Academic Editor:Martins C, Escola Superior de Sa?de de Viseu, Viseu, Portugal
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Trends and inducing factors for illicit drug use in Grenada: Epoch 2001 – 2009.
The psychosocial aspect of drug use is seldom researched in Caribbean nations. Drug use in the Caribbean has been on the rise since the 1990s. Statistical indicators have established evidence for the increased rates of illegal drug use. This study briefly reviewed these indicators and explored factors that influenced the state of drug affairs in Grenada from 2001 to 2009.
Interviews conducted in a semi-structured form were carried out on key stakeholders involved in drug prevention in Grenada. Literary review of pertinent articles from search engines was used to buttress results. Further search through statistical records provided by the Drug Control Secretariat and Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was used to obtain information on recent developments surrounding drug related activities in Grenada.
Trends show marijuana as the drug of choice and males being primarily involved in illegal drug activities. Additionally, cultural, and psychological factors play major roles in the proliferation of the drug problem in Grenada.
Despite preventive measures used to raise awareness on the dangers of drug use, drug use/abuse/activities are still at an all-time high in Grenada. Focusing on the social, cultural, psychological factors influencing illicit drug activities, and increased cooperation between anti-drug organizations may be effective in curbing illegal drug use in Grenada.
Since the 1990s, records of illegal drug use in Caribbean nations have been at an all-time high. While there are several reported influencing factors to drug use, psychosocial factors are seldom researched and documented.
According to the Yale Medical group, psychosocial factors are defined as factors that influence an individual emotionally or socially. Psychosocial factors that encourage drug use and abuse include but are not limited to psychological problems such as psychiatric conditions, environmental factors mainly peer pressure, culture, economic state and so on 1. The Caribbean culture, which supports the use of illegal drugs such as marijuana especially at social functions, makes the drug problem in these regions worse. Mainly adolescents, who look up to adults and peers get involved in drug use and abuse. While trying to emulate the adults mostly other family members and members of their age group, Caribbean adolescents fall in the trap of drug use 2.
In Grenada, alcohol, marijuana, crack, cocaine and a combination of the aforementioned are the drugs abused. Although alcohol and cigarettes are legal drugs, the Caribbean Epidemiology Centre (CAREC) reports that these drugs are frequently abused in the Caribbean. In the past three to four decades, CAREC reported remarkable increase in illegal drug activities in Grenada 3.
In this article, the terms “drug abuse” and “drug use” are used to denote illegal drugs or substances. Additionally, the terms “drug situation” and “drug problem” are similar and indicate the woes of drug activities on the society. Exploring the historical trends and socio ecological factors surrounding this drug situation is essential to address the drug problem. The purpose of this study is to identify the socio-ecological causes of drug initiation among Grenadians.
In the Grenadian culture, celebrations or social events seldom occur without the use of illegal drugs this gives room to the propagation of the drug problem. The brewing and growth of alcohol and marijuana take place in the home of many residents. It is with such early exposure to illegal drugs ingrained in the minds of future generation of the Caribbean nations that makes the eradication of drug use and abuse arduous. Illegal drug use poses social burden and health risks through its use and addiction and underwrites social concerns such as amplified crime rates, domestic violence, unemployment and mental health problems 4.
The encumbrance of illegal drug use and abuse produces direct and indirect societal costs in the form of increased security strains, treatment programs and demands, and more reliance on social programs. Relinquished income and tax revenues upon the society and strained national budget due to increased health demands are some of the aftermath of drug use 5, 6. Drug use and abuse in the Caribbean creates a cycle of poverty and vulnerability to peril through use, dependence, treatment and recidivism. The underlying social and psychosocial factors behind the drug problem in Grenada, the Caribbean should be addressed lest the perpetuation of this vicious cycle.
The Drug Control Secretariat in conjunction with the Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) routinely collects statistical data on the drug situation in Grenada. Data is requested from the hospitals, treatment centers, customs, excise department, laboratories, police force, prisons and financial intelligence unit. This information is then compiled and published in order to increase the cognizance on the dangers of illegal drug use 7.
The historical trends and socio ecological factors surrounding this drug situation is essential to address the drug problem. The purpose of this study is to:
1) Investigate trends in drug use.
2) Identify the socio-ecological causes of initiation among Grenadians.
