Students’ perspectives on drugs and alcohol abuse at a public university in Zambia

serves as basis for scholars in the field of biblical theology engaged with justice, health and human development. The article is a contribution to the research project Biblical Theology and Hermeneutics. The results of this research can especially be utilised by scholars in the field of psychology of religion, the sociology of religion and practical theologians focusing on youth ministry.


Introduction
The abuse of alcohol and psychoactive substances is still an important public health concern around the world especially among students.Students in Higher and Tertiary Education Institutions (HTEIs) usually abuse alcohol, drugs, and other psychoactive substances (Bullock 2004).Psychoactive substances are defined as both legal and illegal substances that when consumed can affect the way individuals' taste, smell, feel, behave, and see things (Ministry of Health 2021).Kabbash, Zidan and Said (2022) acknowledged that abuse of drugs and substances among young people is a global challenge that has effects that are detrimental to the security of nations and affect individuals' health and their livelihood.Kaluwe (2019) and Carney et al. (2013) postulate that the effects of drug abuse among students lead to increase in crimes, violence, poor academic performance, school dropout, corruption and drain on economic resources.Masiye (2016) on the other hand states that drugs impact the pupils` experience in their educational journey and create challenges on the management of learning institutions.Students who abuse drugs and other substances tend to care less about themselves and their learning (Oshodi, Aina & Onajole 2010).It was yet to be proven how students perceive the drug and alcohol abuse on campuses.Bullock (2004) studied attitudes, beliefs, use of alcohol and drugs among Swedish university students from which it was proven that cannabis use scored highest with 25.4% of students having tried it while the other commonly abused drugs were amphetamines (4.1%) Access to students' perspectives on substance abuse is essential for effective youth intervention projects development.This study aimed to explore students' perspectives on abuse of drugs and alcohol with probable development of student-led intervention strategies.The study was conducted at public universities in Zambia.Student's perspectives on drugs and alcohol abuse were documented using a mixed method design that employed purposive and snowball sampling to select 200 respondents to questionnaires and 10 to in-depth interviews.A humanistic theory approach was applied in the interpretation and analysis of the data collected.The findings showed that cannabis (30%) and codeine contained in Benylin (17%) were commonly abused.Further findings showed that students' academic pressure was the leading cause of substance abuse (27%), followed by peer pressure (20%).Students knew that abuse of drugs and alcohol led to low academic performance, violence and theft, risks of contracting sexually transmitted infections (STIs), and other social maladjustments.The study recommends that institutions of learning increase student-led awareness campaigns, security surveillance on campus, and collaboration with government drug enforcement agencies.Institutions of learning should involve students in the planning of programmes to deal with drug and alcohol abuse.

