This study originated from the perceived increasing prevalence of drug and substance abuse in society and the hazard this abuse represents in Nigeria and the world at large. Before the execution of this study, minimal research had been conducted on drug and substance abuse in specific regions of the country. This study aimed to broaden the scope of drug and substance abuse epidemiology in Nigeria and increase awareness of the effect and availability of these drugs. Because of the cross-sectional design, the study’s primary limitation is its time-specific emphasis; it does not provide information on trends in prevalence and associated factors in the population of interest. Nevertheless, the study provides a snapshot of evidence high-quality empirical information on the prevalence and factors associated with substance abuse within the Nigerian population.

The number of students who indulge in drug and substance abuse is notable. Students are increasingly adopting innovative methods for smuggling these substances into universities in high enough quantities to meet growing demand. This trend may result from the inadequate efforts of security operatives in various Nigerian universities. Study findings supported a 45.7% prevalence of drug and substance abuse among participants. The most abused drug or substance were alcohol (61.5%) and cigarettes (54.5%), likely because these substances are legal for use in Nigeria despite restrictions on use before driving and for minors. Our findings are more recent and more comprehensive than the study of 1000 students by Oshikoya and Alli¹⁷ at Lagos State University, which covered only one institution whereas our study included four representative universities.

Our study highlighted 12 factors that influence the abuse of drugs and substances. The major factor was “to get high.” The findings are consistent with those of Adekeye et al.’s study.¹⁸ In recent years, the psychological effects of drugs and substances and the observable increase in abuse have not gone unnoticed. Risk awareness is a key factor in addressing drug and substance abuse. Despite establishing that a large number of respondents understood the risk associated with drug and substance misuse, the study recorded a considerable prevalence of abuse. Therefore, we can postulate that perceived factors that drive drug and substance abuse prevail over risk considerations.

Taking a critical look at the substances that are being abused within the population of interest is important. The top-ranking substances of abuse, alcohol and cigarettes, are generally considered social drugs because they are legally allowed. The majority of the population of interest fell within the age bracket of those allowed to consume these social drugs; this may account for why these substances were the most popular among users. Notwithstanding, this should also be considered alongside other factors that predispose individuals to consume substances to alter their state of mind, to “feel good” or to “get high.” Socioeconomic and environmental factors largely contribute to the use and abuse of these substances in a large percentage of the population.^19,20 A consideration of these factors is therefore critical in any effort to address the threat of drug and substance abuse within the broader population in Nigeria.

Furthermore, the inclusion of tramadol and cough syrup among the five top-ranking substances of abuse is of special interest. Illegally repurposed and abused as drugs, tramadol and cough syrup are often readily available over the counter and are currently substantially abused despite being medicinal drugs. Codeine-containing syrup is of considerable interest as a substance of abuse.²¹ Notably, these drugs now rank higher than other illegal drugs such as cannabis (sixth), tobacco (eighth), cocaine (ninth), heroine (twelfth) and amphetamines (fifteenth) in our study. Interestingly, the aforementioned drugs are priority targets in efforts by stakeholders and government agencies to curb the menace of drug abuse.

In addition, findings indicate a contrast in the hierarchy of importance and popularity of substances of abuse when compared with data obtained approximately three and half decades ago.²² Although the UNODC⁸ and another study⁹ rank cannabis as the leading illicit drug or substance of abuse, the present study indicates that codeine-containing syrup and tramadol have overtaken cannabis in importance and popularity among drug abusers in Nigeria. The increasing popularity of these emerging though unconventional substances of abuse necessitates a continuous research effort to uncover the actual state of substance use and drug abuse in the population; effort should be made to address such challenges in an evidence-based manner. Therefore, this research reveals that tramadol and cough syrup, for example, deserve more attention than they have been given considering how popular they have become among users of illicit psychoactive substances. Furthermore, a lack of awareness of the actual state of affairs concerning substance and drug abuse in the community may lead to negligence that can inadvertently but progressively promote the use and abuse of such substances. This in turn can result in the escalation of the problems associated with mental health and social well-being in society.

The five top-ranking reasons for dependence on drugs or substances reported in this study primarily converge on respondents’ efforts, however dysfunctional, to address their social and psychological problems or to achieve psychological escape. Importantly, socioeconomic and environmental factors ranked highest as factors that predisposed people within the studied population to substance use and drug abuse. Although efforts that are aimed at curbing the threat of substance abuse should be sustained and enhanced, critical consideration of these socioeconomic and environmental factors can address the vulnerable within these populations. When relevant underlying socioeconomic and psychological problems are addressed, the need to achieve a state of “being high” or attempts to numb emotional pain or burden will dissipate. Given these factors are directly associated with the reason for individuals abusing substances or consuming illegal drugs, we anticipate that addressing these factors can be a fundamental means of tackling the problem of drug abuse within the population.

Furthermore, a consideration of more holistic policies that reduce vulnerabilities that predispose people to craving substances—and not only those aimed at punishing consumers of illegal drugs or restricting access—is critically required. In addition, as previously recommended by Ajayi and Somefun,²⁰ adequate educational programs that create awareness about the consequences of the consumption of psychoactive agents or a permissive culture that directly and indirectly promotes substance abuse must be considered. A comparison of the current trend with findings from previous studies indicates that the situation might not be static but is rather dynamic and susceptible to trends likely premised on socioeconomic and cultural dynamics. This necessitates implementing a high-quality surveillance system to study these dynamics and trends to accurately assess the current environment of drug and substance use and to guide the development of effective and tailored solutions at every point in time. This should be a priority in policy and practice, and should also be a key subject of interest in mental health and epidemiology.