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Official websites use. Share sensitive information only on official, secure websites. Corresponding author. Psychoactive substances act on the central nervous system producing changes in mental processes, such as perception, consciousness, cognition or mood and emotions. The present study aims to identify: i the most used psychoactive substances, ii how psychoactive substances are acquired, iii and possible reasons for the use of psychoactive substances amongst university students. A literature search was carried out without language restrictions and included articles published between and in journals indexed in the electronic databases of Pubmed and Scielo. The inclusion criteria considered were: i original articles, ii studies carried out with university students, iii providing data on the use of psychoactive substances. Reasons that led to the consumption of psychoactive substances include: feelings of loneliness after moving away from family; difficulty making new friends; poor academic performance and susceptible environment to acquisition of these substances. In the selected studies, alcohol was identified as the main drug used. In light of the findings reported in this review, new prevention and harm reduction measures can be formulated, based mainly on the reasons that lead to the use of psychoactive drugs, consumption patterns and how the drugs were acquired by university students. The consumption of psychoactive substances is not a recent phenomenon and has been around since prehistory across a diversity of human cultures. Throughout history, the use of psychoactive drugs has not only been associated with medicine and science, but also magic, religion, culture and recreational use Tavares et al. Studies show that the main reason individuals start to consume a psychoactive substance is the sensation of pleasure, called positive reinforcement, experienced after its consumption. Thus, individuals increasingly make recreational use of psychoactive substances as an attempt to find relief from the difficulties of day-to-day life or just due to the desire to experience something new Carvalho et al. Among the different psychoactive substances available, there are legal and illegal drugs. Alcohol and tobacco are considered legal drugs in several countries and are the most widely used drugs associated with substance use disorder in the world United Nations Office on Drugs and Crime, Marijuana is the most consumed million people , followed by amphetamines 25 million , opiates 16 million, 11 million of whom are heroin users , cocaine 13 million and ecstasy 10 million United Nations Office on Drugs and Crime, Some drugs, such as anxiolytics, opioid analgesics and amphetamines are important therapeutic resources of modern medicine. However, due to the worldwide consumption of these legal drugs, they have also become associated with the harmful effects of substance use disorders commonly associated with the use of illicit drugs Sengik and Scortegagna, It has been observed that substance dependence and abuse are statistically related, mainly, when barbiturates, benzodiazepines, opioid analgesics and amphetamines are involved. The consumption of high doses of analgesics, antipyretics and non-steroidal anti-inflammatory drugs NSAIDs leads to the appearance of anticholinergic effects, such as delusions and hallucinations, which has increased its use as a recreational drug Silva et al. Regarding cognitive enhancers, they are increasingly being used among healthy individuals, mainly students without any diagnosed cognitive disorders, to increase their alertness, concentration, or memory, in the belief that these cognitive enhancers will improve their performance during examinations or when studying Sharif et al. The link between an adverse childhood and the susceptibility to substance use disorder has been widely described. A research study shown that the immune system mediates this relationship. This study demonstrated that exposure to psychosocial stress in early life makes permanent changes in the peripheral and central immune system, rendering it more sensitive to immune challenges later in life. Furthermore, the authors also revealed that sensitization to cocaine in early life-stressed individuals also involves brain and peripheral immune responses Iacono et al. Some epidemiological studies have been undertaken in Brazil assessing the prevalence of psychoactive drug use among the university population. Most of them agree that the use of alcohol and other substances is higher among university students when compared to the general population and high school students Stempliuk et al. Findings from studies show that the consequences of university students consuming psychoactive substances include car accidents, violence, risky sexual behavior, poor academic performance, decreased perception and stress Silva et al. The present study aims to identify: i the most used psychoactive substances, ii how psychoactive substances are acquired, and iii possible reasons for the use of psychoactive substances amongst university students. A review of the current literature on the use of psychoactive substances among university students around the world has been carried out. The electronic databases used were Pubmed and Scielo. These terms were applied to all databases used. This review was completed on April 30, This review was developed without language restrictions and included articles published between and , to obtain more recent evidence about the use of psychoactive substances before Covid pandemic. The inclusion criteria considered were: i original articles, ii studies carried out with university students, and iii studies providing data on the use of psychoactive substances. Studies that did not meet these criteria as well as retrospective studies or studies with incomplete or missing data were excluded. To select the articles, an analysis was performed first by title and, later, by abstract, which allowed the exclusion of those articles that did not meet the eligibility criteria. The selected articles were read in full and after that, once they met the criteria, included in this review. The studies were evaluated by two authors G. In case of disagreement, a third author D. After analyzing the titles and abstracts, 15 articles were included in this review. Among the studies included, 4 papers addressed possible reasons that lead to the use of psychoactive substances Kahsay et al. The characteristics of the included studies are shown in Table 1. The findings were not affected by the COVID pandemic, as the selected articles were carried out before the pandemic. While changes in drug use were closely related to stringent restrictive measures during the and lockdowns and subsequent phases of reopening, a lack of control about drinking was observed Gili et al. What motivates university students to use psychoactive drugs, has been a topic of much debate over the years. In a study conducted in Ethiopia, the following themes emerged as drivers for the use of