Dominant Stories Related to Substance Abuse by Learners at Selected High Schools in the Capricorn District of Limpopo Province, South Africa

Received: 26-Jan-2022, Manuscript No. jdar-22-56302; Editor assigned: 28-Jan-2022, Pre QC No. jdar-22-56302 (PQ); Reviewed: 11-Feb-2022, QC No. jdar-22-56302; Revised: 18-Feb-2022, Manuscript No. jdar-22-56302 (R); Published: 25-Feb-2022, DOI: 10.4303/jdar/236161

Abstract

Substance abuse is an increasing problem amongst learners which leads to negative outcomes, such as risky sexual behaviors, theft and violent bahviours. The purpose of this study was to explore and describe the dominant stories related to substance abuse by learners at the two high schools in Capricorn District of Limpopo Province. A qualitative, explorative, descriptive and contextual research design was utilised. The schools were purposive selected based on its high percentage of learners who abuse alcohol and leanerners were conveniently sampled used to select teachers to participate in the study. The sample of 23 participants was determined by data saturation. Data were collected through in-depth individual interview using audiotape, field notes were also taken. Data were analysed by means of thematic, Tesch’s method. Measures of trustworthiness were ensured. Results indicate that learners have the tendency to miss class and inefficiency in tests and examinations, which adversely affect their overall success. The study recommends that the school’s management or governing body, together with learners should host awareness campaigns that allow engagement of learners and school teachers in debates on issues around substance abuse. It is also recommended that teachers should not allow learners go outside the school premises during school hours as most. The provision of health information is imperative where alcohol or tobacco products are sold.

Introduction

Substance abuse is defined as using substances continuously even with knowledge of their long term effects that may lead to addiction and debilitating problems. Statistics at global level are of the impression that drug abuse has become a problem for every country and its effects are detrimental from a personal level to the national level. A report released by the United Nations Drug Control Programme (UNDCP) in 2004 estimated that 3.3%-4.1% of the global population consumes drugs [1].

In South Africa the scourge of drug has been noticed. Statically, today, drug use amongst school learners in South Africa is recognised as one of the greatest health and social problems facing post-apartheid South Africa [2]. It is estimated that millions of South African school learners use alcohol, tobacco, cannabis (dagga), solvents (like petrol and glue) and other drugs [3].

In Limpopo Province of South Africa, [4] found that among urban secondary school pupils, majority of both boys and girls first used any substance at the age of 16 years or less. The same study also identified that the use of tobacco and inhalants was particularly likely to commence at such an early age. Thirteen years of democracy in South Africa has resulted in policy and legislative reforms that seem to be changing the social and economic circumstances of rural communities including Capricorn in Limpopo province [4]. Learners who abuse substances may have difficulty in establishing their identity, developing relationships or skills, gaining physical and emotional independence and preparing for the future responsible adulthood. Substance abuse impedes learners’ matuarity causing them to continue immature behaviour into adulthood [5]. The abuse of alcohol and other drugs among high school kids remains a prominent concern for most schools. Problems commonly associated with such abuse include property damage, poor academic performance, impaired relationships, unprotected sexual activity, physical injuries, date rape rape and suicide [6].

The nature of drug abuse at secondary schools in South Africa has left indelible problems that include school drop outs, injuries and unwanted pregnancies. As a result of substance abuse, teachers at Mamolemane and Moshubaba High School complain that learners are skipping classes, fighting in class and bullying has forced many learners to fear coming to school. It has also been observed that during the day most learners are seen hanging out in bottle stores and taverns, drinking alcohol whilst in uniform. It is against this background that the current study seeks to ascertain the teachers’ perceptions concerning substance abuse at Mamolemane and Moshubaba High School, Capricorn District, Limpopo Province personal level to the nation at large.

Research method and design

The qualitative exploratory, descriptive and contextual research design were used to explore the dominant stories related to substance abuse by learners at selected high schools. Teachers from Mamolemane and Moshubaba high school, Bahlaloga Circuit, Capricorn District, Limpopo Province formed the population from which the sample was selected [7]. Purposive sampling method was used to select the school based on its high percentage of learners who abuse alcohol [8]. Convenience sampling technique was used to select 23 participants and was determined by data saturation [9].

