How can I buy cocaine online in Pokhara
How can I buy cocaine online in PokharaHow can I buy cocaine online in Pokhara
How can I buy cocaine online in Pokhara
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How can I buy cocaine online in Pokhara
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A qualitative study to understand drivers of psychoactive substance use among Nepalese youth
How can I buy cocaine online in Pokhara
Official websites use. Share sensitive information only on official, secure websites. Substance use among health care students threatens professional standards and the delivery of quality services, potentially placing the public at risk. Therefore, our study aims to determine the prevalence and correlates associated with substance use among Nepalese health care students. A cross-sectional survey using a self-administered health professional questionnaire was conducted among pharmacy, nursing, and public health students at three universities in Nepal in The overall lifetime prevalence of substance use i. Marijuana was the most commonly used illegal drug 8. Substance use was directly associated with cigarette smoking, peer influence, and heavy drinking. In addition, respondents reported some major and minor dysfunctions because of their substance use. The prevalence of substance use among health care students at the three universities in Nepal was high. Peer influence, cigarette smoking, and heavy drinking were significant predictors of substance use. The online version of this article Substance use is defined as the continued use of substances, illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences \[ 1 \]. The lifestyle of health care professionals plays an important role and has a significant influence on the lifestyle of patients or clients \[ 2 \]. No health care professional is immune to substance use e. Substance use by the health care professionals might influence their professional behavior and threaten the standard of the delivered health care services, potentially placing the public at risk \[ 3 \]. Moreover, In Nepal, substance use by medical students ranges from With a few exceptions \[ 8 , 15 \], most of the previous studies did not investigate multiple types of substance use among multiple groups of students \[ 9 , 11 , 16 \]. For instance, Ahmadi et al. Similarly, Deressa and Azazh studied khat Catha edulis chewing among medical students in Ethiopia \[ 11 \]. The use of marijuana and heroin together with the misuse of psychoactive and sedative drugs is of great national concern in Nepal \[ 17 \]. In , the annual prevalence of cannabis abuse was 3. In , the estimated prevalence of opiate abuse was to be 0. Cannabis and opiates were the most commonly used drugs. In decreasing order, the user preference was for cannabis, heroin, pain medicine, and cough syrup \[ 19 \]. The annual growth rate of drug users is Taken together, there is a strong need to assess substance use among health care students. Therefore, this study was conducted to determine the extent of prevalence of substance use among health care students. In addition, we aimed to examine the correlates of substance use among health care students in the Nepalese context. The results of this study are expected to contribute to design preventive programs, primarily focusing on the health care students. In , we carried out a cross-sectional survey of undergraduate pharmacy, nursing, and public health students at three universities i. All students taking pharmacy, nursing, and public health courses at those three universities were the study population. Altogether, responses were received Additional file 1 : Table S1. Excluding all the missing data, a total of responses, i. Data were collected using a modified version of the Health Professional Questionnaire developed by Kenna and Wood \[ 15 \]. The survey instrument was pilot tested for face validity with a group of ten volunteers from the first-year medical students of Tribhuvan University, Nepal. No major changes were required on the questionnaire. The four-page final version of the survey contained information about basic demographic characteristics and details of substance use including the effects of the substance use, if any. We asked respondents about their age, gender, faculty, year and university of the study, active participation in religion, family history of alcohol, and family history of drug use. We asked about cigarettes and alcohol use. Participants were also asked about the number of times they received offers of alcoholic beverage and legal psychotherapeutic drugs e. They were also asked whether they had worked with a co-worker or a colleague who accepted self-medication with psychoactive drugs during the past year. Participants were asked about their lifetime experience and the tendency of use of each of three commonly found street drugs i. If the students used any of the illegal drugs, at least once in their lifetime, past year, and past month, they were regarded as illegal drug users during their lifetime, in the past year, and the past month, respectively. The lifetime, past year, and past month use of the illegal drugs was computed. A total of seven groups of prescription drugs major opiates, minor opiates, stimulants, sedative-hypnotics, tranquilizers, anxiolytics and other prescription pain medicines with examples were provided to assess drug use without authorization or prescription. To facilitate identification, examples of generic and brand names