Students' perspectives on drugs and alcohol abuse at a public university in Zambia
Read online: and ecstasy (3.2%).Prescription drugs that are supposed to be prescribed by a physician were among the abused psychoactive substances (Iloabuchi et al. 2021).In yet another study conducted in colleges and university campuses within Eldoret Municipality in Western Kenya the prevalence of substance abuse was at 69.8% with alcohol abuse at 51.9%, cigarettes use at 42.8% and cannabis at 2% (Lukoye et al. 2011).In South Africa, a similar study was conducted to establish the prevalence and factors associated with substance abuse at a university in the Western Cape, which revealed a 62.7% substance use among students with 80.6% alcohol, 46% cannabis and 5.3% ecstasy (Blows & Isaacs 2022).Such information brings to the fore the need for a study to re-look at how the students themselves perceive the drug and alcohol abuse on campus and prove strategies the students propose, and feel can help reduce the drug and alcohol abuse in HTEIs.
In HTEIs drug and alcohol challenges are seen in students' behaviour as they get associated with things such as truancy, rudeness, low attainment in academics, graffiti, vandalism, and a lack of respect for authority in some cases (Adekeye et al. 2015).Masiye and Ndhlovu (2016) postulate that most negative behaviours among students are associated with drugs and alcohol abuse.However, it is not clear how students perceive the abuse of these substances.Nyimbili et al. (2019) contrary to other scholars argues that such behaviours start with parents who abuse substances and set an example to young people indirectly and young people in turn start to get drugs and alcohol using the resources from parents, which is not part of the traditional roles for parenting.
The extent of the drug and alcohol abuse among students in Zambia is far more concerning than is reported (Masiye & Ndhlovu 2016) Another study conducted by Kusanthan (2014) showed drug trafficking prevalence in Zambia with Lusaka showing 87% followed by Copperbelt with 58%, Eastern at 44%, Southern 34% and Muchinga 33%, Central with 26% and the least concentration of traffickers was North-western with 20%.This shows the availability of psychoactive substances in different regions.Masiye (2016) postulates that there was an overwhelming negative consequence resulting from the abuse of drugs and alcohol on individuals, families, schools, and communities.Such information and evidence from research and stakeholder's shows that drugs are in use and are being abused among students.This study was anchored on the identified increase of substance abuse among students hence the need to explore and document students' perspectives on the abuse of drugs and alcohol among young people and probable development of student-led intervention strategies.
This study employed the humanistic theory in interpreting the findings.The humanistic psychology as stated by Bland and Derobertis (2019) emphasises an inter-subjective, empathetic approach in their therapeutic and research approaches to have an appreciation of the lived world of individuals (Grant & Osanloo et al. 2014).Thus, it is assumed that individuals have the freedom to adjust their personality as they experience new interactions with their immediate environment.
The theory is seen to be suitable for this study, as it will help in appreciating the lived experiences of students as individuals in their subjective experiences.Furthermore, in trying to develop ways of mitigating the incidences of drug abuse, the study will not impose measures but will propose mitigation measures based on the understanding from the study's findings and evidence from literature on the matters raised.
The study was guided by the following broad objectives: Assessing students' views on how drugs and alcohol cases should be managed in universities, establish the types of drugs used on campus, and to establish students' views on factors necessitating alcohol and drug abuse in institutions of learning.

Study design
The study adopted a mixed methods research design.The quantitative arm of the study used descriptive survey design while the qualitative arm used phenomenology because of its ability to describe in-depth the common characteristics of the phenomena that has occurred (Creswell 2009;Tavakoli 2012; Kasonde-Ng'andu 2014) and collect data on alcohol and drug abuse from the perspective of the student.

Target population and sample size
Participants were recruited into the study based on the inclusion criteria that they were enrolled students at any university in Zambia in 2022.The study employed purposive and snowball sampling methods to select students to respond to the questionnaire and participate in the in-depth interviews.The participant's selection process strived to be gender balanced.A total of 200 students (n = 200) completed the questionnaire with a 3% no response, while 10 (5 female and 5 male) were recruited to participate in in-depth interviews.

Study population and sampling procedure
The study site was purposively picked because of proximity of the research team.Snowball sampling was used in combination with purposive sampling to reach the targeted 200 students.The initial distribution of questionnaires had a 3% no response rate.The initial 10 students were selected purposively based on their willingness to participate in the study.The 10 students were asked to distribute 19 questionnaires each in their respective networks.The initial 10 students were engaged in the in-depth interviews depending on their consent to participate in the study.

Data collection
The

Data analysis and interpretation
The data collected from the questionnaires was analysed using excel for quantitative data while the open-ended questions were analysed using thematic coding analysis approach.
The data from both the quantitative and qualitative data analysis was triangulated to increase validity by corroborating the different descriptions of the phenomenon.

Types of drugs in use on campuses
The study's findings established the commonly abused substances on campuses.
From Figure 1 the commonly abused drugs on campuses turned out to be cannabis popularly known as weed, codeine accessed through Benylin and alcohol in the form of spirits (Bols).These results may be linked to studies conducted by Bullock (2004) among Swedish university students were cannabis scored high at 25.4% compared with other drugs that were abused.Some of the reasons attributed to these results could be that it was accessed from a residential area near the campus and could be easily smuggled on campus and sold.In a similar study performed by Nsemukila and Mutombo (2000) identified some factors leading to learners abusing substances such as cannabis that could be attributed to cultural beliefs, medical practices rooted in traditions, misinformation about substance abuse among young people, in combination with the feeling of excitement and fun, pressures among peers and family, claims of high achievement and performance in academics.

