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SMAD. Revista eletrônica saúde mental álcool e drogas

versão On-line ISSN 1806-6976

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.) vol.15 no.4 Ribeirão Preto out./dez. 2019

http://dx.doi.org/10.11606/issn.1806-6976.smad.2019.000364 

10.11606/issn.1806-6976.smad.2019.000364 ORIGINAL ARTICLE

 

Drug use and abuse among university students and interface with public policies

 

 

Elisa Carneiro Pereira CamargoI; Jamila Souza GonçalvesII; Adriana Olimpia Barbosa FelipeIII; Silvana Maria Coelho Leite FavaIV; Márcia Maria Fontão ZagoV; Eliza Maria Rezende DázioVI

IPrefeitura Municipal, Estratégia Saúde da Família, Monsenhor Paulo, MG, Brazill / Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
IIInstituto Federal de Educação Ciência e Tecnologia do Sul de Minas, Passos, MG, Brazil / Bolsista da Fundação de Amparo de Pesquisa de Minas Gerais (FAPEMIG), Brasil
IIIScholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil / Scholarship holder at the Fundação de Amparo de Pesquisa de Minas Gerais (FAPEMIG), Brazil
IVScholarship holder at the Fundação de Amparo de Pesquisa de Minas Gerais (FAPEMIG), Brazil
VUniversidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
VIUniversidade Federal de Alfenas, Alfenas, MG, Brazil

Corresponding Author

 

 


ABSTRACT

OBJECTIVE: to analyze the meaning of the use and abuse of alcohol and /or other drugs among university students in accordance with Brazilian public policies on drugs.
METHOD: 49 university students from a Public Institution of Higher Education in the Southeast region of Brazil participated.
RESULTS: Bardin's Content Analysis elaborated the analytical category: "Dissonance between public policies and the meaning of drug use among university students". Drug use and abuse begin in adolescence; Stimulated by family and friends, and refers to the happiness and flight of problems.
CONCLUSION: it is fundamental to know the meaning of drug use and abuse, from the perspective of the university for the elaboration and implementation of public policies.

Descriptors: Students; University; Drug Abuse; Public Policy.


 

 

Introduction

In contemporary times, the use and abuse of drugs among young people, especially university students, has become a public health problem and requires action on the part of the State, universities, and society as a whole to prevent and control this phenomenon (1-2).

Admission to higher education institutions may represent the opportunity for most academics to gain the desired professional training. It allows young people to change their social, family and school environment and, for many, represents the beginning of the administration of life on their own(3). However, such moment of life can be stressful and turn some young people more vulnerable to risky behaviors, such as consumption of alcohol and/or other drugs. This is especially so because they move away from the family environment and start associating with peers, due to the need to make new friends, to adapt to a new dwelling, and to manage the newly acquired freedom(2).

Our attention has been drawn to the fact that in the daily life of university students, certain students show behavioral changes. Some of them become sad, depressed, angry, euphoric or even indifferent, even missing the proposed activities. In our view, these behaviors impose on the university and the teachers attitudes, not of discrimination, but rather of embracement, especially when such behaviors are related to the use of psychoactive substances. It is not enough that higher education entities excel in the advancement of scientific knowledge and the use of information and communication technologies for the training of educated, critical and reflective professionals; they must also urgently train the citizens, imbuing them with values for life(4). To that end, establishing a link between teachers and students is fundamental, and educators need to offer alternatives that enable young people to face the challenges imposed in their lives, in this age group, such as prevention and reduction of drug use(4).

Given the magnitude of the problem of use and abuse of substances among university students, it is imperative to know the understanding this public has of the use and abuse of alcohol and/or other drugs. Thus, the following concerns are raised: What do university students think about drugs? What do drugs offer them? Why public policies are not effective? What could be done at universities to prevent or minimize the use of drugs among university students? In this context, this study aims to analyze the meaning of use and abuse of alcohol and/or other drugs among university students, in line with Brazilian public policies on drugs.

Studies have emphasized the need to conduct research on consumption of alcohol and/or other drugs among university students to contribute to the perception of this phenomenon, and at the same time serve to detect the resources and vulnerabilities of this group(1,4-5). It is also important to develop studies of this nature to offer subsidies for primary and secondary prevention programs aimed at this population, taking into account that the role of universities is to generate social changes(5).