Data was collected through indepth individual interviews using 23 participants who were teacher’s fromMamolemane and Moshubaba High School and the size of the sample was determined by data saturation. The following question directed data collection ‘can you please explain to me how substance abuse affects learners’ behaviour’. An audiotape was used to capture information, field notes were also taken. The method was used because it provides a clear set of instructions for interviewers and provides reliable, comparable qualitative data. It has assisted in attaining high response rate and also to give the researcher chance to make important observations aside from the responses given to the questions asked. Since the study was qualitative in nature, qualitative data analysis was used. This was done through classifying the data into logical thematic categories based on the objectives of the research. The researcher read through all scrpts and got a sence of the ideas emanating from data, similar information was cluster into categories and various categories were grouped to for themes and subthemes according to Tesch`s method.

Measures to ensure trustworthiness

Four criteria for developing trustworthiness were used; namely, credibility, dependability, conformability and transferability. Credibility was ensured through, prolonged engagement, reflexivity, triangulation, member checking, peer review and structural coherence. Transferability was ensured through purposive selection of the schools, a description of the demographics of the participants, and a dense description of the results with supporting direct quotations from participants. Consistency was ensured code and re-code data analysis, a dense description of the research methodology and peer examination, an audit trail and reflexive notes were used to establish conformability of the study.

Ethical considerations

Permission to conduct a study was obtained from the the University of Venda ethics committee (Ethics no:SHS/14/ PH/01/1605). Head of the Department of Education Limpopo Province and also from the selected school in Capricorn District, Bahlaloga Circuit; namely, Mamolemane and Moshubaba High School. The aspects applied to ensure that ethical considerations were adhered to be informed consent, anonymity, confidentiality and the right to self-determination

Results and Discussion

Educators delineated the dominant stories related to substance abuse by leaners at two participating schools. This theme emerged from the data analysis. Sub-themes that emerged from dominant stories related to substance abuse by leaners were lack of consistent class attendance, different types of substances abused, concertration directed, negative interpersonal relationship with peers, presentation of physical violence by learners, methods used to abuse substaces and behaviour related to substance abuse (Table 1).

Table 1: Theme and sub-themes reflecting the dominant stories related to substance abuse by learners at selected high schools in the Capricorn District of Limpopo Province.

Theme: Dominant stories related to substance abuse by learners

Teachers described dominant stories related to learners’ substance abuse. This theme emerged from the data analysis. Sub-themes that emerged from the dominant stories related to learners’ substance abuse are as follows: lack of consistent class attendance, different types of substances abused by learners, concentration directed to non-academic matters, negative interpersonal relationships with peers, presentation of physical violence by learners, methods used to abuse substances and behaviours related to substance abuse.

Lack of consistent class attendance

During the interview, teachers pointed out the lack of consistent class attendance that the learners have the tendency to miss class and inefficiency in tests and examinations, which adversely affect their overall success. As evident from their profile presented earlier, none of the learners implicated in this study would have completed their study programme in record time. The following are some of the comments from teachers.

“More often they are absent from the school, dodge classes and have no homework or classwork done when they should submit. They lose concentration in the classroom. They also bully others.” (Participant 0020)

“These learners are very much problematic, why? Because when they smoke marijuana, they exchange words with us (teachers), they don’t complete their given tasks, they dodge classes, they come late to the school and also if you can check their schoolwork you could see that is not clean/ tidy.” (Participant 0021)

Teachers have articulated that having low academic aspirations and performing poorly at school have been found to be related to adolescents’ use of alcohol, as have absenteeism and repeating a year at school [10-12]. The availability of drugs in and around schools facilitates their acquisition and use. Furthermore, where school lessons are not stimulating, learners are more likely to become prone to using drugs [13]. Alcohol and drug use are more prevalent among children and adolescents who attend schools where alcohol and drugs are more readily available. Alcohol and other drugs are brought to and consumed on the premises of some schools, particularly in disadvantaged communities [14].

Teachers further revealed that leaners abuse substances in schools even though they have signed the code of conduct that prohibit the possession and use of substances on the school premises (South African Schools Act No. 84 of 1996). The high prevalence of substance abuse among adolescents makes the school environment unsafe to both the educators and learners. That is why learners are unruly and do not respect educators and fellow learners. That ultimately leads to poor academic performance. This revelation was also confirmed in other studies, namely, that substance abuse has a negative effect on the academic performance of learners [15]. The participants in this study reported that learners’ use of substances made them fail and repeat grades. Furthermore, they regretted their use of substances.

