The abuse of alcohol, illicit and prescription drugs among adolescents is a major health problem internationally. The United Nations Office on Drugs and Crime (UNODC) reports that in 2010 approximately 5 % of the world’s population, most of which are young people, used an illicit drug. It is estimated that alcohol abuse results in 2.5 million deaths pet year and that heroin, cocaine and other drugs are responsible for 0.1 to 0.2 million deaths per year (UNODC, 2005, 2010). Research findings reveal high prevalence of substance abuse among adolescents in Nigeria (Omokhodion & Faseru, 2007; lgwe et al.,2009; Oshodi et al.,2010).

In a related research carried out in the USA by The Substance Abuse and Mental Health Services administration (SAMHSA, 2013) on the Annual National Survey on Drug Use and Health (NSDUH), an increase in the use of illicit drugs among Americans aged 12 years or older was reported. Also people in their late teens and twenties returned the highest use of illicit drug. In 2013, 22.6 percent of 18- to 20 year-olds reported using an illicit drug in the past month (SAMHSA 2013). There were just over 2.8 million new users of illicit drugs in 2013, or about 7,800 new users per day. Over half(54.l percent) were under 18 years of age (National Institute on Drug Abuse (NIDA, 2015).

The health risks of tobacco are vastly underestimated because of the 30-40 year time lag between the onset of smoking and the peak in the deaths that it causes (Proctar &Robert, 2006). Thus, in the developing world, tobacco poses a major challenge, not just to health, but also to social and economic development, and to environmental sustainability.

Data from studies on the harmful consequences of smoking on health have confirmed the quantitative relationship between smoking and many diseases such as coronary artery disease, lung cancer, bladder cancer, pulmonary emphysema, peripheral vascular disease and neonatal mortality (Dhala et al., 2004; Khan et al., 2005). Similarly, geographical variation in the prevalence of cigarette smoking contributes to differences in the mortality patterns of smoking related diseases such as lung cancer, chronic obstructive lung disease and coronary heart diseases (Giovino et al., 2004). Globally during the past two decades, cigarette production has increased at an average of 2.2% each year, outpacing the population growth rate of 1.7% (Crofton & Simpson, 2002). Consequently, the World Health Organization (WHO), at the forty-second World Health Assembly, recognized that worldwide the use of tobacco is responsible for two million premature deaths annually (WHO, 1998), and in 2000, an estimated 4.83 million premature deaths were attributable to smoking, of which almost 50% were in developing countries (Ezzati & Lopez, 2003).

According to the National Household Survey on Drug Abuse, 42% of persons aged 18 to 25 reported that they have had five or more drinks at the same occasion on at least 1 day in the past 30days, while 40% of 18 year olds reported that they have used marijuana (NIISDA, 2005). Travares et al. (2001) reported the rate of drug use among students as follows: alcohol (86.8%), tobacco (41.0%), marijuana (13.9%), inhalants (11.6%), anxiolytie drugs (8.0%). amphetamines (4.3%), and cocaine (3.2%). According to Oliha(2014), majority of the youth ignorantly use one form of drug or the other for their various daily activities such as social, educational. political, and moral, etc. Drug use at 18 years is associated with an eightfold greater likelihood of developing substance dependence in adulthood (Tirns et aI.. 2002).

The harmful use of drug has led to a number of physical and psychosocial problems in an individual’s life. The repeated use of drugs can lead to a ‘dependence’ syndrome, commonly referred to as addiction – The symptoms include strong desire to take the drugs (cravings, difficulties in controlling its use, loss of control) and continued use despite harmful consequences (UNODC. 2011). Other symptoms include higher priority given to drug use than to other activities and obligations, increased tolerance; a withdrawal state (physical andfor psychological) (UNODC, 2011).

This study is interested in drug use among female undergraduates. Prior to 1985, rates of drug use among females were significantly lower than their male counterparts, however, rates of alcohol tobacco, marijuana and inhalant use by females began to approach those of their male counterpart in the 1980’s (Substance Abuse and Mental Health Services Administration, (SAMHSA, 1997). Currently, use rates for certain drugs are greater for females than males (Johnston et al., 2007).