 

Method

This is a qualitative, descriptive study based on Brazilian public policies on alcohol and/or other drugs, in which the data obtained in two studies entitled "Meaning of use of alcohol and/or drugs among male university students" study 1, and "Meaning of use of alcohol and/or drugs among female university students" study 2, previously conducted by the researchers. Both studies were developed at a public university in the Southeastern region of Brazil, which offers undergraduate courses in the face-to-face and distance modality and postgraduate studies lato sensu and stricto sensu. The selection of participants in study 1 was performed according to the following inclusion criteria: male college students, over 18 years old, regularly enrolled in face-to-face undergraduate courses, who used alcohol and/or any other drugs at the moment of the study. The selection criteria of study 2 were the same, but with female participants.

For the accomplishment of the two studies, consent from the Pro-Rector of Undergraduate courses of the University was requested. Students were searched in the classrooms, and the objectives of the studies were clarified. The students who agreed to participate searched for the researchers and were clarified again about the objectives. Then, a time for interviews was scheduled at the university or in their residences.

Data collection took place from November 2014 to July 2015 through a form for collecting socioeconomic information. The following guiding questions were used in the interviews: "Tell me how it is to you to be a (male) university student and make use of alcoholic beverages and/or other drugs" study 1 and "Tell me how it is to you to be a (female) university student and make use of alcoholic beverages and/or other drugs" study 2. The techniques of interviews, participant observation, and field journal annotations were used in the studies. Interviews were conducted by the authors of studies 1 and 2 and occurred on the day, time and place of preference of the participants. On average, two to three interviews per participant were made, lasting 40 minutes, and were recorded in a MP4 device. Immediately after completion, the interviews were transcribed verbatim by the researchers, enumerated in accordance with the sequence in which they were carried out, analyzed and filed electronically using the Word software. The participant observation and field journal annotations were recorded in several moments during the meetings with the students in various environments.

In the present study, the participants' statements were evaluated through content analysis using the thematic analysis technique, following the phases of pre-analysis, material exploration and conversation of results with inference and interpretation(6).

The study was approved by the Committee on Ethics and Research with Human Beings of the Federal University of Alfenas under Opinion nº 822,626. Thus, all the ethical and legal precepts regarding research with human beings regulated by Resolution 466/12 of the National Health Council were observed and respected. The participants signed the Informed Consent Form - ICF and received fictitious names, at the choice of the researchers.

 

Results and Discussion

Forty-nine university students enrolled regularly in the undergraduate courses of a public university in the southeastern region of Brazil participated in the study. Of these, 20 were males and 19 females; they were in the age range from 20 to 32 years, most of them were single, white and Catholic. There was a predominance of family income of four minimum wages and 29 declared to live in student houses. As for personal income, one participant mentioned exercising work activity; 37 were dependents on their parents; 14 were scholarship recipients, nine from scientific initiation programs and one from the Tutorial Education Program - PET. Two participants reported having a scholarship of R$ 400.00 as only income, since they did not receive any other financial resource to stay in university. All participants were regularly enrolled between the 2nd and 10th semesters of the courses; 21 reported having at least one "dependence" on disciplines; 21 were from the area of Health Sciences, and of the total of participants, 12 already attended another course. In order to answer our questions, we found the following analytical category: Dissonance between public policies and the meaning of drug use among university students.

Because alcohol is considered a legal substance, it is legally accepted and tolerated. This perception contributes to young people to think that drugs do not cause problems. It is important to consider that easy access and transference of these substances contribute to the their use and abuse(7). The following testimonies illustrate the reality of consumption of alcohol and/or other drugs among university students:

[...] I consume alcohol and cigarettes... but alcohol was before college, at home we drink wine, not beer. Then I tried it with my uncles, you know?... later with my friends in the street, bar after classes in college (S1 Augusto); [...] I drink shots, not many, it's like, I drink brandy because my grandfather used to drink at lunchtime and he would leave a bit in the bottle and he would make me drink, and I like it, it brings me a good memory. A good memory (S1 Jeane).

The testimonials of university students revealed that alcohol was often part of the lives of the young people since an early age, introduced through family and friends. Studies have shown that the use and abuse of alcohol and/or other drugs is associated with examples in the family and among peers(8-9). It should be noted that examples are the major influence motivating learning among young people(8). These data indicate a dangerous path in which they may come to tread, because the consumption of drugs stimulated by family and friends makes this process to appear natural, without consequences for life(10).

The Ministry of Health shares the idea that the consumption of alcohol and/or other drugs among family members and peer groups is a risk factor and portrays the need for assistance to family members of dependents(11). Furthermore, the Emergency Plan to Expand Access to Treatment and Prevention in Alcohol and Other Drugs (HDPE) separates alcohol from other drugs and appears to depict alcohol as if it were not a drug. On the other hand, it is understood that such separation was made to avoid further disruption and discrimination in relation to the treatment of people who use and abuse alcoholic beverages(12).

