Educators’ views of alcohol use at a selected high school in the Limpopo Province of South Africa

Received: 24-May-2021;Accepted Date: Jun 07, 2021; Published: 14-Jun-2021

Introduction

Alcohol consumption is an important risk factor for morbidity, mortality and social harm worldwide, leading to 2.5 million deaths each year [1]. According to [2] substance abuse is the improper, irresponsible or self-damaging use of addictive substances. This involves using substances continually with the knowledge that their usage might cause harm. This definition concurs with that of the [3] stating that substance abuse is using substances continuously even when knowing about the long term harmful effects that might lead to addiction and debilitating problems. [1] define substance abuse in similar terms: namely, the excessive usage of psychoactive substances or alcohol, resulting in lowered levels of functioning on several cognitive and physical levels which affect the health of an individual. The abuse of alcohol and other drugs among high school learners remains a prominent concern for many schools. Problems commonly associated with such abuse include property damage, poor academic performance, damaged relationships, unprotected sexual activities, physical injuries, date rapes and suicide [4]. Institutions have responded to problems of substance abuse by developing counseling and health education programmers and by imposing strict policies. Simply educating youths about the variety of abused drugs, their effects, and the associated health risks might produce more sophisticated (knowledgeable) users but have shown no significant benefits in changing behaviour [5].

The continuous use of these substances over a longer period will lead to addiction. Drug abuse in the context of the current study might affect the learners’ physical, social and psychological behaviour. Drug misuse implies that a drug has proper medical use and is being employed for an incorrect purpose. [6] stated that substance use is associated with immediate health problems such as academic difficulties, injuries, interpersonal violence.

Symptoms of drug misuse may include craving for increasingly larger doses of drugs, withdrawal symptoms and loss of control over abusive substances intake [7]. The immediate consequences of teen substance abuse range from injuries and unintended pregnancies to medical conditions such as asthma, depression, anxiety, psychosis and impaired brain function, reduced academic performance and educational underachievement [8]. A report released by the [9], estimated that 3.3 to 4.1 per cent of the global population consumes drugs.

Alcohol use among school learners in South Africa is recognised as a major health and social problem [10]. Six of the ten leading risk factors of morbidity and mortality among young people ages 15–19 years, and three of the ten among young people age 10 to 14 years, are behavioural, including smoking, alcohol use, drug use, and unsafe sex [11].

According to [12], maintained that Capricorn District was becoming more urbanized; poverty was being alleviated; more families were becoming empowered economically; basic infrastructure was improving; more adolescents attended schools, and women and children were becoming aware of their rights. Western cultures seemed to influence traditional ways of life for the people in the Capricorn district, including the use of the substance, especially among adolescents. The consequences of adolescent substance abuse and addiction place an enormous burden on schools, health care, criminal justice, and social service systems. The devastating effects, especially on the academic performance of school learners, life orientation teachers face a challenge to change the behaviour of the affected learners.

[13], there are many consequences of underage drinking. Youth who drink alcohol are likely to experience physical problems, such as hangovers or illnesses; unwanted, unplanned, and unprotected sexual activities, disruption of normal growth and sexual development; physical and sexual assault, higher risk for suicide and homicide, memory problems, abuse of other drugs, changes in brain development that might have life long effects; and death from alcohol poisoning. The most affected age groups are young people aged 15-20. Studies have also shown that drug abuse at secondary schools in South Africa has aggravated school dropout rates, injuries and unwanted pregnancies.

Statistics at a global level have shown that drug abuse has become a problem for every country and its effects are detrimental [12]. As a result of alcohol use, educators at Mamolemane and Moshubaba High School were concerned that some learners are seen loitering around bottle stores and taverns, seemed to be drinking alcohol while wearing school uniforms. The current study’s purpose was to explore and describe the educators’ views of alcohol use amongst learners in two selected schools in the Capricorn District in Limpopo Province.

