Journal of Drug Abuse Open Access

Use of Psychoactive Substances in Schools in Benin: Ethnography of Contexts, Sources of Supply and New Habits

Odile Kougblenou¹, Pierre Meliho¹, Charles Sossa¹, Eric Akpi^1*, Ferdinand Adounkpe², Assad Bio Sya², Arnaud Agbanlinsou³, Adolphe Kpatchavi¹, Dismand Houinato⁴ and Anatole Laleye^{3 1}Department of Sociology and Applied Medical Anthropology, University of Abomey-Calavi, Godomey, Benin
²Department of Narcotics and Toxicology, University of Abomey-Calavi, Godomey, Benin
³Department of Histology, University of Abomey-Calavi, Godomey, Benin
⁴Department of Epidemiology, University of Abomey-Calavi, Godomey, Benin
^*Correspondence: Eric Akpi, Department of Sociology and Applied Medical Anthropology, University of Abomey-Calavi, Godomey, Benin, Email:

Received: 21-Jul-2022, Manuscript No. IPJDA-22-13953; Editor assigned: 25-Jul-2022, Pre QC No. IPJDA-22-13953(PQ); Reviewed: 08-Aug-2022, QC No. IPJDA-22-13953; Revised: 10-Oct-2022, Manuscript No. IPJDA-22-13953(R); Published: 17-Oct-2022, DOI: 10.36648/2471-853X.22.8.12.132

Introduction

The use of drugs and other psychoactive substances has been a concern in recent decades in a range of research areas, including public health and the social sciences. Each of the has contributed significantly by providing strong evidence and recommendations. Pharmacology research has shown that SPA abuse has a major impact on adolescent health, family and social relationships and is strongly associated with poor adolescent academic performance. However, the use of psychoactive substances persists and is widely favored in some contexts. To this end, the drug report indicates that about 275 million people used drugs in 2021, an increase of 22% compared to 2010. The same report projects that by 2030, demographic factors will lead to an increase in the number of consumers by 11% worldwide, and up to 40% in Africa alone from this unwanted situation flows UNODC's strategic vision for the continent in 2030 which is to "estimate drug use, drug related morbidity and drug related mortality in West and Central African countries" in Africa, studies have revealed a social and educational context favorable to the use of SPAs. There is statistical and qualitative evidence that adolescents start using drugs and psychoactive substances early. This correlated with a set of complex factors including: anxiety, self-medication, and the search for performance, the quest for stress relief, urbanization, peer influence, representations of performance. Curiosity, the relaxation of family norms and values, the dysfunction of the pharmaceutical system are also the reasons for the use of SPAs among adolescents and young people in the school space. In Benin, some studies have been carried out emphasize that the way in which medicinal products and other psychoactive substances are distributed influences the sale and use of those products. In addition, due to the repression against this phenomenon, schools are becoming the new hubs for the trafficking and consumption of psychoactive substances. Yet the production of evidence based knowledge for a comprehensive understanding of the phenomenon remains at an early stage. Apart from the fragmentary prevalence’s provided by some quantitative studies and the motivations for these behavioursare identified through a qualitative approach, particular emphasis has not been placed, for example, on sources of supply. This is the main objective of this article, which offers readers ethnography of the sources of supply and the contexts facilitating this supply as well as the use of SPAs by school teenagers in two major cities of Benin [1-6].