The interview revealed that teachers felt substance abuse causes learners to want to leave school. Furthermore, teachers said that learners had lost the ability to concentrate in class and that their only focus was on using illegal substances. They said that they would suddenly lose focus and start to think about smoking marijuana. Teachers responded by stating that learners were not attend important life issues such as their schooling. Substance abuse has a negative effect on teachers’ scholastic achievement and puts the learner at risk of underperforming and failing academically.

Different types of substances abused by learners

Teachers said in interviews that there are different types of substances abused by learners, but alcohol and marijuana remain the most popular abused drugs and the consumption of alcoholic beverages is growing. Alcohol and cigarettes are gateway drugs because they are usually the first drugs that are tried out. Learners’ experimentation with alcohol leads to dependence. The following are some of the comments from teachers.

“They (learners) always smell of marijuana after coming back from the toilet” (Participant 0017).

“… and also there are learners who inhale glue one day I caught a learner carried a glue when I ask him, he told me that is a shoe repairer and I felt the smell from his mouth when we were talking.” (Participant 0021)

The findings revealed that drug and alcohol abuse are important problems that affect school aged youth at earlier ages than in the past. Young people frequently begin to experiment with alcohol, tobacco and other drugs during the middle school years, with a smaller number starting during elementary school. By the time students are in high school, rates of substance use are remarkably high. According to national survey data, about one in three twelfth graders reports being drunk or binge drinking (i.e., five or more drinks in a row) in the past thirty days; furthermore, almost half of high school students report ever using marijuana and more than one-fourth report using marijuana in the past thirty days.

Marijuana is the most commonly used illicit drug among high school students. However, use of the drug ecstasy (3,4-methylenedioxy-methamphetamine or MDMA) has seen a sharp increase among American teenagers at the end of the twentieth century, from 6% in 1996 up to 11% reported having tried ecstasy in 2000. Indeed, at the beginning of the 21st century, ecstasy was used by more American teenagers than cocaine [16] indicates that cigarette smoking is the gateway to other drugs of abuse. Cigarette smoking regularly serves as the starter drug delivery agent and the addictive substance contained in cigarettes is called nicotine. Children become hooked on cigarettes at any age for various reasons such as stimulation by other people using the substance, curiosity and the desire to experiment.

NIDA found that research showed marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally reported lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana using peers (ref). For example, marijuana use is associated with a higher likelihood of dropping out of school. Furthermore, asserted that alcohol and tobacco were important “gateway” drugs that lead to increased use of other illegal drugs. Most drug use starts during the period of adolescence especially for ‘gateway’ drugs [17].

A study by [18] investigating the influence of smoking habits of family members on tobacco use by adolescents, revealed that smoking habits by relatives, especially siblings influenced tobacco use by adolescents. They also found an association between smoking by adolescents and mother’s employment and between the smoking status of girls and family status. Postulates that cigarette advertising also lures adolescents and young adults to start smoking.

Nearly all first use occurs in secondary school. It is common for adolescents to feel social pressure in many ways from clothing and music to risky areas such as drugs, sex and smoking and they tend to experiment and try out new experiences [19].

Concentration directed to non-academic matters

During the interviews with teachers, it became apparent that the learners concentrate directly to non-academic matters. They concentrate too much on the substance abuse which was very important problems that affect school age youth at earlier ages than in the past. Learners frequently begin to experiment with alcohol, tobacco, and other drugs during the middle school years, with a smaller number starting during elementary school. By the time students are in high school, rates of substance use are remarkably high. The school actually does not condone the illegal or otherwise irresponsibility every member of the school community knows the risks associated with substance use and abuse. In this situation it is clear that learners are focusing on irrelevant academic matters rather than good ones, because at times they come to school with hangovers and find it hard to concentrate. More often they are absent from the class. One participant commented as follows:

“The learners spend most of time concentrating on funny things like going to a tavern during break hours to drink beers, because their school is nearby taverns and not coming back to the class.” (Participant 0019)

Similar findings indicated that leaners who abused substances became notorious and ruinous. Some of the notorious and ruinous behaviours included bullying, stealing, looking dirty and scruffy. They further stated that their use of substances endangers the lives of both their families and other people in their communities. They become dangerous to everybody [20].

