Substance Use by Egyptian Youth: Current Patterns and Potential Avenues for Prevention

Abstract

Background. Substance abuse in Egypt is a serious public health threat. Recent studies have demonstrated increases in the prevalence of the use of tobacco, illegal drugs, and over-the-counter drugs, particularly among youth. Methods. We conducted focus groups with a total of 40 male and female youth participants, ages 12–14 and 15–18, recruited from two different areas (Cairo and Alexandria) in 2012. We investigated their knowledge and perceptions regarding current substance use, its sources, and promoting and protecting factors, broadly addressing the use of tobacco products, illicit and prescription drugs, inhaled substances such as glue and solvents, and alcohol. Results. Our findings suggest that: (1) youth in Egypt had access to and were actively using substances encountered in similar research worldwide, including tobacco, alcohol, illicit drugs, glue sniffing, and pharmaceutical agents; (2) smoking cigarettes and using hashish were the most common practices, and Tramadol was the most commonly used pharmaceutical drug; (3) peer pressure from friends stood out as the most common reason to start and continue using substances, followed by adverse life events and having a parent or family member who used substances; (4) strict parenting, religiosity, and having non-user friends were among the factors perceived by youth to prevent substance use or help them quit using substances; (5) most youths were aware of the adverse health effects of substance use. Conclusion. These findings will inform the design of quantitative surveys aimed at estimating the prevalence of specific behaviors related to substance use among youth and potential avenues for prevention.

Keywords :

• substance use
• youth
• drugs
• smoking
• focus groups

THE AUTHORS

Christopher Loffredo, PhD, co-directs the Cancer Prevention and Control Program of the Lombardi Comprehensive Cancer Center at Georgetown University, where he teaches epidemiology and leads international research in cancer and birth defects. His research focuses on environmental and genetic causes and prevention of liver, bladder, and lung cancer.

Dina Nabih K. Boulos, PhD, is an Associate Professor of Public Health in the Faculty of Medicine of Ain Shams University, Egypt. She also teaches at the American University of Cairo supporting the Diploma of Clinical Nutrition, leads the Tobacco Health Costs Study in Egypt funded by the World Health Organization, and she works as a consultant for other research projects.

Doa'a Ahmed Saleh, MD, PhD, is an Associate Professor of Public Health, Preventive and Social Medicine at the Faculty of Medicine of Cairo University. She teaches epidemiology and public health and leads research in communicable and non-communicable diseases and health systems research.

Irene Jillson, PhD, is an Assistant Professor at Georgetown University where she has designed and launched five courses in global health. She teaches medical ethics and health research and has conducted local, national and international health research studies, primarily in the Middle East, North Africa, Latin America and the Caribbean, for more than 25 years.

Magdy Garas, MD, is the co-director of Caritas-Egypt and the manager of CARITAS-EGYPT's program on combatting drug abuse in Egypt. He directs Caritas-Egypt's mission, focusing on assisting all aspects of human development. His work experience and activities include rehabilitation, sensitization, public relations and supporting human rights.

Nasser Loza, MD, completed his training in the Institute of Psychiatry and the Maudsley Hospital in London after which he returned to Cairo in 1987. He is Chairman of the Middle East Division of the Royal College of Psychiatrists and Chairman of the Scientific Committee of the Arab Board of Medical Specializations. He served as the Secretary General for Mental Health in Egypt from 2006–2011.

Philip Samuel, MD, has worked as a Psychiatrist at the Rehabilitation and Detox Center for Drug Abusers in Alexandria since 1995. He is also the manager of the Harm Reduction Program for Intravenous Drug Users, which includes syringe exchange and condom distribution and is a joint collaboration between Caritas and the United Nations Office on Drugs and Crime. Additionally he works as a counselor for high-risk persons at a Voluntary Counselling and Testing Center.

Yousri Edward Shaker is the executive secretary of Caritas-Egypt, which is affiliated with Caritas International. He has worked with Caritas since 1989 and has designed and supervised the implementation of several development projects during his time with Caritas.

Mar-Jan Ostrowski manages health research projects in Egypt; the projects are collaborations between Georgetown University and the National Institutes of Health of the United States. They include field and laboratory operations and are focused on the causes and prevention of bladder cancer and substance abuse.

Sania Amr, MD, is a physician scientist who heads the Division of Preventive Medicine at University of Maryland School of Medicine, where she also directs a training program for physicians in Preventive Medicine and Public Health, teaches environmental and occupational health, and conducts public health and prevention research.

GLOSSARY

• Glue sniffing: The practice of inhaling intoxicating fumes from the solvents in adhesives.

• Hashish: A cannabis product composed of compressed or purified preparations of cannabinoid-rich glandular hairs known as trichomes. It contains higher concentrations of active ingredients, including THC and other cannaboids, compared with unsifted cannabis buds or leaves.

• Tramadol: An opioid that was first synthesized in Germany in 1962 and has been available for pain treatment since 1977. It is sold under additional trade names such as Tamol, Ultradol, Tramidine, and Tramal.

Declaration of Interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

The work was supported by grant number 1RO1DA025205 from the National Institute of Drug Abuse, U.S. National Institutes of Health.