Illegal Drugs Usage Among Saudi University Students

Illegal drug usage among Saudi university students (Online survey)
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Table of Contents
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INTRODUCTION  PAGEREF _Toc438015082 \h
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BACKGROUND OF THE STUDY  PAGEREF _Toc438015083 \h
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Search strategy and Boolean operators  PAGEREF _Toc438015084 \h
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Inclusion/ exclusion criteria  PAGEREF _Toc438015085 \h
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Literature review  PAGEREF _Toc438015086 \h
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STUDY DESIGN 10
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Sample  PAGEREF _Toc438015088 \h
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Data collection  PAGEREF _Toc438015089 \h
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Data analysis  PAGEREF _Toc438015090 \h
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Ethical issues  PAGEREF _Toc438015091 \h
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CONCLUSION  PAGEREF _Toc438015092 \h
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Reference list 19

INTRODUCTION
The study seeks to understand the prevalence of drug abuse among Saudi Arabian university students. To ensure confidentiality and anonymity the study will use an online study, and the results will then be analyzed to determine the percentage of the students who have been involved in illegal drug abuse at one point in time. Additionally, the study will identify the most common types of drugs that are abused by the Saudi students. The study will also seek to establish whether using illegal drugs is related to drug abuse, including certain drugs being the gateway to other harder drugs. Substance abuse is a concern to public health workers since it increased the healthcare burden, while illegal drug use is associated with the growing psychological problems. In the Gulf Arabian region, the main forms of substance are tobacco and illegal drugs, heroin, hashish and to some extent alcohol (Al-Haqwi, 2010, p. 2). The rising cases of substance use is a concern, while the rapidly changing social transitions mean that there is a risk that drug abuse may become a worse public health concern if there are no measures to deal with the problem. There have been past allegations of drug trafficking of hard drugs like cocaine and hashish involving some family members of the Saudi royalty, but accessing such information is difficult as the state controls the media (O’Grady, 2015).
Students joining universities have more independence from their families, while this also provides opportunities for self-exploration. Additionally, the peer pressure and self-decision making opportunities available means that university students are at high risk of substance abuse compared to other young people who live with or near their family members. Substance abuse increases risk of dependence, and intervention programmes need to focus on strategies to eliminate substance abuse the Ministry of Health in Saudi Arabia has reported increased cases of people seeking specialized psychiatric services, and this could partly be because of substance abuse (Ministry of Health Saudi Arabia, 2012).
Even as the problem of substance use has affected Saudi university students, there are few studies that focus on the factors contributing to the problem. The Saudi society is conservative and based on Sharia law, highlighting that there is a religious urge to tackle the problem but at times downplaying the role of mental and medical practitioners. The males are also more likely to abuse substances compared to females, and gender specific prevention programmes are effective in reducing substance abuse (Park, Al Agili & Bartolucci, 2012, p. 1830). Incidences of substance abuse in Saudi Arabia are less common compared to the western societies, but it is necessary to understand how this affects university students.
Prohibition by law and religion may have contributed to low prevalence of substance abuse in the Saudi Arabia, but the culturally unacceptable behaviour is more common in institutions of higher learning (McMurran, 2013, p. 29). As such, understanding the frequency of substance abuse will provide valuable information on drug dependence and complications among the students. Lack of knowledge on the side effects of substance abuse might also explain the rising cases of the behaviour. The likely hood of statistical association between substance abuse of certain drugs with others cannot be ruled out.
BACKGROUND OF THE STUDY
Search strategy and Boolean operators
The search strategy mainly focused on the Ebscohost and Proquest database to gather relevant information related to substance abuse and substance abuse, as the Boolean operators allows one to narrow down the research terms. The main search terms were substance abuse among Saudi Arabian college students. Combining the three Boolean search terms substance abuse And Saudi students yielded 23 results in the Ebscohost data base. This compared to 1,629 scholarly journals in Proquest, but the results also include many articles with either of the search terms. On the other hand, the general search terms ‘substance use and university students’ yielded 9,221 in Ebscohost. The study then focused on academic journals focusing on substance abuse in universities mainly the Journal of Substance Use and International Journal Of High Risk Behaviors & Addiction. The search terms were relevant to the study given the need to narrow down the search to substance abuse among Saudi Arabian students, to understand abuse and prevalence. The choice of the sources was based on the CASP tools highlighting the need to review the quality of the study results, relevance of the results and relevance of the results at the local context.
