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DECLARATION

This research proposal is the product of my original work and is not done in any collaboration whatsoever; it has not been presented before to this or any other institution as a credit of qualification.

PRESENTED BY: TANUI KIMUTAI DENNIS

COLLEGE NUMBER: D/PHARM/16001/206

SIGNATURE…………………………………………

DATE…………………………………………………

APPROVAL

This undersign certify that she read and recommended to the department of pharmacy the acceptance of the research proposal entitled A STUDY ON THE EXTENT OF CANNABIS SATIVA ABUSE AMONG STUDENTS IN KENYA MEDICAL TRAINING COLLEGE ELDORET CAMPUS.

SUBMITTED BY: TANUI KIMUTAI DENNIS

RESEARCH SUPERVISOR: DR.PHOEBE KIGUNDU

SIGNATURE……………………………………

DATE……………………………………………..

DEDICATION

To Almighty God who has been the utmost source of my strength and divine inspiration in every achievement.

To my loving family Dad, Cleophus Kendagor,Grace Tanui and brothers and sisters.

ACKNOWLEDGEMENT

My sincere gratitude goes to my supervisor Dr.Phoebe Kigundu for her close and professional guidance, variable advice and contributions that led to a successful completion of this proposal writing.

Secondly to my family for their tireless support all through the process.

Finally to my close friends whom worked closely and believed in me, may the best be in store for their destinies, leisher Nyawira, Shaddrack kipchirchirand Sharon Jeptum.

LIST OF ABBREVIATIONS

WHO -World Health Organization.

NACADA -National Campaign against Drugs Abuse.

DAWN -Drug Abuse Warning Network.

NIDA -National Institute on Drug Abuse.

ICD -International Classification of disease.

MOH -Ministry of Health.

KMTC -Kenya Medical Training College.

ABSTRACT

Drug abuse is the habitual intake of addictive or illegal drugs.[Lewiston et al 2005].cannabis sativa, being one of the most abused drugs, the abuse can be defined as administration of cannabis in quantities not recommended for non-medical purposes. The abuse of cannabis sativa amongst college students in both Kenya and most parts of the world is still a disturbing issue to the health and education sector but more alarming since so far no permanent measures have been put in place to ensure a lasting solution in curbing and managing the menace, due to this, as a researcher, in this proposal entitled A STUDY ON THE EXTENT OF CANNABIS SATIVA ABUSE AMONG K.M.T.C STUDENTS ELDORET CAMPUS, I sort to;

i. Find out the factors that influence the cannabis sativa abuse in the college.

ii.Identify the effect of cannabis sativa abuse on students in the college.

iii.Find out on the strategies by institution’s management to curb the abuse of cannabis sativa among

the college students.

The study will be carried out in KENYA MEDICAL TRAINING COLLEGE ELDORET CAMPUS. Results obtained will be presented in tables and pie charts.Questionnaires and interviews will be used in data collection

Table of Contents DECLARATION i APPROVAL ii DEDICATION iii ACKNOWLEDGEMENT iv LIST OF ABBREVIATIONS v ABSTRACT vi CHAPTER ONE 1 1.0 INTRODUCTION. 1 1.1 Background Information 1 1.2 Problem statement 1 1.3 Justification 2 1.4 Objectives 3 i. Broad objective. 3 ii. Specific objectives 3 1.6 Research Question 3 1.7 Assumptions 3 1.8 Limitations and delimitations. 3 Limitations 3 Delimitations 3 CHAPTER TWO 4 2.0 LITERATURE REVIEW 4 2.1 Introduction 4 CHAPTER THREE 8 3.0 RESEARCH DESIGN AND METHODOLOGY 8 3.1 study Area 8 3.2 Study population 8 3.3 Sampling method 8 3.4 Study Area 8 3.5 Background Information 8 3.6 Data collection 8 3.7 Data analysis and presentation 9 REFERENCE 10 APPENDIX I; WORK PLAN 11 APPENDIX II: 12

vii

CHAPTER ONE

1.0 INTRODUCTION.

1.1 Background Information

Cannabis sativa abuse is the use of cannabis for its non-medical purposes, in quantities and frequencies which may impart inability to function and result in physical, social and or emotional harm.

Attending college has been associated with finding oneself academically, socially and spiritually. During those undergraduate years, the young students are faced with new ideas that may change their perceived norms, may be introduced to an academic field that sparks a lifelong carrier, or may establish (or disengage) faith in higher power. Students are exposed to host factors that impact their collegiate experience; some yield a positive influence, whereas others may produce a more nefarious impact on lifelong learning.

