INTRODUCTION
The definition of substance abuse is a state of periodic or chronic intoxication caused by multiple usage of a substance, the features of which are: (1) strong compulsion to continue substance use and to produce it in any way; (2) increasing the dose; (3) a dependence on or addiction to its effects; and (4) a detrimental effect on the individual and on the society.1 Substance abuse is self-administration of any drug or substance in a manner that deviates from the normal pattern.2 Substance abuse is the excessive and long-term use of any pertinent material.3 Opines addiction can lead to chronic brain problems which characterized by great substance seeking and misuse, despite harmful consequences.4 The National Institute for Drug Addiction (NIDA) revealed that addiction is like cardiac problems.5 Many problems caused by drug or substance misuse can affect the addict themselves and their loved ones, Substance misuser reaches a point where they seek and take substances. Some may begin to feel the need to increase the dose and its frequency, even at the early stages of substance misuse.6 Death of substance addicts occur every year in large numbers as a result of high dose, while many die due to human immune virus/acquired immune deficiency syndrome (HIV/AIDS). Many substance misusers consider it to be a relaxing and pleasurable social activity.7
SUBJECTS AND METHODS
Case definition
This study was performed among the youth aged between 15 and 24 years in Tikrit city.
Study type: A cross-sectional study that was performed from the 1st of November, 2018, to the 31st of March, 2019.
Sample size and sampling
A total of 450 youths (359 males and 91 females) aged between (15 and 24) years who lives in Tikrit city were included in this. They were chosen by simple random sampling method and only those who agreed to participate were included.
Questionnaire and data collection
Data were collected by the members of the study group in Tikrit city. Two versions of the questionnaire were designed, one in Arabic and the other in English. As the self-administration method was adopted the participants could choose the language of their choice and have a clear idea of the objectives of the study.
Data analysis, management, and presentation
Data were represented suitable tables and charts by using Microsoft Office 2013. All data were analyzed by using the manual statistical method.
Ethical consideration
Permission was taken from the respondents for answering the questionnaires using self-administration.
RESULT (see table and figures)
Table 1. Percentage of Youth Who Had Knowledge about the Definition of Substance Abuse.
| Sex | Defined abuse correctly | (%) | Could not define abuse correctly | (%) |
|---|---|---|---|---|
| Male | 153 | 42.6% | 206 | 57.4% |
| Female | 43 | 47.3% | 48 | 52.7% |
Table 2. Knowledge of Youth in Tikrit about Substances that Are Misused
| Name of substance | Males-knowledge | (%) | Females-knowledge | (%) |
|---|---|---|---|---|
| Cannabis (Hashish, Marijuana…,etc.) | 186 | 51.8% | 48 | 52.7% |
| Cocaine | 253 | 70.5% | 65 | 71.4% |
| Heroin | 201 | 56.0% | 48 | 52.7% |
| Morphine | 154 | 42.9% | 34 | 37.4% |
| Codeine | 83 | 23.1% | 21 | 23.0% |
| Ecstasy | 144 | 40.1% | 23 | 25.3% |
| Tramadol | 123 | 34.3% | 30 | 32.9% |
| Pethidine | 44 | 12.3% | 13 | 14.3% |
| Tussiram | 51 | 14.2% | 9 | 9.9% |
| Amphetamine | 71 | 19.8% | 17 | 18.7% |
| Others | 58 | 16.2% | 13 | 14.3% |
Table 3. Factors that Male Youth Think Would Help in the Prevention of Substance Abuse.
| Factor | Agree | (%) | Don’t know | (%) | Disagree | (%) |
|---|---|---|---|---|---|---|
| Educational programs can aid in the prevention of substance abuse | 274 | 76.3% | 53 | 14.8% | 32 | 8.9% |
| Having better education is a protective factor against substance abuse | 282 | 78.5% | 53 | 14.8% | 24 | 6.7% |
| Close family ties provide protection from substance abuse | 290 | 80.8% | 43 | 12% | 26 | 7.2% |
| Avoiding friends who are substance abusers can help | 296 | 82.5% | 33 | 9.2% | 30 | 8.3% |
Table 4. Factors that Female Youth Think Would Help in Prevention of Substance Abuse.
| Factor | Agree | (%) | Don’t know | (%) | Disagree | (%) |
|---|---|---|---|---|---|---|
| Educational programs can aid in the prevention of substance abuse | 60 | 65.9% | 23 | 25.3% | 8 | 8.8% |
| Having better education is a protective factor against substance abuse | 73 | 80.2% | 13 | 14.3% | 5 | 5.5% |
| Close family ties provide protection from substance abuse | 69 | 75.8% | 15 | 16.5% | 7 | 7.7% |
| Avoiding friends who are substance abusers can help | 78 | 85.7% | 10 | 11% | 3 | 3.3% |
FIGURE 1. Knowledge of youth about substance abusers.