Contrary to the above findings, UNODC (2015) found that learners end up being rejected by the very society that is supposed to nurture and guide them. That implies moral decay. These adolescents end up being arrested for their criminal activities and add to the already existing high rate of inmates in prisons

Sub-Theme 1.4: Negative interpersonal relationships with peers

During interviews, teachers postulated out the negative interpersonal relationship with peers. Participants mentioned that learners are using substances with the intention of enhancing their performance in the class. Due to this, there is absenteeism in school, resulting in learners taking too long to complete their studies. Some learners usually start a fight with teachers.

“Learners that are abusing alcohol in terms of performance they are under undeveloped and misbehaving … lack of concentration from learners when they are in the class, they are not controllable, they are also bullies.” (Participant 0019)

“… actually, drugs/alcohol is in one way or another affecting the general school performance, low concentration, disrespect/disobedience, missing lessons such as late coming, staying at toilet and playing truancy and also learners have become scarce crows to their teachers.”(Participant 0020)

Substances of abuse result in a major decline in the functions carried out by the brain

Drugs affect the students’ concentration span, which is drastically reduced and boredom sets in must faster that for non-drug and non-substance abusers. The students also lose interest in school work, including extra curriculla activities [21].

Nyathi stipulated that alcohol is a drug of choice amongst youth, it is mood altering and therefore has a potential to impact negatively on behaviour, academic performance and interpersonal relations. A substantial number of youths who drink tend not to know where to draw the line between social and pathological drinking [22]. This tends to predispose them to a host of risks, some of which might have long lasting effects on their lives. There is evidence that heavy alcohol use by students can lead to increased chances of risky behaviour. Over half of the young offenders involved in rape, murder and assault had been drinking during the event [23]. Negative effects experienced by respondents in this study were mostly risky and/or life threatening.

Presentation of physical violence by learners

Teachers said in the interviews that there was presentation of physical violence by learners. There is evidence that heavy alcohol use by learners can lead to increased chances of risky behaviour. In their pursuit for pleasure and fun, participants found learners in situations that rendered themselves vulnerable to gender based violence. Whilst under the influence of alcohol the learners’ judgment as well as their ability to detect possible danger tended to be impaired. Most of the time, the learners are more influential to other learners and display bad behaviour. The following are some of the comments from the teachers:

“Most learners are becoming bullies to the teachers and other learners; they are acting like bosses to other learners. They are swearing the teachers and they are not respectful.” (Participant 007).

“Eishh … they are not controllable, they take monies forcefully from young ones, and they are more influential to other learners and having bad behaviour.” (Participant 008).

The literature indicates that there are serious problems of ongoing violence within schools in South Africa. These problems are not of major concern to the government, the teaching profession, as well as civil society. According to [24], “there is increasing concern within South Africa that primary and secondary schools are the sites of widespread violence.” Where the school has been constructed as a space in which children can come and learn in a safe and protected environment, it appears that this is unfortunately not the case in the majority of schools within South African society. According to [25], the problem of school based violence is not a new phenomenon. However, what is becoming evident is the increasingly serious nature of the violence taking place within the context. For example, types of violence have shifted from cases of bullying to more serious forms of victimization that involve violence. This is evident in the case of the random killing of 16 year old Jacques Pretorious by MorneHarmse with a samurai sword at a Technical High School in the West part in Gauteng.

School violence is a problem of particular significance in South Africa. Shooting, stabbings, and physical and emotional violence have taken place in both public and private schools [26],; Zulu, Urbani and Van der merwe, 2004. A report by the South African Institute of Race Relations [27], suggested that only 23% of South African learners said they felt safe at school. In contrast, research suggests that schools in Norway, Denmark, and Sweden were the safest in the world with approximately 20% of learners saying they felt safe at school [27].

Due to children spending approximately half of their hours at school, schools can serve as the second most important socializing mechanism after the home. From a holistic perspective, [24] contends that schools are important environments in which children not only gain knowledge, but also learn about themselves, how to behave as well as how to interact with other children. In such a way, children who are exposed in this context will tend to model this behaviour. Schools therefore have the potential of being a negative or positive reinforcing agent [24].