The National Drug Law Enforcement Agency (NDLEA: 2007) report showed an alarming 22% of the total Nigerian population using cannabis. Other studies spanning several decades indicated prevalence ranging from 0.4% 84% (Gureje et al., 2007) across different populations. Documented evidence in cross sectional studies among secondary school pupils, showed that cannabis abuse ranges from 9.4% to 26% (Eneh & Stanley, 2004). Among tertiary university students, current cannabis use ranged from 0.6% among medical students (Makanj uola et al., 2007) to 9% among other university non-medical students (Abikoye et al., 2014), while lifetime use ranged from 2.3% (Makanjuola etal., 2007) to 14.5% (Abikoye et al., 2014).

University students are more susceptible to drug abuse due to myriad factors ranging from academic stress, desire to remain awake at night; peer- group pressure; increasingly falling educational standard, drugs accessibility; violence and the dire need for risk sexual behaviors enhancement (Obot, Ibanga, Ojiji & Wai, 2001; Gureje & Olley, 1992). Other risk factors include social approval for drug consumption in people’s social environment such as family and peer group (Agrawal et al., 2006;Ellickson et al., 2007; Guxens et al., 2007) and socio-demographic variables (Guxens, et al., 2007).

It creates vastly more social, economic and moral problems than the several illegal drugs combined.(Folawiyo, 2000) Alcohol is tied up with many areas of our lives, and we use it in a plethora of ways: to help us relax, feel brave, introduce ourselves, seal business deals, celebrate life events, drown our sorrows, remember, forget, welcome people, say goodbye to people, get to know people, manipulate people, because we feel like it, because we need it, to numb ourselves, to feel grown up, to feel young, to belong, to distinguish ourselves, and sometimes, because we’ve forgotten how to do anything without alcohol.

Alcohol consumption is one of the main risk factors to health. It is responsible each year for about 3.3 million premature deaths worldwide, more than AIDS, tuberculosis and violence combined (WHO, 2014). Injuries both unintentional and intentional account for more than a third of the burden of disease attributable to alcohol consumption (WHO, 2009). These include injuries from road traffic crashes, burns, poisoning, falls and drowning as well as violence against oneself or others. The impact of alcohol-related injuries affects not only those who are intoxicated at the time of injury occturence, but also those who fall victim to their behavior. These include the pedestrian or cyclist knocked over by a drunk driver or the woman or children beaten by a drunkhusband or father.
It is against this backdrop that this review critically explores the rising alcohol consumption in Africa, its consequences for the contemporary African society and suggests some remedies. It then looks to International Best Practices with regard to alcohol prevention and asks how relevant such
recommendations are for Africa.

Adolescent transition is generally premised on many developmental huddles which include biological transition, generally known as puberty; cognitive transition, the many dimensions of adolescent thinking processes; emotional transition, a repertoire of self-assessment cognitions leading to how they, in turn, view themselves, especially in their capacity to function independently; and social transition, the clearly noticeable changes in the ways adolescents spend time with peers, authority figures and family members. These dimensions of adolescent transitional process lead to a complex stream of susceptibilities, which include drug use, smoking, and sexually-related vulnerabilities. Since adolescents are impressionable persons, they are likely to be easily influenced by what appears attractive to their blank minds in the context of their high level of innocence. For example, a number of researchers have confimed that the notion of cognitive susceptibility was originally used in research in which adolescent participants were examined on the steps and factors involved in taking up cigarette smoking e.g. (Pierce etal., 1996; Hock et al., 2013).

Away from smoking, there are more and more researches revealing adolescent susceptibilities in many other areas of life, including teen pregnancy (e.g. Kirby, 2001), sensation seeking (Donohew et al., 2000) and conflict with authority especially in relation to drug use. It is a long time since researchers engaged their energies in the developmental problems of adolescents and it is to be expected that by now, these problems should have been tackled and efforts appraised along the realm of success. But this has not been so, as adolescents are found with newer sets of problems or other more complex “versions” of older problems.

There is considerable debate regarding the most appropriate definition of psychoactive substance. To put it in simple terms, “Psychoactive drugs are substances that affect the central nervous system and can have a depressant, stimulant, or hallucinogenic effect on a person (Insight, 2013).
However, the World Health Organisation (WHO, 2004) defines psychoactive substances as any substance that when taken in or administered into the system affects mental processes, e. g. cognition, perception, sensation or affect. In this way, psychoactive substance can affect an individual’s mood, their perception and thoughts; changing the consciousness, mood, and thoughts of those who take thorn.

The use of these Substances constitute a major public health challenge to individuals, families, communities, societies and overall government spending are impacted by the use of these licit and illicit substances despite the negative harmful effect.