FIGURE 2. Knowledge among youth (as to whether alcohol or substance abuse is more dangerous to the community).
FIGURE 3. Respondents’ opinions about whether (substance abuse a problem in Tikrit)
FIGURE 4. The knowledge of youth about (substances being widely available in Tikrit).
FIGURE 5. Knowledge of youth about (substances that are easy to get in Tikrit city).
DISCUSSION
The data on substance abuse in Iraq are limited.8 The current study revealed that 99 out of 450 (22%) youth in Tikrit knows at least one substance abuser, while survey of substance abuse in Iraq in 2015 reported that a total of 10.3% of male participants from the special population sample reported knowing other people who misused licit drugs, and 7.8% females reported knowing others who used illicit drugs.9 This was the first national household survey to explore mental health problems in a representative Iraqi population sample.10 Results reported lifetime abuse of any substance in 1.29% of males and 0.25% of females.11,12 Another study conducted in the capital city of Baghdad in 2010 reported the lifetime prevalence of any illicit substance use at 7%.13 This rise in the prevalence of substance users and knowledge of the public about them can be a consequence of the current political status of the country and the recent situation of the war against ISIS few years ago. The general knowledge of commonly used illicit substances globally or locally was not enough. The highest known or heard about substance was cocaine (71.4%) in females and (70.5%) in males, followed by heroin (52.7%) in females and (56%) in males; cannabis came in the third place, while Tussiram® came in the last place recording that (9.9%) of females were aware of this substance. This knowledge seems to be low according to a study in Ireland where over (97%) of the population were aware of cannabis followed by cocaine (96.4%) and heroin (94.3%).14 This difference in results may be a reflection of the difference between the two community traditions and religions, with the Iraqi society being more strict than the European society. The study revealed that male (59.6%) and female (41.7%) respondents agree with the fact that of all illegal substances are equally harmful to health, while the response of (15.6%) males and (25.3%) females “Don’t know.” These results suggest a failure to recognize the different pharmacological and other effects associated with different substance types.15 This study showed that (62.6%)of the female respondents, and (52.6%) of the male respondents have an opinion that substance abuse comprises a real problem in Tikrit, while a study in Saudi Arabia revealed that (76%) agreed with the idea of substance abuse being a common problem in their society.16 The results revealed that (84.6%) of the female respondents would be nervous of those who used illegal substances and (76.9%) would tend to avoid substance addicts, while (48.3) agreed to the fact that substance addicts exaggerate their problems to get sympathy. The positive point from the results was the percentage of respondents, 80.2% female and 78.5% male respondents, who agreed-that treatment should be available to all substance addicts..17
With regard to the knowledge about the availability of substances in Tikrit city, this study showed that (24%) of females and 30% of males agreed that substances are widely available in Tikrit, while (70%) of females and 54% of males said they don’t know about such a thing. More recently, there have been multiple reports of Iraq becoming much more central to the trafficking of substances in the Middle East. Transit of heroin from Iran, Captagon from the Gulf and from labs in the chaos in Syria and more recently Lebanon, and tramadol from pharmacies in Jordan and the laboratories in Pakistan and India are all being reported in increasing amounts.18,19
CONCLUSION
The study has concluded the following:
General knowledge about globally and locally used illicit substances is not enough for both genders.
Negative attitudes towards substance abusers and substance abuse were clearly apparent in their responses.
The youth population agreed with spending money on the treatment of many substance abusers as possible.
Illicit substances and other substances that cause abuse are being increasingly available in the society and that is a big problem that needs a quick response in order to minimize its harmful consequences.
The population showed good knowledge about the ways and factors that may help in the prevention of substance abuse.
Recommendations
More education about substance abuse is very necessary for the population and education programs should be carried out as soon as possible.
Regarding the attitudes of the society, some negative attitudes of the youth population towards substance abusers need to be targeted and modified into better attitudes.
Standard preventive methods and programs should take place to minimize the problem of addiction in our society.