The use of cannabis sativa and other substances is a global phenomenon with a long history. According to [Alder Freda.et al 1995:320], they trace the use of chemical substances that alter the normal behaviour to the Stone Age period. They observed that the Egyptians, from 350 BC relied on depicted opium in religious rituals, cannabis sativa being one of the chemical substances, it has a rich history of 5000 years.

Cannabis sativa is the most commonly used illicit drug with an index of [17.43 million past-month users] according to the February 2010 National Survey on Drug Use and Health [NSDUH].Its use is most common among adolescents and young adults, this issue has negatively challenged the youthful population wasting the prime of their lives when they are most needed to invest in worthy nation building ventures [Kenya Times, July 4th 2003].with the same intensity, the abuse has greatly affected the academic sector in Kenya, particularly the tertiary institutions.

The world drug report (2010), indicates that cannabis sativa remains the world’s most widely produced and used as illicit substance. The same report contains a chapter on the extent of cannabis abuse in colleges and estimates that there’s an increase in marijuana abuse by 3% annually among the college students, which should be a cause of alarm to all stake holders.

1.2 Problem statement

Kenyan institutions have its share of drug abuse [and by extension, drug trafficking] among students, affecting the academics and the security of the institutions. Kenya Medical Training College Eldoret campus being no exception.

[Ndirangu,200] for instance, observers view that cannabis sativa abuse among Kenyan youth is a social catastrophe in waiting, similarly, according to [NACADA,2004]drug abuse especially cannabis sativa in Kenya is widespread and cuts across all social groups with the youth being more affected which translates to the extent of abuse within youth in the college.

In Kenya, cannabis sativa and other substances abuse is increasingly recognized as a serious problem with negative consequences on the; academics, health, security, socio-physiology, economic and cultural development of the individual drug abuser and the community at large. Previous studies have established that cannabis sativa abuse affects the age bracket of 10-25 years, normally, the learning age and most expected productive age bracket especially academically.

Unfortunately over 60% the age group is reported to be victims of cannabis sativa abuse,40%being students in college .[NACADA,2006]

According to National AIDS Control report,2016, drug abuse among the youth in colleges is directly related to increase in new HIV/AIDS infections. Second after Alcohol, was marijuana.This poses a great threat to the future of both the nation and generation.

1.3 Justification

According to WHO Mental health plans 2013-2020, adolescents are among venerable groups in the society with increased risk of mental health problems and risk of first exposure to substance use which eventually lead to addiction. More than 50% mental health disorders in adults develop by the age of 14 years, so prevention and strategies should be implemented among aged adolescents to teach them about the risks related to substance use.[WHO,2013].within the context of drugs use worldwide, especially among adolescents, the WHO developed the Global school-based Student Survey, which has already been used in most of the participating countries included in the

Multi-centric project. These adolescents are part of the ones in schools e.g. colleges.

Chile, in 2013, conducted a survey and data revealed that among youth aged 18-23 years,27.4% had tried marijuana at least once. Of these, 60.9%had tried it before 18 years.[Ministerial de Saluda de Chile,2013].

Effects of the abuse within learning institutions are so much serious in terms of deterioration of learner’s health, insecurity, but most seriously on academic performance. In accordance with the most recent report by NACADA, Nyanza reign branch, showed that Nyanza is the second leading drug abusing region in Kenya after coastal region, with marijuana being on the lead. The close proximity of Nyanza to Eldoret could be a major contributing factor to the abuse of cannabis sativa within the KMTC facility.

Progressive increase in the rate of youth first use of cannabis sativa before the age of 18 is growing concern that needs a solution. The proposed study will investigate the extent of this cannabis sativa abuse with KMTC Eldoret campus being the area of study.

1.4 Objectives

i. Broad objective.

To determine the extent of cannabis sativa abuse among KMTC Eldoret campus students.

ii. Specific objectives

1. To find out the factors that influence cannabis sativa abuse in the college.

2. To identify the effect of cannabis sativa abuse on the students in the college.

3. To find out strategies of managing the abuse of cannabis sativa among the students in the college.

1.6 Research Question

1. What factors influence the abuse of cannabis sativa in the college?

2. What are the effects of the abuse?

3. What measures are being taken to curb the abuse?

1.7 Assumptions

Co-operation from those taking part in questionnaire answering.

1.8 Limitations and delimitations.

Limitations

The respondents may give wrong or false information on the items from the questionnaire.

Delimitations

This study will be carried out and confined to the sample population may not project the exact picture of cannabis sativa abuse in the whole institution.

