Three Barriers Keeping Ugandan Youth from Getting Help for Substance Use
I don’t belong here.” That’s how one young adult in Lango, Uganda, described being admitted for substance use treatment. A new study in Frontiers in Public Health reveals why so many young people in sub-Saharan Africa never seek or complete care for substance use disorders (SUDs).
1. Substance use starts early—and feels “normal.”
In many Ugandan homes, alcohol is part of daily life. Children often grow up helping parents brew waragi, a local spirit, and drink it casually with family. By adolescence, social drinking has already become routine, and peer pressure only deepens the habit. Many participants said they never saw alcohol—or even cannabis—as dangerous.
Prevention has to start early—before drinking becomes a family norm. School- and community-based programs that challenge these social norms could help delay or prevent first use.
2. Few people seek treatment willingly.
Most participants didn’t see their substance use as a medical problem. They came to the hospital only after a health scare—like blacking out from intoxication—or because family members forced them to go. Even then, many believed their problems were caused by witchcraft or stress, not addiction.
Awareness alone isn’t enough. Treatment programs need to be culturally sensitive, integrating community leaders, faith groups, and families to reframe SUDs as health issues rather than moral or spiritual failings.
3. Stigma and poor treatment experiences drive people away.
Many participants said being in a “mental hospital” made them feel ashamed. Some feared being seen there; others described being treated “like mad people.” Side effects from medication, strict rules, and lack of respect from staff fueled resentment and poor treatment compliance.
Reducing stigma and improving provider-patient communication are critical. Creating youth-friendly spaces that protect privacy and dignity could encourage sustained engagement in care.
The bigger picture: The Lango study shows how early social exposure, denial, and stigma form a perfect storm—keeping youth trapped in cycles of use and relapse. For Uganda and similar settings, integrating culturally rooted prevention, community education, and peer-led support may be the strongest prescription yet.
Which of these barriers feels most urgent for your community? Share this post to spark a conversation on how we can build more compassionate, culturally grounded responses to substance use.