Another aspects is that the consumption of alcoholic beverages is naturalized and valued socially, and is associated with festivities, leisure, relaxation, fun, strengthening of bond with peers, forgetfulness of problems experienced, freedom and pleasure(9,13), as verified in the following statements:

[...] so I have alcohol in my life as a kind of leisure when I'm with my friends, when I go partying, I go out at night, when I'm with my girlfriend... I do not have a very good reason, but I like it, I think beer is tasteful [...] if I go to sit in one place and drink two beers to talk I do it, I think it's nice and a custom that we create without realizing it sometimes. And ah we get more drunk like this, but not easy-going, because I'm already like that LOL... (S1 Marcelo); [...] Goodness, I don't know, alcohol I always remember being with friends, celebrating, chating. As I do not exaggerate, it is happiness (S1 Carla).

It can be inferred that university students choose alcohol as the drug of choice to minimize the day-to-day pressure, to feel pleasure and happiness. In this mode of thinking, consuming alcoholic beverages is part of the routine of these young people. This is a reason for concern because such consumption establishes a flimsy line between recreational consumption and dependence(13).

It is relevant to consider that the use and abuse of alcohol by university students aims to minimize shyness and, thus, to establish social relationships with peers. This was highlighted in the testimonials below:

[...] In my view, what it takes the university students to use it, besides sensations, is the environment; they also use to become cool. And, as you drink, everything gets better. (S1 Paul); [...] I think the alcohol inevitably brings people closer, leaves you more relaxed to talk, cooler for some things, I think that brings people closer, so much speaking of this age group that we are, it makes us less shy to arrive and talk things... different from when the person is not drinking, a more timid personality, the person wouldn't do it (S1 Marcelo).

University students describe euphoria and disinhibition as effects of alcohol(14). The testimonies show that the use and abuse of alcohol and/or other drugs is also mentioned by young people as a way to alleviate the problems experienced:

[...] I drink alcohol really to overflow, or I drink because I have a lot of things in my mind, you drink a little and forget it all, huh? (S1 Julio); [...] I Think (drugs) they're something you use to enhance the moment (S1 Flavia).

The data are consistent with the literature, emphasizing that drug consumption is one of the ways to minimize the pain, suffering, frustrations, and losses that occur in daily life. Young people use these substances in an attempt to alleviate the anguish caused by the fragility of family ties, although their use and abuse provoke more conflicts in the family environment(15). The National Policy of the Ministry of Health for Comprehensive Care to users of alcohol and other drugs emphasizes the importance of the family entity being preserved and optimizing the contact between family members as a form of protection against the use and abuse of chemical substances(11).

With this in mind, it is imperative that educational institutions conduct research on the well-being and mental health of students and plan effective actions in this process, minimizing the effects of such changes and the use and abuse of alcohol and/or other drugs as an attempt to restore well-being. The National Plan for Assistance to Students determines that one of the priority areas for assistance to university students is psychopedagogical care and care for chemical dependence(16). It is, therefore, important to mention the need for educational programs to raise awareness among university students and for insertion of the National Policy for Alcohol and other drugs as well as of the laws in force in the country to understand this phenomenon(1,9). It is recommended families and the support network be involved throughout the process with the objective of promoting the dialogue among the various social actors(4). It should be noted that selling alcoholic beverages for persons over 18 years of age is legal(11), but there are no age limits for consumption(17). This is reiterated in the following testimony: [...] The issue of drinking for example, at 15 I started drinking at home and hanging out with friends, but my dad would tell me you can try but do not abuse (S1 Paulo).

There seems to be a chasm between compliance with this law and alcohol use and abuse because young people under the age of 18 consume these beverages through sharing between friends and relatives(9).

It should be noted the National Policy of the Ministry of Health for Comprehensive Care to users of alcohol and other drugs of 2004 and the Decree nº 6,177 of May 22, 2007, aim to regulate, control, monitor, and restrict advertisements related to the use of alcoholic beverages(11,18). However, such legislation is not always respected because advertising is rarely audited. A fact highlighted among the participants: [...] we learn (of parties with alcoholic beverages in the banners) through advertisements (E1 Marcelo).

The literature has associated the behavior of young people towards use and abuse of alcoholic beverages with ideas disseminated by the media. Thus, limiting the use of these advertisements can be one of the ways to prevent and reduce alcohol use and abuse(19).

