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Effect of Community-Based Substance Use Screening on Substance Use Disorder Detection among Young Adults in Nigeria

Abstract

Substance use and substance use disorders remain important public health concerns among young adults in Nigeria and may have significant consequences for physical health, mental health, education, employment, family relationships, social functioning, and overall well-being. Young adults may use substances such as alcohol, tobacco, cannabis, opioids, prescription medicines, and other psychoactive substances for various reasons, while some individuals may develop patterns of use that result in dependence, impaired functioning, or other substance use disorders. Substance use disorders may remain undetected because of stigma, fear of discrimination, limited awareness, denial, social pressure, and inadequate access to appropriate screening and treatment services. Delayed detection may increase the risk of health complications, risky behaviours, mental health problems, social difficulties, and other adverse outcomes. Community-based substance use screening provides an opportunity to identify individuals at risk of problematic substance use within accessible community settings through systematic assessment, brief screening instruments, health education, counselling, and referral to appropriate treatment and support services. However, limited screening coverage, shortage of trained personnel, stigma, concerns about confidentiality, inadequate referral services, and limited availability of treatment facilities may reduce the effectiveness of community-based substance use screening programmes in Nigeria. Against this background, this study investigates the effect of community-based substance use screening on substance use disorder detection among young adults in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Systems Framework. The Health Belief Model explains how young adults' perceptions of susceptibility to substance use disorders, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in substance use screening. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, organizational, and broader societal factors on substance use behaviour and access to preventive and treatment services. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective substance use screening and treatment programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based substance use screening may influence the detection of substance use disorders among young adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise young adults aged 18 to 35 years residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, youth centres, and eligible young adults. Community-based substance use screening will be measured using indicators such as availability of screening services, screening coverage, frequency of community screening activities, accessibility of screening locations, number of young adults screened, use of validated substance use screening instruments, availability of trained healthcare or mental health personnel, confidentiality procedures, substance use education, counselling services, and referral arrangements. Substance use disorder detection will be assessed using indicators such as positive screening results, patterns of problematic substance use, suspected substance use disorders, newly identified cases, severity of substance-related problems, identification of dependence or harmful use where applicable, referrals for professional assessment, confirmed diagnoses following appropriate evaluation, and linkage to treatment or support services. Data will be collected using structured questionnaires, validated screening instruments, community screening registers, healthcare records, counselling records, referral registers, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, substance use patterns, screening coverage, and detection outcomes. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based substance use screening on substance use disorder detection. Where appropriate, detection rates before and after implementation of community-based screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based substance use screening has a significant positive effect on substance use disorder detection among young adults in Nigeria. Young adults who participate in community-based substance use screening are expected to have a higher likelihood of having previously undetected problematic substance use or substance use disorders identified than young adults without access to such services. Community-based screening may improve early identification of risky substance use patterns and provide opportunities for brief intervention, counselling, professional assessment, treatment, rehabilitation, and continued support. Providing screening services within communities may reduce geographical and financial barriers and create opportunities for young adults who may not voluntarily seek specialized mental health or addiction services to be identified and referred for appropriate care. Confidential and non-judgmental screening may also encourage greater disclosure of substance use problems. Conversely, stigma, fear of discrimination, concerns about confidentiality, inadequate screening coverage, shortages of trained personnel, limited treatment facilities, and weak referral and follow-up systems may reduce the effectiveness of community-based substance use screening. The study therefore expects accessible, confidential, and well-organized community-based substance use screening to contribute significantly to improved detection and early management of substance use disorders among young adults in Nigeria. The study is expected to contribute to the literature on community-based substance use screening, substance use disorder detection, young adult health, addiction prevention, mental health, community health services, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Drug Law Enforcement Agency, state ministries of health, primary healthcare centres, mental health and addiction treatment facilities, youth organizations, community health workers, healthcare providers, development partners, and policymakers regarding strategies for strengthening early detection of substance use disorders. The study will also provide evidence-based recommendations for expanding community-based substance use screening programmes, improving access to confidential screening services, strengthening training of healthcare and community health workers, increasing awareness of substance use disorders among young adults, reducing stigma and discrimination, strengthening referral and treatment pathways, improving availability of rehabilitation and support services, and integrating substance use screening into primary healthcare, mental health, and youth health programmes across Nigeria.

Keywords: Community-based substance use screening, substance use disorder detection, young adults, substance use, addiction, substance abuse, mental health, community health services, early detection, preventive healthcare, Nigeria, public health.