Substance Addiction Among Youth in Northern Cyprus


This review paper reports on a study that investigated substance addiction among youth living in Northern Cyprus related to an increase in the use of illegal substances in Northern Cyprus is noticeable compared to previous years. A critical review of literature was undertaken, and the purpose of this study is to compare research findings related to substance addiction among young people internationally with that of Northern Cyprus in order to create mechanisms for the individuals, their families, educational institutions, and government agencies to use to help addicted individuals. The findings revealed the increase in drug use among young people in the past 15 years and that the preferred substance were cannabis, synthetic cannabinoids, ecstasy, and cocaine. Finally, the findings of this research can be considered beneficial especially in identifying the risk factors and create mechanisms to help overcome this problem as well as to conduct more preventive studies.

Keywords: Substance addiction, youth, Northern Cyprus, youth, prevention of addiction, roles of stakeholders

Substance use in North Cyprus

The rate of illegal substance use in Northern Cyprus was determined as 3.0 - 11.7% between 2003 and 2017 (Çakıcı et al., 2003; Çakıcı et al., 2006; Çakıcı et al., 2019) which are lower than in Europe and the USA. However, an increase in the use of illegal substances in Northern Cyprus is noticeable compared to previous years. According to the UNODC World Drug Report 2022, “around 284 million people aged 15-64 used drugs worldwide in 2020, a 26 per cent increase over the previous decade. Young people are using more drugs, with use levels today in many countries higher than with the previous generation. In Africa and Latin America, people under 35 represent the majority of people being treated for drug use disorders. Globally, the report estimates that 11.2 million people worldwide were injecting drugs” (n.p). The findings of this report reveal the seriousness of the situation for the young not only in Northern Cyprus, but worldwide.

In recent years, many studies have been carried out in Northern Cyprus, and the current situation has been revealed by comparing the research findings on substance use in different years, especially in primary, secondary, high schools and universities. The studies of Çakıcı et al. for the last 20 years were analyzed and presented in a report in 2021 by the Anti-Drug Commission which revealed the substance use status of students at different educational levels (North Cyprus Anti - Drug Commision, 2021).

According to the results of a research at primary school level in 2015, it was determined that 10.9% of primary school 5th grade students smoked at least once in their lives, and the lifetime alcohol consumption rate of students was 23.5%. A study conducted in at-risk regions conducted in 2019 found that 17.0% of the students smoked at least once in their lifetime. In addition, in the aforementioned study, the lifetime alcohol consumption rate of primary school 5th grade students was determined as 27.6%.

The findings of studies conducted in 2015 and 2019 on secondary school level substance use conducted are briefly presented here. The 2015 study found an 8.7% rate of smoking at least once in a lifetime among all secondary school youth; 36.3% rate of alcohol use; 4.9% rate of other psychoactive substance use. The research was repeated with the same methods in 2019 and found that 10.9% of the students smoked at least once in their lifetime. In the study, lifetime prevalence of alcohol use in the same age group was determined as 40.1%. The rate of students trying any alcohol usage in Days Per Month (DPM) for life was determined as 5.3% in 2019, with the lifetime use rate of cocaine, heroin, amphetamine, LSD and ecstasy between 0.3-0.9%. It is noteworthy that the use of ecstasy, which is one of the most used substances increased threefold from 1996 to 2004.

As for smoking and alcohol consumption, the 2019 study found the rate of smoking at least once was determined as 35.8% and the rate of alcohol use at least once in a lifetime was 67.4% while the lifetime use of other psychoactive substances was 9.1%. The rate of smoking at least once in a lifetime among Turkish Cypriot high school students was rated as 31% in 2015, with an increase to 35.8% in 2019.

Studies conducted in Northern Cyprus on the substance use of university students in 2019 found that the lifetime smoking rate of students was 64.9% and the lifetime alcohol use rate was found to be 65.8%. The study found that the rate of illegal substance (DPM) use was 16.7%. In terms of substance preferences, the study found that the most commonly used illegal substance was cannabis, accompanied by the use of synthetic cannabinoids.

