Introduction

Based on the characterization of the use of psychoactive substances in four private universities in the city of Pasto, it has been possible to identify the types of psychoactive substances used by the university population, analyze the perception of risk regarding them, the ease of acquisition among students, the frequency of use, the age of initiation and other relevant factors. This information is key to the design of precise preventive measures adapted to local realities.

The use of psychoactive substances among university students is a worrying phenomenon that varies according to the type of substance and the institution. Alcohol stands out as the most commonly used substance in the population studied, indicating a normalization of its use in social and academic life, facilitated by its accessibility and the perception that it is socially acceptable. Although tobacco has lower consumption rates than alcohol, it is still consumed at a considerably high rate, reflecting its use as a coping mechanism against academic and social stress, in addition to the influence of peer groups in its normalization.

As for marijuana, there is an increasing trend in its use. Previous studies indicate an increase among young university students, which may vary according to the social and cultural context of each institution. On the other hand, although cocaine consumption is lower compared to other substances, its presence highlights the need for monitoring and prevention, given its potential to cause serious health problems and dependence.

In addition, the inclusion of inhalants and hallucinogens, albeit at low rates, indicates the need for monitoring and preventive interventions. While it is encouraging that no cases of heroin have been reported at some universities, it is critical to remain vigilant to any signs of heroin use, as it may signal deeper social problems. In this context, there is a clear urgency for specific preventive approaches that address the risks associated with the use of these substances, tailored to the realities of each university.

Substance use is a problem with high psychosocial costs, the negative effects of which have intensified over time. People who use these substances tend to be less involved in important decisions and are at greater risk of escalating to the use of more dangerous substances. At the family level, conflicts increase and the mixing of drugs, especially alcohol, with other substances exacerbates the negative consequences. In addition, risky practices, such as use combined with unprotected sex or the use of non-conventional substances, contribute significantly to the increase in harm.

Furthermore, the low perception of risk associated with drug use, combined with easy access to these substances, favors their spread. Drug use is a much more complex problem, linked to social, economic, political and cultural factors that must be understood in order to formulate effective prevention strategies. It is therefore essential to adopt a comprehensive vision that allows us to address this phenomenon in all its dimensions.

In various university contexts, previous research has been useful in identifying patterns of consumption of these substances, focusing on socio-demographic variables and emphasizing the age of onset, risk factors and protective factors that may influence the development of addictive behaviors. This information is crucial not only for prevention, but also for mitigating the consequences of use, such as school dropout and the negative impact on social and family dynamics, both within and outside the educational environment (Castaño-Pérez & Calderón-Vallejo, 2014).

The World Drug Report, prepared by the United Nations Office on Drugs and Crime (UNODC, 2018a), revealed that 275 million people between the ages of 15 and 64 have used drugs worldwide, and about 31 million suffer from drug use disorders. This situation indicates an increase in the use of these substances: «In 2021, about 1 in 17 people aged 15-64 worldwide had used drugs in the past year. The estimated number of users will increase from 240 million in 2011 to 296 million in 2021» (UNODC, 2023a, p. 13).

In addition, the UNODC World Drug Report 2023 estimates that around 500,000 people die each year from the use of psychoactive substances (PAS). Of these deaths, about 40% are attributed to overdoses, while the remaining 60% are related to diseases such as HIV and hepatitis C, acquired through the inappropriate use of injections.

In the case of the university population in Colombia, the IV Andean Epidemiological Study on Drug Use (UNODC, 2023b) found that the majority of students use drugs experimentally, although a minority develop addiction problems. Legal substances such as tobacco (especially in the form of electronic cigarettes) are common among young people, while alcohol shows signs of dependence. As for illicit drugs, 45% of the university population report having used some of them, without perceiving great risks in their experimental use. The most common substances are marijuana, LSD and cocaine (UNODC, 2023a).

Drug use is a global phenomenon that generally begins at an early age and intensifies between the ages of 18 and 25. This age group includes a large proportion of university students. This pattern has a significant impact on human capital and profoundly affects individual, family and societal aspects (UNODC, 2023a).

