CHALLENGES OF DRUG ABUSE AMONG THE YOUTH

BY SSEMUJJU JOSEPH

ACRONYMS/ABBREVIATIONS AIDS: ATS: ETS: DEA: CIA: CNS: CEIDA: HIV: IDU: NGO: Acquired Immune Deficiency Syndrome Amphetamine type stimulants Environmental Tobacco Smoke Drug Enforcement Administration Criminal Investigation Agencies (CIA) Drug abuse makes central nervous system (CNS) Teenagers Talking to Parents about Drugs Human Immune Deficiency Virus Injecting Drug Use Non-governmental organization

NCAIANMHR: National Center for American Indian and Alaska Native Mental Health Research NUDIST: NWDC: SACENDU: SANAB: SAPS: TADA: UNODC: USA: WHO: Non numerical Unstructured Data Indexing Searching and Theorizing North West Development Corporation South African Community Network on Drug Use South African Narcotics Bureau South African Police Services Teenagers Against Drug Abuse United Nations Office on Drugs and Criminal United States of America World Health Organization

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TABLE OF CONTENT DECLARATION ...................................................................Error! Bookmark not defined. APPROVAL ..........................................................................Error! Bookmark not defined. ACKNOWLEDGEMENTS ...................................................Error! Bookmark not defined. DEDICATION .......................................................................Error! Bookmark not defined. ACRONYMS/ABBREVIATIONS......................................................................................... ii TABLE OF CONTENT ......................................................................................................... iii ABSTRACT ........................................................................................................................... vi

CHAPTER 1: ORIENTATION TO THE STUDY ............................................................ 1 1.0 Introduction ....................................................................................................................... 1 1.1 Background ....................................................................................................................... 2 1.2 Definition of Key Concepts .............................................................................................. 3 1.2.1 Drug abuse, .................................................................................................................... 3 1.2.2 Drug addiction, .............................................................................................................. 3 1.2.3 Drug Enforcement Administration ................................................................................ 3 1.2.4 Drug idiosyncrasy .......................................................................................................... 4 1.2.5 Drug interaction, ............................................................................................................ 4 1.2.6 Adolescence ................................................................................................................... 4 1.2.7 Adolescent...................................................................................................................... 4 1.2.8 Substance ....................................................................................................................... 4 1.2.9 Substance use ................................................................................................................. 5 1.2.10 Substance dependence ................................................................................................. 5 1.3 Statement of the Problem .................................................................................................. 5

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1.4 Purpose of the Study ......................................................................................................... 6 1.5 Specific Objectives ........................................................................................................... 6 1.6 Research Questions ........................................................................................................... 6 1.7 The scope of the study. ..................................................................................................... 6 1.6.1 The conceptual and Geographical scope............................................................................ 6 1.8 Justification of the Study. ................................................................................................. 6

CHAPTER TWO :LITERATURE REVIEW .................................................................... 8 2.0 Introduction ....................................................................................................................... 8 2.1 Drug Abuse among the Youth .......................................................................................... 8 2.2 Types of Abused Substances ............................................................................................ 9 2.3 Prevalence of Substance use and Abuse among Adolescents ........................................... 9 2.4 High Risk Youth - Alcohol and other Drug Use............................................................. 10 2.5 Challenges of Drug Abuse .............................................................................................. 10 2.6 Causes of Drug Abuse among the Youth Today. ........................................................... 17 2.7 Impacts of Drug Abuse among the youth ....................................................................... 18 2.8 Immediate resolutions to Drug Abuse among the Youth................................................ 20 2.8.1 Develop a working relationship ................................................................................... 20 2.8.2 Screen all adolescents for drug use. ............................................................................. 20 2.8.3 Provide further assessment of Drug Abuse among the Youth as required .................. 21 Assessment principles ........................................................................................................... 21 2.8.4 Interventions of different Personnel in helping Youth stop Drug Abuse .................... 21 2.9 Examining Conceptual Models for Understanding Drug Use ........................................ 28

CHAPTER THREE: METHODOLOGY ........................................................................ 32 3.0 Introduction ..................................................................................................................... 32 3.1 Research Strategy and Design ........................................................................................ 32 3.2 Survey Population and Size ............................................................................................ 32 3.3 Survey Procedure ............................................................................................................ 32 3.4 Data Processing and Analysis ......................................................................................... 32 3.5 Sample design ................................................................................................................. 32 3.5.1 Sampling method ......................................................................................................... 32

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3.5.2 Sample size .................................................................................................................. 33 3.6 Data Collection Methods and Tools ............................................................................... 33 3.6.1 Questionnaire ............................................................................................................... 33 3.6.2 Observation .................................................................................................................. 33 3.6.3 Interviewing ................................................................................................................. 34 3.7 Documentary review ....................................................................................................... 34 3.8 Ethical issues. .................................................................................................................. 34 3.9 Limitations. ..................................................................................................................... 34

CHAPTER FOUR:PRESENTATION AND DISCUSSION OF FINDINGS ............... 35 4.0 Introduction ..................................................................................................................... 35 4.1 Brief Introduction of some Drug abuse Participants....................................................... 35 4.2 Supplementary Respondents ........................................................................................... 36 4.2.1 Response rate ............................................................................................................... 36 4.2.2 Description of the respondents..................................................................................... 36 4.3 RESULTS ....................................................................................................................... 39 4.3.1Age and grade for substance use ................................................................................... 39 4.3.2 Reasons/Causes of Drug abuse among the Youth in Kawempe Division ................... 39 4.3.3 Maintaining the substance abuse habit ........................................................................ 42 4.3.4 Challenges of Drug Abuse among the Youth in Kawempe Division .......................... 42 4.3.5 Curbing substance abuse among the Youth in Kawempe Division ............................. 44 4.4 Chapter Summary ........................................................................................................... 45

CHAPTER FIVE SUMMARY, CONCLUSION AND RECOMMENDATION .......... 46 5.0 Introduction ..................................................................................................................... 46 5.1 Summary ......................................................................................................................... 46 5.2 Conclusion ...................................................................................................................... 47 5.3 Recommendations ........................................................................................................... 48 5.3.1 Future research ............................................................................................................. 48 5.3.2 Policy Implications ...................................................................................................... 49

REFERENCES ..................................................................................................................... 51

APPENDIX A ....................................................................................................................... 53 A MAP OF KAWAMPE DIVISION SHOWING THE GEOGRAPHICAL AREA OF STUDY ................................................................................................................................. 53 APPENDIX B ....................................................................................................................... 54 APPENDIX C ....................................................................................................................... 57

ABSTRACT Drug abuse among the youth is the major problem facing the world today. In order to understand the reasons for adolescent substance abuse behavior, various theoretical perspectives were utilized and strategies to curb drug abuse among the youth were also identified. The study was conducted in the slum areas of Kawempe division, Kampala district capital of Uganda. The participants included 12 male and 4 female adolescents, whose ages ranged from 12 to 22 years. A qualitative, explorative research design was employed. Data was gathered using semistructured interviews, questionnaires and observations. The study found that substances abused by the participants include alcohol, nicotine, khat Mairungi, cannabis and heroin and the most affected areas included Bwaise, Mulago, Katanga, Kikoni, among others. Their reasons for using these substances include individual, family and environmental factors. However, peer group pressure was identified as the primary factor for adolescent substance use. This study emphasizes the painful nature of drug abuse among the youth, yet at the same time it succeeds in highlighting the strategies that can be employed to address drug abuse among the youth. In addition, this study recommends a concerted effort by all the stakeholders in addressing the substance abuse problem.

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CHAPTER 1

ORIENTATION TO THE STUDY 1.0 Introduction Substance abuse, also known as drug abuse is a maladaptive pattern of use of a substance that is not considered dependent. Kawempe division is situated in Kampala the capital of Uganda. The division has the biggest number of victims of drug abuse among the youth in the country due to the fact that the biggest number of these residents is youth school dropouts and employed. A considerable number of young people in this division often use drugs and they have faced many challenges of drug use such as unemployment due to idleness, and waste of time, poverty, involvement in criminal activities such as rape, fighting and robbery. Drug use among the Ugandans population has been majorly cited in Kawempe division and the key challenge among others is the negligence of parents over their children and the drivers of HIV/AIDs epidemic yet no efforts have been made to address this problem as a matter of urgency. The victims of drug consumption among the youth in Kawempe division show signs of cultural influence. Most tribes have a culture of dealing and brewing drugs in homes thus exposing the youth to such drugs at an early age. As young people reach adolescence, drug consumption increases due to peer pressure. Young people prefer strong local spirit which is easily assessable in miniature sachets at very low prices and other drugs like cannabis, tobacco, khat Mairungi heroin and other medically prescribed gangsters. Addition levels begin to emerge at the age of 21 and highly associated with other stressors and peer coping skills among young people. Drug consumption increases by age among the youth in Uganda.

In Kawempe division Kampala district, drug abuse is at a very high rate and it shows up young people between the ages of 12 to 25. The main factors that perpetuate drug abuse amongst the youth in Kawempe are their affordability and easy accessibility. Other reasons like the need for courage to do certain things, lack of physical strength, sleeplessness, loss of appetite, poor diet and nutrition also precipitate drug use among the youth. Young people like to taking drugs to feel high, relieve stress, relax, prove their maturity, for adventures sake and to go through periods of cold weather.

1.1 Background During the past decade, some advances have been made in understanding the nature and extent of the drug use problem encountered by the youth (Beauvais et al. 1989; Bachman et al. 1990). Results obtained from this research have provided suggestive evidence that even the Ugandan high school seniors in Kawempe division are more likely use and abuse licit and illicit drugs. Data also suggest that stress caused by assimilation into African society and lack of family cohesiveness and support may be related to the drug use behavior of Hispanic and AfricanAmerican youth (Vega et al., this volume: Szapocznik and Kurtines 1980). Information on the prevalence and causes of drug abuse among minority youth has been utilized by human service and health care providers, law enforcement officials, and policymakers to develop interventions and policies geared toward addressing the drug problem experienced by these youth (Beauvais et al. 1989; Bachman et al. 1990).

Drug abuse among adolescents continues to be a major problem worldwide, and in particular, Uganda. Most teenagers begin to experiment with substances at an early age (De Miranda, 1987; Jaffe, 1998). The most widely abused substances are alcohol, tobacco and cannabis because they are in excess (Alcohol and substance abuse information, n.d.; Madu & Matla, 2003). Most high schools encounter problems with males who smoke cigarettes and dagga on the school premises. Some of these males come to school under the influence of liquor.

Abuse of substances among adolescents is associated with a broad range of high-risk behavior. This type of behavior can have profound health, economic and social consequences, for example, some adolescents participate in deviant peer groups, unprotected sexual intercourse, interpersonal violence, destruction of property and perform poorly in their studies (De Miranda, 1987; Jaffe, 1998; Substance Abuse and HIV/AIDS, n.d.).

According to the United Nations Office on Drugs and Crime (2008), substance abuse is worsened by complex socio-economic challenges such as unemployment, poverty and crime in general. These social ills are devastating many families and communities. Substances from all over the world currently flood Uganda. Drug pushers are forcing young people into taking substances so that once they are hooked; they can manipulate their friends into taking substances

(United Nations Office on Drugs and Crime, 2008). Too many youth seem to think of experimentation with substances as an acceptable part of transition into adulthood. Few take seriously the negative consequences of dependence on substances (Madu & Matla, 2003).

