Title : Drug addiction, behavioral health, and help-seeking among youth in the Tamale Metropolis, Ghana: Community-level risk factors, stigma, and pathways to recovery
Abstract:
Background: Substance use disorders (SUDs) among youth represent a growing public health crisis in West Africa. Cannabis use prevalence in West and Central Africa reached nearly 10% in 2022, while tramadol misuse is now widespread across the sub-region (UNODC, 2024). The Tamale Metropolis — capital of Ghana’s Northern Region and among West Africa’s most rapidly urbanising cities (Fuseini & Teye, 2015; Ghana Statistical Service, 2021) — has emerged as a critical locus of youth drug use. Studies document widespread abuse of tramadol, shisha, and marijuana, driven by peer pressure, inadequate parental supervision, and constrained service access (Amadu et al., 2024; Salifu et al., 2024). Yet Tamale’s evidence base remains almost exclusively qualitative and cross-sectional, with no studies examining the behavioural health dimensions of addiction — stigma, help-seeking, family dynamics, and recovery pathways — among young people. This is a critical and addressable gap.
Objectives: This study aims to: (1) examine the prevalence, patterns, and community-level risk factors associated with the initiation and escalation of drug use among youth aged 15–24 in Tamale; (2) investigate how addiction-related stigma, cultural beliefs, and family dynamics shape help-seeking behaviour among young people who use drugs; (3) map recovery pathways and identify barriers impeding treatment access during the recovery phase; and (4) examine the policy implications of community-level stigma and service gaps for northern Ghana’s regional health policy, with broader relevance for Ghana’s national drug policy agenda.
Methodology: This study adopts a convergent parallel mixed-methods design (Creswell & Plano Clark, 2018). A WHO ASSIST-informed questionnaire will be administered to a stratified random sample of 400 youth across community, educational, and health facility settings in Tamale. Sample size was determined via power calculations assuming 80% power, 5% significance, and an estimated substance use prevalence of 21% (Belete et al., 2024). In-depth interviews and focus group discussions will be conducted with youth who use drugs, health workers, religious leaders, and family members. Quantitative data will be analysed using binary logistic regression; qualitative data will undergo Framework Method thematic analysis. Both strands will be integrated through a convergence coding matrix identifying confirmation, expansion, and divergence. The study is anchored in the Health Belief Model (Rosenstock, 1966). Acknowledging the HBM’s individualist limitations in collectivist settings, it is complemented by an Africentric framework (Longshore & Grills, 1998), foregrounding community, cultural identity, and relational values in shaping recovery.
Expected Outcomes and Significance: This study will produce robust, location-specific evidence on the social-ecological determinants of drug addiction among Tamale youth, illuminate how stigma inhibits help-seeking, and deliver a community-validated map of recovery pathways and service gaps. Findings will directly inform the Ghana Health Service Northern Region Directorate, the Tamale Teaching Hospital mental health unit, and the University for Development Studies School of Public Health. The study advances mixed-methods, community-centred approaches in a field dominated by cross-sectional, biomedical paradigms, and responds to the ECOWAS WENDU call for enhanced sub-national addiction research and the UNODC’s (2024) mandate for context-sensitive investment in prevention and treatment across Africa.
Keywords: Adolescent substance use; Substance use disorders; Behavioural health; Youth; Ghana; Tamale Metropolis; Northern Ghana; Stigma; Help-seeking; Recovery; Tramadol misuse; West Africa; Mixed methods; LMIC