The institutional review board at the St. George’s University, School of Medicine, Grenada, West Indies permitted ethical approval for this study.
This study was carried out with data and reports from the Grenada Drug Control Secretariat and GRENDIN/NOD particularly the drug control officer. GRENDIN/NOD are government agencies that accumulate and provide statistical data on drug use to the community. Data for the years 2001 to 2009 were collated from GRENDIN/NOD and reviewed for relevance to this study. GRENDIN/NOD also documents the perception of different individuals on drug and its consequences. For example the link between drug use and HIV/AIDs is noted in the GRENDIN/NOD documents.
Through literature search, supplementary secondary sources were acquired. MEDLINE with Full Text, PUBMED and Google Scholar were the search engines used for this study. Furthermore, health- based organizations such as: the Government of Grenada, Ministry of Health in Grenada, United Nations, World Health Organization, were used as online sources to search for any statistics and reliable details pertaining to trends and influencing factors of drug use in the Caribbean and Grenada.
The terms “Illegal drug use”, “Social factors AND Illegal drug use”, “Ecological factors AND Illegal drug use”, “Psychological factors AND Illegal drug use”, “Caribbean OR Grenada AND Illegal drug use”, “Caribbean OR Grenada AND Marijuana use”, “Social factors AND Marijuana use”, “Ecological factors AND Marijuana use”, “Psychological factors AND Marijuana use”, “Caribbean OR Grenada AND Drug treatment” were searched as key words or phrases on the search engines and organization websites. There have been findings addressing the use of illegal drugs but there is a scarcity of research on the psychosocial aspect of illegal drug use particularly in Grenada and the Caribbean as a whole.
As a result of this dearth in literature on developing nations such as Grenada, inclusion criteria consisted of all available articles from search engines and organization websites that explored drug use and their influencing factors in the Caribbean and precisely in Grenada. All other articles with information not relating to drug use in Grenada were excluded.
Semi-structured interviews were conducted for primary data to further elaborate on drug trends, and the socio-ecological factors surrounding the drug problem in Grenada. Eleven key representatives from various agencies including the Royal Grenada Police Force, Carlton House Treatment Centre, Drug Control Secretariat, General and Mental hospitals, Grenada Ports Authority, Customs and Excise, Ministry of Legal Affairs, and Financial Intelligence Unit were interviewed. All interview sessions were tape recorded except for two interviewees who declined being tape recorded.
Interview responses were comprehensively reviewed to identify the main and overlapping themes. These themes were then organized by informant. The interview findings were used to supplement the findings of the secondary data and literature reviews. The interviews also provide the most updated information from those key representatives involved in combating drug use and abuse in Grenada.
The GRENDIN reports which met the inclusion criteria; information related to drug use in the Caribbean and Grenada in the period 2001 to 2009 were collected. Additionally, 22 articles, documents meeting the inclusion criteria were also gathered. Interviews were carried out on eleven staff members of significant agencies involved in drug control. These staff members comprise of one police officer, one customs intelligence investigator, two prosecution officers, one drug control officer, one manager administrator of the Ports Authority, one financial investigator, one counselor, one nurse and two doctors.
The Drug Control Secretariat reported the lifetime prevalence of drug consumption among Grenadians. The reported lifetime prevalence for drug consumption in 2005 was 30% for cigarette use, 84% for alcohol and 27% lifetime prevalence for marijuana. The lifetime prevalence for tranquilizer was 5.9% and that for other illegal substances was 19.3%.7 According to the Drug Control Secretariat, alcohol use is more rampant than crack cocaine, marijuana and poly drugs use 7.Other estimates indicate a persistently higher level of drug involvement in males than females. According to the physician from Mt. Gay Mental hospital:
“It is socially acceptable for men to engage in alcohol use and to a certain extent marijuana use. Female alcohol and marijuana use is often frowned upon and often underreported”
There have also been emerging trends showing a possible increase in the use and trade of drugs such as ecstasy and methamphetamines. According to the police officer,
“Within the last ten years there have been instances of other types of drugs introduced into Grenada. Ecstasy…there has been two significant seizures of ecstasy in Grenada. Once it is available, a lot of the youths might gravitate towards this drug. It can become a major problem in Grenada”.