1.2 Definition of Key Concepts For the purpose of this study, the following key terms were used below:

1.2.1 Drug abuse, The use of a drug for a no therapeutic effect. Some of the most commonly abused drugs are alcohol; nicotine; marijuana; amphetamines; barbiturates; cocaine; methaqualone; opium alkaloids; synthetic opioids; benzodiazepines, including flunitrazepam (Rohypnol); gammahydroxybutyrate; 3,4-methylenedioxymethamphetamine (MDMA, ecstasy); phencyclidine; ketamine; and anabolic steroids. Drug abuse may lead to organ damage, addiction, and disturbed patterns of behavior. Some illicit drugs, such as heroin, lysergic acid diethylamide, and phencyclidine hydrochloride, have no recognized therapeutic effect in humans. Use of these drugs often incurs criminal penalty in addition to the potential for physical, social, and psychological harm.

1.2.2 Drug addiction, A condition characterized by an overwhelming desire to continue taking a drug to which one has become habituated through repeated consumption because it produces a particular effect, usually an alteration of mental status. Addiction is usually accompanied by a compulsion to obtain the drug, a tendency to increase the dose, a psychologic or physical dependence, and detrimental consequences for the individual and society. Common addictive drugs are barbiturates, alcohol, and morphine and other opioids, especially heroin, which has slightly greater euphorigenic properties than other opium derivatives.

1.2.3 Drug Enforcement Administration The federal agency charged with monitoring use and abuse of narcotics. It provides the drug schedules used to determine the addiction potential of dental drugs.

1.2.4 Drug idiosyncrasy An adverse drug reaction that occurs in a small number of persons and presents no correlation to dosage or means of therapy.

1.2.5 Drug interaction, A modification of the effect of a drug when administered with another drug. The effect may be an increase or a decrease in the action of either substance, or it may be an adverse effect that is not normally associated with either drug.

1.2.6 Adolescence Adolescence is a Latin word adolescere which means to grow. Adolescence refers to a stage of physical and mental human development that occurs between childhood and adulthood (Berk, 2007; Louw, Van Ede, & Louw, 1998). The ages that are considered to be part of adolescence vary according to the culture and ranges from pre-teens to young adults of 19 years (Berk, 2007). According to the World Health Organisation (WHO), adolescence covers the period of life between 10 and 20 years of age. This transition involves biological (i.e., pubertal), psychological, and social changes (Shaffer & Kipp, 2007). In this study, adolescence refers to a transitional stage of development between childhood and adulthood, in which males between the ages 12 and 15 years experience physiological, psychological and social changes.

1.2.7 Adolescent Adolescent refers to a boy or girl between the ages 10 and 20 (Berk, 2007; Louw et al., 1998).

1.2.8 Substance A substance is a chemical used in the treatment, cure, prevention or diagnosis of disease or to enhance physical and mental well-being (De Miranda, 1987; Kring, Davison, Neale & Johnson, 2007; Pressly & McCormick, 2007; Rice & Dolgin, 2008). Furthermore, a drug also refers to chemical substances that affect the central nervous system, such as tobacco, alcohol, dagga, cocaine, and heroin. These drugs are used for perceived beneficial effects on perception, consciousness, personality and behaviour. These chemical substances, both medicinal and recreation can be administered in a number of ways; orally, inhaled, injected and rectally (Butcher, Mineka, Hooley, & Carson, 2004; Carson, Butcher, & Mineka, 2000; Craig &

Baucum, 2001; Davison, Neale, & Kring, 2004; De Miranda, 1987; Kring et al., 2007). These substances can be legal or illegal. In this study, drugs refer to legal and illegal substances abused by male adolescents, which are not used for medicinal purposes and which have a negative effect on their mind, thinking, perception, and their behaviour, for example, alcohol, cannabis, cocaine and heroin. 1.2.9 Substance use Substance abuse refers to chronic or habitual use of any chemical substance to alter states of body or mind, other than medically warranted purposes leading to effects that are detrimental to the individuals physical or mental health or the welfare of others (De Miranda, 1987; Kring et al., 2007; Rice & Dolgin, 2008; Drug Addiction and Drug Abuse, 2008). In this study, substance abuse refers to the misuse of legal products (prescription medications) and illegal products such as cocaine and cannabis, which are harmful to adolescents well-being as well as the welfare of the society. 1.2.10 Substance dependence Substance dependence refers to the uncontrollable craving and use of substances despite the potential or actual harm to the person and society that may result from it (De Miranda, 1987; Kring et al., 2007; Pressly & McCormick, 2007; Rice & Dolgin, 2008). It includes both legal and illegal substances. Those dependent on substances are often unable to quit on their own and need treatment to help them to stop using the substances (Alexander, 2001; Ciccheti, 2007; Jaffe, 1998; Kring et al., 2007). In this study substance dependence refers to continued use of a substance or substances by male adolescents, despite the physical and psychological harm that may result from it. 1.3 Statement of the Problem Drug abuse among the youth in Uganda has been majorly cited in Kawempe division and the consumption tremendously increases all the time. Nevertheless, the victims of drug consumption among the youth show signs of cultural influence. Most tribes have a culture of dealing and brewing drugs in homes thus exposing the youth to such drugs at an early age. As young people reach adolescence, drug consumption increases due to peer pressure. Young people prefer strong local spirit which is easily put in miniature sachets at very low prices and other drugs like cannabis, tobacco, khat Mairungi heroin and other medically prescribed thugs. Other causes include; high illiteracy levels, high degree of unemployment, extreme poverty, peer groups, among others. 5

Consequently, the young generation and the youth have ended up spoilt, imprisoned, raped, homeless, jobless, early and forced marriages, unwanted pregnancies, prostitutes and others have died of the HIV/AIDS. Due to this problem the future of Uganda is not only at the state of doubt but also in a terrible dilemma since the youth are looked at as the parents and leaders of tomorrow. The solution to this problem is to look at the challenges of drug abuse among the youth in Uganda, which will at the end of the day can be employed to control drug abuse among the youth? 1.4 Purpose of the Study To find out the challenges of drug abuse among the youth. 1.5 Specific Objectives i. To establish the causes of drug abuse among the youth. ii. To assess the challenges of drug abuse among the youth. iii. To suggest remedies to respond to drug abuse among the youth. 1.6 Research Questions i. What are the causes of drug abuse among the youth? ii. iii. What are the challenges of drug abuse among the youth? Which strategies can be employed to curb drug abuse among the youth?

1.7 The scope of the study. 1.6.1 The conceptual and Geographical scope. The focus of the study is on Challenges of drug abuse in Uganda, with a case study of Kawempe division. The area covered during the research was Kawempe division-Kampala district (Uganda) which among the Ugandas most populated areas and cited as one of the most affected areas by drug abuse in Uganda. 1.8Justification of the Study. I. The enable government of Uganda assesses the challenges of drug abuse in the youth and come up with an instantaneous solution to this problem II. To help students get rid of the habits associated with drug abuse

III.

The study will also help the Uganda Police and the Criminal Investigation Agencies (CIA) to identify and allocate common drug abuse and criminal areas in Kawempe division

IV.

The study will also help future academic researcher view and access literature related to this research

CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction This chapter consists of other writers views in relation to the topic; it covers challenges of drug abuse among the youth according to different scholars, mainstream and subcultural explanations of drug use, immediate resolution of drug abuse in the youth among others. 2.1 Drug Abuse among the Youth According to Hayden Browne (1991), Those [young people] who reach the attention of drug and alcohol agencies, the criminal justice system or the welfare system, are not typical of all young people who have ever used, or who do occasionally use, illicit drugs. Rather, the evidence indicates that those drug users have generally experienced a far more disrupted family background and are finding the processes of adjustment to school, family, and other facets of life more difficult to accomplish than most other people of their age. On the whole, their use of drugs is not the cause but more largely an effect of their distresses. Young people who begin to use drugs heavily as distinct from those who are tentatively experimenting with substances do so largely to escape from subjective states which are intensely disagreeable to them, such as anger, frustration, loneliness, anxiety and depression. estranged from their families or homeless. Many are unemployed, poorly educated,

Hayden Browne (1991) observed that, the challenge which presents itself to those agencies which are charged with the responsibility for improving the quality of life for such young people is to alleviate those distresses which induce so many to use drugs. Illicit drug use may be for some the predominant concern, but it should not be seen or treated as the central, or solitary, issue. Illicit drug use is neither the ultimate nor immediate cause of most of the distress among young people encountered by the welfare system; nor has it proven effective to mark drug use as the sole target for intervention in the lives of such young people, since at the same time they are often beset by problems of homelessness, hunger, unemployment, limited social and recreational

opportunities, and by estrangement from their families, school and other facets of conventional society. Timely and practical assistance for young people is an imperative necessity. 2.2 Types of Abused Substances Adolescents abuse both legal and illegal substances. Legal substances are socially acceptable psychoactive substances (De Miranda, 1987; Parry, 1998), and include over the counter and prescription medicines, such as pain relievers, tranquilisers including benzodiazepines, cough mixtures containing codeine and slimming tablets (Craig & Baucum, 2001; Conger, 1991; Rice, 1992). In addition, there are other agents such as solvents in glue, alcoholic beverages, nicotine and inhalants, nail polish and petrol. Illegal substances are prohibited and the use, possession or trading of these substances constitute a criminal offence (De Miranda, 1987). These substances include cocaine powder, crack cocaine, heroin, ketamine, cannabis, ecstasy, fentanyl, morphine, methaqualone (Mandrax), opium, flunitrazipam (Rohypnol), methamphetamine and Wellconal (Craig & Baucum, 2001; De Miranda, 1987; Parry, 1998).

2.3 Prevalence of Substance use and Abuse among Adolescents A number of institutions gather information about the prevalence and trends of alcohol and other substance use. These include, among others, the Centre for Addiction and Mental Health, Canadian Medical Association in Europe, United Nations Office on Drugs and Crime (UNODC), and the South African Community Network on Drug Use (SACENDU). Studies on the use of substances among adolescents have been conducted throughout the world. An estimated 13 million youths aged 12 to 17 become involved with alcohol, tobacco and other substances annually (Lennox & Cecchini, 2008). In general, tobacco and alcohol are the most frequently used substances by young people, with cannabis use accounting for 90% or more of illicit substance use in North America, Australia, and Europe (Alexander, 2001). Furthermore, the Canadian Centre on Substance Abuse (2002) has conducted a survey which indicated that the average age for first users of substances was 12 years. About 64.7% of the youth in grades 7 to12 reported the lifetime use of alcohol, 29% cannabis, 43% cocaine powder and less than 4% other substances including heroin, ketamine and crystal methamphetamine (Canadian Centre for Substance Abuse, 2002).

Studies conducted in South Africa (see Alcohol and drug abuse module, n.d.; Madu & Matla, 2003) indicate that the average age of a first-time substance user is 12 years, which is similar to findings in European countries (Karen Lesly, 2008; Parrott, et al., 2004). In a study conducted by Fisher (2003), 45% of participants had tried drugs and 32% were still using them, while in a study conducted in treatment centres in the Free State, Northern Cape, and North West, alcohol was found to be the most common primary substance of abuse among patients (Plddermann, Parry & Bhana, 2007). In addition to that, a survey conducted in Cape Town found that more than 10% of 11 to17 year olds had been drunk more than 10 times (South African Community Network on Drug Use Report 11, n.d.). There is also a considerable abuse of over the counter and prescription medicines such as slimming tablets, analgesics, tranquilisers and cough mixtures. Cannabis was found to be the second most common substance used among patients under 20 in treatment centres in the Free State and North West (Plddermann et al., 2007).