In particular, the department of Nariño, located on the border with Colombia, presents unique characteristics and multiple risk factors stemming from social, economic, cultural, and family instability. These conditions have historically influenced the biopsychosocial development of the population, generating problems related to the use and abuse of PAS. These problems affect all sectors of society, especially the most vulnerable, who suffer the consequences of poverty, marginalization and discrimination (Gobernación de Nariño, 2016; Departamento Administrativo Nacional de Estadística [DANE], n.d.).

In order to design truly effective prevention strategies, it is essential to take a comprehensive view of all the factors involved. Interventions must be adapted to local realities and address not only the visible aspects of consumption, but also the underlying factors that facilitate it, such as risk perception and the influence of the social environment. Only through a comprehensive vision that combines education, prevention and psychosocial support will it be possible to reduce the harm associated with substance use and promote a healthier and safer university environment. In this sense, the present study was proposed as a necessity, with the aim of characterizing the use of PAS in the university population of the department of Nariño, and thus generate relevant information that allows guiding more appropriate and effective preventive interventions.

Methodology

The study was descriptive and cross-sectional in nature. The reference population consisted of students from four private universities in the municipality of San Juan de Pasto, Nariño. A total of 2,984 students were expected to participate in the sample, but only a total of 1,623 students were selected from the four universities.

It is worth mentioning that the collection of information coincided with the beginning of the pandemic (March), so the effective response rate was 1,623 in relation to the desired sample. To calculate the sample size in each university, the following parameters were considered, taking as the primary indicator of the study the use of any illicit drug in the last year: prevalence in the last year = 10.0%, error = 1.8%, confidence level = 95%, based on a simple random sampling within each university and, with the necessary adjustments for the sample size.

The university population had remote access to the questionnaire that was validated and applied in the last national study of consumption in the Colombian population, in 2016. This was placed on a server of the Organization of American States, so that the selected students could respond directly through a web page and online [Inter-American Unified Data System (oas.org)]. The main advantages of this procedure were to achieve a better quality of responses, thanks to the privacy that the student has to answer the questionnaire, the lower cost that this procedure implies, and the lower number of errors in the transfer of data from the questionnaire to a database.

The inclusion criterion for the analysis presented in this report was to have completed the online questionnaire up to the alcohol module. The exclusion criterion was answering ‘No’ to the following item: «I hereby declare that I am providing this information voluntarily».

The instrument used was agreed upon by the Inter-American Commission for the Control of Drug Abuse (CICAD), the professionals of the Project to Support the Reduction of Demand for Illegal Drugs in the Andean Community (PREDEM), and the focal points of the four Andean countries. The questionnaire includes several modules: 1) general information; 2) tobacco and alcohol use; 3) questions about use, abuse and dependence in the case of alcohol; 4) risk perception regarding the use of drugs, marijuana, cocaine, LSD and others; 5) questions about use, ease of access and supply; 6) risk perception regarding the use of drugs: tranquilizers, stimulants; 7) questions about use, access by prescription or not; 8) risk perception regarding use; 9) exposure to drug prevention programs; and 10) need for treatment (Sistema Único de Indicadores sobre Consumo de Sustancias Psicoactivas [SUICAD], 2014).

The study was evaluated and approved by the Bioethics Committee of the Universidad Mariana, in accordance with the guidelines established by Resolution 8430 of 1993 of the Ministry of Health, which provides a legal framework for the protection of research subjects in Colombia, and the Declaration of Helsinki of the World Medical Association, which establishes fundamental ethical principles for medical research worldwide. These regulations and international documents ensure that research meets the highest ethical and safety standards and protects the rights and welfare of participants. Adherence to both ensures that the study is conducted with rigor and respect for fundamental ethical principles.