psychoactive substances among university students: feeling lonely after moving away from the family; having previous experience with other substances; socialization reasons; poor academic performance; the university environment which made it easier to gain access to substances; and limited recreational activities Kahsay et al. The practice of neuro-reinforcement to improve concentration and increase alertness, often due to academic pressure, were reported reasons for the misuse of stimulating drugs. In Saudi Arabia, a research study reported that the most common reason for misuse of stimulants by many university students involves attempts to prolong study time Alrakaf et al. In a study with university students from Bosnia-Herzegovina, the consumption of coffee, energy drinks, nicotine, alcohol and marijuana, for neuro-improvement purpose, increased during the week prior to the exams Kusturica et al. Furthermore, a study carried out in Europe investigated the correlation between sleep quality and drug use among university students. Insomnia symptoms were highly prevalent and more common among younger students. In the sections below, we will discuss the main findings in relation to consumption patterns of psychoactive substances by continent. A study conducted in Nigeria with university students showed that the level of previous alcohol use throughout life at least once and current alcohol use was Another research study from Nigeria, with undergraduate students participating, shows that lifetime prevalence of psychoactive substance use was The prevalence of current use was Of the students included in this study, In South Africa, a study was conducted with medical students; were second year students and 58 were third year students. Alcohol use was reported in In the second year, 2. Tobacco use was common in both groups, with In a study of students from different European universities, A research study on the use of illicit substances with students from 17 different colleges in Berlin, evaluated different periods of use, and found that In relation to multiple drug use, a study in Spain participants showed that In addition, weekend consumption was higher than during the week, in all types of multiple drug users Font-Mayolas et al. A survey was carried out with students from a large university in the Midwest. According to another study investigating the use of hallucinogens with students, they found prevalence of 4. The use of hallucinogens has also been associated with the use of several other drugs, for example, alcohol, opiates, and the development of mental health problems and risky sexual behavior Grant et al. A cross-sectional survey of undergraduate students in the field of social sciences and health sciences in San Salvador, El Salvador, showed that in relation to consumption in the year prior to the survey, The study inferred that the use of alcohol, cocaine and marijuana did not affect academic performance of the students Olano and Wright, In Peru, 86 third-year nursing students from a private university in the Arequipa Metropolitan Region, participated in a survey. The results show a high prevalence for the use of legal substances during their whole life, with Regarding illegal drugs, Furthermore, in terms of legal drugs tranquilizers were the most commonly reported In a survey conducted at seven of nine universities in Wales, students who reported using one or more illegal drug were asked how they obtained their drugs, how they financed their use, whether they sold, marketed or distributed illegal drugs, along with their reasons for trading drugs. The results showed that about half of the users obtained medicines from friends and associates only, and one fifth exclusively from external dealers. One quarter used friends and associates, as well as external markets. In many cases, supplying drugs amounted to sharing them or giving them away. However, over one third of students said that they had sold drugs Bennett and Holloway, This research is limited to presenting a systematic review of linked studies in two databases and in a specific period, without implementing a meta-analysis. The need for systematic reviews with meta-analysis is highlighted to estimate a summary measure of the prevalence of psychoactive substance use among university students worldwide. In addition, we did not find studies carried out in Oceania countries that met the inclusion criteria. From the studies reviewed, it appears that alcohol is the most commonly used psychoactive substance used by university students, but the consumption profile for some substances differs across continents. For example, khat is more common used in the African continent; cocaine use is commonly used in South and Central America; hallucinogens and recreational medications, such as sedatives and tranquilizers, are commonly used in North America; while in Europe the combined use of cannabis, alcohol and tobacco is common. The main reasons found for the consumption of these substances were related to being far away from family, influences from friends, ease of obtaining drugs at university and an attempt to improve academic performance. In this way, the present review emphasizes the need for prevention and harm reduction measures in university environments. In addition, the information reported in this review about the reasons that lead to the use of these substances, consumption patterns and how these substances are acquired, may help in the formulation of new public policies aimed at preventing the abusive use of psychoactive substances and harm reduction in university students. Suzana Braga de Souza: Supervision, Writing — original draft. On behalf of all the authors I declare that all of us have none competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Brain Behav Immun Health. Find articles by Gustavo Reis Sampaio. Find articles by Gabriel Silva Lima. Find articles by Suzana Braga de Souza. Find articles by Denis de Melo Soares. Published by Elsevier Inc. Open in a new tab. Alrakaf et al. Kusturica et al. Ajayi, Owolabi and Olajire Ajayi et al. Tesema et al. Vorster et al. Viohl et al. Font-Mayolas et al. Grant, Lust and Chamberlain Grant et al. Urday-Concha et al. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Kahsay, Tesema and Bazzano Kahsay et al. Main reasons for use are: feeling powerless after the family has left, previous experience with substances and socialization. The ability to prolong study time has been reported as the most common reason for illicit use of stimulants by students. The consumption of psychoactive substances such as energy drinks, nicotine, alcohol and marijuana, for neuro-enhancement purposes, increased during the week before the exams. Insomnia symptoms were highly prevalent and more common among younger students, who had been studying at the university for less time and had high levels of illicit drug use. Current use of High prevalence throughout life The prevalence of hallucinogenic use in the last year was 4. Olano and Wright Olano and Wright, Bennett and Holloway Bennett and Holloway,