2.4 High Risk Youth - Alcohol and other Drug Use According to Jon Rose (2000), providing services to adolescents who are using legal and/or illegal drugs raises a range of specific issues. The developmental challenges of this stage requires those engaged in their care to apply age appropriate strategies rather than simply thinking of this diverse group as mini adults. Young people who come to the attention of health and welfare professionals often use drugs as a means of coping with situational and emotional distress. While this drug use may also exacerbate problems, practical assistance in areas such as accommodation, family, recreation, financial, vocation and educational support will most often need to precede or coincide with any drug use management. Linking drug-related effects and interventions to goals identified by the client will enhance the possibility of change. This is the same effect with Kawempe divisions case.

2.5 Challenges of Drug Abuse Mainstream and Sub cultural Explanations of Drug Use Although mainstream theories of deviance are largely based on the experiences of nonminority youth, they constitute an essential point of departure for conceptualizing minority adolescent deviance.

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These theories differ on the factors they emphasize as central, but most agree on the types that must be included.

Most theories view delinquency as a reaction to disadvantaged status in terms of ethnicity or class (Rutter and Giller 1983; Braithewaite 1981; Datesman et al.1975) that adversely influences individuals options in life. Social psychological processes have been posited to link disadvantaged status to deviance. An important example is strain theory (Cloward and Ohlin 1960; Simon and Gagnon 1976; Elliott and Voss 1974), which emphasizes discrepancies between achievement aspirations and expectations as the motivational mechanism for deviance.

In some theories, a social environment tolerant of crime and drug use is viewed as contributing to adolescents engaging in deviant behavior (Conger 1971; Shaw and McKay 1942; Smith 1983). An antisocial environment may provide opportunities for involvement in deviant behavior through the availability of inappropriate behavior models to emulate or through instrumental opportunities. For example, drug use is more likely if drugs are available in the neighborhood (Dembo et al. 1979, 1986).

Most mainstream theories view deviance as the result of failures in conventional bonding by the family, school, and other institutions whose functions are to socialize youth to the conventional order (Kandel 1980; Jessor and Jessor 1977; Brook et al. 1990). When socialization is effective, youth develop an emotional attachment to the school and family, a commitment to conventional activities, an involvement with such activities, and a belief in the moral order underlying conventional bonds (Elliott et al. 1985; Kaplan et al. 1984; Kandel 1980; Jessor and Jessor 1977; Hirschi 1969).

Peer bonding is another critical element in explaining deviance. In the social learning perspective (Akers 1977; Sutherland 1947) adolescents learn delinquency by modeling-exposure to friends delinquent behavior, peers social approval of delinquent acts, and anticipated rewards for engaging in delinquency. Peer group influences on deviance are especially likely when there is weak bonding to the family and school (Elliott et al. 1985; Kandel 1980; Jessor and Jessor 1977; Hirschi 1969). Similarly, peer group influence is one of the biggest challenges of drug abuse in Kawempe division.

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More proximal to problem behavior and influenced by the more distal social factors discussed above is the adolescents self-conceptthe overall sense of personal worth and efficacy (Bandura 1982; Brook et al. 1990; Kandel 1974; Kaplan 1975; Kaplan et al. 1984). Serious psychological disorders such as depression may underlie poor self-concept (Jensen et al. 1988; Mitchell et al. 1988). In the same way, Kawempe division, adolescents self-concept is a key factor to drug abuse among the youth.

The factors discussed above can be integrated. For example, Rodriguez and Zayas (1990) point out that disadvantaged status, low income, and discrimination, together with social environments that tolerate deviance, may be posited to weaken conventional bonding and strengthen deviant peer bonding. Weak conventional bonds and strong deviant peer bonds may directly influence deviance, but they may also foster a weak self-concept, a more proximate and psychological influence on deviance. Models such as these, which generally have not been informed by insights from studies of minority group behavior nor tested among minority subpopulations, are nevertheless assumed to be universally applicable. Therefore, it is important to consider how explanations derived from the sociocultural experiences of minority groups provide insights not encountered within mainstream approaches. Delinquency and drug use research on minority populations has often relied on explanations that link such behaviors to subcultural characteristics, for example, ethnically derived norms and values about the male role (Anderson 1978; Curtis 1975; Horowitz 1982). Other sub culturally based concepts, such as delinquent subculture (Miller 1958) and lower class subculture (Curtis 1975; Hannerz 1969; Lewis 1961; Liebow 1967; Rainwater 1970; Suttles 1955), emphasize the existence of survival strategies to deal with disadvantaged status. Likewise, the effect is more less the same as the drug abuse situation observed in Kawempe division.

Although subcultural theories have had an important influence in deviance research, they have not been integrated into mainstream drug use and delinquency research. Often based on difficultto-replicate qualitative research, they have seldom been empirically tested through large-scale sample surveys. How then can models attempting to integrate subcultural and mainstream explanations be tested? To address this issue, the authors applied Elliott and colleagues (1985)

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ISC model to inner-city Puerto Ricans. The ISC model integrates factors relevant to major explanations of deviancestrain theory (Elliott and Voss 1974; Simon and Gagnon 1976), social control theory (Hirschi 1969), and social learning theory (Akers 1977; Conger 1976). The model posits that straindiscrepancies between aspirations and expectations about school, family, and occupationindirectly influences deviance through its negative effects on conventional bonding to the family and school (a social control construct). Conventional bonding in turn indirectly reduces deviance through its negative effect on tolerance of deviance (social control) and deviant peer bonding (a social learning construct). Thus, the effects of strain and conventional bonding are filtered through deviant peer bonding. Similarly, deviant peer bonding in Kawempe division is yet another challenge of drug abuse among the youth.

The factors emphasized in the ISC model are also conceptualized in adolescent drug use research. For example, Johnson and coworkers (1987) found that integrated differential association and situational group pressure notions satisfactorily explained the role of peers in the etiology of drug abuse. In a similar way, Krohn (1974), Jacquith (1981), and Kaplan and colleagues (1984) found the same effects. Peer group drug use and bonding also predict drug use in the empirical studies by Meier and Johnson (1977), Kandel (1978, 1985), Ginsberg and Greenley (1978), Jessor and coworkers (1980), Clayton (1981), Glynn (1981), Clayton and Lacy (1982), Krosnick and Judd (1982), Bank and colleagues (1985), Needle and coworkers (1986), Castro and colleagues (1987), Kandel and Andrews (1987), Newcomb and Bentler (1987), and Brook and coworkers (1990). However, the ISC model may be useful to apply to drug use because of its attempt to integrate different conceptual approaches to deviant behavior (including strain theory, which is less often applied to drug use) and because of its demonstrated applicability to both behaviors in the National Youth Survey (NYS) (Elliott and Huizinga 1984; Elliott et al. 1985).

Our analyses were based on the assumption that mainstream models of problem behavior are applicable to Hispanics, Like mainstream youth, Hispanics may face problems of getting along with their families and teachers, are subject to influences of peer pressures, and experience varying levels of frustration based on the extent of discrepancy between their aspirations and

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expectations. However, our analysis focused on how subcultural factors relevant to Hispanics and other minority groups interrelate with factors drawn from the ISC model.

As in ethnographic studies of African-American populations, some studies of Hispanic problem behavior have followed the general approach of examining the influence of subcultural norms on delinquency and other behaviors (Horowitz 1982; Moore 1978). However, in examining Hispanic subcultural influences, a more common approach is found in the concept of acculturation, which refers to the social psychological process whereby immigrants and their offspring change their behavior and attitudes toward those of the host society as a result of contact and exposure to the new dominant culture (Berry 1980; Padilla 1980). The importance of the concept lies in its ability to capture an important psychosocial aspect of the immigrant experience, the problem of meeting the normative demands of two different cultures. Because it involves conflict and stress, acculturation has been linked to dysfunctional behavior (Anderson and Rodriguez 1984; Rogler et al. 1991; Szapocznik and Kurtines 1980; Szapocznik et al. 1980).

How is acculturation linked to problem behavior? In one conceptualization, immigration is seen as disrupting adherence to the country of origins values, norms, and social bonds, one of whose functions is to inhibit dysfunctional behavior. For most immigrant groups, acculturation involves adaptation from a traditional culture, which provides controls on behavior, to the more modern American culture, which places fewer restraints on nonconventional behavior. Un acculturated families may lack knowledge of accepted behavior norms in the United States and, therefore, may be less likely to socialize their children adequately, which in turn may influence problem behavior by weakening family and school bonds. Evidence for this hypothesis is provided by studies finding higher rates of alcohol and other drug use, suicide, eating disorders, and other problem behaviors among acculturated and/or second-generation Hispanics (Sorenson and Golding 1988; Caetano 1987; Gilbert 1987; Pumariega 1986; Buriel et al. 1982; Graves 1967).

A closely related conception focuses on the relationship between acculturative stress, intergenerational conflict, and problem behavior. Immigration may generate stress as immigrants try to adapt to and resolve differences between the old and new cultures (Vega et al. 1985a , 1985b; Born 1970). For example, in their study of drug use among adolescent Cuban-Americans, Szapocznik and associates suggest that the discrepancy between the parents and adolescents

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level of acculturation will cause conflict for the adolescent and, therefore, a greater dependency on the peer group (Szapocznik and Kurtines 1980; Szapocznik et al. 1980). (See also Fitzpatrick [1971] with respect to delinquency among Puerto Rican youth and Beauvais and colleagues [1985] with respect to drug use among American Indian youth.) Adolescents in this situation may turn to drug use as a way of resolving acculturation conflicts with parents. In contrast to theories that view imbeddedness in traditional culture as inhibiting problem behavior, the biculturalism hypothesis asserts that those competent in negotiating the contradictory demands of both cultures should behave less dysfunction ally than those oriented to either Hispanic or American culture.

In several analyses, Rodriguez and Recio (in press), Rodriguez and colleagues (1990), and Rodriguez and Weisburd (1991) addressed the applicability of the ISC model to drug use and delinquency among inner-city Puerto Rican youth, focusing on the following two research questions.

First, would the factors operate among Puerto Rican adolescents in the same way as among mainstream youth, that is, with the same correlative strengths and in similar interrelationships? A related question is, would the factors operate similarly with respect to drug use and delinquency? It was hypothesized that two aspects of the sociocultural situation of Puerto Rican adolescents the significance of the family in Puerto Rican culture and the relationship between conventional institutions and peer groups in the inner citywould influence the interrelationships among family, school, and peer involvement and their effects on deviant behavior (Rodriguez and Weisburd 1991). The sociological and anthropological literatures have often noted the influence of Hispanic family norms and values in Puerto Rican society (Roberts and Stefani 1949; Rogler 1978; Rogler and Hollingshead 1985) and the relevance of the Hispanic family for instrumental and emotional support (Recio 1975; Rogler and Cooney 1984). The family was expected to have a stronger influence among Puerto Ricans than was the case for the national sample. By implication, it was expected that peer involvement would be less important. The inner-city character of the Puerto Rican sample suggested that conventional institutions would have different effects on peer groups than the effects expected for a mainstream population. Conventional institutions in the inner city may control adolescents through individual rather than collective action (Suttles 1955). As inner-city institutions, the family and school may

15

exert less control over adolescent behavior in the street than is the case in other communities because there is likely to be less communication between these institutions. Consequently, innercity youth may be more able than other youth to keep separate their actions in school, the family, and the peer groups. Thus, in contrast to what Elliott and associates (1985) found for mainstream adolescents, among Puerto Rican adolescents the family and school were expected to have direct negative effects on drug use.