Injecting Drug use is predominantly a male habit, however there are also female People who Inject Drugs. HIV Prevalence rate among PWIDs is 4.2%.with prevalence among female WlDs about 7 times higher than amongst their male counterparts. About 38.1% of female WIDs prostituted in the past 12 months. PWIDs, especially females are generally unexposed and hard to reach. They are a highly mobile group with distinct identities and social roles that go beyond injecting drugs and sexual practices.

The habit of injecting drugs is often associated with high rate of criminal involvement, low risk perception and poor health-seeking behaviour (IBBSS 2010). The project “scaling up Gender-sensitive HIV/AIDS prevention, treatment, care and support interventions for Mo.st At- Risk Populations in Nigeria ”currently being implemented by Center for the Rights to Health (CRH) under the Global Fund Round 9 phase 2 is used as a case study for this paper. Its objectives seek to focus on reducing HIV prevalence among PWID by promoting behaviour change through education in order to increase accurate knowledge, increase early Sexually Transmitted Infections (STIs) detection, treatments and partner notification. Moreover, it also aims at increasing HIV counseling and testing Uptake, consistent and correct condom use, as well as reduce related stigma and discrimination.

Furthermore, this paper has been developed based on field experiences and feedback from the CRH Implemented project. It seeks to promote good practices as well as highlight major gaps that could improve programming for PWID in Nigeria.

Similarly, the World Drugs Report (2005) observed that the use of illicit drugs has increased throughout the world in recent years. The report further noted that a major trend is the increasing availability of many kinds of drugs to an ever-widening socio-economic spectrum of consumers. The report argues that the main problem of drugs at the global level continue to be opiates (notably heroine) followed by cocaine. For example, for most of Europe and Asia, opiates continued to be the main problem of drugs, accounting for 65% of all treatment of substance abuse in 2003. Reports from a total of 95 countries indicated that drug seizures increased four-fold in 2003 and more than half of these were cannabis (UNODC, 2005).

Another report released by United Nations Drug Control Programme (UNDCP) in 2004 estimated that 3.3% to 4.1% of the global population consumes drugs but more worrisome is that according to the UNDCP executive director-, those who are dependent are getting younger and younger every year. In Pakistan for example, it was reported that the share of those who started heroine use at 15-20 years has doubled to almost 24% of those surveyed. Another survey in the Czech Republic showed that 37% of new drug users were teenagers between 15 and 19 years old (Aniuzu, 2012).

Every country in the world, developed or developing incurs substantial cost as a result of negative effects caused by substance abuse (World Drug Report, 2005). The World Health Organisation (WHO) estimates that 1. 1 billion people representing a third of the world population above the age of 15 years, use tobacco, principally in the form of cigarettes. Out of these 800 million smokers, 700 million are from developing countries (WHO, 2004).

Reliable and comprehensive information on the drug situation in Africa is not available. The limited data available suggests, however, that substance use, especially cannabis use is of about 12.4%. In West and Central Africa this percentage is probably higher than the global average of 3.8% (UNODC, 2014). In Nigeria, the expert perception is that there has been a significant increase in the use of cannabis(UNODC, 2012). According to the national survey on alcohol and drug use in Nigeria, conducted in 2009 (Neuropsychiatric Hospital (NPH) 2012), aside from alcohol, the non-medical use of tranquillizers had the highest annual prevalence (5.5%) among the population aged 15-64 years. The misuse of prescription opioids was also reported to be high and more prevalent than the use of heroin (3-6% annual prevalence of other opioids, and 2.2% annual prevalence of heroin). High levels of use of other substances were also reported, with annual prevalence as follows: cannabis, 2.6%; amphetamine, 1%: methamphetamine, 1.6%; “ecstasy”, 1 .7%; cocaine, 1 .6%; and crack, 2%.

Substance abuse is a major public health concern globally due to its association with reduced quality of life as well as substance-related morbidity and mortality. Substance use disorders take heavy toll on the patient in terms of personal suffering, to the families as a result of the burden of care and life-time lost productivity, and on the society at large. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), substance-related death is the most extreme form of harm that can result from substance use/abuse (EMCDDA, 2009). The United Nations Office on Drugs and Crime (UNODC) estimates that there were 183,000 drug-related deaths in 2012, corresponding to a mortality rate of 40.0 deaths per million persons aged 15-64.

