors associated with theproblem as well as the implications of the problem. During the study, the views of majority ofstakeholders who had worked directly with substance abusers tended to be more liberal, whilethat of stakeholders who had never worked directly with substance abusers were moreconservative. These variations may be due to the fact that the two groups of stakeholders aremore likely to have different understanding of the problem owing to their different training andexperiences with the problem. Furthermore, the culture of the Nigerian people may alsoinfluence the way stakeholders view substance abuse. Unlike in some western countries wheresubstance abuse is seen as a medical condition which the individual has no control of, substanceabuse in developing countries like Nigeria is seen from the moral or cultural perspective whichdefines the problem as a conscious choice made by morally- and/or spiritually-deficit individualswho should be held responsible for their actions (12).Notwithstanding the varying positions on the substance abuse in Nigeria, a general appraisal ofstakeholder responses indicate that despite the gloomy state of the problem, the potential todevelop and implement effective and sustainable substance abuse interventions in the countryexists.While stakeholders unanimously agree that developing effective and sustainable substance abuseintervention is vital in the fight against substance abuse in the country, their responses indicatethat a multifaceted approach involving collaboration amongst all stakeholders may be the moreappropriate way forward. 18
  19. 19. Therefore, having earlier noted the importance of understanding the views of stakeholders andalso getting them involved in the planning, implementation and evaluation of substance abuseinterventions, it is expected that the results of this study would serve a framework for makingdecisions on issues related to the development of substance abuse interventions in Nigeria aswell for conducting further studies on issues highlighted in this study. 19
  20. 20. REFERENCES1) United Nations Office on Drugs and Crime. World Drug Report. New York : United Nations Publications, 2011.2) United Nations Office for Drug Control and Crime Prevention. Global Illicit Drug Trends. New York : United Nations, 2001.3) National Drug Law Enforcement Agency. About NDLEA. [Online] 2009. National Drug Law Enforcement Agency. [Cited: December 20, 2011.] http://www.ndlea.gov.ng/v1/?q=node/1.4) National Agency for Food and Drug Administration and Control. NAFDAC Organization. [Online] 2010. National Agency for Food and Drug Administration and Control. [Cited: December 20, 2011.] http://www.nafdac.gov.ng/index.php?option=com_content&view=article&id=138&Itemi d=54.5) Obot, IS. Ethical and legal issues in the control of drug abuse and drug trafficking: the Nigerian case. Social Science and Medicine, 1992, 35(4): 481-493.6) Obot, IS. Substance abuse, health and social welfare in Afirica: analysis of the Nigerian experience. Social Science and Medicine, 1990, 31(6): 699-704.7) Obot, IS. Responding to substance use problems in Nigeria: the role of civil society organizations. Substance Use and Misuse, 2004, 39(8): 1287-1299.8) Onifade, PO, et al., et al. A descriptive survey of types, spread and characteristics of substance abuse. Substanec Abuse Treatment, Prevention and Policy, 2011, 6: 25.9) Gaynor, JR, et al., et al. Recognizing the role of stakeholders in drug, alcohol and tobacco prevention and reduction programs. Atlanta : Paper presented at the annual meeting of the American Educational Research Association in April 12-16, 1993. 20
  21. 21. 10) Oshodi, OY; Aina, OF and Onajole, AT. Substance use among secondary school students in an urban setting in Nigeria: prevalence and associated factors. African Journal of Psychiatry, 2010, 13(1): 52-57.11) Ebirim, ICC and Morakinyo, OM. Prevalence and perceived health effect of alcohol use among male undergraduate students in Owerri, South-East Nigeria: a descriptive cross- sectional study. BMC Public Health, 2011, 11: 118-124.12) Fields, R. Drugs in Perspective. 7th Ed.: McGraw-Hill, 2009. 21
  22. 22. FREEDOM FOUNDATION 24 HENRY ADEFOWOPE CRESCENT, AWUSE ESTATE, OPEBI, IKEJA, LAGOS, NIGERIA Telephone: 0808729000Email: info@freedomfoundationng.org; Website: www.freedomfoundationng.org 22

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