Inclusion/ exclusion criteria
The inclusion criteria for the search are the articles that either focuses on substance abuse among university students or the general population. Additionally substance abuse for university students in other countries is also considered to provide information. Since the study is based on self-reporting by the students the participants are those who will agree to participate in the study. Studies that also link substance abuse with behavioural problems will be identified as they provide vital information on the likely risks of the problem and provide vital information on the measures to be undertaken. The exclusion criteria are the articles that highlight cognitive impairment as there is an assumption that the study participants will understand the side effects of substance abuse.
Literature review
In a study by Alsanosy, Mahfouz, & Gaffar (2014, p. 2) the researchers sought to understand how the prevalence of khat chewing affected secondary students in the Jazan region. Even though, the khat chewing behaviour was found across socioeconomic groups, the authors reported that male students were more likely to chew khat compared to the female respondents (Alsanosy, Mahfouz, & Gaffar., 2014, p. 5). This is consistent with past research that males are more likely to engage in substance abuse. Besides, gender cigarette smoking and peer pressure were associated with khat chewing. The implication of these observations is that abusing one drug increases the risk of abusing others, with males at a higher risk since there is peer pressure to conform to certain specifics. Intervention strategies then to deal with substance abuse need to take into account the socio-demographic profile of individuals at a higher risk of substance use. Even though, the researchers differentiated the Quranic and Formal schools, they did not point out how differences in perceptions were associated with the risk of illegal drug usage.
Since there are sporadic efforts to undertake effective substance abuse programs in Saudi Arabia, there is a need to understand how risk factors that affect drug use. Bassiony, (2008, p. 38) looked at how the age onset affected the stages of substance use progression including alcohol and tobacco. Patterns of abuse differ across generation with the youths more likely to have indulged in drug abuse at a younger age compared with the adults. The study only used male participants who were also drug dependent or abusing drugs, and there the results may not mirror those of female substance users. Understanding the pattern of substance abuse is relevant while intervening and reducing the risk of young people getting addicted to illegal drugs, alcohol and tobacco. Failure to intervene early on is associated with the risk that the youth will likely be drug dependent, and this is a health concern that affects the individual, their families and the societies.
The adolescence period is considered vulnerable to risky behavior including substance use (Bassiony, 2013, p. 452). At the universities, there is a risk that those who become first time users who get hooked on drugs if there is inadequate intervention. Intervention program focusing on the risk factors and preventing cases of substance abuse are more effective in cases where intervention is at the individual level and family level where possible (Bassiony, 2013, p. 451). However, since the university students are likely away from the families understanding the prevalence of substance abuse and association with sociodemographics. The larger cities are most affected by the drug problem including Riyadh, Jeddah and the port cities where there are higher supplies of drugs, tobacco and alcohol.
Albrithen (2014, p. 547), conducted a study to identify the characteristics of people with alcohol problems in Saudi Arabia highlight that those with high levels of alcoholism were more likely to be smokers and were at a higher risk of relapsing. Another study by Bassiony, (2013), identified amphetamine, heroin, alcohol and cannabis as the most abused substances, with the use of heroin having fallen over the past decade patients who were drug dependent were also more likely to suffer relapse Bassiony, 2013, p. 447. Illegal drug usage was also identified a public health concern as those affected were more likely to experience psychiatric disorders compared to those who did not indulge in drug use (Bassiony, 2013, p. 454).
According to Al Nahedh (1999, p 243), substance abuse is a growing problem in Saudi Arabia and the high rate of relapse is concern to healthcare workers. Analysis of data collected from the Al-Amal Hospital showed that the average age of illegal drug usage was 29.5 years with the individuals having using illegal drugs for 9.5 years. The individuals who were unemployed and facing social stress were at a high risk of relapse. Another study by Heydarabadi (2015, p. 2), conducted in Iran concentrated on illegal drug usage among university students, pointing out that a majority of the students experimented with drugs while living in school dormitories. Peer pressure and lack of parental supervision are identified as factors that increase the risk of substance abuse.