Views on factors necessitating alcohol and drug abuse in institutions of learning
This study investigated the students' views on how likely they were to engage in drugs or alcohol abuse in a set of given scenarios.The findings that the highest number of students agreed to substance abuse being a problem on campus was eye opening as seen from Figure 3.
These findings are an affirmation of what other studies established that substance abuse was a global concern (Kabbash et al. 2022).It raises concerns after 95% of the students accepted that drugs and alcohol abuse were a problem despite them still getting involved in the abuse of such substances.
The students were asked on what they see to be the causes of engaging in drug and alcohol abuse among fellow students on campus.
The data in Figure 4 expresses the views of students on what they thought led to substance abuse in institutions of learning and assumptions drawn from the findings was that students needed to adopt coping mechanisms, and/or the systems of education lacked support services such as a proactive counselling and student support services recommended by Mwanza (2021) to help them on how best to handle such stress.Masiye and Ndhlovu (2016) in a study on drug and alcohol abuse prevention education in secondary schools in Zambia recognised that the issue of drugs was a growing social concern and was a public health problem among learners in Zambia that needed addressing from systems point of view.

Ways of how drugs and alcohol cases should be managed in universities
The respondents gave views on what they thought would be solutions to substance abuse on campuses.The students suggested that inspection of student residential halls of residence might assist in curbing substance abuse and trafficking as stated by a male student '… normalise doing regular inspection' and '… restrict the use of such substances on campuses.' A regular check in students' halls of residence as suggested by students can be attained through use of both campusbased security and state police.Masiye (2016) postulates that in Zambia three types of organisations, namely agencies from government ministries, non-governmental and religious organisations conducted activities of drug and alcohol abuse prevention.Regular check of student halls of residence with the use of sniffer dogs would go a long way to reduce the presence and availability of illicit drugs on campuses.The need to increase surveillance on campus was a crucial aspect that the study established.The need to control entry into university campuses was not supposed to end as policies but an issue that needed to be invested into, to limit the students contact with the outside community and further control access to campuses by outsiders.
The study further established that there was a need to have more awareness campaigns on anti-substance abuse.The students suggested ways of conducting such awareness campaigns using approaches such as student clubs and societies.Other students indicated that: 'Sensitise people, students on the adverse effects of alcohol and abuse of other substances' and '… also encourage formation of clubs that are in line with such challenges amongst the student's populace.'(Participant, IDI, female, student 1) The students proposed the need to increase information sharing among students that could be accomplished through empowering student led programmes aimed at reaching out to peers targeting both classrooms and halls of residences.Students further indicated the need to use fellow students to do anti-substance abuse campaigns.The use of peer educators was seen to be an effective way of sharing information and creating awareness on campuses.Students were seen to have an advantage in relating with their peers on issues of drugs and alcohol, as they were familiar faces.

Percentage
The respondents proposed that student-led campaigns would reach more students as they easily relate with fellow peers.A student proposed by stating that: 'making use of peer educators to increase sensitizations is an effective way to go as they are living amongst the students, and they are students' themselves.' (Participant, IDI, female, student 2) While another student added that: 'formation of student led societies on campuses could help reach more students within their hostels.'(Participant, IDI, male, student 5) This is like the study by Mwanza, Mwale and Lukwesa (2022) who discussed the need to have student-led campaigns to increase sensitisations and awareness on campuses.
The challenge of misinformation was identified as a facilitating factor in drug and substance abuse.Nsemukila and Mutombo (2000) echoed similarly on the need to disseminate correct information on drug abuse among students.There seems to be several misconceptions relating to drugs, hence the need arises to provide scientifically proven facts to students and young people in universities.
This study also established the need for institutions of learning to collaborate with external government agencies specialised in drug enforcement.A student stated that: 'work hand in hand with DEC and Ministry of Health to help control the drug problems.'(Participant, IDI, female, student 2) While another student responded by saying: '… we need recreational activities on campus which should be accessible, things like basketball, volleyball and the gym would help us a lot.' (Paricipant, IDI, male, student 5).
It was also established that there was need to engage parents of students abusing drugs as a few of such behaviours come from homes, hence this responsibility should not be left to the university alone as evidenced from Nyimbili et al. (2019).Indeed, university life provides both social and academic freedom that needs to be used for human development, hence universities and parents must collaborate to build a student who is a responsible citizen.Some student's wished for stiffer sanctions on drug users and drug dealers with words such as: 'punitive action like expulsion would inflict much fear in students.'(Participant, IDI, male student 5) Another student added that: 'empowering the campus security guards to search students rooms thoroughly and reduce corrupt acts.' (Participant, IDI, male, student 3) Students suggested the use of punitive action on offenders as opposed to the findings of Masiye and Ndhlovu (2016) who found that current policies in some institutions of learning were more punitive than educative or remedial in nature.
Policies that are punitive in nature are seen not to support behaviour change, as most of the learners would avoid coming out because of fear of the sanctions (Glisic 2010).The better position is to find a balance between providing a punitive action towards the sellers and a remedial approach for the users willing to let go of the vices and undergo rehabilitation.Students could be empowered to report drug abuse acts with relevant authorities with full confidentiality and protection.This would entail that students themselves could report even some of the abusers of substances and this would go a long way in increasing the levels of vigilance.Through such increased vigilance, students can take responsibility over personal well-being and resist substance abuse.