A related issue concerned the relationship between alcohol and other drug abuse and delinquency. Our analysis focused on whether the relationship was spurious or causal (Elliott and Ageton 1976; Gandossy et al. 1980; lnciardi 1981; Collins 1981; Watters et al. 1985; White 1990). Either both behaviors are elements in a concurrent pattern of behaviors (Kandel 1980; Jessor and Jessor 1977) or both behaviors are explained by a common cause (White et al. 1987; Elliott et al. 1985). The ISC model has been shown to be equally applicable to drug use and delinquency; that is, the factors have similar strengths and interrelationships. The authors expected the same with respect to Puerto Rican adolescents.

Second, how would acculturation, the major factor identified in examinations of Hispanic adolescent deviance, interrelate with the ISC factors? Two hypotheses were entertained. One was that adherence to traditional Hispanic culture would inhibit deviance through the greater role accorded to institutional authority, as embodied by parents and teachers. Thus, the authors theorized that acculturation would exert powerful but indirect effects on drug use and delinquency through its influence on conventional and deviant peer bonding. Acculturated youth would be less bonded to their families and schools and more bonded to deviant peers and, thus, would be more likely to engage in drug use and delinquency. In a second and contrasting hypothesis, we assumed that biculturally involved youth would be less likely to engage in drug use and delinquency. Control Measures of Drug Abuse among the Youth

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2.6 Causes of Drug Abuse among the Youth Today. Jon Rose (2000) observed that, Young people who come to the attention of health and welfare professionals often use drugs as a means of coping with situational and emotional distress. While this drug use may also exacerbate problems, practical assistance in areas such as accommodation, family, recreation, financial, vocation and educational support will most often need to precede or coincide with any drug use management. Linking drug-related effects and interventions to goals identified by the client will enhance the possibility of change. Providing services to adolescents who are using legal and/or illegal drugs raises a range of specific issues.

Peer group influence has been noted as a key factor to drug abuse among the youth. In the social learning perspective (Akers et al. 1977) adolescents learn delinquency by modeling-exposure to friends delinquent behavior, peers social approval of delinquent acts, and anticipated rewards for engaging in delinquency. Peer group influences on deviance are especially likely when there is weak bonding to the family and school (Elliott et al. 1985; Kandel 1980; Jessor and Jessor 1977; Hirschi 1969). Similarly, peer group influence is one of the biggest challenges of drug abuse in Kawempe division.

As with sex, drug issues may be a secretive area for young people. This is particularly so if the young person perceives possible negative consequences for disclosure (e.g. refused accommodation, judged, probation breached or parents informed). Jon Rose (2000) According to Art Linkletter (1971), The narcotics problem came into public consciousness in the late 1960s as the "drug culture," an aspect of the youth movement, or the "counter-culture," as it was frequently called. The use of the hallucinatory drug LSD, promoted by Harvard University psychologist Timothy Leary, and other narcotics soon was widely practiced in so-called hippie communities, notably in the Haight-Ashbury neighborhood of San Francisco. By the end of the decade drug abuse was described by government officials as an epidemic, and the smoking of marijuana spread far beyond the youth culture. The use of LSD fell off rapidly by 1970, but other "hard" drugs such as "speed" and heroin persisted, education campaigns and stricter laws notwithstanding. One byproduct of growing drug use was an increase in crime, particularly in urban areas. Drug abuse by soldiers in Vietnam was also reported to be very extensive, and many veterans returned home as addicts. In October 1970 Congress passed the toughest drug control law in history, but no great hope was entertained that laws alone could stem the situation. One of

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the best known spokesmen in the campaign against drugs was television entertainer Art Linkletter, whose daughter had died after using LSD. On September 14, 1971, he spoke to a special United Nations audience in New York on effective ways to deal with the drug menace. Equally, Ugandan citizen have lost their children due to the effect of drug abuse. 2.7 Impacts of Drug Abuse among the youth Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.[8] There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse.[9] In the USA approximately 30 percent of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.[10] Drug abuse, including alcohol and prescription drugs can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during the withdrawal state. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation of use and cannabis may trigger panic attacks during intoxication and with use it may cause a state similar to dysthymia. Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate alcohol sustained use may increase anxiety and depression levels in some individuals. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence.[11]

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Drug abuse makes central nervous system (CNS) effects, which produce changes in mood, levels of awareness or perceptions and sensations. Most of these drugs also alter systems other than the CNS. Some of these are often thought of as being abused. Some drugs appear to be more likely to lead to uncontrolled use than others.[12] Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however; drugs for substance abuse treatment have faced many barriers. Naltrexone, a drug originally marketed under the name "ReVia," and now marketed in intramuscular formulation as "Vivitrol" or in oral formulation as a generic, is a medication approved for the treatment of alcohol dependence. This drug has reached very few patients. This may be due to a number of factors, including resistance by Addiction Medicine specialists and lack of resources.[13] The ability to recognize the signs of drug use or the symptoms of drug use in family members by parents and spouses has been affected significantly by the emergence of home drug test technology which helps identify recent use of common street and prescription drugs with near lab quality accuracy. The initiation of drug and alcohol use is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from Monitoring the Future (2008), a nationwide study on rates of substance use, show that 47% of 12th graders report having used an illicit drug at some point in their lives
[14]

. In 2009 in the

United States about 21% of high school students have taken prescription drugs without a prescription.[15] And earlier in 2002, the World health Organization estimated that around 140 million people were alcohol dependent and another 400 million suffered alcohol-related problems.[16] Thankfully, the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%) [17]. According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."[18]

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2.8 Immediate resolutions to Drug Abuse among the Youth

2.8.1 Develop a working relationship As with sex, drug issues may be a secretive area for young people. This is particularly so if the young person perceives possible negative consequences for disclosure (e.g. refused accommodation, judged, probation breached or parents informed). The following points may help in discussing drug use issues: a) Provide practical support. This demonstrates care in a tangible way. b) Discuss boundaries of confidentiality - Depending upon age, may be required to advise parent - Statutory requirements if harm to self or others - Reporting conditions if on statutory orders (e.g. juvenile justice) c) Identify clients immediate, short and longer-term goals d) State what you have to offer and what you expect e) Negotiate any bottom line rules or boundaries

2.8.2 Screen all adolescents for drug use. Evidence suggests the majority of young people who come into contact with the welfare sector may rely on drug use as a method of coping and to have fun.

a) Use bridging questions such as, Many young people find alcohol or other drugs helpful in coping as well as for having fun can you tell me about your alcohol and other drug use? This question normalizes and presumes drug use allowing for a more honest answer. b) If there is a relationship of trust, a more straightforward question could be; how many joints or cones do you have a day what about other drugs and alcohol? c) Routine questions; Do you smoke cigarettes? Drink alcohol? Other drugs? How do they help? Have they ever been a problem? Do others see them as a problem?

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2.8.3 Provide further assessment of Drug Abuse among the Youth as required Assessment principles Drug frameworks may not only assist staff in developing methodical drug assessments, they may also help young people find order in what may otherwise be confusing and chaotic behaviour. Assessment should not be an interrogation but rather an ongoing gathering of data. The order presented is not necessarily the order you should use. Identifying those aspects which are fixed and those which are changeable is helpful. Strengths and weaknesses as well as helps and hinders of change should also be identified. Assessment is an intervention in its own right.

2.8.4 Interventions of different Personnel in helping Youth stop Drug Abuse 1. Involve key stakeholders (parents, peers, partners & professionals) As adolescents is a time of rapid development and identity formation, the above can be very influential. They can exacerbate or inhibit drug use and associated problems or both. They may also help/hinder the young person achieve life goals which compete with drug-related problems.

Parents/legal guardian Parental rights have to be weighed against client rights along with the clinical utility of involving parents. Parents/legal guardians must be informed of significant issues if the young person is under 13 years. From 13 to 16 years, young people may choose to withhold information from their parents only if they are deemed to have the cognitive and emotional maturity to make informed decisions. At 16 years and above, informed consent from the young person is required to inform parents. However, where possible, parents/legal

guardians should be involved in decision making and planning where possible. - Discuss parental involvement with the young person - Encourage the young person to raise the issue with their parents if they have not done so already. Resource material is available on-line to assist:

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Teenagers Talking to Parents About Drugs (CEIDA) - Provide parents/care-givers with support and resource material: - If safety of the young person with their parents is a potential problem, consider raising the issue of drug use with the parents yourself (with permission of the young person).

Peers With permission of the young person, involve as much as possible Aim to maximise positive influence and minimise negative influences. Utilise/develop peer influence and peer support (help a mate) and buddy programs. Provide assertion training and refusal skills to help manage negative peer influence. Teach first-aid to peers.

Partner Provide relationship support and where appropriate, couples counseling if young person has a partner. Discuss sexuality and the role of drugs (drugs sometimes used to enhance sex or make sex more bearable (young women) and to delay ejaculation (young men). Discuss use of protective strategies regarding transmissible diseases and contraception. Additional support may be required if ambivalent about sexual orientation.

Professionals (Inter-agency case management) Often many other agencies and professionals involved. What other agencies are/have been involved? How successful or otherwise is/was this? Seek permission to contact these agencies to coordinate care. Decide which agency will be primary case manager.

2. Provide practical assistance Reduces need for substance use, provide assistance and enhance relationship.

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Support areas of accommodation, family relationships, recreation, education, vocation, financial, peer and partner supports.

Identify and manage where drug use interferes with provision of practical assistance.

While it may be possible to utilise practical assistance as a leaver to encourage the reduction of drug use/drug problems, basic rights such as accommodation should not be withheld on the basis of drug use.

3. Manage the functional aspects of drug use Providing alternatives to the functions of drug use may: a. reduce the need for using b. reduce the possibility and intensity of relapse if reducing or stopping drug use. Identify and provide alternatives to positive reinforcements of drug use (e.g. fun/recreation, socialization, adventure, sexual enhancement, Dutch courage, feelings of power and freedom) Identify and provide alternatives to negative reinforcements of drug use (e.g. coping with negative emotional states, avoidance of withdrawal symptoms, pain relief)

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4. Manage actual and potential problem areas (harm reduction) Particular attention to overdose, transmissible diseases & wanted sex, driving when intoxicated, legal consequences, and violence. Discuss safer injecting practices if injecting. Discuss overdose risks, particularly if mixing drugs. Discuss issue of risk-taking. Separate risks into categories of a) High danger & un-cool (e.g. drink driving, sharing needles) b) Low danger & cool (e.g. surfing monster waves) Ask them how they have, and are going to maintain their safety elevates them to position of responsibility. If any suicidal ideation and/or behaviour, manage prior to harm reduction strategies. Teach first-aid. May be useful for themselves and/or drug using peers.

5. Identify goals and assess motivation, particularly in relation to drug use. Use motivational interviewing techniques. Steps are: Ask about the positives of drug use. Ask about the negatives. Summarise Ask about life goals and compare to drug use. Ask for a decision (e.g. continue to use, cut down or stop). Make a short-term goal and plan.

