Michael Mireku¹*, Kwame Peprah Boaitey ¹, Benjamin Botwe ¹, Irene Kretchy 2
1 Pharmaceutical Society of Ghana, Baatsonaa off Spintex Road, Accra 
2 University of Ghana School of Pharmacy, University of Ghana-Legon, Accra

Introduction: It is estimated that the prevalence of drug use disorder may have increased in Africa in recent times. There is reportedly high use of tramadol, codeine and diphenhydramine among the youth in Ghana. Prescription opioid misuse, while not as common as cannabis abuse, is important because of its wide-ranging consequences. Yet, the menace is inadequately characterized. This study was conducted to determine the factors associated with use of tramadol, codeine and diphenhydramine among Junior and Senior High School students in the Brong Ahafo region.

Methods: A cross-sectional study was conducted involving 1 Junior and 1 Senior high school in each of 5 randomly selected districts in the Brong Ahafo region. A structured questionnaire was used to extract relevant data from students. Multiple logistic regression was used to determine the likelihood of a student being a user of tramadol, diphenhydramine or codeine.

Results: While tramadol awareness was almost universal (96%), diphenhydramine awareness was 14 % and 27% had heard of codeine. Of all respondents, 11% (95% CI: 9.5 – 12.8) reported to having ever used any of the drugs. The prevalence of tramadol, diphenhydramine or codeine use among the students was 9% (95% CI: 7.1 – 10.0) with 94% of them using tramadol, 7% using codeine and 5% using diphenhydramine. Two-thirds (66%) of students who were abusers of tramadol were taking a total of more than 100 mg daily. The factors associated with being a current user were; religion of mother (10.10, 95% CI: 1.6, 63.6), student being a worker relative to a non-worker (AOR= 1.58, 95% CI: 1.001, 2.50), student’s class; JHS 2 (AOR= 2.94, 95% CI: 1.16, 7.45); JHS 3 (AOR= 8.06, 95% CI: 3.21, 20.25); SHS 1 (AOR= 5.00, 95% CI: 1.99, 12.59); and SHS 2 (AOR= 2.85, 95% CI: 1.15, 7.10) relative to JHS 1 students. 

Conclusion: The factors that influence the use of tramadol, diphenhydramine or codeine among students include mother’s religion, student’s working status and class.