Ways of sharing information
The study recognised ways that student saw as effective in sharing information on anti-drug and alcohol abuse.
Empowering peer educators on campus with the right knowledge enables them to share with peers in their residences and classes.
Making use of major university calendar events such as orientation of first year students to include drug and alcohol abuse awareness campaigns is an opportunity that should be seized with both hands.These major university events call for a huge audience and could be effectively packaged to work as platforms for sensitisations.A student stated that: 'during orientation a lot of sensitization needs to be done and information on students' portals' and 'the information should be shared in ways that are not judgemental that would encourage people to seek help.'(Participant, IDI, female, student 4) Similarly, Okoye et al. (2022) and Baharudin et al. (2012) attributed the continuous abuse of drugs among undergraduate students as being connected to their level of awareness.
Other ways of information sharing identified included the use of both on campus and off campus student programmes that aim at raising awareness.Activities such as debates, sports tournaments, walks, road shows, and social media could be used to reach a bigger audience.The other activities could be workshops, seminars, television, and radio programmes.Okoye et al. (2022) concluded from the findings that mass media campaigns were not effective in the fight against drug abuse.Baharudin et al. (2012) argued that media campaigns can be used to provide useful information to a targeted audience with emphasis on the use of scientific studies in the content.Kabbash et al. (2022) concluded that there was need to implement student tailored programmes that are designed to support and increase awareness services that would lead to prevention and management of drug abuse among university students.Such findings entail that there is need to use tailor-made methods that would respond and speak to the needs of young people in institutions of learning.

