Burden of Substance Abuse in Freetown, Sierra Leone and Its Implications for Public Health

Abstract

Background: Substance abuse is an escalating public health crisis in Freetown, Sierra Leone, contributing to profound socioeconomic costs, domestic violence, and a heightened risk of sexually transmitted diseases (STDs). This study aimed to investigate the prevalence, characterize the types of substances abused, and identify the sociodemographic drivers of substance abuse among residents in the Western, Central, and Eastern parts of the city.

Methods: A mixed-methods approach was utilized, incorporating qualitative and quantitative research designs. Data were collected through structured questionnaires and personal interviews with 50 randomly selected respondents. Participants were primarily targeted at high-risk locations, including ghettos, entertainment centers, and psychiatric facilities across Freetown. 

Results: The most commonly abused substances were alcohol (80%) and kush (80%), followed closely by cigarettes (66%) and cannabis (64%). Less frequently used substances included tramadol (34%), cocaine (14%), heroin (10%), amphetamines (6%), and inhalants (2%). The demographic profile revealed that usage peaked among young adults aged 15–24. Furthermore, 80% of users were single, 50% were unemployed, and men abused substances at a higher rate than women. A staggering 100% of respondents noted a recent surge in both the variety of available substances and the number of users. Risky sexual behaviors were highly prevalent, with 65% reporting they never use condoms and 68% having no regular sexual partner, highlighting a severe risk for spreading STIs like HIV/AIDS. Additionally, only 18% of users had sought treatment for their substance use. 

Conclusions: The trend of substance abuse in Freetown is on a massive increase, particularly among unemployed youth, driven by the domestic production and affordability of substances like cannabis, kush, and alcohol. These findings underscore an urgent need for multifaceted public health interventions. Critical recommendations include nationwide education campaigns, the enforcement of stringent anti-drug policies, enhanced parental oversight, and the establishment and strengthening of rehabilitation facilities to safeguard public health.

Key words: Substance abuse, Public health, Freetown, Sierra Leone, Kush, Youth unemployment, Sociodemographic drivers, Risky sexual behavior, Polysubstance use