Teach S.M.A.R.T. (Specific, Meaningful, Assessable, Realistic, Time-bound) goal setting

6. Develop general skills as appropriate Rather than rehabilitation young people with drug problems often require habilitation (development of life skills). Consider enhancing the following: Decision making, goal setting, problem solving skills. Other life skills such as cooking, budgeting, study, social, recreational skills. Skills to deal with negative emotional states (e.g. stress management, anger management, coping with depression)

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7. Impulse control Adolescent with drug use problems often have poor impulse control. Identify something important which may be lost if client acts on an impulse Ask if this is worth 10 to 20 minutes Give definition of impulse; a sudden tendency to act without reflection Ask client to practice delaying an impulse regarding something important for 10 20 minutes. Possibly use reflection during this time.

8. Relapse prevention and management Relapse is a normal part of the change process and is the rule rather than the exception for most attempting to stop or reduce drug use. Use the analogy of a fire drill to help raise this issue. Identify and develop strategies to manage high risk situations Manage cravings (urge surfing techniques) and learn impulse control Teach refusal skills Develop alternative behaviours which compete with drug use. Learn to manage slips (lapse) before they turn into a total collapse (relapse) Reframe previous and current relapses as learning opportunities. Consider harm reduction (e.g. caution regarding reduced tolerance with overdose and other unsafe behaviour)

9. Drug Testing (Urinalysis) Drug testing may be helpful in providing an external motivation to maintain change and provide accurate feedback on drug using. However, unless part of a statutory condition, informed client consent will be required. Drug testing should be reframed in the positive as giving an opportunity to demonstrate change (particularly useful to clients who are facing drug-related court charges) Consequences for both positive and negative urine results should be clear prior to testing. - Random testing will help improve reliability.

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- Urine testing may encourage more hazardous drug use as substances such as cannabis are detectable in urine for a long time while heroin and amphetamines are detectable for a much shorter period.

10. Intoxication Have policies for dealing with intoxication. Assume impaired control that is, make it clear intoxication is no excuse for inappropriate behavior. Praise desirable behavior while being vigilant in the increased possibility of undesirable behavior. Call for assistance Separate from others where possible Use short, clear sentences and do not engage in therapy while intoxicated. Attempt to assess amount, type and time of drug(s) used. observations of conscious state. If overdose suspected, call an ambulance and apply first aid as required. Provide frequent

Withdrawal Withdrawal symptoms can often be successfully managed on an outpatient basis. Residential withdrawal indicated if severe addiction, few supports and accommodation a problem. Utilize medical assessment and management through GP services. Provide enjoyable alternative activities to shift focus Use warm baths, massage and symptomatic treatment to provide comfort

11. Pharmacological Treatments A range of drug treatments can be used to assist in treating drug addiction and related problems. These treatments are prescribed by a medical practitioner and often under the supervision of a drug specialist. Treatments include:

Blocking: Replacement Symptom

eg naltrexone blocks heroin (and alcohol) eg methadone replaces heroin eg clonidine reduces heroin withdrawal symptoms

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Drug treatments are often seen as attractive by drug users as they are often seen as a quick fix by drug users. Pharmacological treatments are most successful when: they are the choice of the client there is a supportive partner and/or parent (who may administer the drug in some cases) there is adjunctive counselling

12. Exit planning Link with ongoing supports If injecting drug use suspected, either provide injecting equipment and/or needle exchange facilities Provide follow-up evaluation and support Provide self-help written material If excluded or rejected from service due to drug use, provide names of other services as well as requirements to re-enter current service. Consider duty of care issues including informing statutory agencies if required as well as parents if under 16 years of age.

13. Self-disclosure of drug use (licit; and illicit) Staff disclosure of own drug use may compromise professional integrity and may be used to blackmail or undermine staff. It may also divert attention away from the clients issues. While there are benefits to self-disclosure, it is generally a high-risk behaviour. Ask the client how such information will help them Tell client it is not your drug use which is causing them problems Tell client it is not agency policy for staff to disclose own drug use

14. Slang drug terms Drug terminology changes rapidly. e.g. dope may mean cannabis or heroin. Always ask for clarification of drug jargon. This elevates the young person to the role of teacher. Dont attempt to use jargon with youth you are not a teenager. If your terms are incorrect, you will lose credibility and its important to maintain role boundaries.

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2.9 Examining Conceptual Models for Understanding Drug Use Alcohol and other drug abuse are of most serious concern among American Indian populations (Beauvais et al. 1989; Segal 1989; Young 1988). Recent research has found that there is more substance abuse among American Indians than most, if not all, other ethnic minority groups in the United States (Beauvais et al. 1985, 1989; Office for Substance Abuse Prevention 1990). In the same case, alcohol and other drug abuse are becoming common in Uganda especially in Kawempe division

Seventy-five percent of all American Indian deaths are related to alcohol (Young 1988), and 5 of 10 major causes of death among American Indians are directly attributable to alcohol: automobile crashes, cirrhosis of the liver, alcohol dependency, suicide, and homicide (Andre 1979; Jones-Saumty and Zeiner 1985). Like wise, a remarkable number of the youth in Uganda deaths are to alcohol and other drug abuse and such cases have been commonly seen in Kawempe division.

Lifetime prevalence rates for alcohol use among American Indian adolescents have been shown to average 80 percent or higher (Beauvais et al. 1989; King et al., in press). Hence, the risks for American Indian adolescents for deviant drinking behaviors are greater than those for many other ethnic populations (May 1982). In the same way, Lifetime prevalence rates for alcohol use among Ugandan adolescents are rising day by day.

American Indian youth begin using an array of substances at an earlier age than their white counterparts (Cockerham et al. 1976; Okwumabua and Duryea 1987; Young 1988). They are more likely to try marijuana and to begin this experimentation at an earlier age (Office for Substance Abuse Prevention 1990; Young 1988). Inhalant use is twice as high for young American Indians than the national average. Toluene-based solvents are among the first drugs used by American Indian youth and often precede the first time alcohol is used (Beauvais et al. 1985). Substance abuse reaches near epidemic proportions in American Indian boarding schools (Dinges and Duong-Tran 1989). May (1982) noted that, in general, American Indian boarding schools are characterized by a high concentration of high-risk or problem youth. Dinges and Duong-Tran (1989) found that lifetime prevalence rates for alcohol use in a boarding school population reached 93 percent, and 53 percent of these students were considered to be at an at28

risk level for serious alcohol abuse. King and colleagues (in press) found that one of five American Indian boarding school students used alcohol at least every weekend and that one of four had experimented with inhalants. Noting that approximately 20 percent of the American Indian and Alaska Native student populations attend boarding schools, reasons for these high rates of substance abuse must be examined (U.S. Department of the Interior 1988). Also, Ugandan youth start using an array of substances at an earlier stage (range of 14 years and above).

Although high prevalence rates for alcohol and other drug use have been well established among American Indian youth, explanations for these behaviors have yet to be tested scientifically (Oetting and Beauvais 1990). Attempts to identify and understand the factors contributing to these high rates of alcohol and other drug abuse have considered various causes.

Life stress factors have been postulated to predict rates of alcohol and other drug use among adolescents (Bruns and Geist 1984; Carman 1979; Labouvie 1986; Chassin et al. 1988). Stressful life events heighten during adolescent development with social adjustment factors, separation, individuation, career issues, and peer pressures becoming paramount, Hence, the theory has developed that alcohol and other drug use may be an escape or a way of buffering the effects of these stressors. Several studies have found strong correlations between drug use and number of stressful life events (Bruns and Geist 1984; Headlam et al. 1979; Newcomb and Harlow 1986). Labouvie (1986) has hypothesized that life stress factors contribute to poor social relations. Substance abuse becomes a way of coping with these difficulties. Despite the widely recognized stress of life in American Indian communities (Bechtold et al., in press), this aspect has just begun to be examined among American Indian youth (King et al., in press).

Social support has been identified as a moderating factor that reduces the impact of stressors that may contribute to substance use (Aneshensel and Huba 1984; Segal et al. 1980). Research efforts have examined the relative effects of family and friend support (Wills and Vaughan 1989; Zucker and Gomberg 1986). Degree of family support appears to be inversely related to rates of substance use (Chassin et al. 1988; Mann et al. 1987; Wills 1986; Wills and Vaughan 1989). However, during adolescence, friend support becomes increasingly more important than parental

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or family support (Zucker and Noll 1982). Friend support has been consistently linked to rates of substance use (Jessor 1987; Smith et al. 1989; Swaim et al. 1989; Wills and Vaughan 1989). Again, examination of the influence of social support among American Indian adolescents has received very little attention (King et al., in press).

Psychological and emotional distress has also been studied in relation to adolescent substance use (J.J. King and J.F. Thayer, unpublished data: Russell and Mehrabian 1977; Watson and Clark 1984). Some studies have found only minimal relationships between emotional and psychological distress and substance use (Johnson and Matre 1978; Labouvie 1986; Oetting et al. 1988; Swaim et al. 1989), whereas others have found that substance abuse serves as a buffer to or an escape from negative affect (Aneshensel and Huba 1983; Blane et al. 1968; Lex 1987; Watson and Clark 1984). Questions of this nature are only now being asked about American Indian youth.

Researchers now agree that no one predictor, in isolation, can account for the variability in the nature and pattern of substance use (Aneshensel and Huba 1984; Stein et al. 1987; Swaim et al. 1989). The most promising models for substance abuse consist of multiple contributing factors (Aneshensel and Huba 1984; King et al., in press; Newcomb and Harlow 1986; Smith et al. 1989).

Aneshensel and Huba (1984) developed a multifactor model that examined the effects of life stress, social support, illness, alcohol use, and depression. They found that life stress significantly influenced levels of social support, depression, alcohol use, and illness. They also found that social support mediated the impact of life stress on these other factors.

Multifaceted models of this kind hold the most promise for examining the area of substance abuse. The study discussed in this chapter examines two of the more prominent theoretical approaches in this area: the life stress/social support model as proposed by Aneshensel and Huba (1984) and the peer cluster theory as postulated by Oetting and Beauvais (1986).

The life stress model proposes that the primary predictive factors for substance abuse are life stressors and degree of social support. In this particular framework, alcohol and other drug use is

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viewed as a coping strategy that reduces the impact of life stress. Social support serves as a mediating variable between life stress and substance use; that is, the greater the social support, the less likely it is that one needs to use alcohol or other drugs.

The peer cluster theory (Oetting and Beauvais 1986) hypothesizes that the strongest predictive factor for substance use is peer influence. The group with which the individual most closely associates determines where, when, and how alcohol and other drugs are used. This cluster group also determines the attitudes and beliefs about alcohol and other drugs. The peer cluster theory does not ignore other psychosocial factors; rather, they are seen as background variables that influence the adolescents choice of peer group. These factors include social structure (e.g., family support), socialization processes (e.g., religious identification, school success), attitudes and beliefs, and psychological factors (e.g., self-confidence, alienation).

This study utilizes structural equation modeling (Jreskog and Srborn 1989) to test the relative value of these two theories. Data were collected as part of a longitudinal biannual survey of American Indian high school students. This survey was conducted by the National Center for American Indian and Alaska Native Mental Health Research (NCAIANMHR). The survey began at the request of the tribal administration because it wanted to better understand how these students were doing academically, socially, and psychologically and to what extent alcohol and other drugs were being used. Although more than 20 percent of all American Indian children attend boarding schools (U.S. Department of the Interior 1988), there are significant differences among tribes and among American Indian boarding schools.