Materials and Methods

This study covered 20 high schools and colleges in the cities of Cottoned and Parakou located respectively in the south and north of Benin of a transversal type, it is based on two approaches: quantitative and qualitative. Conducted between the months of March and April 2020, the field survey lasted forty two days. The various data were collected from 617 adolescents and young people aged 10 to 24 from the 4^th to the final year. The latter were selected by the two stage cluster sounding technique. From the sampling frame (list of public and private institutions in Benin), we randomly drew 10 establishments at the first degree at the rate of five (05) public and five (05) private in each of the cities. At the second degree, a class was drawn by chance by class level from the 4^th in Terminable. In each of the clusters (the classes), we randomly took 1/5 of the students with regard to the qualitative aspect of the research, 65 actors, including 40 adolescents and young people, five school leaders, three nurses and one officer responsible for the suppression of illicit trafficking in psychoactive substances, were selected from this sample by reasoned choice and snowball for in depth individual and group interviews. The data collection techniques used is the questionnaire and the individual and group interview. The quantitative data obtained was entered into the Kobo collect software and processed using the SPSS software, version 30. Qualitative data were processed by the content analysis method. A favorable ethical opinion has been obtained in the context of this research from the ethical committee of the Institute of Applied Biomedical Sciences (ISBA) under the number 125 of February 11, 2020. This was supplemented by a written authorization from the minister of health of Benin authorizing the collection of data on the sites concerned by the study. Provisions in accordance with the ethical opinion have been taken to guarantee anonymity, respect for dignity and protection of participant’s personal data. The audio tapes are destroyed after transcription of the data and coding process has been carried out which does not require the real names of the participants. In addition, ethical provisions related to research involving human beings have been taken into account. The ISBA Research Ethics Committee (ISBA-CER) reviewed the research protocol and gave favorable approval under number. This guaranteed respect for confidentiality and the protection of privacy as well as respect for the accuracy of the inter locators remarks [7-10].

Results

Socio Demographic and Cultural Characteristics of Respondents

In total, 67.1% of respondents attended public and private schools in Cotonou and 32.9% attended public and private schools in Parakou of these, 60.62% were male and 39.38% female. The most represented age was between 15 and 19 years (71.8%). The 3^rd (28.69%) and terminable (21.88%) levels are the most represented. The majority, 40.36% were Fun and 74.07% were Christian. A minority were orphans (16.21%) and 48.3% lived in a two parent family (Table 1).

Table 1: Socio demographic and cultural characteristics of respondents.

Contexts Facilitating the Supply and use of SPS by Adolescents

The field survey reports that the use of SPAs by adolescents and young people in the school environment is favored by several factors: political, socio economic and socio environmental [11].

Political Contexts

In Benin, pharmaceutical activities such as the supply and distribution of medicines are regulated by a legislative framework. However in practice, it should be noted that these activities are often not in line with the legislation, thus giving way to abuses such as illicit sales and consumption practices outside the medical context. Indeed, the Beninese state has implemented a set of approaches such as the promotion of essential medicines and medicines under the "generic" name, the sensitization populations, and the initiation of spectacular repressive actions against sellers in the city of cottoned in order to combat these practices. It should also be recalled the strengthening of the legislative system on the organization of pharmaceutical activities in the republic of Benin, such as law no. 2021-03 of 1^st February 2021. However, its application encounters complex contextual difficulties. This explains the existence and functioning of a black or parallel market for drugs and psychoactive substances that can have negative and irreversible impacts on the lives of adolescents. This "loosening" of control standards has favored the access of the targets of this research to psychoactive substances, such as psychotropic drugs, in this case tramadol, ecstasy, diazepam, and addictive substances such as cannabis, cocaine, morphine, which are products sold in pharmacies on medical prescription and provided only when necessary by the competent persons. The field survey shows that products available only in pharmacies are accessible by adolescents and young people through falsified prescriptions and through a parent health worker. The sale and consumption of these products then changed from an open form to a hidden form; this poses a real problem with regard to the distribution, sale and access to these products by adolescents and young people [12].

Socio Economic Contexts

The school space has extensions on economic spaces constituting the environment around the schools. As an extension of these school spaces, there are actors who offer a diversity of canteens. These actors, made up of both men and women sellers of food products, have settled in kiosks where psychoactive products (alcoholic beverages, cigarettes, Tramadol, cannabis, ecstasy) are offered clandestinely. The pupils, being in interaction with this extra curricular economic space at the time of recess, or on the occasion of the exits of the classes. It is in this interaction that they discover and use psychoactive substances.

Socio Environmental Contexts

The sociability of adolescents and young people in the school environment goes further than this immediate space of the school environment described above. The pupils, for recreational and festive reasons, frequent other spaces such as beaches, game rooms, bars and refreshment bars, unfinished houses, even ghettos. These are the spaces in which SPAs are available and accessible to all age categories. By way of illustration, we can mention the offer of shisha in addition to alcoholic beverages in bars and restaurants and at the beach; the supply of cannabis, cocaine and shisha in unfinished houses and gambling halls. Sociability in these spaces is a means of discovery and use of SPAs by adolescents and young people.