Methods and Design

The study adopted a qualitative, exploratory, descriptive and contextual design. A qualitative design is a systematic, subjective approach used to describe life experiences and give them meaning, using the natural setting as the source of data. ER. Babbie Postulated that an exploratory design aims at establishing facts, gathering new data and determining whether there are patterns in the data [14]. Accord- ing to WL. Neuwman, an exploratory study is conducted when little is known about the research topic. The study was descriptive which refers to a more intensive examination of phenomena and their deeper meanings, leading to a thicker description [15] detailed that contextual designs believe that human actions and decisions should be understood within their context rather than viewing contextual variables as a nuisance [16].

The population included educators from Mamolemane and Moshubaba High schools at the Bahlaloga Circuit in the Capricorn District of the Limpopo Province. The non-probability purposive sampling method was used to select the schools based on the high percentage of learners who use alcohol [17]. The number was determined by data saturation which was reached when 23 participants had par- ticipated in four sessions of focus group discussions [18], guided by a translated semi structured interview schedule. An audiotape was used with the permission of the participants to capture verbatim information. Observations and field notes were compiled. Probes and follow up questions were used to deepen the discussions [19]. The recorded information was transcribed verbatim and then translated into English. Data were analysed following Tech’s eight steps of qualitative analysis [20].

Measures to ensure trustworthiness

Trustworthiness is a way of ensuring data quality or rigour in qualitative research. [21] articulated four criteria for developing trustworthiness, namely: credibility, dependability, conformability and transferability. The following techniques were used to ensure credibility: prolonged engagement, reflexivity, triangulation, member checking, peer review and structural coherence. The criterion of applicability was utilized to ensure transferability [21]. Describing the demographics of the participants, and compiling a dense description of the results, with supporting direct quotations from the participants, enhanced transferability. The criterion of consistency was applied to ensure dependability through a stepwise replication of the research method, coding and recoding of the 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 [22].

Ethical considerations

Permission to conduct a study was granted by the University of Venda, School of Health Sciences Research Committee, as well as the University’s Higher Degrees and Ethics Committee (Project number: SHS/14/PH/01/1605), the Head of the Department of Education of the Limpopo Province and principals of Mamolemane and Moshubaba High Schools. The researcher informed the participants about the purpose of the study and the research method, as well as the procedure that was to be followed when conducting the study. This ensured that there was informed consent. Anonymity, confidentiality and the right to self determination were also ensured [23].

Results and Discussions

Educators postulated their views related to learners’ alcohol use at two participating schools. This theme emerged from the data analysis. Sub themes that emerged from the educators’ views related to learners alcohol use as a public health problem were: ways of identifying learners who use alcohol, health consequences of alcohol use, psycho social effects and poor academic performance.

Theme: Consequences of alcohol use to learners as viewed by educators

Alcohol use amongst learners was viewed as problematic and complex. It has been linked to high risk behaviours and health crises. The theme that emerged was consequences of alcohol use to learners as viewed by educators and sub themes were: ways for identifying learners who use alcohol, health consequences related to alcohol use, psycho social effects and low academic performance.

Sub theme 1: Ways for identification of learners who use alcohol

During the focus group discussion (FGD) interviews, educators cited ways for identifying learners who use alcohol. They mentioned that learners may experience extreme forms of behaviour; they might begin to tell lies, keep secrets, steal or borrow money or engage in sneaky and suspicious behaviour. Learners might either become extremely aggressive or unusually quiet. On the other hand, they might be rebellious, stubborn, temperamental, bad tempered or verbally abusive. The following is a remark from an educator in FGD 1:

The family remains the primary source of attachment, nurturing, and socialization for humans in our current society. Therefore, the impact of substance use disorders (SUDs) on the family and individual family members merits attention. Each family and each family member is uniquely affected by the individual using substances including but not limited to having unmet developmental needs, impaired attachment, economic hardship, legal problems, emotional distress, and sometimes violence being perpetrated against him or her. Thus, treating only the individual with the active disease of addiction is limited in effectiveness [22].