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CHAPTER THREE

METHODOLOGY 3.0 Introduction This chapter is a representation of the methods and instruments that were used in data collection and data analysis. It deals with the research design, study area, study population, sampling, data collection methods, research instruments, ethical issues and limitations. 3.1 Research Strategy and Design Quantitative and qualitative methods were used to study the challenges of drug abuse among the youth. Questionnaires and interviews were used to find out the challenges of drug abuse among the youth in Kawempe division. 3.2 Survey Population and Size The survey population was in Kawempe Division Kampala District. The study size was a random sampling technique. Seventy (70) youth victims of drug abuse were interviewed, (50) division residents, fifteen (15) local council officials and fifteen (12) opinion leaders (staff of Kawempe division head office). 3.3 Survey Procedure The respondents for the study were randomly established. However, purposive random sampling was used targeting both the youth and other respondents who were willing to provide information. 3.4 Data Processing and Analysis The findings were tabulated and themes were discussed to give meaning. 3.5 Sample design A sample is a part of the population which is deliberately selected for the purpose of investigating the properties of population. 3.5.1 Sampling method A sample is part of the population which is deliberately selected for purpose of investigating the properties of the population.

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According to Penn (1994) sampling means selection of a part to represent a whole.

The

sampling technique of random sampling was used because it ensures that each member of target population has an equal chance of being included in a sample. 3.5.2 Sample size This consists of at least 60% of the target population which was about 20 respondents. This was done by considering respondents with full information in Kawempe division who were 10 and 30 respondents with related information. Procedures Questionnaire was administered to the Kawempe division head office staff. Participation was voluntary. The division staff members explained the nature and purpose of the study and administered the informed consent and questionnaire to other staff members. Other staff members were onsite to assist if necessary. Confidentiality was stressed, and compensation for participants was provided through raffle prizes. 3.6 Data Collection Methods and Tools 3.6.1 Questionnaire Questionnaires were used to gather information from all the respondents. A questionnaire containing open and close questions will be used in case the respondents doesnt know how to read and write, the researcher assistant helped to interpret the questionnaire for the responses from the illiterate respondents. These are easy to administer and analyze. They can be given out to the respondents and they fill them at their own time thus saving time. 3.6.2 Observation Challenges of drug abuse among the youth in Kawempe district were observed the, more still, the life style of the youth victims of drug abuse in the division were observed. Available record at the Kawempe division head office was consulted to give a picture about drug abuse in the community.

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3.6.3 Interviewing Interviewing was posted to the staff of Kawempe division head office in Bwaise, Kaempe police headquarter (Wambogo police station). Local Council (LC) officials for example LC 1 chair persons in different areas of Kawempe division including Bwaise, Mulago, and Kalalwe were interviewed. But a lot of time was spent with LC officials and members to get in-depth information about the challenges of drug abuse among the youth. The interview lasted for a maximum of fifteen minutes with pre-set questions being administered. 3.7 Documentary review This is where the documents that are in line with the research topic were considered in order to supplement on the research, these were often got Kawempe division head office in Bwaise, and Kaempe police headquarter (Wambogo police station). For example they may be reports of the organization where one is carrying research. Also, further reading was made on the global Internet to review literature closely related to the study. (See chapter 3) 3.8 Ethical issues. Permission to carryout research was granted by the head of Department of Open and Distance Learning, College of Education and External Studies, Makerere University. And the approval the topic Challenges of Drug Abuse in the Youth was authorized and approved by my supervisor Mr. Kalule Duncan. The information given out regards this research was kept confidential to avoid its explosion to unauthorized audience. 3.9 Limitations. There was some hardship in funding the research throughout the research period, for example, transport costs, secretarial services and other costs. There was a limitation of time, one had to forego other activities and carry out research in a period specified, hence one had to budget well for his time.

The problem of lack of sufficient and fast hand information by some residents of Kawempe division and police offers at Kawempe division police headquarter.

Some times some members of Kawempe division head office, and some LC officials were most often not available so I had to move up and down looking for them to equip me with adequate information necessary for this research.

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CHAPTER FOUR

PRESENTATION AND DISCUSSION OF FINDINGS

4.0 Introduction In this chapter, the data analysis was presented. A brief introduction of some drug abuse participants were presented before moving on the analysis of the data. In order to protect the identity of the participants, numerical numbers are allocated to distinguish the participants. The study also included the staff of Kawempe division (headquarter) Kampala district, Kawempe division police headquarter senior officers. 4.1 Brief Introduction of some Drug abuse Participants Participant number 1 was from Bwaise 1, staying with both biological parents and siblings. Only his father is employed at a shop in town. The mother is not employed. The participant is 15 years old and third born in the family. He is repeating grade 8. He was introduced to substances by a cousin during his visit in Gauteng province. He was in primary school doing grade 4 at the time. He uses beer, cigarettes and heroin. The first substance that he used was heroin. He is dependent on these substances; using them three times a day; that is in the morning, during the day and at night. He also uses substances during weekends. His mode of use of these substances includes smoking, inhaling and drinking.

He used substances because his cousin introduced him to them; his parents reprimand him a lot at home and because of peer group pressure. These substances were sold in the area where the participant is residing (Bwaise 1).

Participant number 2 is 15 years oldi a residing in Kikon, with his extended family. He was the eldest at home. He used tobacco, and alcohol. The modes of use of these substances were smoking and drinking. The reasons for using substances were that he wanted to experiment or taste the substances and friends influenced him to use substances. He was dependent on these substances and uses them in the morning, during the day and at night. He often absented himself from school and joins his friends in the bush to use substances. He also used them at the local

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tavern. He and his friends each contributed money to buy the substances, and also used his pocket money to buy substances. His parents were not aware that he uses substances. He was arrested for stealing computers at a store with his friends. He is currently serving a sentence every Saturday at the Correctional Services. Substances have affected his academic performance. He is repeating the grade and still obtains low marks. He knows the effects of using substances and regrets his use of substances. He has an uncle who smokes cigarettes.

Participant Number 3 is 15 years old, a P.7 dropout and staying with both of his biological parents in Katanga. Only his father is employed. Substances used are alcohol and cigarettes. He uses these substances at the tavern with his friends during weekends. He was dependent on alcohol. His reasons for using substances are ill treatment by his parents, an uncle who was arrested, became sick and who later died, peer group pressure, entertainment and the fact that an uncle introduced him to cigarettes because he asked him to light them for him. His parents allowed him to go to the tavern. Once he is under the influence of alcohol, he becomes violent and fights with people. He uses his pocket money to buy substances. His academic performance dropped because of his use of them. He knew the effects of using substances and regrets his use of substances.

4.2 Supplementary Respondents 4.2.1 Response rate It was a good response so much so that, from both the public (division residents), all the 30 questionnaires were returned and from Kawempe division head office, LC officials all the 10 were returned. 4.2.2 Description of the respondents A total number of forty respondents were considered under the study and these included; ten staff members of the Kawempe division head office, Local Council officials.

The table below shows the gender, frequency and percentage of respondents from new Kawempe division head office.

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Table 1; Respondents from Kawempe Division Head Office.

Gender Male Female Total Rate of Recurrence 7 3 10 Percentage 70% 30% 100%

(Source: researchers field data collection) The table above shows that from Kawempe division head office ten respondents were reached, 7 were male contributing 70% of the population and 3 were female contributing to30% of the Population thus making total of 100%

Table 2; Respondents from Kawempe Division LC Officials.

Gender Male Female Total Rate of Recurrence 8 2 10 Percentage 80% 20% 100%

(Source: researchers field data collection) The table above shows that from Kawempe division local council officials ten respondents were reached, 8 were male contributing 80% of the population and 2 were female contributing to 20% of the Population thus making total of 100%

Table 3; Respondents from Kawempe Division Police Headquarter Officers.

Gender Male Female Total Rate of Recurrence 6 4 10 Percentage 60% 40% 100%

(Source: researchers field data collection)

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The tables above shows that from Kawempe division police headquarter officers ten respondents were reached, 6 were male contributing 60% of the population and 4 were female contributing to 40% of the Population thus making total of 100%

Table 4: Respondents from the public (Residents of Kawempe Division)

Gender Male Female Total Frequency 20 10 30 Percentage 67% 33% 100%

The table above shows that from the public, there were 30respondents and of which 20 were male, contributing to 67% of the population and10 were female contributing to 33% totaling to 100%. All the respondents both from the general public and resident victims of drug abuse made a total of 40.

Table 5: Age of the respondents

Age group 20-30 31-40 41 and above Total Frequency 4 4 2 10 Percentage 40% 40% 20% 100%

The above table shows the age group of Kawempe division head office staff and local council officials respondents, 20-30 and 31-40 age groups had 8 respondents all together,41 and above had 2 respondents making a total of 10.

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Table 6: Gender of respondents from the division.

Gender Female Male Total Frequency 17 41 40 Percentage 23% 77% 100%

The table above shows the gender of respondents from the Kawempe division head office staff, Local council officials and the general public/residents of the division. The male represented the highest number which is 35 with a percentage of 77% and the females were 13, having a percentage of 23%.

4.3 RESULTS This section outlines the findings of this study. The research findings were presented as follows: First, the basic themes and organizing themes are presented and secondly, the themes are supported by extracts from the participants responses. The following themes were discussed in this section: age and grade of substance use, reasons for substance use, maintaining the substance abuse habit, stopping the substance abuse habit and the effects of substance abuse. This section further answer the research questions as highlighted earlier in chapter one of this thesis. 4.3.1Age and grade for substance use The age for first time use of substances in this study was between 12 and 15 years among the male participants. Furthermore, participants in this study started abusing substances P.7 to S.1. One participant reported that he started using substances in grade P.4.

4.3.2 Reasons/Causes of Drug abuse among the Youth in Kawempe Division Participants mentioned various reasons for their use of substances. Their reasons included the following: experimentation, biological, depression, peer group pressure, availability and family structure.

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Experimentation Participants do experiment with substances during adolescent stage. They used substances in order to taste them, and to feel high. The participants reported that: I had a desire for alcohol (Participant 3). I wanted to taste it, I saw my friends father laughing after smoking marijuana, so I wanted to feel happy; I wanted to feel Iry (Participant 1) and I wanted to enjoy myself (Participant 3). One participant reported that: My cousin introduced me to drugs during school holidays while visiting Gauteng (Participant 1). In addition, one participant reported that: I started on my own; I thought it was normal or right to use it (Participant 5).

Depression Most of the participants reported stress as the cause for their use of substances. One of the participants reported that: I feel stressed (Participant 12); I worry a lot that stresses me a lot. I am unable to sleep (Participant 10). Furthermore, most of the participants mentioned the function of using substances as relieving stress. Other components of depression described by the adolescents included irritability, unrelenting anger and powerlessness. As they explained: I feel like running away (Participant 8) and I sometimes feel like killing someone (Participant 4). Most of the participants indicated that they had problems at home. As participants reported: I had problems at home (Participant, 4, 8, 11, 12); My uncle ill-treated me, I also saw him beating his wife with an axe, was arrested, released and later died (Participant 3); I need someone to help me (Participant 6, 8) and I want to be assisted so that I can be like other children (Participant 4).

Biological reasons One participant indicated that he used substances because it helped him with his sleeping problem; others reported that substances helped them to accomplish things that they wanted to do: This is how participants related their stories: drugs helped me to do things; If I was lazy, and want to do something, drugs give me courage or strength to do things (Participant 10); I had a problem of bleeding and at home, they told me to smoke cigarette in order to stop my bleeding problem; I smoked cigarette and it stopped my bleeding problem (Participant 7); I worried a lot about my mother who passed away in the year 2000. I drank alcohol before I sleep

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because I dreamt about my dead mother (Participant 7). If you want to sleep and cannot sleep, and you do not want to think about anything, then drugs can help you. I could not sleep so drinking beer before sleeping enabled me to sleep (Participant 10). I thought using drugs will make me cleverer (Participant 5).