It is noteworthy that, given the permissiveness with respect to abuse of alcohol and/or other drugs among university students, a portion of the population also agrees with this premise and even approves to revert it into profit, with the organization of parties.

[...] In this city, there is no way, right! There is another reality here! At least in my town, I had no contact with this university environment. And there is a college in my city, there is the (name of the university) and such, but it is another reality. In this city, there is a lot of partying! Lots of partying! (S1 Alexandre); [...] Most parties here are open bar; the parties here are geared towards open bar, to alcohol consumption. The consumption in the open bar is very large, I drink more when I go to these parties but I do not drink excessively (S1 Peter).

The participation of university students at parties and the use, as well as abuse of alcohol and/or other substances, are commonplace(1). Still, with regard to the environment, parties, concerts, and bars are the preferred places for use and abuse of alcohol and/or other drugs among university students. This study highlights the need to control parties with free beverages, as well as the availability of alcohol at reduced prices at student events and bars near universities(9).

The start of academic life is permeated by numerous changes, by opportunities and by the establishment of new social links that influence the behavior of academics, as mentioned below:

[...] So, when I was not in college I tried it, but I did not use it that way. Now after entering college you get to drink more socially, and partying with friends, gatherings; there we drink a little more, different from what we used to be some time ago (S1 Ricardo); [...] Marijuana is also a certain form of socialization, and people smoke it a lot here. (S1 Josiel).

It seems reasonable to suppose that in the history of university students the use and abuse of alcohol and/or other drugs is a reality of everyday life. However, this use does not originate in the university; the majority of the students try drugs before their entrance in higher education(14,20). But it is in this environment that the use and abuse of these substances are increased and become risky, leading to problems related to this pattern of consumption(21), as described below:

[...] So, when I was not in college I tried it, but I did not use it that way. Now after entering college you get to drink more socially, and partying with friends, gatherings; there we drink a little more, different from what we used to be some time ago (S1 Ricardo).

It is important to consider that adolescence is a moment of search for new experiences, of individualization, of maturation, and the use and abuse of alcohol and/or other drugs may be present.

The fact that university students claim to have self-control on the use and abuse of alcohol and/or other drugs is a worrying factor, considering the risk of dependence of these substances:

[...] marijuana can get in the way a bit if you do not know the time for leisure and for study (S1 Pedro); [...] I'm used to drinking, I'm strong to drink. Then as I am strong the guys already made me have three for me to drink, and I was firm and strong (S1 Larissa).

The speeches revealed that the university students mentioned strategies of self-control for the use of psychoactive substances. However, it is believed that they do not always use such strategies; investigations conducted with this population have found a considerable rate of problematic consumption of alcohol and/or other drugs(5,22).

It was noticed that university students have knowledge about the harm caused by the use and abuse of alcohol and/or other drugs, but only in abusive circumstances.

[...] we hear that alcohol is not good, of course it is not good, in my area for example, mixing alcohol and cigarettes potentiates mouth cancer; this is something that is very harmful. But I believe that drinking consciously will not bring as much damage as excessive consumption (S1 Marcelo).

Although young people highlight the harm of this consumption, they have the curiosity to experience new things and forget the possibility of the addiction from the initial contact with the drug(15). However, the literature has reported that young people perceive the use and abuse of licit and illicit drugs as harmless to their health(20).

Although undergraduate courses approach the risks of alcohol use and abuse, this approach does not seem to have a positive impact on use of alcohol among university students(9). In such a situation, the use and abuse of alcohol and/or other drugs should be a priority in educational institutions, including it as compulsory subject, as well as psycho-pedagogical support and outreach activities with guidance and prevention programs(22). The approach of this theme must be transversal in all the contents(14). It is important to consider that this strategy should be in line with the public policies on alcohol and drugs in force in the country.

The use and abuse of alcohol and/or other drugs may cause harm to users and to society. However, the participants made the following statements:

[...] but marijuana can mess up in the way you lead with your study routine (S1 Peter); [...] I already drove, but not when I was very drunk or out of my mind... you know? I have levels, I know myself (S1 Alexandre).

It can be seen that university students can develop risk behaviors associated with the use and abuse of alcohol and/or other drugs, including driving of vehicles under the influence of alcoholic beverages(9) despite of the existence of the Law known as "Dry Law", which imposes stricter penalties for drivers who transit under the influence of alcohol or another psychoactive substance that determines dependence(23). It is obvious, therefore, that the legislation alone is not enough to inhibit such behaviors, because there is a cultural way of being know "Brazilian way" to circumvent the legislation. The need to work with young university students to raise their awareness, without reprimands, is evident, to train them as citizens.