Sex work serves as a means of generating income to support drug addiction. Sex workers may also use drugs to cope with the psychological trauma associated with sex work (Gossop et. al., 1994; Nelson, 2012). The relationship between drug use and sex work varies depending on the type of sex work investigated (Goldstein, 1979; Sillbert & Pine, 1982). The use of drugs in order to deal with the aversion which sex workers feel towards their clients has also been reported (Plant, Plant, Peck & Setters, 1989). Similarly; sex workers may use drugs to enhance feelings of self-control and self-confidence, to suppress guilt associated with selling sex (Young, Boyd & Hubbard, 2000), or to medicate the psychological effects of exposure to violence (Weeks at. al., 1998).

Drug use among sex workers is associated with various consequences for their emotional, mental and physical health. For example, drugs increase sex workers risk of infection with Sexual Transmitted Infections (STIs), including HIV (Weeks et. al., 1998; Sterk, 1999), physical violence and rape, especially in the hands of drug using pimps and clients (Silbert & Pines, 1982; Miller & Schwartz,1995). Furthermore, drug use is linked to various forms of psychiatric disorders, including anxiety and affective disturbances (Johnson & Kaplan, 1990; DeMillo, 1989; Mehrahian, 2001). Drug users have higher rates and severe levels of psychological impairments than do individuals who do not use drugs (Campbell & Stark, 1990; Burch, 1994), and sex workers who use drugs are clearly at risk of these problems. Drug use is also significantly related to decline in the psychosocial well-being of sex workers, especially their level of psychosomatic complaints and social insecurity (Vanwensenbeeck, 1994). Illicit drug use is part of many factors impacting negatively on the health of sex workers. Other factors are violence, sexual abuse, societal stigma and the cognitive and behavioural coping strategies associated with the intrusive nature of sex work. This paper reports findings of a qualitative study of illicit drug use and health-seeking for drug-related morbidity among sex workers in a Nigerian city.

People abuse substances such as alcohol, tobacco, and other drugs for varied and complex reasons, but it is clear that several adverse effects accompany drug abuse not just on the users but on the entire society. For instance, the UNODC estimates that in 2010, 15.5 38.6 million people worldwide were problem drug users. It was further stated that around 200,000 people worldwide die each year drug- related deaths (UNODC, 2012). According to WHO (2011) 320,000 young people between the ages of 15-29 die from alcohol-related causes each year.

Stress is conceptualized as a threefold process: first, it is an excessive rate of wear and tear in the body and occurs whenever the rate of breakdown exceeds the rate of repair. Second, it is the non-specified stereotyped response of the body to any demand interpreted a threat to physical or emotional homeostasis. Lastly, it is a specific syndrome (Selye, 1936). Stress has also been viewed as the adjunctive demand made upon the individual, due to the problem in living with which the individual must cope; especially if his needs are not met (Muthuveloo & Rose, 2005). Sarros et al. (2001) therefore described stress as a negative experience, which depends a lot on people’s perception of a situation and their real ability to cope; noting that mental health problems, poor physical health, financial strain, single-parenting, hosting of some positive events and occasion, examinations/interviews, and bereavement could serve as stressors.

Studies have found relationships between stress and smoking; Greenberg, et al. (2012) found positive relationships between all clusters of post traumatic stress disorder (PTSD) and cigarette smoking. Harling et al. (2009) found a complex interrelationship between psychosocial stress. demoralization and the consumption of psychotropic substances among practicing veterinary professionals. Empirical investigation showed occupational stress factors were associated with lower levels of nicotine dependence (Schmidt et al., 2010). Also, Redonnet et al. (2012) reported that tobacco smoking, alcohol, cannabis, and poly-substance use are common behaviour among adults who experienced socio-economic disadvantages.

Within Nigeria, visitors visiting new towns for the first time for business or otherwise will typically take a taxi to their destinations. The taxi driver therefore becomes their first contact and invariably the first ambassador to the city. Lagos state is no different but quite necessary for research. being the commercial hub for Nigeria and positioning as the commercial hub for West Africa and indeed Africa. According to Bello et al.(2011b), “about 10% of the population consumes more than 70% of alcohol”. Bello et al (2011b) report that in sub-Saharan Africa, drivers of commercial vehicles are a notable high-risk drinkers with prevalence of use ranging from two-thirds to over four-fifth keeping in mind that alcohol intoxication impairs judgment. It was also reported that those studies revealed that alcohol was a factor in about 50% of drivers‘ death in road traffic accidents in South Africa and 27% accidents in which the driver was not killed (Bello et al, 201 lb). Alcohol intake was the most significant determinant of gastrointestinal symptoms in taxi drivers (Bawa & Srivastav, 2013) and was also found to be a risk factor in depression among the same population (Bawa & Srivastav, 2013; Shattell et al.,2012. In this study the prevalence of alcohol use and the mental health status of taxi drivers was examined.