Peer group pressure In adolescents talk about substances, the influence of friends was articulated as a key factor. The frequency of the talk about the influence of friends was perhaps to be expected, given that peer group is frequently perceived as the major reason or cause of substance abuse among adolescents.

In the following extracts, participants explained how their friends influenced them to use substances: I used drugs because of my friends; my friends introduced me to drugs, they asked me to contribute money so that we can buy two Amstel Lagers (Participant 3); my friends told me to smoke, at first I refused but later on I joined them (Participant 10); it was because of my friends. I smoked cigarette and drink alcohol with my friends (Participant 7); my friends told me to smoke and drink alcohol (Participant 4) ; my friends told me to smoke dagga (Participant 2) and my friends told me to use drugs in order to forget my problems (Participant 6, 11). I was lonely and my friends told me to use drugs to relieve stress (Participant 6); my friends told me not to be stressed because I will die of heart attack (Participant 12). Another participant reported that: my friends father used to send his son to buy dagga for him. We stole part of it. We saw his father laughing after smoking dagga, so we wanted to feel that way. We felt happy after smoking it (Participant 9).

Availability Substances are easily available in the participants communities. When participants were asked about where they bought these substances, they indicated that they bought them in their locations or villages. Majority of the participants mentioned that they were able to buy substances in their

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local shops, taverns, and butchery (Participant 1, 2, 4, 5, 6). I bought alcohol and cigarette at the shop (Participant 7). I bought alcohol at the tavern (Participant 4, 12); I bought them from the 86 butchery (Participant 11); I buy cigarette from our tuck shop (Participant 11); I bought them from someone in our village (Participant 1, 2, 5, 10) ; and We bought drugs from the son of the chief (Participant 8). Drugs are within easy reach of the participants and as such they afford to buy them. 4.3.3 Maintaining the substance abuse habit The means of obtaining substances varied amongst the participants. Other participants obtained money from home, whereas others used their pocket money or earned a salary that could support their substance use. In some instances their friends bought substances for them, for example, as participants explained: I used pocket money (Participant 1, 9, 10); We contributed money with 88 my friends (Participant 3); We contributed R2.00 each to buy dagga (Participant 2); If I do not have money to buy drugs, my friends bought them (Participant 11); I have friends who are employed, they buy alcohol for me (Participant 4); During holidays, friends from Gauteng brought some drug in the form of a pill for us (Participant 9); I do part-time jobs and use money earned to buy drugs (Participant 1); I help people to carry their groceries and use money earned to buy drugs (Participant 8); We do traditional dance, and I use money earned to buy alcohol (Participant 12); I requested money from my mother (Participant 11); and I gamble by playing dice (Participant 5) . Thus participants use various means to ensure that they have substances. 4.3.4 Challenges of Drug Abuse among the Youth in Kawempe Division All the participants in this study are aware of the effects of abusing substances. They mentioned the following health, social and economic effects of substance abuse:

Health Effects: One participant reported that people become slaves to substances (Participant 10). Most of the participants indicated that substances affect their lungs (Participant 5, 6, 10, 11), heart, eye sight, movement, as well as the mind (Participant 5). Furthermore, other participants noted that: drugs abuse cause heart disease (Participant 6); and eyes become red; I am not able to see properly (Participant 1). One participant reported that: drug abuse cause muscle disease (Participant 6); drug use affect the brain and can make one to be mad (Participant 8);

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and drugs destroy lives (Participant 7). Furthermore, one participant reported that: I know someone who died because of drugs (Participant 9).

Dependence: Most of the participants reported that they were dependent on substances. Participants described their continuous use of substances as follows: I use drugs twice or even thrice in a day; I use drugs in the morning, during the day and at night (Participant 1, 2, 5, 6, 8); and I use drugs on my way to school, during break, during the lessons, and after school(Participant 9, 11). However, other participants reported that they used substances during the weekend only: I use drugs during weekends; on Fridays, Saturdays and Sunday (Participant 1, 2, 4, 12); and I am addicted to alcohol and drink it during weekends(Participant 3). Thus, most of the participants in this study are addicted to drugs.

Social effects: All the participants were aware that their use of substances also affects other people, for example, they mentioned that substances: make people not to respect others and may do anything wrong (Participant 1, 8); make people tease you (Participant 7); make people aggressive; make people violent; I fight with other people after using drugs (Participant 3, 4); make people to rape (Participant 4); drugs make people to think of raping (Participant 7); andpeople using drugs end up in jail (Participant 8). One participant indicated that: after using drugs, he feels like killing someone (Participant 4). In addition, other participants reported that:drugs make me not to respect the educators and other learners (Participant 1); and drugs make people do bad things (Participant 11). Another participant reported that: I was forced to keep friends using drugs, otherwise, I would not get things that I need; I ended up supporting friends doing funny things because they were not going to buy me food, if I had not supported them (Participant 6). Drugs make people think of stealing (Participant 7); We used drugs, went to steal computers at a shop not far from or village and we were arrested and sentenced for two years (Participant 2).

Economic effects: Majority of the participants indicated that substances affect their academic performance and that one may end up dropping from school. Furthermore, the participants mentioned that substances affect their studies, as participants explained: Drugs affect me at

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school, I am not able to do homework (Participant 11); I am not able to concentrate in the classroom (Participant 4, 9); I am not performing well in my studies (Participant 9, 10); I pass some subjects and fail other subjects (Participant 11); Academic performance become poor, I did not pass well (Participant 1, 9, 10); I was absent from school; I did not get a chance to study; Performance drops, low marks and one ends up failing (Participant 2, 9); and I am repeating the grade (Participant 1, 2, 3, 4). The use of substances had a negative impact on the academic performance of these participants. However, one participant reported that his use of substances enabled him to make plans: I was able to make chairs and tables (Participant 2). Thus, the use of drugs had health, social and economic effects on the adolescent drug user. 4.3.5 Curbing substance abuse among the Youth in Kawempe Division All the participants emphasized that they want to stop using substances and as such need assistance. As participants respond to this question: Would you like to stop using drugs? Responses of participants: I want to stop using drugs (Participant 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 12). I need someone to guide me (Participant 6); I need help and will appreciate it if I can be helped (Participant 10); I have tried to stop using drugs but I am unable to stop (Participant 11); I am addicted to alcohol (Participant 3); I need someone to help me stop using drugs (Participant 1, 4, 6); I can stop using drugs if I can stop going out with friends using drugs and live on my own (Participant 8); and I can stop using drugs if I can stop going out with friends using drugs and relocate from this place (Participant 10). I want to stop using drugs and be father of the future, I am considering my future, and I also want to encourage others that it is not good to use drugs, and that they must stop using drugs (Participant 5); I want to stop using drugs and need someone to take care of me (Participant 6); and I want to stop using drugs and be like other children (Participant 4). The participants in this study are aware that substances are not good for them. They regret their use of substances, and as such would like to stop using substances. They have also indicated their need to get help in order to stop using substances. However, some participant reported that they had stopped using substances: I have stopped using drugs (Participant 5); I had stopped using drugs after realising that drugs are not good (Participant 2); and I stopped using drugs after my mother requested me to do so (Participant 9).

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Develop a working relationship with victims of drug abuse. As with sex, drug issues may be a secretive area for young people. This is particularly so if the young person perceives possible negative consequences for disclosure (e.g. refused accommodation, judged, probation breached or parents informed).

Screen all adolescents for drug use. Evidence suggests the majority of young people who come into contact with the welfare sector may rely on drug use as a method of coping and to have fun. Use bridging questions such as, Many young people find alcohol or other drugs helpful in coping as well as for having fun can you tell me about your alcohol and other drug use? This question normalizes and presumes drug use allowing for a more honest answer. Interventions of different Personnel in helping youth stop drug abuse Involve key stakeholders (parents, peers, partners & professionals) As adolescents is a time of rapid development and identity formation, the above can be very influential. They can exacerbate or inhibit drug use and associated problems or both. They may also help/hinder the young person achieve life goals which compete with drug-related problems. 4.4 Chapter Summary In this chapter, the data analysis was presented. The profile of participants in this study was presented as well as the steps that were followed in analyzing data were discussed and the identification of basic themes, organizing themes and global themes were explained. The basic themes, organizing themes and global themes were presented in tables and in web like structures. Furthermore, the findings of the study were discussed and supported with the extracts that were derived from the interview transcripts.

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CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION 5.0 Introduction This chapter gives a summary of the research, draws conclusion from the research findings and makes recommendations regarding challenges of drug abuse among the youth in Kawempe division. The purpose of the study was to find out the challenges of drug abuse among the youth with a case study of Kawempe Division Kampala District and the study was supported by the following objectives. - To establish the causes of drug abuse among the youth. - To assess the challenges of drug abuse among the youth. - To suggest remedies to respond to drug abuse among the youth.

The objectives of the study formed the basis for recommendations, the summary and conclusions were as a result of appropriate analysis of the collected data, from the analysis of the gathered data, and summary was made. Data was collected through questionnaires and observations made by the researcher. 5.1 Summary An impressive amount of research has established that the youth are likely to behave in a manner consistent with the behavior of their friends. In accounting for challenges of drug abuse in Kawempe division, peer group influence is perhaps the strongest and most consistent correlate of adolescent misbehavior of drug abuse. It is therefore surprising that more is not known about why this relationship exists, but also little is known about the structure of friendship networks or the processes that generate the similarity in behavior patterns which has put the division in danger over the outcome of drug abuse including cases to do with rape, robbery, murder, prostitution, un wanted pregnancies, imprisonment, among

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5.2 Conclusion In conclusion the study which was carried out in Kawempe division-Kampala district enabled the researcher to achieve all the objectives and aims of the study and the following findings were appreciated: Prior research has clearly established that adolescents in Kawempe who have friends who use drugs are also likely to use drugs. Although this finding is among the strongest and most consistent in research on drug use among the youth in Kawempe division, little is known about the characteristics of the networks that constitute these relationships. Based on data from this research challenges of drug abuse in the youth; a case study of Kawempe division, this study contributes to the national understanding of the effects/challenges, causes and possible resolutions to of drug abuse in the youth not only of Kawempe division the entire country.

Previous studies have found that the affective quality of relationships that users have with friends is at least as close as that of nonusers. Had the present study examined only the intimacy of the relationship of social networks, its conclusion would have been similar to that of prior research. This research found that users have more intimate or supportive relationships with their friendship network than do nonusers. It also found that user networks are generally as dense as nonuser networks. In addition, it found that although relationships within user networks appear to be more intimate, they are also less stable over time.

Interpreting the paradox of drug abuse victims having more intimate but less stable social networks is difficult. The measure of intimacy included items that focused on expressive and instrumental support that friends provide one another. The fact that users have higher values on this measure may indicate that they need to lean on friends more for this type of help than do nonusers. The need for users to rely on friends for social support may also be a result of a more alternative relationship with parents. Although parental social support was not examined in the current analysis, parents of users were found to be less involved in the social networks of their children. Hence, although the friendship networks of users may be weaker as evidenced by their transitory nature, users may need to call on their friends for more social support than nonusers, On the other hand, the friendship networks of users are not less multiplex or less dense than those of nonusers. Therefore, the finding regarding stability may indicate that users are simply

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more sociable, putting them in a better position to constantly make new friends, Once those new friendships are formed, users are more likely to open up to those friends.