In a study conducted among Grenadian youths in 2003, peer pressure was reported as a major contributory factor to the early age of initiation of marijuana use 8. The peer pressure from friends and classmates influenced many to use drugs. A physician at the general hospital stated that there is an attraction to “get rich fast schemes” which illegal drug trade often accompanied by drug use provides.
A customs department official said,
“the ease of relativism which makes a person want to explore new and often dangerous things, creates a disregard for the connection between traditional Christian values and modern knowledge so that most youths no longer feel the need to respect what their ancestors have achieved over the years”.
Social Ecological Factors
The results of the data and literature reviews and the key informant interviews identified drugs such as alcohol and marijuana as the major cause for the drug problem in Grenada. The use of these two drugs is shaped by social and cultural beliefs, as there seems to be a positive perception across the Caribbean about drugs such as marijuana 9.Although the trafficking, possession and cultivation of marijuana is as illegal in the Caribbean as it is in the United States, there happens to be a positive perception of marijuana by the Caribbean population 9. Marijuana often called by its Indian name, “ganja”, is frequently used as herbal remedy in the Caribbean 9. Over the years marijuana use has flourished in the Caribbean. Its ritual, medicinal and recreational value has become integrated into the lifestyle of many particularly males. The Drug Control Secretariat official stated,
“…with marijuana it has a lot to do with the rastafarian movement which promotes marijuana use which is part of their religion or practice. They believe it is a herb, Jah made it, its ok…a lot of it has to do with/it ties into the music (Bob Marley) influence”.
Alcohol is also an important part of the Caribbean economy, most especially rum production which plays an important role in the history of many countries in the Caribbean including Grenada 6. According to the drug control official,
“Alcohol is traditionally accepted in this society; from birth to death alcohol is involved
in almost every event. Parents openly send children to supermarket to get alcohol.”
Over the years as alluded above, research findings have shown that drugs negatively affect the psychological state 10. Illegal drugs alter the mental state and fuels psychological conditions in Grenadians. However, the mental health physician reported that in the drug using population, genetics might play a role in the predisposition to illegal drug use. He also stated that,
“in an effort to deal with the symptoms of certain psychological problems such as schizophrenia, they (psychiatric patients) might gravitate towards use of these illegal substances”
Another important psychological factor in males more than females is the fact that men often times struggle with expressing their emotions. The Carlton House treatment Centre counselor explained that males often lack an avenue to express their emotions and this causes them to turn to drug use. The Drug Control Secretariat official shared similar views. He stated:
“Some other individuals use marijuana and alcohol as a defense mechanism, to escape or to confront issues”… “for example, if they want to confront a neighbor that has done them wrong they would first “bang the head”” meaning drink or use an illegal substance to get high and would then “proceed to go curse and fight/confront the neighbor”
The current poor economic situation is identified as the major culprit promoting illegal drug activities in Grenada. Several interviewees stressed this. The demise of the banana industry during the 1980s to 1990s negatively affected the agricultural industry 8. In an effort to improve their economic situation, many Grenadians became involved in the illegal drug trade. According to interviewees, some people use these illegal drugs to help them forget their poor economic status. An upward trend in the illegal drug use and activities of persons aged 40 years and above has been observed 7.Findings have related this emerging trend to unemployment and the poor economic state of the country.
It has also been observed that islands in the West Indies over the past 10-15 years have become major transshipment centers for cocaine and Heroin from South American suppliers to distributors in Europe and the United States 9.This new routing arrangement has propagated the illegal drug trade in Grenada and throughout the Caribbean.
St. George’s, Grenada, West Indies is the location of this study and so the results are precise to this area. Nonetheless, because of the analogous socio-demographic features of Grenada to other Caribbean countries, discoveries in this study may be applicable to other areas. Studies have already established the upsurge of illegal drug use and activities in Grenada and the Caribbean as a whole 3, 8, 9. Conversely, there is a scarcity of research on the psychosocial aspect of drug use in the Caribbean. The current study has also shown an increase in drug use in the period 2001 to 2009 in Grenada. However, prevalence of drug use among secondary school students has decreased in recent years 11.
