Socio-Cultural and Economic Drivers of Youth Substance Use in Tamale, Ghana: A Qualitative Exploration

Abstract

Background: Substance use among youth is a pressing public health issue, especially in low- and middle-income countries where socio-economic instability and weakened traditional structures increase vulnerability. In Ghana, most studies focus on southern cities, with limited attention to northern regions like Tamale, where distinct cultural and economic factors may shape youth substance use. Objective: This study explored the socio-cultural and economic influences on substance use among youth (aged 15–24 years) in the Tamale Metropolis, Ghana. Methods: This study employed a qualitative exploratory design using phenomenological approaches to understand the lived experiences of youth regarding substance use in Tamale Metropolis. Eighteen youth with current or past substance use were recruited through snowball sampling. This study used In-Depth Interviews (IDIs) as the primary data collection tool to explore the socio-cultural and economic influences on substance use among youth in the Tamale Metropolis. Interviews were conducted one-on-one and lasted between 20 to 30 minutes. The interviews took place in private, quiet locations such as participants' homes or neutral spaces within the community, ensuring confidentiality and comfort. Data were collected through in-depth interviews conducted in Dagbani, transcribed, translated, and analyzed thematically using Braun and Clarke’s six-phase framework in Dedoose. Rigor was ensured through member checking, peer debriefing, and intercoder reliability. Results: The study used Four themes such as socio-cultural influences, economic pressures, gender roles, and mental health. Peer pressure and social conformity were strong initial motivators, often reinforced by weakened traditional norms and limited elder oversight. Economic hardship, especially unemployment, drove substance use for emotional relief, while informal workers used drugs like tramadol to cope with physical demands. Gender dynamics revealed that males associated substance use with masculinity and peer respect, whereas females concealed use due to social stigma. Mental health challenges—including stress, anxiety, and grief—fueled substance use as a form of self-medication in a context with limited psychosocial support. Conclusion: Youth substance use in Tamale is shaped by intersecting socio-cultural, economic, gendered, and psychological factors. Interventions should include mental health services, gender-responsive programming, economic empowerment, and community-based education, alongside engagement with traditional leaders to restore protective norms. Gender-specific interventions should be introduced to address the distinct pressures faced by young men and women. Collaboration with community leaders and policymakers is also crucial to reinforcing positive cultural norms and creating supportive environments for youth development.