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Introduction

There are number of drugs being abused in the society currently, cannabis sativa, also marijuana being among the most abused drug. There is a strong scientific support concluding that cannabis sativa has high potential abuse and addiction. Diagnostic guidelines by both The International Classification of Disease [ICD] and the Diagnostic and Statistical Manual of Mental Disorders [DSM] have designated that cannabis sativa is addictive and currently recognize cannabis related dependence disorders.

By 2014, cannabis sativa had the highest rate of use, with the cohort of 20-29 year olds consuming the most. In 2013,it was estimated that about 6.6 million[10.25%] had used cannabis sativa in the previous 12 months. About one in 20 Australians [5.3%] had used cannabis sativa in the month prior to the survey and 3.5% had used in the previous week.

Among people aged 14-24, the age at which they abused cannabis sativa had increased between 2010 and 2013, cannabis users were more likely to try cannabis at their teens. The age of first use was younger compared to other illicit drugs. One third [32%] of recent cannabis users used it as often as weekly.

One fifth of recent cannabis sativa users stated all or most of their friends currently used the drug in contrast to only 0.8% of those who had never used cannabis. In parallel with the US, between 2010 and 2013, the proportion of people aged 59-60 or older using cannabis rose [from 5.5% to 7.3% and from 0.5% to 1.2%, respectively], which is the highest levels seen over the past decades, this may reflect an aging cohort of cannabis users.

According to [Bell, Wechsler &Johnson, 2007] approximately 25% of college students have used marijuana within their past years. Ultimately, with one fourth of college students using marijuana.

For more than a decade, researchers have commonly noted a steady increase in marijuana use among college students. Researchers completing a longitudinal study segregated marijuana users into two groups, past

30-day and past year’s users. The percentage of 30-day marijuana users increased from 13% in 2003 to 17% in 2007 while, the past- years marijuana users rose from 23% in 2003 to 30% in 2007.Report from [The Higher Education Centre for Alcohol and Other Drug Abuse and Violence prevention, 2008]

College can be a time where parental surveillance is at an all-time low and where young adults experiment with high risk behaviour before having to face the responsibilities in adulthood. About 33% of college students on marijuana reported that they first experimented wit he substance when they were 18 or older.[Gledhill-hyot,lee,storte,&Wechsler,2006] .

One study focused on cannabis use with first year college students and found that marijuana use was the highest in freshman year in college and progressively declines with each following year but an increase at the end of the academic year proving that when weather is of warmer temperatures and enforcement is not as intense, it becomes an ideal time for colleges to use [Dierker et al, 2000]

The most recent study at University of Maryland college park focused on marijuana use with first year college students found that one in ten incoming freshman were considered, by clinical definition, to have cannabis use disorder. Another concern, among the students who had used marijuana five times or more over time,[40.1] reported concentration problems, regularly putting themselves in danger,[24.3%],driving under marijuana influence,[18.6%] and oversleeping hence missing classes at[14%](caldeira et al.2008).

According to Monitoring Future Report [Johnstone,O Malley,Bachman,&schulenberng,2006,2008]indicated that 37% college students had used illicit drugs,28% of the cases being marijuana.

To address the social and academic impacts of marijuana use has n our college students,[Mattew J.Burcherding,st.Cloud university]guided by Austin (1985) theory of involvement, the social aspect of involvement examine the effective psychology domain. The literature demonstrates the impact of marijuana on intellectual development [Goode,1971,Indlekofer,et al;2008;Lynkey&Hall,2002;wadsuorthmoss,simpson&smith,2006]and specifically on one’s ability to recall information, as well as the conception that marijuana linked is immotivational syndrome-a pattern of behaviour linked to apathy and an overall lack of motivation.

The NACADA 2012 countrywide survey among students and school leavers revealed that substance of abuse both licit and illicit were forming a sub-culture among Kenyan youth. Contrary to common assumptions, the survey showed that substance abuse was wide spread with youth being the most hit; surprisingly, across all social groups with the most common abused drugs being alcohol, khat and cannabis.

According to National statistics from the Rapid Situation Assessment of Drugs and substance Abuse in Kenya,[NACADA,2012]11.7% of people aged 15-24 are current users of alcohol,4.7% Khat while 1.5% are users of cannabis. In addition, the median age of initiation to tobacco products is 10% years while minimum being 8 years.

Several number of authors and researchers have shown that there are many contributing factors to drug and substance abuse among the students. Drug abuse is caused by a combination of factors; Environmental, biological and psychological [Agrawal&Dick, 2008; kuppin&carprino, 2006].The most influential include the family, peer association, school performance and social membership. The family especially parents are the child’s basic socializing agents.