A 2017 study conducted one thousand people to represent the general public in Northern Cyprus, the frequency of lifetime smoking was 60.9%; the frequency of alcohol use was 63.5%; and the frequency of DPM use was 11.7%. It has been observed that the use of illegal substances has increased gradually in Northern Cyprus since 2003, while the most frequently used substances are cannabis, synthetic cannabinoids, ecstasy, codeine syrup and sedative drugs. Cyprus is a small country which facilitates the easy distribution of substances which allows for easy access to such substances thus increasing the rates of substance use among the population.

Considering the above research results, substance use can be considered a severe threat to young people. As such, it is imperative to identify the risk factors for substance use for young people in an effort to provide recommendations to implement preventive measures. This is covered in the final section of the Findings.


A qualitative approach was utilized using a literature review to generate the data drawn by accessing current work undertaken in this area. Reports, theses, and articles from the past as well as current work were accessed and thoroughly scrutinized for information that could be extracted to answer the research questions. The reason why past years’ work was used in this study is to allow for an in-depth understand of the nature of the issues as they have evolved over the years, and since this paper also aims to provide recommendations, past seminal work may hold valuable information that cannot be underestimated or overlooked in the search for ways to overcome this extremely serious life debilitating issue of substance addiction among young people.

Risk Factors of Addiction for Youth

To get a handle on any issue, the primary step to take is to identify the risk factors and the potential consequences those factors could have. The National Institutes of Health (NIH) (2019) identifies the top risk factors for opioid use disorder as the following: region, age, race, sex, education, occupation, poverty level, previous prescription opioid use, psychiatric comorbidities, and region. Other risk factors include psychiatric comorbidities.

Addiction to substances, which is closely related to substance use disorders (SUDs), represents a large and growing public health problems that account for nearly 6% of the burden of disease on a global scale (Degenhardt et al., 2018). One way to look at it is as an issue with multiple facets, some of which are mental health, cultural norms, biological factors, and predispositions (Hatoum et al., 2022). In addition, substance use disorders (SUDs), which include both substance abuse and substance dependence (Saunders, 2017), are neuropsychiatric conditions characterized by a recurrent desire to continue taking a substance or drug despite the fact that doing so will have negative effects on one's life (Zou et al., 2017). The DSM-5 criteria to identify substance use disorder are outlined in American Psychiatric Association (2013). According to these criteria, an individual exhibiting two to three symptoms is considered to be in the mild category; four or five symptoms is considered to be in the moderate category; and six or more symptoms is considered to be in the severe category (Saunders, 2017). Each individual substance is treated as a distinct form of substance use disorder. One of the most common types of mental illness is substance use disorder (SUD). In a different research, researchers performed in-person interviews with 36,309 adults as part of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions–III. This survey was a cross-sectional representative survey of the United States. During the months of February and March in 2015, data were evaluated. According to the findings, the prevalences of Drug Use Disorder (DUD) over the course of a year and throughout a lifetime were, 3.9% and 9.9% respectively (Grant et al., 2016).

Individual Risk Factors

The argument that genetics play a significant role in addiction and addiction patterns has been strengthened in recent years by the study of predispositions and genetic patterns in DNA. According to Rylaarsdam (2018), "Recent advancements in genomic analysis and gene expression profiling are beginning to advance our knowledge of genetics to addiction" (p.232). The advancement of DNA technology has led to new discoveries, which in turn contributes to the growth of the body of knowledge surrounding the genetics of behavior, with a specific focus to addiction,

The importance of a family history of substance abuse as a risk factor for substance use disorder is supported by a significant body of research in the field (Merikangas et al., 1998). There is a possibility that a significant portion of this risk is inherited. In studies on adoption conducted by Cadoret et al. (1995) genetic risk factors were found to have a potentially significant impact. They discovered that offspring of biological parents who were alcoholic had a higher risk of developing a substance use disorder (SUD), even if they were separated from their biological parents at birth. The offspring of biological parents who were antisocial had an even greater risk of developing a substance use disorder via a path that began in childhood aggression and behavior problems. Studies involving behavior genetics and twins have also been used to investigate the heritability of a substance use disorder (SUD) and to differentiate between genetic, shared environmental, and individual environmental factors.