Sub theme 2: Health consequences related to alcohol use

During the FGDs, educators pointed out the consequences of alcohol use. The educators mentioned the symptoms that indicated addiction. These included craving for nicotine, withdrawal symptoms and loss of control over tobacco intake. Learners would show one or more symptoms of nicotine addiction, while some children could smoke up to five cigarettes a day without showing any signs of addiction.

The following are some of the comments from the participating educators:

There are some consequences of underage drinking. For example, youth are likely to experience physical problems, such as hangovers or illnesses; unwanted, unplanned, and unprotected sexual activities; disruptions of normal growth and sexual development; physical and sexual assaults; higher risks for suicide and homicide; memory problems; abuse of other drugs; changes in brain development that might have life long effects; and death from alcohol poisoning [24].

According to a report [25], smoking was commonplace among male learners in grades 8 (7%), 10 (16%) and 12 (24%), whereas among female learners the rates were 8%, 16%, and 22% for learners in grades 8, 10 and 12, respectively. More than 36 million (22%) of the total population of 170 million drug users in Brazil were adolescents aged 10-24, and 70% dropped out of school early. Drugs were implicated in the social imbalances experienced by adolescents in Brazil and accounted for the high mortality rates ascribed to homicides, fatal injuries or gun related killings. [26], revealed that alcohol has both beneficial and detrimental impacts on diabetes, ischemic stroke, and ischemic heart disease, depending on the overall volume of alcohol consumed, and, in the case of ischemic diseases, consumption patterns. However, limitations exist to the methods used to calculate the relative risks and alcohol attributable fractions. Furthermore, new studies and confounders may lead to additional diseases being causally linked to alcohol consumption or may disprove the relationship between alcohol consumption and certain diseases that currently are considered to be causally linked. These limitations do not affect the conclusion that alcohol consumption significantly contributes to the burden of chronic diseases and conditions globally, and that this burden should be a target for intervention. Drug abuse also contributes to the formation of uric acid, which exacerbates disorders like arthritis, gout, osteoporosis and heart attacks, especially in people with coronary hypertensive conditions [4].

A student who presents with any of these physiological effects will experience difficulties with normal learning tasks and might attend school irregularly. Drug abuse alters brain functions and hence causes a major decline in overall performance [27]. Drugs also affect students’ concentration span, which, when drastically reduced, causes boredom much faster than in non drug and substance abusers. Con- sequently, the student will lose interest in school work and extramural activities [27]. Due to this drop in schoolwork, absenteeism results and the student generally takes longer to complete his/her studies. Most of the psychoactive drugs affect the decision making processes of the students and their creative thinking abilities. Furthermore, the development of the necessary life and social skills might be im- paired.

Sub Theme 3: Psycho social effects

During the interviews, the educators explained the psycho social effects encountered by learners who use alcohol. The educators said that drug and substance abuse have varied physiological and psycho social effects with adverse consequences like insomnia, prolonged loss of appetite, increased body temperature, increased risk for hepatitis and HIV infection. In some instances, an overdose of a particu- lar type of alcohol could cause sudden death. The data analysis indicated that learners who abused alcohol and other substances tended to lose interest in school work, including extracurricular activities. Most of the psychoactive drugs not only affected the decision making adeptness of learners but also their creative thinking and the development of the necessary life and social skills. One participant commented:

In the description of the bio psychological spiritual model, [27] mentioned biological, psychological and social components when social workers and counsellors looked at causes and consequences of addiction. The effects of substance abuse touch every aspect of social functioning, including physical, social, psychological and spiritual. One major consequence of drug abuse is dependence and addiction, characterized by compulsive drug craving seeking behaviours and use. The continuous use of these substances over a long period would probably lead to addiction [28].

Alcohol use, in the context of the current study, refers to the non medical self administration of a substance to produce psychoactive effects, intoxication or altered body image, despite the knowledge of its potential adverse effects. Drug misuse implies that a drug has proper medical use and is being employed for an incorrect purpose. [29] stated that an addicted learner might show a decline in academic performance, frequently fail to attend classes, and lose interest in school work and have poor health. Symptoms could include craving for more substances, withdrawal symptoms and loss of control over the intake of abusive substances [7].

