Factors Associated with Patterns of Drug and Substance Abuse among Youths in Bo City, Sierra Leone

Abstract

Background Drug and substance abuse remains a major public health concern among young people, particularly in sub-Saharan Africa, where increasing availability of illicit substances poses significant social, behavioural, and health-related challenges. Bo City, the second-largest urban centre in Sierra Leone, has experienced a substantial increase in substance-related incidents; however, empirical evidence regarding the determinants, patterns, and accessibility of substance use among youths remains limited. Understanding these factors is essential for developing targeted prevention and control interventions. Objective This study aimed to investigate the factors associated with patterns of drug and substance abuse among youths in Bo Municipality, Sierra Leone. Specifically, the study assessed youths’ knowledge and awareness of drug abuse, identified commonly abused substances, examined factors influencing substance use, and determined sources of drug availability among young people. Methods A descriptive cross-sectional study design was employed among 401 youths in Bo Municipality, Sierra Leone. Participants were selected using a purposive sampling technique. Data were collected using a structured and pre-tested self-administered questionnaire. Data analysis was conducted using IBM SPSS Statistics Version 25.0. Descriptive statistics were used to summarize participant characteristics and substance use patterns, while Chi-square tests of independence were performed to assess associations between sociodemographic factors and substance use outcomes. Statistical significance was determined at a p-value < 0.05. Results The majority of respondents were males (72.3%), aged 16–23 years (54.1%), had secondary education (32.2%), and were unemployed (57.4%). Kush was the most commonly abused substance, with 71.3% reporting lifetime use and 64.6% identifying it as their most frequently used substance, followed by marijuana (10.2%). The leading reasons for substance use included peer pressure (26.2%), escaping personal problems (19.0%), and lack of recreational activities (16.2%). Social media was the primary source of information about drugs (49.6%), whereas formal sources such as schools (3.0%) and healthcare workers (5.5%) contributed minimally. The main sources of drug availability were local markets (43.6%) and street vendors (21.7%), with 68.1% of respondents reporting that substances were either easy or very easy to obtain. Furthermore, 68.5% perceived law enforcement efforts as ineffective, while 70.6% were unaware of existing drug-related laws. Significant associations were observed between gender and type of substance used (χ²=57.55, p < 0.001), age group and substance used (χ²=57.20, p < 0.001), peer pressure and substance use (χ²=100.94, p < 0.001), and reasons for substance use and substance type (χ²=196.23, p < 0.001). Conclusion Drug and substance abuse, particularly Kush use, has become a serious public health concern among youths in Bo Municipality. The high prevalence of Kush use appears to be influenced by peer pressure, psychosocial challenges, unemployment, limited recreational opportunities, and easy accessibility through informal supply networks. Strengthening youth-focused prevention programmes, improving drug education, enhancing community awareness, and implementing effective regulatory and law enforcement measures are critical to addressing the growing substance abuse challenge in Sierra Leone.