The Rural-Urban Paradox and Focused Risk Profile of Adolescent Substance Use Disorders in Lagos, Nigeria: An...

Area of Science:

• Public Health
• Epidemiology
• Adolescent Psychiatry

Background:

• Adolescent substance use disorders (SUDs) pose a significant public health challenge in sub-Saharan Africa.
• Current prevalence data often rely on self-reports, not clinical diagnoses, hindering effective treatment planning.

Purpose of the Study:

• To estimate the prevalence of SUDs and alcohol use disorders (AUDs) in adolescents in Lagos State, Nigeria.
• To identify predictors of SUDs and AUDs in this population.
• To assess the treatment gap for adolescent SUDs.

Main Methods:

• A cross-sectional survey was conducted in 47 secondary schools in Lagos State, Nigeria.
• The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid) was used to assess DSM-IV diagnoses in 9,437 adolescents aged 11-17.
• Multivariable logistic regression identified independent predictors of SUDs and AUDs.

Main Results:

• The prevalence of SUD was 2.4% and AUD was 4.3%.
• Rural adolescents had significantly higher rates of SUD and AUD compared to urban peers.
• Independent predictors included rural residence, male gender, older age, maternal alcohol use, domestic violence, and academic problems. The treatment gap exceeded 97%.

Conclusions:

• Adolescent SUDs represent a substantial burden in Lagos State, with a notable rural-urban disparity.
• Family dysfunction and academic difficulties are key risk factors.
• The massive treatment gap necessitates urgent implementation of school-based screening and accessible services for adolescents.