This study demonstrates the socio- ecological and psychosocial factors stimulating the use and abuse of illegal drugs. Based on responses from interviews of major stakeholders in the Grenadian communities, it was revealed that the social acceptable nature of alcohol and drug use among Grenadians promoted the persistence of the drug problem. Additionally, poor family role models, culture, peer pressure, economic status, laxity of the borders, and skewed judgment of medicinal benefits of illicit drugs are cited as the influencing dynamics.
Studies have explored the impact of peer pressure and family role models and have shown that a link exists between drug use and family background. Adults and parents are accustomed to exposing the younger generation to illegal drugs by portraying the use of such drugs and also involving the youth in the purchase of alcohol and marijuana 2. The influence of peer pressure in adverse behavior is a worldwide phenomenon. In Grenada, peer pressure plays a role in the initiation of drug use but not solitarily because the culture of illicit drug use is ingrained in the society and plays a larger role in the initiation and continued use and abuse of drugs. Notably, the Rastafarian culture championed by Bob Marley is widely popular in the Caribbean and became more like a religion. A religious move that glorifies illegal drug use, abuse, and activities thereby encouraging a continued drug use among the young and the old.
The continued substance use and abuse is also fueled by the altered mechanism of combating unfavorable situations, a kind of defense mechanism to deal with situations such as disagreements. This is referred to in psychology or behavioral science as an immature ego defense mechanism. It can be likened to the “acting out” immature defense mechanism defined as substantial emotional or behavioral frenzy to cover up underlying feeling or idea. In this case the substance use and abuse is used as a cover up for the pain and anger faced in the society.
The dwindling economic state of the Caribbean society, which solely relies on tourism and agriculture, shows shrinkage particularly shrinkage of the middle class and a growing state of poverty. The increasing poverty rate creates drug-related crimes, which expand these nations’ susceptibility to instability and poverty since most of their resources are drained in the process of resolving these drug problems 12. In an effort to alleviate the pain of poverty many turn to drug use thus enhancing this dangerous cycle. Additionally, since drug business proves to be lucrative, drug trade is used as an avenue to make money and get out of poverty.
In an effort to address the drug problem, programs and policies have been put in place by the Grenadian government. Awareness has been raised through television shows and monthly newsletters enlightening the masses on the dangers of drug abuse. The Drug Abuse (Prevention and Control) Act was implemented in 1992. Drug and violence prevention programs have also been executed targeting high school students in the Grenada and Carriacou region. The Grenadian National Drug Control program is another program targeted at reducing the drug problem present in Grenada. However, there also seems to be a lack of interagency collaboration between some of the agencies involved. Education of the public is one of the key areas that can significantly influence perceptions about drug use. For instance, one police officer explained that programs such as the Drug Abuse Resistance Education (DARE) helped in the past but is no longer in existence. Therefore, reorienting beliefs and practices to change unacceptable norms is crucial. With the implemented programs discussed earlier there have only been minor reductions in drug abuse and activities 11.
Meaningful decrease in this drug problem can be attained by implementing strategies focusing more on educating the population on the dangers of certain cultural belief systems for example belief systems promoting Rastafarian movement of drug use in Grenada. Aggressively approaching the initiating factors discussed in the result section of this article by educating the masses, addressing the psychosocial inducing factors, and instating laws that attack drug trafficking by strengthening inter-agency alliance that curtail drug trade are steps in the right direction towards eradicating this drug problem.
This study is limited by natural disasters. Hurricane Ivan occurred in 2004 destroying the major drug rehabilitation center, Carlton House in Grenada and this led to loss of records/data 13, 14. The focus of the current study has not been well researched in the past particularly in Grenada. This limits the efficiency and quality of information or data for this study. The sole source of quantitative information, Drug Control Secretariat/GRENDIN, limits the methodology of this study due to the lack of varied information; there is limited opportunity for quantitative data comparisons. Nonexistent information on the method of analysis employed by GRENDIN adds to the limitation to this study. For the interviews conducted in this study, reporting bias due to respondent’s inaccurate recollection of events is another possible limitation to this study. Social desirability bias could also have affected these results.
Lastly, this study highlighted the need for additional research on drug use and abuse in Grenada in the areas of drug treatment, contributing factors, and emerging drug trends. For example, uprising drugs such as ecstasy and methamphetamines, and the link between HIV/AIDs and drug use should be assessed in future research. These imminent studies can afford solutions to this dilemma.