Results

Table 1 presents data on the use of different types of PAS among students at the four universities. Alcohol was the most commonly consumed substance in all of them, with consumption rates above 88%. The Corporación Universitaria Minuto de Dios had the highest rate at 93.52%. Cigarette consumption was very high in all universities, with rates between 40% and 48%. Marijuana use varied widely, with the highest rate at the Universidad Mariana at 25.84% and the lowest at the Corporación Universitaria Minuto de Dios at 12.96%. Cocaine use was relatively low at all universities, with the highest rate at the Universidad Mariana at 5.49%. Inhalant use was low; the Corporación Universitaria Minuto de Dios had the lowest rate at 0.40%. Hallucinogen use was highest at Mariana and Cooperativa de Colombia universities (5.14%). Heroin use was minimal; some universities reported zero cases.

Table 2 shows the results of the risk perception regarding the use of the different PAS by the students of the Universidad Mariana. Low risk perception was common for alcohol consumption, followed by cigarettes and marijuana; the students of this university indicated that alcohol consumption has low risks, that their friends and family approve of it, and that it is easy to access and consume, making it the most consumed substance in absolute terms, both in sporadic and frequent use, unlike amphetamines and heroin, which had a very low incidence compared to other substances due to higher risk perception.

Table 3 shows the low risk perception of alcohol consumption among the students of the Corporación Universitaria Minuto de Dios. These perceptions influence their consumption behavior. Therefore, this analysis highlights the importance of focusing on alcohol consumption, given their low risk perception, as well as the need for educational and preventive interventions on cocaine and other substance use, considering that there was a high percentage of respondents who did not know or did not respond.

Table 4 shows the results from the Universidad Cooperativa de Colombia, with similar results to the other universities. Alcohol had a low perception compared to other substances with 48.46%; cigarettes also had a low risk perception with 54.69%. Regarding marijuana, cocaine, inhalants, hallucinogens, amphetamines and heroin, the majority of respondents indicated a high-risk perception of these substances, with percentages ranging from 62.50% to 80.19%.

The percentages of Don’t know/Don’t answer are low or zero for all substances. These data confirm the need for prevention and education programs, especially for alcohol and cigarette consumption.

Among the students of the Fundación Universitaria San Martín (FUSM), the perception of risk for alcohol and cigarettes was low, with 56.06% and 65.04%, respectively. However, a significant proportion indicated a high perception, with 43.94% and 34.96%, respectively. For marijuana, cocaine, inhalants, hallucinogens, amphetamines and heroin, the majority of respondents had a high-risk perception of these substances, with percentages ranging from 60% to 100%. There were no respondents who did not know or did not answer for any of the substances.

In contrast to the other universities, FUSM students had the highest risk perceptions for substances such as marijuana, cocaine, inhalants, hallucinogens, amphetamines, and heroin. This indicates the need for prevention and education programs focused on the perception and use of these substances, in addition to continued efforts to address alcohol and cigarette use on all campuses.

Table 6 describes the ease of acquisition of PAS by students from the four universities. Alcohol was the most accessible substance, with more than 84%. Cigarettes were also perceived as easy to obtain by a significant majority, more than 90% in all cases. Marijuana had a variable perception of accessibility, being easier to obtain at the Universidad Mariana (86.99%) and less so at the Corporación Universitaria Minuto de Dios (62.50%). Cocaine was moderately to highly available at the Fundación Universitaria San Martín (71.43%) and the Universidad Mariana (67.74%). In contrast, the Universidad Cooperativa de Colombia (57.14%) and the Corporación Universitaria Minuto de Dios (25%) had lower percentages of perceived accessibility. Inhalants, hallucinogens, amphetamines and heroin were generally considered less accessible by the majority of students, with low percentages in all universities. These perceptions are essential to guide prevention and control policies in educational institutions.

Discussion

The use of PAS in the university population shows a clear trend towards the use of alcohol as the most common substance, followed by cigarettes. This trend is related not only to the accessibility of these substances, but also to their market supply and cultural acceptance. Alcohol, in particular, is seen as a legal and commonly used substance in different social contexts, which has led to a normalization of its consumption, reducing the perception of risk among students.