, having a family history of substance use disorders, being young, and having a comorbid psychiatric disorder such as major depressive disorder, bipolar disorder, or posttraumatic stress disorder are all factors that increase the likelihood of developing a substance use disorder (Grant et al., 2016). The consequences associated with substance use disorders are staggering and include compromised physical and mental health, increased spread of infectious disease, loss of productivity, reduced quality of life, increased crime and violence, increased motor vehicle accidents, increased instances of child abuse and neglect, and increased costs associated with health care (Day, 2018).

, or the proportion of observed variation that can be attributed to genetic factors, has been estimated to be anywhere between 40 and 60 % in the case of SUD. Cocaine (72%) was found to have the highest heritability, while hallucinogens (39%) were found to have the lowest (Goldman et al., 2005). According to Verhulst et al’s (2015) research, the heritability of alcoholism is 50%, while the heritability of opioid addiction ranges from 23% to 54% (Kendler et al., 2000).

Regarding the findings related to candidate genes, which have traditionally been selected on the basis of biochemical hypotheses (Agrawal et al., 2012), several significant genes have been identified that are related to metabolism (alcohol dehydrogenase) or to neurotransmission. In addition, several candidate genes that were found to be associated with both metabolic processes and neurotransmission (dopamine, serotonin, or gamma-aminobutyric acid). These genes were found to be associated with two or more instances of SUD: OPRM1, DRD2, DRD4, BDNF, and SLC6A4 (Lopez-Leon et al., 2021). A recent study from Turkey provided new insights about the individual risk factors related to substance use, specifically with respect to the role of Alexithymia, Depression, Somatization, Age, Gender, Attachment Styles (Ünübol & Sayar, 2022).

- There is some evidence that prenatal exposure, at least to alcohol, may constitute a risk factor for an adolescent substance use disorder that is independent of the genetic risk. This risk factor is beginning to emerge (Yates et al., 1998).

- Certain personality constellations may put an individual at a higher risk for substance use disorder (Glantz & Sloboda, 1999). Individual temperament is a constellation of characteristics that are present from birth, largely stable throughout life, and may form the basis for personality. It may constitute a risk factor through the interaction of the individual with their environment. In light of this investigation, it is pertinent to discuss a few key temperament clusters. Behavioral disinhibition, which is characterized by under-control, impulsivity, and sometimes aggression, has been shown in a number of studies to often predict later substance use as well as poor behavioral outcomes. According to research conducted on adolescents, another temperamental trait that may be predictive of the likelihood of developing a substance use disorder is a desire for novel experiences or sensations (Wills et al., 1994).

- The findings of several population-based studies have shown that individuals who begin using substances at an earlier age than the majority of their contemporaries are more likely to develop a substance use disorder (SUD), and this finding does not appear to be an artifact caused by a longer period of follow-up (Hanna & Grant, 1999).

- Glantz and Sloboda (1999) and Weinberg and Glantz (1999) offer an in-depth discussion of the high rates of comorbidity, also known as the co-occurrence, psychiatric disorders and substance use disorders. In addition to substance abuse, a strong correlation has been found between conduct disorder and substance use disorders (Biederman et al., 1997). In point of fact, there might be significant genetic connections between a behavioral disorder and a substance use disorder, at least for alcoholism (Slutske et al., 1998). The co-occurrence of internalizing (mood and anxiety) disorders and externalizing (conduct or impulsivity) disorders should be considered because it may in itself predispose children to developing an SUD (Windle & Windle, 1993). It is common knowledge that both genetic and environmental factors play a significant role in the etiology of SUD (Prom-Wormley et al., 2017).

