Beyond the Smoke: A Phenomenological Study of Health and Social Implications of Kush Use Among Sierra Leonean Youths

Background: The rising use of "Kush" among Sierra Leone's youth is a public health concern. Kush, a concoction of Cannabis indica and synthetic substances, symbolizes the broader issue of drug misuse in low-income settings. This study explored the intricacies of Kush use among young Sierra Leoneans, highlighting the gravity of the crisis. Methods: The research employed a phenomenological method, gathering insights through Focus Group Discussions (FGDs), Key Informant Interviews (KIIs), and In-Depth Interviews (IDIs) to understand motivations and repercussions of Kush consumption. Selecting participants from diverse socio-demographic groups, the study included habitual users and those in vulnerable situations. Ten interviews were analyzed thematically, facilitated by NVivo software and Concept maps, to distill information. Results: Findings identified numerous reasons for Kush use, from managing stress and trauma to seeking social belonging and economic necessity. Users experienced severe health issues, economic instability, and productivity loss. The effects varied by Kush strain, underscoring its heterogeneous nature. Despite a strong will to quit, influenced by health, family, and aspirations, youths faced hurdles like withdrawal symptoms, peer pressure, and scarce support systems. Conclusion: Kush consumption in Sierra Leonean youths is entwined with socioeconomic and post-conflict factors, leading to significant adverse effects. Effective intervention requires a multifaceted strategy, focusing on underlying drug abuse causes and providing robust support systems. This study calls for tailored measures and policies that acknowledge the complex motivations behind Kush use and its impacts, aiming to foster an environment conducive to youth empowerment and health. Keywords: Kush, Prevention Strategies, Youths, Sierra Leone ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Funding was through the capacity development funds of the IDRC supported West African One Health Research under the Collaborative One Health Research Initiative on Epidemics (COHRIE) ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Njala University Institutional Review Board reviewed and gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request.