Dangers of substance abuse
Students expressed their thoughts on the dangers of substance abuse pointing to mental health consequences.
The study revealed that students ascribed mental illness to substance abuse.A female student stated that: 'I have seen someone who went mad, who was a heavy user of cannabis, and on alcohol it can cause liver damage and others have developed ulcers.'(Participant, IDI, female, student 5) This follows the writing by Fernando, Stochl and Ersche (2022) who looked at drug use in night owls and how it increases the risk of mental health problems.There is a relationship between mental health and substance abuse.Kabbash et al. (2022) adds that drug abuse in adolescents is the main cause of most of the health-related problems in many parts of the world including mental health problems and maladjustment to school circumstances.
Students know that substance abuse might lead to development of ulcers and damage of some internal organs including the liver because of excessive intake and consumption of substances.Other scholars such as Wyler (2012) have showed the huge burden on public healthcare systems because of the negative effects of substance abuse.These challenges that come because of substance abuse go further to destabilising the social systems of communities such as families.Students abusing substances demand for financial support from guardians to sustain their drug and alcohol intake leading to financial and economic drain on the family.
The findings in this study showed that academic performance was somehow affected by substance abuse.The respondents stated that poor academic performance was somehow related to abuse of substances.A statement from a student said: 'Poor academic performance is usually associated with drug and alcohol abuse among the male students.'(Participant, IDI, male, student 3) The students associated poor academic performance in some cases with drugs and alcohol abuse which is supported by Kaluwe (2019) who established that drugs were a growing concern in Namibia among students that affected their academic performance and they dropped out of school.Students attributed the substance abuse to beliefs that usage of certain drugs would increase and enhance academic attainment especially the intake of drugs with stimulants and performance enhancers, which might have long-term health effects.
Some of the findings pointed to some dangers associated with substance abuse.Respondents found issues with health, pregnancy, and others.A student listed some of the issues as: 'Unwanted or unplanned pregnancies, damage of internal organs, abuse of substances while driving causing accidents, easily irritable individuals, and lifestyle related diseases.'(Participant, IDI, male, student 1) This may lead to unlawful high-risk abortions.The consumption of alcohol during pregnancy may also lead to having babies born with fetal alcohol syndrome.Kabbash (2022) adds that among the challenges of alcohol abuse was the issue of sex without the use of condoms because of unplanned sexual intercourse.The unplanned sexual intercourse and sex without the use of condoms contributes to unwanted and unplanned pregnancies among students.
Research performed by Masiye and Ndhlovu (2016) argues that individuals who persistently abuse drugs and alcohol experience challenges including poor social and personal relationships leading to contraction of HIV and sexually transmitted infections.The students' perspectives showed that sexually transmitted infections including HIV could easily be transmitted during the sharing of drugs especially the practices of using unsterilised injectables.Students gave an example of a new trend called 'Bluetooth' in the face of scarcity of drugs, one student injects themselves then the others access the drug through the blood of the first user.
The study documented abusers of alcohol and drugs to be prone to commit violence especially towards other genders.Some of the students stated that: 'Gender based attacks and violence, mental health challenges and illness coupled with low academic performance levels in most times.'(Participant, IDI, female, student 4) 'most of the users tend to show moods, they sometimes engage in lawlessness like stealing, violence, and vulgar language on campus.' (Participant, IDI, female, student 3) 'Poor decision-making leading to risky behaviour affecting the health of an individual and can lead to complications like addiction and dependency on the abused substance.'(Participant, IDI, male, student 2) Some showed that they developed lawlessness and failure to observe laid down regulations on campus.This is confirmed by the writing of Kaluwe (2019) on the increase in crimes and violence because of abuse of substances among school going children.

Recommendations
Based on the findings, the following recommendations were made: • Training of more peer counsellors to reach more students in the halls of residence with awareness campaigns on anti-substances abuse massages.• Enforcement of clear institutional policies and procedures on how to manage and control drug related problems in institutions of learning.• Create a platform for parent and university management engagement to address substance abuse.
• Increase security clearance to access the institution and surveillance on drug abuse.• Student service providers to have an initiative-taking service delivery that reaches the students on adjustment to university life including academic stress management.

Conclusion
Students' perceptions on drug and alcohol abuse are fundamental in developing interventions that appeal to young people.The students indicated that alcohol, cannabis, codeine, and shisha were the predominately abused substances.
Students viewed drugs and alcohol abuse to be a problem on campus as it affected their academic performance, contributed to violence, theft, mental health issues, and unsafe sexual practices causing health-related problems such as STIs, unplanned pregnancy, abortions, and other social maladjustments.The literature reviewed in this study attested to the need to address substance abuse among students in the HTEIs.The information from this research calls to action stakeholders to be innovative and engage students when developing substance abuse intervention programmes.There is a clear need for policy and practice adaptations that will prevent substance abuse in this population.
research used two methods of data collection, a questionnaire, and in-depth interviews with students.The closed ended questions in the questionnaire were for the collection of quantitative data and modelled from the Global School-Based Student Health Survey (GSHS) 2021 expanded version (World Health Organization [WHO] 2021).Qualitative data were collected through open-ended questions in the questionnaire and in-depth interviews with 10 students.The data from in-depth interviews were audio recorded and stored under a two-step password on the laptop.The audio recordings were transcribed in MS word.
Data from Figure2revealed that the environment in which students are found contributed to the choices they made in relation to drugs or alcohol on campuses.The environment created opportunities for peers to influence others, provoke students' curiosity and desire to experiment.The finding validates the literature from Kaluwe (2019) that suggests peer pressure; genetic factors, curiosity and depression were factors that contributed to drug abuse among students.