This normalization is even more evident in areas near universities, known as ‘pink zones’, where the availability of alcohol is high and easily accessible. Some establishments that provide alcohol are located near universities, facilitating its consumption among students, as noted by the Chamber of Commerce. On this topic, Estrada-Durand and Salinas-Salas (2019) explain that alcohol consumption among young university students can be understood from multiple factors, including genetic predisposition, mental disorders, life cycle, gender, socioeconomic factors, social events, and social pressures.

The use of prescription drugs ranks fourth in prevalence and is more common among women, suggesting a pattern of both medical and self-prescribed drug use. Most respondents reported that these drugs were prescribed by general practitioners, although there are cases where psychiatrists, neurologists and other medical specialties are involved in prescribing. According to UNODC (2018b) women who face drug use problems usually have fewer resources and face greater socioeconomic barriers than men. This finding highlights the need to implement preventive actions with a gender focus.

The age of onset of PAS use is usually between 16 and 20 years, which has multiple social, academic, and health consequences, as this period coincides with a crucial period of personal and educational development. Biologically, it can disrupt brain development, affecting critical areas such as the prefrontal cortex and increasing susceptibility to addiction due to neural plasticity during adolescence (Arain et al., 2013; Spear, 2016). Psychologically, it is associated with an increased risk of mental health problems, such as anxiety and depression, and poor academic performance (Jordan & Andersen, 2017). Socially, early PAS use can negatively affect interpersonal relationships, increase school dropout, and increase participation in risky behaviors (DeWit et al., 2000; Salas-Wright et al., 2016).

This information was essential, as it showed the need to implement actions to prevent the use of substances, both legal and illegal, in university institutions with a gender approach. According to UNODC (2018b), women facing drug consumption problems often have fewer resources, such as education, employment and economic income, compared to men. In addition, many of them live with partners who also face substance use problems, suffer physical and emotional abuse, and have family responsibilities. They also frequently experience psychological or psychiatric disorders, often related to mood disorders.

Tobacco was the second most commonly used legal substance, which may be influenced by the growing perception among young people that cigarettes are less harmful than other psychoactive substances. Despite global awareness campaigns about the risks of tobacco, many students tend to underestimate its harmful effects compared with drugs such as marijuana or cocaine. This misperception is partly due to the legality of cigarettes and the normalization of their use in society.

In this context, it is important to highlight the implementation of Law 1335 of 2009, adopted by universities to promote smoke-free environments, which represents a positive step to reduce its consumption.

However, both alcohol and tobacco remain the most widely used legal drugs among the university population, mainly due to their easy accessibility, presence in public spaces and widespread availability despite existing regulations. The oversupply of these substances in various contexts remains a challenge. In addition, tobacco use among young people has a strong social component, as many students smoke to fit into certain groups or as part of a collective ritual. These socialization spaces, where belonging is sought and experiences are shared, often include cigarette consumption, which adds a layer of complexity to the design of effective prevention strategies.

On the other hand, marijuana consumption shows significant differences between universities, with the Universidad Mariana having the highest rate (25.84%) and Corporación Universitaria Minuto de Dios having the lowest (12.96%). This data is consistent with the growing trend observed in the Andean region, as highlighted by UNODC (2017), which reports a sustained increase in marijuana use among university students since 2009. For Cazenave et al. (2017), marijuana consumption among young university students may be linked to a process of identity construction in which they seek to distance themselves from the adult world. The practice of substance consumption can be interpreted as a symbolic act of opposition and belonging to a youth group, in which peers play a vital role as a space for socialization and reinforcement of these behaviors.

Risk perception regarding PAS use is a key factor in the behavior of university students. According to the Report on Drug Use in the Americas (Inter-American Drug Abuse Control Commission [CICAD] & Organization of American States [OAS], 2019), lower risk perception is associated with greater consumption of drugs such as alcohol, cigarettes, and marijuana, and this pattern is also observed in the university population of Bogotá D.C.

The study on the use of psychoactive substances in Bogotá D.C. (Alcaldía Mayor de Bogotá et al., 2022) confirms that university students have a high rate of use of these substances and a relatively low perception of the risks involved. In addition, the report highlights that although injectable drugs carry a high risk of overdose and blood infections, their negative perception of risk contributes to their less frequent use compared to substances such as alcohol and tobacco. These findings underscore the need to increase education about the risks associated with substance use and how risk perceptions influence consumption decisions among students.