Maithiya [2012] and Muchemi[2013] indicate that a child gains his/her first standards of behaviour from the teachings of the parents and other grown up persons around them. They further argue that if the child observes a distinctive between the parents behaviour.Chesang[2013] associates delinquency, for example alcohol and marijuana abuse with inconsistent and abusive parental discipline owing to diverse socialization agents, such as the peer group, teachers, the mass media, the government and the church interaction with various people, the young people are acquiring values that are beyond those of their localized culture. Since the family is less involved in the socialization of the young, very little is communicated to the young people in the way of values and customs of the locality.AS a result, the traditional value system has been eroded leading to drastic moral decay. According to the Sunday Standard Newspaper report by Kibet[June 2014],peers have high degree of influence only when parents have abdicated their traditional supervisory roles.Hence,active and involved parents may be able to limit the influence of peer groups on young people’s attitude towards use of drugs and substance and therefore have a crucial influence on children’s behaviour.

Reports on the impact of substance abuse on academic activities indicate that it interferes with physiological, psychological and emotional functioning. Among the common problems recorded are impaired memory and other intellectual’s faculties and tracking inability in sensory and perceptual functions [Agrawal & Dick 2008].Further, the habit creates preoccupation with acquiring the substances, adverse psychopatethetic complications and the social development. This may lead to truancy, lack of concentration in studies among [Eisenstein, 2005].Reduced cognitive efficiency leads to poor academic performance and thus lowered self-esteem. This highly contributes to instability in individual’s sense of identity, which in turns is likely to contribute to further substance abuse, thus creating a vicious circle [Hawkins et al 2005].Other studies have expounded that it is not only those who abuse substances that are affected. Students who abstain frequently suffer the second hand effects from the behaviour of other students who are psychoactive substance abusers [INCB, 2006]

All forms of cannabis have negative, physical and mental effects. Substantial increase in heartbeat, bloodshot eyes and dry mouth and throat, increased appetite are just some of the characteristics of its use. Use of cannabis may impair or cause short term memories and comprehension, alter sense of time and reduced ability to perform tasks requiring concentration and coordination for example driving. Research shows that those who use them like students do not retain knowledge when under the influence. Motivation and cognition may be altered making the acquisition of new information difficult

Marijuana use among college students has grown steadily over the past decade and the consequences of the abuse has be harmful to the students and has had an effect on their health and well-being later in life. Proven studies have shown that marijuana users are likely to be violent, smoke cigarettes, have less cognitive abilities, and have lowered grade point averages compared to non-user students. College and higher learning institution’s administration should be aware of the fast growing trend and implement prevention and intervention programmes to students.

As one of the means, colleges have tried to curb the cannabis sativa abuse and other illicit drug abuse, guidance and counselling department being in the forefront with a greater role. According to Botvin[2000],guidance is a broad area of educational activities and services aiming at assisting students in achieving satisfactory adjustment in life. While counselling is the part of the guidance process which essentially helps students in dealing with frustrations and obstacles that may interfere with their daily academic lives.

The Kenyan Government has recognized the seriousness of drug abuse in colleges and in the country at large hence initiated the National Campaign against Drug Abuse [NACADA}in early 2001.this organization Is charged with the responsibility of coordinating activities of individuals and organization in the campaign against drugs. There should be a collaborative arrangements institutions boards, law enforcements officers, treatment of organization and non-governmental organizations. There is also need for the colleges to be in contact to be in contact with social workers and counsellors. Clear and specific rules regarding drug abuse should be established.

There should be increased cooperation between anti-narcotics agencies of the three East African countries, Kenya, Uganda and Tanzania. This will help improve information exchange that will facilitate drug seizures and arrests of drug traffickers. All stakeholders should be in harmony and agreements in cooperating and help students to free from the abuse. More commitment among the institutions is needed to curb the abuse. This will go a long way in saving the future generation

CHAPTER THREE

3.0 RESEARCH DESIGN AND METHODOLOGY

3.1 study Area

The study will be done at Kenya Medical Training college Eldoret campus.

Study design

An observation will be conducted in all college students of both genders to get their opinion on the abuse of cannabis sativa abuse.

Questionnaires will be given out to the students who will only be willing to answer, no student will be forced into taking part of the exercise. The questionnaire will be designed to evaluate

The attitude and knowledge about cannabis sativa abuse.

Inclusion criteria

Questionnaires will be given to all students who will agree to take part.

Exclusion criteria

Questionnaires will not be given to students who will be unwilling to take part in the exercise or unable to understand the instructions.