Methods used to abuse substances

During interviews, teachers pointed out the methods used to abuse substances. This was found to be common among participants in this study, thus resulting in risk behaviour which will be discussed as sub-theme 1.7. The teachers described that alcohol and cigarettes are gateway drugs because they are usually the first drugs that are used before other drugs are tried. Alcohol was the most commonly abused. One of the respondents remarked:

“… actually, learners are very much creative and quick thinker, they mix alcohol with cool drinks and put it into the squeeze bottles and drink inside the class and start singing.” (Participant 0018)

The use of alcohol has major public health consequences because of its relationship with acute and chronic physiological, psychological and behavioural problems. Alcohol abuse is one of the most difficult public problems to deal with because the use is accepted at any social function and alcohol, amongst Africans, has socio-cultural and religious significance [28].

NIDA found that research showed marijuana may cause problems in daily life or make person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuan using peers [16]. For example, marijuana use is associated with a higher likelihood of dropping out of school. Furthermore, Blaze-Temple asserted that alcohol and tobacco were important “gateway” drugs that lead to increased use of other illegal drugs. Most drugs use starts during the period of adolescence especially for ‘gateway’ drugs.

Behaviours related to substance abuse

The teachers interviewed stated that there are too many outlets that sell drugs such as alcoholic beverages and other substances, and behaviours related to substance abuse relate to adolescents having the means to buy these substances. Furthermore, it implies that laws prohibiting the sale of substances to minors are not implemented and adhered to in rural areas. This then contradicts government’s strategies of providing services to previously disadvantaged areas and ensuring that all policies and laws protecting the rights of children and minors are enforced and adhered to at all times. The following statement supports this notion:

“Learners spend most of the time concentrating on funny things like going to a tavern during break hours to drink beers, because their school is nearby taverns and not coming back to the class.” (Participant 002).

In addition to that, it seems that parents do not always monitor their children during adolescence. There is lack of monitoring and control from both the parents and liquor boards. The liquor boards do not ensure that the Liquor Act is implemented in shops and taverns in rural areas. The lack of parental control can be ascribed to the migrant labour system as some parents are compelled to work far away from home, leaving their children in the care of grandparents who cannot monitor the movement of their grandchildren. The role of community policing forums becomes questionable in this context. This may mean that such structures are either not established or even though established, are not functional.

The implications of the study

Substance abuse among high school learners situates them at risk for harmful health, behavioural and social consequences. It may also be an contributory risk factors for presentation of physical violence by learners, negative interpersonal relationships with peers, concentration directed to non-academic matters and lack of consistent class attendance. Furthermore, high school substance abuse poses a significant academic risk

Based on the findings of the study, it is recommended that the schools should have social marketing methods such as promoting the concept of “Quit Drugs. Now!”. The community should make sure that it deals with those adults who sell alcohol and tobacco to learners during school hours and the laws should also take its course. Teachers should monitor learners when they go to the toilets to make sure that they do not take drugs during this time.

Limitations of the study

The study only focused on the teachers at two high schools in Capricorn district of Limpopo Province. The study did not include respondents from other schools in Limpopo Province.

Conclusion

In a nutshell, the study discussed about the lack of consistent class, different types of substances abused by learners, concentration on directed to non-academic matters, negative interpersonal relationships with peers and presentation of physical violence by learners, methods used to abuse substances and behaviours related to substance abuse. The aim of the study was to explored and described dominant stories related to learners abusing alcohol. The study revealed that the schools should come up with good strategies that can eradicate substance abuse such as social marketing method.

Acknowledgements

The authors are grateful to all participants for participating in the study. Appreciation is also extended to the University of Venda Research Publication Committee (RPC) for funding the study.

References

1. World Drug Report, United Nations. United Nations Office on Drugs and Crime, 2013.
2. A. G. Moleko, M. Visser, Community Psychology in South Africa , Prtra: Van Schk, (2012).
3. A. Parry, M. Bennets, The genetic epidemiology of cannabis use, abuse and dependence: A review, J Add, 101 (2010), 801-812.

   [Cross Ref] [Google Scholar]

4. K.  Peltzer, Substance abuse in rural primary health care patients in the Northern Province , Med Res Cncl,   (2014), 194-10.

   [Cross Ref] [Google Scholar]

5. L. Much, Adolescent transitions and alcohol and other drug use prevention. Preventing Adolescent Drug Use: From theory to practice, Off Sub Abu Prev Mon, 8 (2002), 13- 51.

   [Cross Ref] [Google Scholar].  

6. T. Wechsler, D. N. Klein, L. P. Riso, Psychiatric disorders: Problems of boundaries and comorbidity. In: Costello, C.G. (Ed), Bsc Iss  Psy, (2013), 19-66.