With regard to academic performance, the bibliography reports that university students are aware of the harms caused by the use and abuse of alcohol and/or other drugs(2). However, despite such awareness, many of them use drugs.

Another issue that causes concern is the indiscriminate use of psychotropic drugs among university students:

[...] I began to take ritalin, because I saw that my performance in college was not good, it was different from my colleagues, I had difficulties concentrating... this one I intend to stop using once I finish college, I expect not to need so much of it (S1 Igor).

There is evidence in the literature of a high rate of university students using the substance mentioned in this testimony; it is used to increase concentration and performance in academic activities(24). Lack of familiarization with facing adversities makes young people to resort to these drugs to better cope with suffering, pain and loss of self-control(15). In our view, it is imperative to review the whole process of education in our country and the State and teachers are in line with this matter. Therefore, it is urgent that educators and students become active subjects of the educational practice for the construction of knowledge permeated by democratic relations, with a view to the autonomy of students and the formation of citizens(25).

The analysis of the testimonies in confrontation with Brazilian public policies on the use of alcohol and other drugs, including medicines used indiscriminately by them, shows that there is a great challenge to be faced by the State, universities, teachers, university students, family members, and society in general.

 

Conclusion

This study revealed that the use and abuse of alcohol and/or other drugs among university students is linked to pleasure, happiness, facilitation of social interactions, and the escape from problems. It is reiterated that drug use and abuse is a public health problem in Brazil and in the world, especially among university students.

Given the magnitude of the theme, the State has been investing in the elaboration and implementation of public policies aimed at preventing and reducing drug use, especially among university students, because they consume more psychoactive substances than the general population, in the same age group.

In this context, in order to minimize the dissonance, it is suggested that public policies be developed and implemented in order to "meet" rather than "combat" the conceptions of students. Actions that allow the academics to be heard in their existential dimension and at the same time to cherish their autonomy must be sought.

Only the emancipatory education, committed to the training of critical and reflexive subjects, will result in the capacity for choices, in the incorporation of new meanings in their process of existence and, therefore, in prevention. In order to achieve this goal, it is necessary to promote the training of servers to deal with the situation, because each one of us must be free of prejudices and judgments and at the same time remember that, for them, the drug is mainly related to happiness and is part of their passage through the university.

We conclude by reiterating that drug use and abuse motivate social disintegration, violence and crime, but it is urgent to rethink and implement public policies committed to social justice and extirpation of iniquity.

This study has the limitations of having been carried out mostly with university students of the last semesters of the undergraduate courses. It is suggested, then, to carry out studies with university students of initial semesters.

It is also recommended that investigations about the use and abuse of alcohol and/or other drugs and mental health of students be conducted at other universities in order to assess the reality of each scenario and thus propose intervention strategies. It should be noted that nurses are one of the professionals who can assist in the diagnosis of the situation and in the implementation of these strategies, contributing to the quality of life of these people.

 

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23. Lei nº 11.705/2008, de 19 de junho de 2008 (BR). Altera a Lei nº9.503, de 23 de setembro de 1997, que institui o Código de Trânsito Brasileiro', e a Lei nº9.294, de 15 de julho de 1996, que dispõe sobre as restrições ao uso e à propaganda de produtos fumígeros, bebidas alcoólicas, medicamentos, terapias e defensivos agrícolas, e dá outras providências. Brasília, 19 de junho de 2008. Disponível em www.planalto.gov.br/ccivil_03/_ato2007-2010/2008/lei/l11705.htm Acesso em: 05 de jul. de 2016.         [ Links ]

24. Coli ACM, Silva MPS, Nakasu MVP. Uso não Prescrito de Metilfenidato entre Estudantes de uma Faculdade de Medicina do Sul de Minas Gerais. Rev Ciênc Saúde. [Internet]. 2016 [Acesso 16 ago 2018]; 6(3). Disponível em: http://200.216.240.50:8484/rcsfmit/ojs-2.3.3-3/index.php/rcsfmit_zero/article/viewFile/582/377        [ Links ]

25. Freire P. Pedagogia do oprimido. 43. ed. São Paulo: Paz e Terra; 2005.         [ Links ]

 

 

Corresponding Author:
Adriana Olimpia Barbosa Felipe
E-mail: adrianaofelipe@yahoo.com.br

Received: Jan 10th 2017
Accepted: Jul 20th 2018

 

 

* Paper extracted from master's thesis "Significado da droga entre universitários e a sua interface com as políticas públicas" presented to Universidade Federal de Alfenas, Escola de Enfermagem, Alfenas, MG, Brazil.

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