were provided for each medication class. Response options and duration of use were the same as that for illegal drug use. Similar to the operational definition of illegal drug users, if the students used any of the prescription drugs at least once in their lifetime, in the past year, and in the past month they were regarded as illegal users of the prescription drug during their lifetime, the past year, and the past month, respectively. We further asked whether the use of illegal drugs or prescription drugs without a prescription caused any dysfunction in their daily activities or life using eight questions. The list of dysfunctions caused by the drug use were as follows: 1 falling behind in work; 2 calling in sick or being late; 3 having trouble getting along with people; 4 worrying that you might be using too much or too often; 5 seriously considered suicide; 6 having an auto accident or other type of accident; 7 providing less than your best patient care performance; and 8 seeing a psychiatrist, psychologist, or a counselor. Students were asked to complete the survey instrument in a ecture room setting voluntarily and anonymously and return the questionnaire in the same setting. No incentive was provided for completing the questionnaire. Cases with any missing data were excluded from the analysis. Demographic variables and substance use were analyzed using descriptive statistics. Adjusted logistic regression was applied to identify the risk factors for substance use. Chi-square test was used to examine any differences in substance use by demographic characteristics and faculty pharmacy, nursing and public health. P value for statistical significance was set as less than 0. Completed responses were received from respondents. However, only responses were used for the final analysis because of the missing data, with a response rate of Respondents were from Tribhuvan University Among them, Nursing students were all women. Detailed demographic characteristics are presented in Table 1. The overall prevalence of substance use illegal use of prescription drugs and illegal drug use was Overall, 8. Similarly, men Overall, A higher percentage of nursing students There was no significant gender difference in the frequency of illegal use of prescription drugs Table 2. Minor opiates e. The difference among groups was not statistically significant. The rate of lifetime prescription drug use by pharmacy students ranged from 1. None of the nursing students reported the use of stimulants and sedatives during their lifetime. Similarly, none of the pharmacy students reported the use of major opiates during their lifetime. In addition, 41 Similarly, 15 3. A higher number of pharmacy students reported both major 5. In addition, cigarette smoking and heavy drinking were the significant predictors of illegal use of prescription drugs Table 4. Variables were entered simultaneously in the model and significant results are denoted in bold fonts. To our knowledge, this is the first survey conducted in Nepal that included a broad range of substances and multiple groups of health care students. The overall prevalence of substance use among health care students was found to be Peer influence, heavy alcohol drinking, and cigarette smoking were the significant predictors of substance use among Nepalese health care students. Marijuana was the most commonly used illegal drug. The rate of use of marijuana in our study 7. Pharmacy and public health students had a higher prevalence of illegal drug use during their lifetime. Pharmacy students used marijuana and designer drugs more frequently. However, only a few and no nursing students reported the use of marijuana and designer drugs, respectively, in their lifetime. This difference was less apparent after adjusting for demographic variables. Our results differ from a report of lower prevalence of marijuana and cocaine use observed for pharmacy students than nursing students in the US \[ 5 , 8 \]. The observed higher prevalence of illegal drugs among pharmacy and public health students in our study may be attributable to differential demographic characteristics, such as gender, because nursing students in our study were all women and none of them reported the use of designer drugs. The most commonly used illegal prescription drugs were minor opiates codeine cough syrups In the US, misuse of prescription-type drugs e. In our study, nursing students had a higher lifetime prevalence of illegal prescription drugs use than other groups. This pattern still remained after adjusting for demographic variables. Nursing students used minor opiates e. These results seem consistent with the higher prevalence of opiates use observed for nursing students than pharmacy students in the US \[ 8 \]. However, care should be taken with this comparison because our study population comprised female nursing students. In Iran, the most commonly used substance by nursing students was opium \[ 10 \]. In contrast, pharmacy students were significantly more likely to report the use of sedatives or hypnotics during their lifetime than nursing and public health students. This finding is consistent with the use of benzodiazepam 3. However, this observation is inconsistent with the earlier US report \[ 8 \]. Pharmacy students in our study were probably more stressed about their studies than nursing and public health students, which led them to use these drugs more often. Students reported both major and minor dysfunctions because of their use of