It is not possible with the current information to determine which of these interpretations is valid. However, it is evident that the suggestion in prior research that the friendship networks of alcohol and drug users are more intimate than those of nonusers may be premature. With a more complete description of characteristics of social networks, that explanation is called into question.

The results do confirm that users of alcohol and marijuana in Kawempe division are more likely to have friends who also use. Moreover, these friends are more likely to live in the same neighborhood than the friends of nonusers. This finding underscores the importance of the neighborhood context in determining use patterns and, coupled with the finding that the networks of users are less likely to come from the same school, suggests that intervention strategies should include neighborhood-based as well as school-based strategies.

A more difficult finding to deal with in terms of social policy is that victims of drug abuse in Kawempe division are more likely to have a girlfriends or boyfriends. This result may reflect that the use of alcohol and marijuana is part of the normal pattern of interaction among adolescents who are more socially active. This pattern was especially pronounced for females, which suggests that they are more prone to be influenced by the behavior of their boyfriends. It is difficult to suggest a strategy for dealing with this tendency. Perhaps Uganda programs that focuses on social skills and strategies of saying no are on the right track. 5.3 Recommendations 5.3.1 Future research It is recommended that a larger sample, inclusive of female participants, covering a wider geographical area be drawn in future investigations, in order to improve the generalisability of the findings. In addition, adolescents who do not attend schools should also be part of the study. Furthermore, the study should also include other racial groups. Interview questions must be translated into the participants preferred language before interviews are conducted. Furthermore, in addition to face-to-face interviews, it is also recommended that participants be

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allowed to write down all the other aspects that relates to the study which they find difficult to express during interaction with the interviewer.

This study recommends further research undertaking regarding parental support during adolescence. In addition, this study calls for research on substance abuse monitoring devises that can be used in schools to curb substance abuse behavior. Furthermore, more than one researcher could collect data in order to ensure objectivity during data analysis. Both qualitative and quantitative approaches can be used to gather information about substance abuse among adolescents. By combining both approaches, I could have maximized the strength and minimized the weaknesses of each approach. This may have strengthened the results and contributed to 107 theory and knowledge (Morse, 1991). In addition, since multiple and diverse observations could be used, the study could have enriched the understanding of the substance abuse problem among adolescents. However, the volume of data produced, would have been immense and an extremely broad knowledge base was required to analyze it. The investigator would then have had to contract other researchers to work on the different parts of the analysis (Miles & Huberman, 1994). 5.3.2 Policy Implications This study recommends that a database of adolescents abusing substances be developed and such adolescents be referred to social workers for intervention. Most of the participants reported that they bought cigarettes and alcohol from the shops and butchery in their villages including Mulago, Bwaise 2, Bwaise 1 among others. Other participants indicated that they drank alcohol in taverns. This evidence shows that even though law strictness is employed, some of the tavern owners do not comply with it. Furthermore, this means that some entrepreneurs do not only sell goods that are stipulated in their business licenses. This has implications for policy makers to strengthen strategies employed to implement, monitor and evaluate policies. In addition, there is a need to educate entrepreneurs, tavern owners, parents, adolescents and community members in rural areas about the Liquor act because they are important stakeholders who may play a role in ensuring that the act is implemented. They may also assist in reporting cases of non compliance of the Liquor act by some entrepreneurs and tavern owners (Liquor Act no. 59 of 2003).

The majority of the participants reported that they used substances in the bush and mountains where no one sees them. This study recommends that Ugandan Police Service collaborate with

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communities through Community Policing Forum to address substance abuse problem among adolescents. Furthermore, adolescents need to be empowered through victim empowerment programmes to stop abusing substances because they have a right to develop to the fullest and be protected from harmful use of substances. In addition, there is a need for proper monitoring to control the influx of substances from urban areas to rural areas. Teenagers should be encouraged to participate in community policing forums because they seem to know the sources of the substance supply.

As mentioned earlier, Teenagers Against Drug Abuse (TADA) support groups need to be established in schools (National Drug Master Plan, 2006). These goups help in encouraging peers to refrain from substance abuse. In addition, no adolescent should be allowed to enter school premises if he or she is under the influence of substances, as he or she can endanger the lives of other learners. The services of police officers that are adopted in schools must be fully utilized to address substance abuse behavior among adolescents and to ensure substance free schools.

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REFERENCES I. Rubaga Division Report (2009/2010) Jon Rose (2000), High Risk Youth Alcohol & Other Drug Use, DrugNet Web www.drugnet.info/parent_child/youth.doc Page.

II.

III.

State of Drug Abuses in Uganda (UYDEL) Uganda Youth Development Link. (2008 Report)

IV.

World Health Organization Report (2005)

V.

Akers, R.L. Deviant Behavior: A Social Learning Perspective. Belmont, CA: Wadsworth, 1977.

VI.

Anderson, E. A Place on the Corner. Chicago: University of Chicago Press, 1978.

VII.

Anderson, E., and Rodriguez, 0. Conceptual issues in the study of Hispanic delinquency. Research Bulletin. Vol. 7, Issues 1-2. Bronx, NY: Hispanic Research Center, Fordham University, 1984.

VIII.

Bandura, A. Self-efficacy mechanism in human agency. Am Psychol 37:122- 147, 1982.

IX.

Bank, B.; Biddle, B.; Anderson, D.; Hauge, R.; Keats, D.; Keats, J.; Marlin, M.; and Valantin, S. Comparative research on the social determinants of adolescent drinking. Soc Psychol Q 48:164-177, 1985.

X.

Beauvais, F.; Oetting, E.; Chavez, E.; and Swaim, R. Cultural Identification Scale. Fort Collins, CO: Rocky Mountain Behavioral Sciences Institute, 1987.

XI.

Beauvais, F.; Oetting, E.R.; and Edwards, R.W. Trends in drug use of Indian adolescents living on reservation; 1975-1983. Am J Drug Alcohol Abuse

51

XII.

11(3-4):209-229, 1985.

XIII.

Berry, J. Acculturation as varieties of adaptation. In: Padilla, A., ed. Acculturation: Theory, Models, and Some New Findings. Boulder, CO: Westview Press, 1980. pp. 9-25.

XIV.

Born, D. Psychological adaptation and development under acculturative stress: Toward a general model. Soc Sci Med 3:529-547, 1970.

XV.

Braithewaite, J. The myth of social class and criminality reconsidered. Am Social Rev 43:36-57, 1981.

XVI.

Brook, J.S.; Brook, D.W.; Scovell Gordon, A.; Whiteman, M.; and Cohen, P. The Psychosocial Etiology of Adolescent Drug Use: A Family Interactional Approach. Genet Soc Gen Psychol Monogr 116 (2), 1990.

XVII.

Buriel, R.; Calzada, S.; and Vasquez, R. The relationship of traditional MexicanAmerican culture to adjustment and delinquency among three generations of MexicanAmerican male adolescents, Hispanic J Behav Sci 4:41-55, 1982.

XVIII.

Caetano, R. Acculturation and drinking norms among U.S. Hispanics. Alcohol Alcohol 22:427-433, 1987.

XIX.

Castro, F.G.; Maddahian, E.; Newcomb, M.D.; and Bentler, P.M. A multivariate model of the determinants of cigarette smoking among adolescents. J Health Soc Behav 28:273289, 1987.

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APPENDIX A
A MAP OF KAWAMPE DIVISION SHOWING THE GEOGRAPHICAL AREA OF STUDY

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APPENDIX B QUESTIONNAIRE KAWEMPE DIVISION HEAD OFFICE (STAFF)

INTRODUCTION I am Nakayaga Stellah, a student of Makerere University, offering a Commonwealth Youth Diploma in Development Work. I am carrying the research on the topic,challenges of drug abuse in youth; a case study of Kawempe division -Kampala district. You have been chosen to be one of the respondents and the information provided for this research will be used for study purpose and will be handled with a lot of confidentiality.

1. Characteristics of respondents Please tick or fill in the correct options.

a) Age 15-25 25-30 31-40 41 and above

b) Gender Male Female

2. What is your experience about drug abuse in the youth of Kawempe division? ............................................................................................................................................................ ............................................................................................................................................................ ........................................................................................................ 3. From your own observation, which age group is commonly involved in drug abuse in Kawempe division? (i) All age groups (ii) Kids (iii) Youth (iv) Old people (v) Others (Mention).................................. 54

b) Do you think there is any step taken by the government of Uganda to combat the problem? (i)Yes (ii)No c) State reasons for your answers. ............................................................................................................................................................ ............................................................................................................................................................ .......................................................................................................................

4. How do you assess the effectiveness of controlling drug abuse in Kawempe division? ............................................................................................................................................................ .................................................................................................................................... .......................................................................................................................................... 5.a Do you have a relative or a friend who engage in drug abuse? (i) Yes (ii) No b. If yes have you ever taken any steps towards advising him/her over the consequences of drug abuse? (i) Yes (ii) No (c).In what format do you get the feed back? ........................................................................................................................................................ ............................................................................................................................................................ ........................................................................................................................ What do you think would be the immediate resolutions to stopping this problem? . . b. How should they be implemented? ........................................................................................................................................................ .............................................................................................. 7. what is your onion on the challenges of drug abuse among the youth in Kawempe division?

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........................................................................................................................................................ ............................................................................................................................................................ ............................................................................................................................................................ ...........................................................................................................

END

THANK YOU FOR PARTICIPATING

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APPENDIX C QUESTIONNAIRE KAWEMPE DIVISION POLICE HEADQUARTER (OFFICERS)

INTRODUCTION I am Nakayaga Stellah, a student of Makerere University, offering a Commonwealth Youth Diploma in Development Work. I am carrying the research on the topic,challenges of drug abuse in youth; a case study of Kawempe division -Kampala district. You have been chosen to be one of the respondents and the information provided for this research will be used for study purpose and will be handled with a lot of confidentiality.

1. Characteristics of respondents Please tick or fill in the correct options.

a) Age 15-25 25-30 31-40 41 and above

b) Gender Male Female

2. What role have the Ugandan police played to stop drug abuse in the youth of Kawempe division? ............................................................................................................................................................ ............................................................................................................................................................ ........................................................................................................ 3. From your own observation, which age group is commonly involved in drug abuse in Kawempe division? (i) All age groups (ii) Kids (iii) Youth (iv) Old people 57

(v) Others (Mention)..................................

b) Do you think that that constant arrest of youth victims of drug abuse has done more harm than good? (i)Yes (ii)No c) State reasons for your answers. ............................................................................................................................................................ ............................................................................................................................................................ .......................................................................................................................

4. How do you assess the effectiveness of the police to control drug abuse in Kawempe division? ............................................................................................................................................................ .................................................................................................................................... .......................................................................................................................................... 5.a Do you have a relative or a friend in police who have engage in drug abuse? (i) Yes (ii) No b. Is drug abuse an outcome of major criminal offenses in this division? (i) Yes (ii) No (c).How cases have you received about drug abuse in Kawempe division for the last 3 months? ........................................................................................................................................................ ............................................................................................................................................................ ........................................................................................................................ 6. What would be the immediate resolutions to undertaken by the police to stop this problem? . . b. How should they be implemented? ........................................................................................................................................................ .............................................................................................. 7. What is your onion on the challenges of drug abuse among the youth in Kawempe division?

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END

THANK YOU FOR PARTICIPATING

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