Different SPAs accessible and Consumed by Respondents

This research reveals a high consumption of different psychoactive substances by the adolescents and young people surveyed. Seven categories of substances are discovered and consumed by respondents. Alcohol was the most consumed (78.28%), followed by amphetamine type stimulants (62.07%) and tobacco (45.06%). Substances such as beer, hemp, shisha, cannabis and Tramadol are the substances most consumed by the pupils surveyed (Table 2).

Table 2: PPS consumed in the last three months preceding the survey.

SPA Supplys

Empirical evidence also shows that the substances used by the adolescents and young people surveyed are obtained through four main sources. Supply on the parallel market was in large proportion (42.46%); it is followed by supply to the pharmacy (31.74%), sourcing from peers (24.67%) and via the internet (1.13%) (Figure 1). The black or parallel market is described by respondents as supplying it to illicit sellers of medicines, places of leisure (beaches, bars and refreshment bars, etc.), gambling halls, and kiosks/cabarets. This supply was also made from street vendors commonly known as "zema", sellers from northern Benin and Niger equipped with a cart loaded with coffee, tea locally called attain. The pharmacy is supplied on presentation of false prescriptions: reuse of a prescription or prescription issued by a parent doctor. Some of them were supplied directly from the pharmacy box in the house. Peer sourcing consisted of obtaining the PPS from a peer who sold or supplied the products free of charge to members of the consumer network. The pupils, suppliers of these products, most often supplied themselves with ghetto vendors (installed in unfinished houses in the environment close to schools). The new information and communication technologies are also used for the purchase of PPS. This is the case of the internet used by a minority of teenagers and young people to obtain supplies. The latter, most often descendants of a family with average grands, buy these products on the sales sites of the SPAs.

Figure 1: Sources of supply for PPS.

Discussion

The present study conducted in private and public secondary schools in Benin had shown that the school environment and its immediate environment had become spaces where access to and consumption of psychoactive products took an important place. The factors favoring this practice were the political context, the socio economic context as well as the social context. It also shows that alcohol, amphetamine type stimulants and tobacco are used excessively. However, these substances are dangerous to health. In a similar vein, some authors showed in their study based on a strictly quantitative method that alcohol was the most consumed substance with a prevalence of misuse of 30.1%, followed by tobacco with a prevalence of 21.7% and amphetamine with a prevalence of 3.3%. This state of affairs is explained by the legislative context of Benin in which alcohol is a substance whose access for the adolescent does not present a legal constraint (obligation to present his identity card for example). Sources of supply such as pharmacies, pharmacy boxes, the black market in the vicinity and the internet were also identified.

For having surveyed adolescents in the few private secondary schools in also identified in their work different sources of supply in line with those identified by this study. The field survey showed that the Internet is also positioning itself as one of the sources of supply for school teenagers. This is what emerges from the 2021 world drug report which explains that the context of the pandemic has favored this kind of practice and although it represents only a fraction of overall drug sales, the trend is on the rise, with a four fold increase between 2011 and mid-2017 and mid-2017 and 2020.

According to the National Academy of Pharmacy, more than 10,000 "e-merchant" sites were in operation in France at the beginning of 2007 with a turnover of e-commerce that amounted in France for the year 2006 to a total of 10 billion euros. In a study conducted by the anti-counterfeiting research institute, 50% of drugs purchased on the internet are on sites that hide their physical address. These sites are increasingly explored by the adolescents and young people surveyed in this study for cats of drugs and other psychoactive products (cannabis, cocaine, especially). This result testifies to the development of new habits of supply and consumption of PPS without prescription in the Beninese context.

Conclusion

The present research attempted to contribute to the production of knowledge on the use of psychoactive substances among school adolescents in Benin. The result is a diversity of sources of supply and distribution. Similarly, a set of dysfunctions make the social contexts in which these adolescents live favorable to this phenomenon. Therefore, it emerges the need to put in place concrete actions in order to effectively combat this dangerous phenomenon while putting research to work. In other words, it involves: (1) Conducting a national survey on substance use and school health in order to establish an evidence base and updating for appropriate interventions; (2) To carry out multispectral interventions to effectively combat the use of PPS by adolescents and young people.

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