According to Harling & Turner (2012, p. 236), negative attitudes by nursing students on illegal drug usage affects the success of intervention programmes. The relevance of understanding the attitudes of healthcare workers is that it affects the intervention and education approaches to eradicate illegal substance abuse. In some instances individuals affected by trauma may result to illegal substance usage as a coping strategy (Bianchini et al., 2015, p. 141). Positive relationships and social support are necessary to provide hope to individuals facing trauma. Additionally, inadequate mental health intervention may increase the risk of substance abuse as individuals do not have positive coping strategies.
According to Tsvetkova and Antonova, (2013, p.86), university students are vulnerable to illegal drug usage compared to their peers, and as the number of high school students joining universities increase, there is genuine concern that more are exposed to illegal substance use. At the same time, individuals who use illegal drugs are vulnerable to suicidal thoughts. Identifying the risk factors to illegal drug usage is then necessary to intervening and reducing drug abuse and preventing suicide among drug abusers (Monirpoor et al., 2014, p. 2). The cultural context and firm religious convictions are associated with lower risk of drug abuse and suicide highlighting that religion has a positive influence on the psychological wellbeing of people because they have positive coping strategies (Monirpoor et al., 2014, p. 4).
Low substance abuse in the many Muslim majority countries comes about because of legal and religious prohibition. Additionally, the notion that substance abuse is against the values of the people and harsh disproval from parents and the society is associated with low illegal drug usage (Negm and Fouad, 2014, p. 163). On the other hand, experimenting with drugs may be viewed as part of normative development of adolescents in some sections of the western society. Negm and Fouad (2014, p. 163), stated that tobacco as the most commonly abused substance in Saudi Arabia followed by amphetamine, with many using more than one substance used together.
Demographic data and student pass time activity also need to be considered when identifying risk factors to substance abuse. A study by (Yusko, Buckman & Pandina, 2008), compared substance use between athletes and nonathletes in a U.S. university. Nonetheless, the differences between the lifestyle of athletes and nonathletes are different in western societies given the impulse to party among athletes. The results of the study may not necessarily be replicated in the Saudi context. Male students were more likely to use performance-enhancing drugs and heavy drinking (Yusko,Buckman & Pandina, 2008, p. 282). However, heavy drinking differed depending on the seasons, and there is a need to consider the decision-making process of different groups at the university (Yusko,Buckman & Pandina, 2008, p. 287). The risk factors associated with illegal drug usage ought to be identified to manage the condition as using one drug is a factor in using other drugs.
Castaldelli-Maia et al (2014), compared drug users and non-drug users among Brazilian university students to determine whether there was a transition process in using drugs. Inhalants and marijuana were identified as the first likely drugs of contact, where the drug users then moved to other drugs. The age of experimentation and length of time one has experienced the illegal drugs also affect the prevalence of illegal drugs usage this is consistent with previous studies, which point out that the first drugs of contact and lifetime experience with illegal substances affect the prevalence of drug abuse with illegal abuse.
Substance abuse in Saudi Arabia is still low since there is low acceptance of the practice while there are legal and religious prohibitions. Khat, hashish and synthetic drugs like amphetamines are the most common drugs, but those who engage in tobacco smoking and drinking are at a higher risk of experimenting with other drugs compared to those with no previous history of drug abuse. From the review of literature, males are more vulnerable to illegal drug usage than females. At the same time, being away from families and being independent may increase susceptibility of young people to experimenting with the illegal drugs. As such, the study design will take into account the following questions
What is the prevalence of Saudi university Students who have used illegal drugs in one point of their lives?
What are the most common drugs used by the Saudi students.
is there any relationship between using an illegal drug and using other drugs
STUDY DESIGN
The research will consider ethics as especially nonmaleficence to assure the respondents that there will be no harm inflicted on them, as privacy and anonymity will be respected. The self- administered online surveys will be undertaken anonymously, but with the students providing information about their profiles on age, gender and their experience with previous drug use if any. Other than sociodemographics details, the frequency of substance use and drug combinations, are important to identify the most relevant treatment alternatives (AbuMadini, Rahim, Al-Zahrani, and Al-Johi, 2008, p. 232). Depending on the demographic profiles and the academic disciplines the information collected is then to be analyzed to determine the emerging patterns on substance use. The response rate and completion rate are all considered in the analysis and the larger the survey the better the reliability of the information. The median age of the respondents is another factor that will be conside...