3.2 Study population

The research subjects will be students residing in the college.

3.3 Sampling method

The sample will be randomly selected among students during their free time.

3.4 Study Area

The study will be carried out in Kenya Medical Training College Eldoret campus

3.5 Background Information

KMTC Eldoret campus, established in 1977 as a community nurses training institute, is located in Uasin Gishu county, Eldoret town, along Nandi road, opposite Moi Teaching and referral Hospital. The institution currently offers 11 courses with approximately 2000 students.

3.6 Data collection

Data will be gathered from the answered questionnaires.

3.7 Data analysis and presentation

Data collected will be arranged to correspond their respective genders and computed to come up with percentage responses to choices in the questionnaires.

REFERENCE

1. Dieker,L,Stolar,M Lloydn Richardson et al (2008)Tobacco Alcohol and Marijuana use among first years U.S college Students.

2. International Narcotics Control Board [INCB,2006].The Impact of drug abuse on crime and violence at community levelhttp://www.highbeam.com.

3. International Journal of Education and Research, volume 3 No.1 Jan 2015.

4. International Journal of Scientific and Technology Research Volume 2 Issue 6th June 2013.

5. Jackelinesec, Ms IHEC intern summer (2000)Marijuana use among college students.

6. Martindale,G,(2009);Marijuana use among College Students, retrieved from http://www.stateuniversity.com/blog/permalink/marijuana use among college students.html.

7. Muchemi R. (2003) Drug and Substance Abuse among people in the informal settlements within Nairobi. A paper presented to NACADA conference, Kenya (2013).

8. NIDA [National Institute on Drug Abuse],(June 2007) U.S department of Health and Human Services National Institute of Health.

9. Substance Abuse and Mental Health Services Administration Office of applied Studies; (2010) National Survey on Drugs Use and Health

10. The higher Education Centre for Alcohol and other Drugs Abuse and Violence Prevention [2008].Marijuana use among students of higher learning.Retrived from www.higheredcentre.org/files/product/marijuana pdf CORE marijuana rates.

11. Timberlake D.S.A comparison of drugs and dependence between smokers and other cannabis users. Substance use and misuse;(2009).

12. United Nations Office on Drugs and Crime.Cannabis review NACADA (2012).Report on rapid situation assessment of Drugs and substance abuse in Kenya, Nairobi Government printer.

13. UNODC;(2016),World Drug Report 2016.United Nation Office on Drugs and crime, Vienna Australia.

14. Matthew J.Borncherding(2016);Marijuana Use Among Community College Students.

APPENDIX I; WORK PLAN

month	Feb	March	April	May	June	July	August	Sept	Oct
Activity
Formulation Of research topic
Research topic presentation
Writing proposal
Submission of proposal
Data collection
Analysis of data
Report writing
Submission of report

APPENDIX II:

KINDLY TICK YOUR RESPONSE (you may tick twice where necessary)

1. Sex/gender……..[M] ……. [F]

2. Do you know anything about cannabis? [Yes] [No]

If yes; how did you know about it? [Here in college] [Before i joined]

3. Have you ever noticed the smell of cannabis around your place in school? [Yes] [No]

If yes; do you know of your friends using cannabis? [Yes] [No]

If yes; how many.[one] [less than five] [more than ten] if more write here…………..

4. Do you know of cannabis user? [Yes] [No]…if yes how frequent do they use?[In the morning only]

[Once a day] [Any time] [Weekends] [Just before and during exams] if other specify………………………….

5. Have you used cannabis before?[yes] [no] if yes why do you use it?[for fun] [because friends use]if other specify………………………if you don’t use; have you been influenced before by friends? [Yes] [No] if yes…how often [Always] [When we meet] [Never]

6. What effect did you notice on academics if cannabis is used?[no effect] [improvement] [poor performance] if other specify…………………..

7. What effect does cannabis have on behaviour? [Violent] [Normal] [Lowered concentration] if other specify……………………….

8. Are you aware of drug abuse rules by the school? [Yes] [No]

9. Has any of your friends been caught for cannabis abuse? [Yes] [No]

10. What action was taken against him/her? [Forgiven] [Suspended] [Taken to police station] [Taken to the guidance and counselling] if other specify………………….

11. Do you have a guidance and counselling or rehabilitation in school?[yes] [no]

12. From your view what’s the number of cannabis users compared to other drug users? [Higher] [Lower] [I don’t know]

13. From your view how should the school handle cannabis abuse in your school? ……………………….

NB; THE ABOVE INFORMATION WILL BE KEPT CONFIDENTIAL.

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