SUBSTANCE USE AND ADDICTION

Substance abuse disorders cause serious disability in a large portion of the population. These problems can be significantly reduced with early diagnosis and appropriate intervention. However, physicians diagnose less than half of patients and only a small percentage are referred for treatment. Additionally, illicit substance use impairs many aspects of functioning, and comorbidities affect 60-75% of patients with substance-related disorders. Eleven types of chemicals, including commonly abused pharmaceuticals, were identified, and other treatments and poisons that caused the condition were placed in the "other or unknown"category. Specific substance-related disorders include intoxication and withdrawal caused by substance use, as well as addiction and abuse, which are classified as substance use disorders. In addition to the difficulties of adolescence, university years also bring with them many problems such as leaving home and family, adapting to a new environment, uncertainty about career expectations, and job search. It is suggested that increased anxiety and stress resulting from these challenges contribute to increased tobacco, alcohol, and substance use among college students. The number of studies investigating the factors affecting substance use in Turkey is quite low. Substance use, which typically begins in adolescence, is greatly influenced by psychological, social and cultural factors. Young people may experiment with substances for various reasons, such as getting pleasure, meeting their social and emotional needs, escaping from problems and pursuing excitement. Numerous risk factors have been identified as precursors to smoking, alcohol and drug use among young people. These factors include family, peer, school, and personal characteristics, as well as social and environmental influences, as well as other risky behaviors. Negative attitudes and behaviors of family members may pose a risk for substance use during adolescence; Examples include substance use within the family and the family's high tolerance for such behavior. There are indications that there is a link between psychological characteristics such as self-confidence, self-esteem and social support and smoking, alcohol and substance use.

Drug users often exhibit low self- esteem. Increasing social support, self-confidence and self-esteem are suggested to be "protective factors" against substance use. Substance use can also be used to relieve symptoms associated with various psychiatric problems. Among these problems, lack of self- confidence, depression, attention deficit hyperactivity disorder, anxiety disorders and experiences of physical, sexual and emotional abuse stand out. Depression is the most common disorder associated with substance use in adolescents, followed by anxiety disorders and other psychiatric conditions. It is common for substance use to coexist with high levels of anxiety and anxiety disorders, suggesting a reciprocal relationship between them. While substance use can increase anxiety levels and trigger anxiety disorders, high anxiety levels and anxiety disorders can also increase the risk of starting substance use. The emergence of substance addiction in adolescents is closely related to family structure; Conflicts, family problems, weak family ties and lack of social support are important risk factors for substance use. Our study revealed that the risk of inhalant use is higher when anxiety levels are high and social support is low. Additionally, physical and or sexual abuse are important risk factors for substance use. Studies indicate that people who have experienced abuse may turn to substance use as a result of some psychological problems caused by this experience or as a way of coping with these problems. 

According to a study, the father's or sibling's smoking and alcohol consumption habits have been identified as factors that increase the likelihood of young people turning to cigarettes and alcohol consumption. In addition, the study revealed that a close relative's involvement in substance use increases the person's risk of using substances. Adolescence, a period heavily influenced by social and environmental factors, serves as a period of significant impact where examples and modeling of identity determination and sociocultural value judgments play an important role in learning. During this stage, young individuals are sensitive to positive and negative attitudes and behaviors from their environment. There are many publications that emphasize the importance of family members and close friends in starting substance use during adolescence. It is widely accepted that the prevalence of substance use in the family contributes to the tendency of young people to imitate such behavior. Most research consistently finds that the social environment in which young people live encourages substance use, especially in households where smoking and substance use are common.

In conclusion, cigarette, alcohol and drug use is common among university students, and there are a significant number of people who start smoking at university. Findings show a relationship between substance use and exposure to violence, high trait anxiety, and low perceived social support. It is seen that the substance use of members of the family and people in the immediate environment poses a risk in terms of substance use. University students should be considered as a risky group in terms of substance use and studies should be carried out to prevent them. First of all, policies to prevent substance use should be developed in universities. Programs can be offered to reduce stress and violence and improve life skills in university students. Medico-social centers of universities can be transformed into a structure that provides not only therapeutic health services but also protective and preventive services.

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