The harm of alcohol sometimes extend to others around the drinker, thus the harm from others‘ drinking is currently receiving global research concern (Laslett et al 2010). These harms are experienced in different places (homes, public centres, work place and the community at large) and at different time (night, morning) and by different people, (family members, friends, co-workers and others in the community). The harm comes in different forms: injury, assault, heavy traffic, work place accident, child neglect, partner abuse, relationship problems, harassment, noise, and damage to property (Hope et al., 2013).

1. Reducing HIV Prevalence Through Promoting and Sustaining Behaviour Change among People Who Inject Drugs (PWlDs) in Nigeria by Boniface Oguche, Udeme Peter-ljeh, Bede Eziefule

2. Perception of Causes and Treatment for Drug Use Disorder among Youths in Mmaku, Enugu State, Nigeria by Innocent Ahamefule Nwosu

3. Factors Affecting the Management of Substance Use Disorders: Evidence from Selected
Service Users in Bayelsa State by Gboyega E. Abikoye

4. IlIicit Drug Use and Health-Seeking among Sex Workers in a Nigerian City by Ediomo-Ubong E. Nelson

5. Psychological Factors as Predictors of Psychoactive Substance Use among Secondary School Students in Ibadan, Oyo State, Nigeria by Rachel Bolaji Asagba, Chatherine Oluwatoyln Chovwen, Adererni lsmail Alarape, Samson Femi Agberotimi

6. Cigarette Smoking, Alcohol Use and Perceived Stress Among Employed Adults in lbadan South East Local Government by Mfon E. Ineme, Helen O. Osinowo & Oladimeji O. Ibrahim

7. Prevalence of Alcohol Use and the Mental Health Status of Taxi Drivers In Lagos, Nigeria
by Olutope E. Akinnawo & Francis C. Uzonwanne

S. lnSchool Adolescents Experiences of Harm From Adults’ Drinking by Olufunke Chenube, Florence Omumu , Pauline Tibi, Patricia Eghagha & Awake Ejedimu

9. Substance Use among Secondary School Adolescents in Ife Metropolis: Implications for Effective School Counsel by Akpunne Bede. Chinonye

10. Pattem of Psychoactlve Substance Use among In-Patients Attending the Psychiatric Unit of Federal Medical Centre Makurdi, Benue State by Perpetual Ngosoo Chia, Grace Ronke Awopetu, Jonathan Iornenge Ugese & Tersoo Joshua Apaa

11. Tobacco Smoking and Percieved Effects among Undergraduate Students in Novena University Ogume, Nigeria by Sunday E. Kolawole, Otovwe Agofure, lmmaculata Nwokolo

12. Family Structure and School Type as Factors Influencing Female Undergraduates Involvement in Drug Use by Enwongo A Okediji & Emeh A. Udoh

13. Predicting Intention and Continous Cannabis Use among Smokers in a Nigerian
University by Benjamin O. Olley & Gboyega E. Abikoye

14: Rising Alcohol Consumption in Africa: A Sobering Thought by Oluwatobi Daniel Odediran

15. Adolescents’ Demographic Profiles and Relationships in the Susceptibility to Drug Use and Sexual Abuse by Iboro F. A. Ottu

16. Drug Use and Dating Violence among University Undergraduates by Emeh A. Udoh, Enwongo A. Okediji, Okokon O. Umoh & Nsidibe A. Usoro

17. The “War On Drugs” in West Africa: An Appraisal by Participants of West Africa Executive Course on Human Rights and Drug Policy, Legon, Ghana by Okokon O. Umoh, Kwadwo Appiagyei Atua, Maria-Goretti Ane, Samuel Molokwu, Charlotte O. Kwakye-Nuako, Chinwike Okereke, Abigail Gyimah, Ediomo-Ubong Nelson, Gloria Karuri, Ateiza S. Adabeneg

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