Regarding the ease of access and supply of drugs in general, the option ‘It would be easy for me to get’, ranked alcohol first, then cigarettes, followed by the first illegal drug: marijuana. In this regard, it is important to note that where availability, ease of access and supply are greatest, consumption rates are highest.

For their part, Torres et al. (2015) focused their study on the different universities in the city of Medellín and found that alcohol is one of the most consumed substances, followed by tobacco, marijuana, and cocaine. Furthermore, the World Drug Report (UNODC, 2018b) that globalization affects drug trafficking and increases the expansion of trade, facilitating agreements between criminal organizations in different territories, while expanding trafficking networks and making control more difficult for the entities responsible for monitoring drug trafficking, which in turn facilitates access, supply and demand.

Castañeda (2019) states that the beginning and permanence of the consumption of SPA in university institutions is due to freedom, diversity, controversy, ideal, autonomy and opposition, aspects that favor and encourage consumption. In addition, the confrontation with family, social and academic demands are the main causes for the beginning, all to achieve a respected status in the university context. Likewise, consumption is associated with affective and emotional difficulties, socioeconomic situations, mental health problems or simple curiosity (Avella et al., 2020). While it is true that these aspects directly influence the consumption of these substances, the university community, especially that of Nariño, is also faced with an imminent risk: the geographical location, since it is strategically connected to the rest of the country by means of land, river and air routes, which facilitates the elaboration and production of this type of substances (Ministerio de Justicia, 2018).

Regarding the strengths of the study, these are mainly due to the sample size, the choice of four university contexts, the use of a nationally validated instrument with high levels of representativeness, which allowed a baseline for future measurements, since it is the same one used by the nation in its measurements as a country. Thus, these results can guide the design and strengthening of universal, selective and indicated prevention strategies in university contexts and the structuring of public policies, as well as periodic measurements that can be compared in the future with those of a national nature. On the other hand, the main limitation of the research was its cross-sectional nature, which did not allow answering causal questions. Likewise, the descriptive level of the study did not allow for a more complete analysis of the variables or aspects evaluated.

Conclusions

The use of psychoactive substances in the university population, especially alcohol and tobacco, reflects a normalization influenced by factors such as accessibility and cultural acceptance. This phenomenon is exacerbated in areas close to universities, where the supply of alcohol is high. Although students are aware of the risks involved, the perception of danger is low, which contributes to the increase in consumption, especially among young people between 16 and 20 years of age. To address this problem, it is essential to implement prevention strategies with a gender approach and public policies that reduce access, increase education about the risks and promote safer consumption practices that reduce harm.

Consumption in universities is influenced by the high availability of the substance and low risk perception, especially in the case of alcohol and tobacco. Socio-economic, cultural and social pressures play a key role in this trend, affecting the academic and social development of students. Therefore, in order to reduce the impact, it is crucial to implement specific prevention programs that take into account these realities, with particular attention to gender differences and social factors that perpetuate consumption in the university environment.

Conflict of interest

The author of the article declares that she has no conflict of interest regarding the work presented.

Ethical Responsibilities

For the development of this study, aspects related to the ethical management of the instrument and the results of the research have been considered, in compliance with the provisions of Law 1090 of 2006 on Psychologists, especially regarding the management of information, participation with informed consent, and the use of scientifically proven procedures and intellectual property in the research process.

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Información adicional

Contribution: Sandra Yaneth Quiroz Coral: Principal investigator, statistical data processing, writing of materials and methods and obtaining the results, analysis and interpretation of results, writing of the introduction, methods, discussion and conclusions.

Article result of the research entitled: Magnitud del consumo de drogas en población universitaria de la ciudad de San Juan de Pasto [Extent of drug use in the university population of San Juan de Pasto, Colombia], developed from June 1st 2020 to September 23rd 2022, in Nariño, Colombia.

Información adicional

redalyc-journal-id: 7761