   [Cross Ref] [Google Scholar]

7. A.S. De Vos, H. Strydom, C. B.  Fouche, C. S. L. Delport, Research at Grassroots for Social Sciences and Human Services Profession s (4thed.) Pretoria: Van Schaik Publishers, (2011).
8. H. Brink, , C. Van der Walt, G. Van Rensburg, Fundamentals of Research Methodology for Health Professionals (3rded.) Cape Town: Juta & Company Ltd. (2012).
9. D.Collen, Adolescent Marijuana Use: Role of Parents and Peers. J Sci, 181 (1990), 1067 -1081.

   [Cross Ref] [Google Scholar]

10. A. J. Flisher, C. D. H Parry, M. Muller , C.  Lombard,  Stages of substance use among adolescents in Cape Town, South Africa, J of Sub Use, 7 (2003), 162-167.

    [Cross Ref] [Google Scholar]

11. J. Parry, N. Bennets, How to Design and Evaluate Research in Education (8thed.) London: McGraw Hill, (1998).
12. T. Zulu, C. D. H. Parry, J. Evans, M. Muller, C.  Lombard, Substance Use by Adolescents in Cape Town: Prevalence and Correlates, J   Adscnt Hlth, 32 (2004), 58-65.

    [Cross Ref] [Google Scholar]

13. E. R. Matthews, R. W.  Edwards, K. Kell, F. Beaurais, Risk and Protective Factors for Drug use among rural American Youth, NIDA Monh, 168 (1999), 90-130.

    [Cross Ref] [Google Scholar]

14. A. T. Zulu,  A. Urbani, W.  Van der Merwe, South African Community Epidemiology Network on Drug Use (SACENDU), (2004).

    [Cross Ref] [Google Scholar]

15. A. Berk, Getting High on Life. Cape Town: Struik Publishers. (2007).
16. G. T. Mhlongo, Drug abuse in adolescents in Swaziland. Masters, Pretoria: University of South Africa, Unpbl Mstr Ths, (2005).

    [Cross Ref] [Google Scholar]

17. NIDA. Qualitative Evaluation and Research Methods (3rded.). CA: Sage Publications, Newbury Park, (2014).

    [Cross Ref] [Google Scholar]

18. C. Borthmer, N. K. Morojele, A. Saban, A. J.  Flisher, Brief report: Social and neighbourhood correlates of adolescent drunkenness: a pilot study in Cape Town, South Africa, J Adls, 27 (2002), 369-374.

    [Cross Ref] [Google Scholar]

19. D.  Merrill, Youth in Peril: Alcohol and Drug Abuse in Kenya. NACADA, (2012)

    [Cross Ref] [Google Scholar]

20. J. Donald, L. Lofland, D.  A. Snow, L.  Anderson, Analyzing Social Settings, Belmont, CA.Wadsworth Publishing Company, (2015).
21. B.  Karechio, Drug Abuse in Kenya, Nairobi.Uzima Press, (2012).
22. N. S. Nyathi, M. C. Selepe, Alcohol use among female students at a tertiary institution, Afr  J  Phys, Hlth Edu Rec Dnc, (2013), 379-393 .

    [Cross Ref] [Google Scholar]

23. J.  Holmes, Does marijuana use cause the use of other drugs,  Jama,  289 (2013), 482-483.

    [Cross Ref] [Google Scholar]

24.  K.  Burton, A population- based twin study in women of smoking initiation and nicotine dependence, Psychol Med, 29 (2008), 299-308.

    [Cross Ref] [Google Scholar]

25. S. Leoschut, Substance Use among Young People in Urban Environment. W.H.O. Geneva,  (2008).
26. C. Akiba, A. Le Tendre, A. Baker, D.  Goesling, South African Community Epidemiology Network on Drug Use (SACENDU), Alchl Drug Abse Trnds: 2008.

    [Cross Ref] [Google Scholar]

27. Sairr,  Genetic and environmental contributions to cannabis dependence in a national young adult twin sample, Psychol  Med, 32 (2008), 195-207.

    [Cross Ref] [Google Scholar]

28. K. Taylor, D.  Miller, Patterns of drug use from adolescence to young adulthood: III. Predictors of progression,  J Pub Hlth, 74 (2013), 673-681.

    [Cross Ref] [Google Scholar]

Copyright: © 2022 Maphuti J. Chueng, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.