drugs. These dysfunctions were higher among pharmacy students. A higher proportion of major dysfunction among pharmacy students is similar to the higher proportion of major dysfunction among pharmacists \[ 15 \], which suggests potential vulnerability in the health of future health care professionals and the quality of the health care services they provid. Thus, a proper actions should be taken to address this issue. Even after adjusting for demographic variables, we found heavy drinking and cigarette smoking were found to be significant predictors for substance use, which suggests that preventive programs to reduce drinking and smoking habits in health care students should be launched to reduce the risk of further substance abuse. It should be taken into consideration that all those controlled variables were significant predictors of substance use in a previous study \[ 8 \]. Concerning the association between peer influence and substance use, we found that peer influence was also a significant predictor. This finding suggested that peer support programs could be implemented to reduce substance use and promote the health care service they provide. In itself, however, this is a challenging task because the students themselves displayed a lack of awareness and suboptimal attitudes towards substance use \[ 23 \]. The considerably high prevalence of substance use among health care students suggests the vulnerability of health care students. In addition, some of the respondents who reported substance use at some point in their lives, also attributed some amount of dysfunction in their daily lives to substance use. Therefore, our findings indicate a need to educate health care students about substance use in any form. They need to know: 1 that self-treatment with prescription drugs, no matter how minor or infrequent, is inappropriate and hazardous; 2 that accepting offer of alcoholic beverage and drugs by friends may predispose them to substance abuse; 3 that alcohol and smoking may be an indicator of substance use; and 4 the warning signs of psychological and physical addiction. In Nepal, only women can study nursing; therefore, comparison of our results with other reports including both male and female students as nursing students would not be valid. In addition, we did not include the medical students in this study; therefore, the study findings cannot be generalized to all health care students. As this was a cross-sectional survey, no causal relationship could be inferred. We recommend a longitudinal study including the questions regarding dependency on substance and initiation of each substance use that we lacked in this study. However, our study has some methodological strengths. It was a large survey including three major universities in Nepal with a range of health care students. The survey also included a broad range of substances. The prevalence of substance use in health care students pharmacy, nursing and public health is evident. Peer influence e. Therefore, health care policy should address prevention of substance use through peer support programs among health care students. We would like to thank Dr. George A. Kenna, Brown University, for providing questionnaire and discussion during the course of study. We thank Dr. Simon Bell, Monash University for critical discussion during the whole course of research. We thank Drs N. Panthee, B. Sigdel, A. Subedi, and Mr. Shakya for the help during data collection. Individual responses will not be shared. The questionnaire used for the study can be found as Additional file 2. BP and SP conceived the research and collected the data. BP and SG analyzed the data. NK supervised data analysis and manuscript writing. BP wrote the manuscript and all the authors read and approved the final manuscript. An information sheet for the participants regarding the nature and purpose of the study was provided to each participant before distributing the survey questionnaire. The process of returning the survey was considered as consent to participate. The participants who did not consent to participate either did not return the survey or returned a blank survey. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Bimala Panthee, Phone: , Email: bimupanthee gmail. 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. BMC Public Health. Find articles by Bimala Panthee. Find articles by Suresh Panthee. Find articles by Saroj Gyawali. Find articles by Norito Kawakami. Received Nov 3; Accepted Dec 5; Collection date Open in a new tab. Prevalence of substance use during lifetime and its demographic correlates a. Factors affecting lifetime illegal drug use and illegal use of prescription drugs. Additional file 1: Total number of students and responses received. DOCX 20 kb. Additional file 2: PDF kb. Electronic supplementary material The online version of this article 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. Experience of working with coworker or colleague who accepted themselves as self- medication. Experience of working with coworker or colleague who accepted self-medication with psychoactive drug.
How can I buy cocaine online in Pokhara
A qualitative study to understand drivers of psychoactive substance use among Nepalese youth
How can I buy cocaine online in Pokhara
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How can I buy cocaine online in Pokhara
A qualitative study to understand drivers of psychoactive substance use among Nepalese youth
How can I buy cocaine online in Pokhara