Abstract
Background
Psychoactive drug use among tertiary students is a public health concern with implications for well-being and academic functioning. This study investigated the prevalence, predictors, and academic-related indicators associated with psychoactive drug use among students in tertiary institutions in Rivers State, Nigeria.Methods
A cross-sectional study was conducted between August 2024 and February 2025 among 1,707 students recruited through multistage sampling from tertiary institutions in Rivers State. Data were collected using a validated, self-administered questionnaire. Descriptive statistics summarised respondent characteristics, drug-use patterns and academic-related indicators. Chi-square tests and independent t-tests assessed group differences, while multivariable logistic regression identified predictors of psychoactive drug use. Multiple linear regression examined the association between psychoactive drug use and self-reported CGPA, with statistical significance set at p ≤ 0.05.Results
The prevalence of psychoactive drug use was 7.7% (95% CI: 6.6%-9.1%). Alcohol (68.9%) and marijuana (30.3%) were the most commonly used substances, while stress relief (42.4%) and recreational use (29.5%) were the leading reasons for use. Male students (aOR = 2.28; 95% CI: 1.54-3.37), undergraduates (aOR = 2.65; 95% CI: 1.22-6.57), students earning ₦25,000 - ₦125,000 (aOR = 2.42; 95% CI: 1.46-4.08), and those earning ≥₦125,001 (aOR = 4.52; 95% CI: 2.19-9.17) had higher odds of drug use. Compared with non-users, drug users more frequently reported difficulty concentrating, sleeping during lectures, missing lectures, missing continuous assessments, failing at least one course, and dropping an academic semester or year. However, no significant difference was observed in mean CGPA or satisfaction with CGPA between the two groups and psychoactive drug use was not significantly associated with self-reported CGPA in multiple linear regression (aβ = -0.09; 95% CI: -0.21-0.04).Conclusions
Psychoactive drug use was observed among students in tertiary institutions in Rivers State, especially males, undergraduates, and students with higher personal income. Although psychoactive drug use was not significantly associated with self-reported CGPA, it was linked to certain adverse academic-related indicators, including poorer concentration, absenteeism, missed assessments, course failure, and dropping an academic semester or year. These findings support the need for targeted prevention strategies, campus-based counselling, and accessible rehabilitation referral services.