Sub Theme 4: Poor academic performance

During the interviews, the educators emphasized that poor academic performance was a huge problem in the schools. Participants mentioned that alcohol could disrupt the entire school when several learners in a class abuse drugs, or absent themselves because of drug abuse, the progress of all the learners is impeded. In addition, drug use implies an illegal practice in the school environment. Illegal use of substances affects the education of learners and their school activities. The following is a comment from a participant:

[27] indicated that for children in the fourth, fifth and sixth grades, academic failure might increase the risk of both drug abuse and delinquent behaviour. Furthermore, drug use could undermine learners’ academic ability and performance. For children in the elementary grades, social adjustment is more important than academic performance as a predictor of later delinquency and frequent drug use. This is also associated with a low degree of commitment to the school. Adolescents who hate school and are not committed to school often feel different or like outsiders. As a result, such children might develop rebellious attitudes that increase the risk of problems with drugs in late adolescence. In the USA, learners who used marijuana regularly were twice as likely to get below average marks or to fail grades and become school dropouts as non drug users [27].

Drug users bring into the school environment illegal practices connected to drug use; such as prostitution, theft and/ or selling of drugs to others. [30] revealed that the illegal use of substances affected the education of learners and their school activities [30].

[31] and [32] specified that school children who used substances often suffered impairment of short term memory and other intellectual faculties such as diminished tracking ability in sensory and percep- tual functions, preoccupation with acquiring substances, adverse emotional and social development and generally impaired classroom performance. Reduced cognitive efficiency leads to poor academic performance, resulting in decreased self esteem, with an eventual drop out of school. This contributes to instability in an individual’s identity, which, in turn, is likely to contribute to further substance consumption, thus creating a vicious circle. [30] also indicated that alcohol and drug use affects the nervous system and interferes with intellectual and thought processes, impairs perception, sensory motor coordination and thinking speed and prevents the individual from functioning normally. Furthermore, [30] maintained that substance abuse causes deterioration of scholastic performance. Learners’ motivation, concentration and general performance dropped drastically when they abused substances. Under these circumstances, the school rapidly loses any positive value for the child and this could lead to an increase in truancy.

Given the findings of this and study and the discussion above, it is recommended that the schools must train educators on Motivational Interviewing (MI) Rollnick skills, for them to facilitate behaviour change amongst learners. The following stages of MI are recommended to aid behaviour change among learners:

• Stage one: Pre contemplation where learners are not aware that alcohol use is a public health problem. During this stage, the goal will be to get learners to know that they have a problem.

• The second stage will be contemplation, learners are to be made aware of their problem, so that they can consider changing their ways, but they might not be committed to taking action, The goal of this stage will be to raise awareness of alcohol use and they need to observe the behaviour.

• The third stage will be preparation, where learners will be prepared to change and would show small behaviour changes, the educators’ support will be very important to encourage learners to change.

• The fourth stage will be action, where educators should involve learners to make decisions about their willingness to change. The goal is to develop action plans suggestions, reinforce changes, and provide support and guidance.

• The last step will be maintenance, where learners need to be supported, to avoid alcohol use. The goal will be to sustain the behaviour change and to help with the prevention of relapse

Limitations

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

Conclusion

The study revealed that, according to the teachers’ perceptions, if learners continue using alcohol, they would experience some health, psychosocial consequences as well as poor academic performance. Teachers should be capacitated and trained to engage with learners to promote health while preventing the use of alcohol among learners as well as promoting awareness regarding the aftermaths of alcohol use. There is a need for learners to be supported and guidance should be enhanced to promote behaviour change and lifestyle modification. Imperatively, the research is needed to focus on preventive programs to curb alcohol use through evidence based interventions.

Conflict of Interest

All authors declare they have no conflict of interest to report.

Authors Contributions

CMJ, LRT and MMS conceptualised and designed the study. CMJ collected data; CMJ, LRT and MMS analysed and verified the results. CMJ, LRT, MMS and ML wrote the manuscript and approved the final manuscript.

Acknowledgments

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.

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