Environmental Risk Factors

As was mentioned earlier, a history of substance use disorder in the family is a strong indicator of the likelihood of substance use disorder in the offspring, and numerous parenting factors have been linked to increased likelihood of substance use disorder (Kumpfer et al., 1998). In addition to the transmission of susceptibility to substance use disorder through genetics, parents who use drugs may also influence their children through specific factors, such as modeling drug use, and nonspecific factors, such as marital discord or exposure to stress. Specific factors include modeling drug use. Nonspecific factors include marital discord or exposure to stress (Merikangas et al., 1998). Genes and the environment interact in very important ways; as a result, the environment may either increase or decrease the likelihood that certain vulnerability genes will be expressed in an outcome associated with a substance use disorder (SUD). A study of childhood and adolescent aggression that utilized an adoption paradigm provided an example of this type of interaction (Cadoret et al., 1995). When compared to children who did not have this known predisposition, it was discovered that children who were born with a biological predisposition to antisocial behavior were more sensitive to conditions in the adoptive home when it came to the manifestation of aggressive behavior during the development process. Therefore, it is unclear when family influences act directly as risk factors, when they act as interaction factors, and when they act as biological risk markers. In addition, the majority of the studies that were conducted on the topic of familial risk factors did not differentiate between the risk factors for substance use and the risk factors for an SUD. Studies on parental supervision have shed light on a few of these issues to a greater or lesser degree. The results of many of these studies found a correlation between inadequate parental monitoring and the use of substances by adolescents (Hawkins et al., 1992). Despite the fact that there is evidence that a maternal substance use disorder is linked to low levels of parental monitoring, however, only a small number of these observational studies controlled for the presence of parental substance problems (Chilcoat et al., 1996).

A common contributor to the development of substance use disorders in adolescents is having friendships with people who partake in drug abuse (Hawkins et al., 1992). It is unclear, however, to what extent peers actually influence use and to what extent the selection of these peers is more of a marker for high risk. Peers are more likely to influence use when they share similar characteristics. According to Iannotti et al. (1996), adolescents may exaggerate or misreport the degree of substance use among their peers, which results in inflated estimates of peer association. Furthermore, despite the fact that influences from vulnerable adolescents' peers may mitigate or moderate the risk of initiating substance use, factors at the individual level probably play a larger role in the progression to a substance use disorder once the use has begun.

By making it easier to obtain substances of abuse, a risky environment may be able to influence the kinds of behaviors that are associated with substance abuse. Having easy access to substances lowers the barriers involved in acquiring, using, and abusing substances, which in turn makes it easier to start using substances and opens the door to the possibility of abusing them. Environments that are highly accessible to tobacco, alcohol, and illegal drugs not only make it easier for people with substance use disorders to acquire substances, but they also may contain environmental cues that cause cravings for those substances (Mennis et al., 2016).

The idea that someone's geographic location can make them more likely to develop an opioid use disorder is baffling. Drug trafficking is more prevalent in areas that have easy access to highways that cross the country. This makes it simpler to supply an area with illegal drugs, which in turn makes that area a risk factor for exposure to opioid abuse (O'Donnell et al., 2017).

Over the course of the past few decades, there has been a significant shift in the culture of nations, which has allowed for a shift in perception regarding the use of and abuse of drugs. According to Hulvershorn (2019), "the public perceives cannabis as a safe source of recreation or even as a cure-all therapy" (p. 39). As an illustration, a growing number of people in the United States are turning to the use of cannabis as a means of alleviating anxiety, treating minor ailments, and assisting in the treatment of a variety of other conditions associated with curing. Cannabis is increasingly being used for recreational purposes, despite the fact that it is essential for the medical community and the culture of the nation to have an understanding of the medicinal properties of cannabis. This has resulted in cannabis becoming a sought-after item because it is perceived as being less harmful than other popular drugs. In recent years, the United States has fostered a culture of using mind-numbing substances to avoid the reality of daily disappointments, frustrations, and catastrophic events. This has been coupled with hands-off parenting methodologies, which have further contributed to the development of this culture. As the country continues to struggle under the weight of high addiction rates, the requirement for cultural shifts becomes an important component in the fight against addiction as well as many other behaviors that are associated with it, such as criminal activity. Many aspects of a person's behavior in everyday life are influenced by their culture, which frequently results in the individual turning to self-medication to cope with challenging circumstances.

Responsibilities of the individual, family, educational institutions and society in preventing addiction

Current understanding of the biological and psychological factors that contribute to addiction has been fundamentally altered by recent advances in science. There is a tremendous potential to translate this vast knowledge base into meaningful advancements in the prevention and treatment of SUDs, which will not only benefit addiction medicine but also the treatment of multitude of health conditions that are triggered or exacerbated by drug use. This would be beneficial to both fields (Schulte & Hser, 2013).

A number of different prevention interventions for substance use disorder have been developed on the basis of epidemiological data identifying factors that increase risk for or provide resilience against SUDs. These interventions are evidence-based and have been shown to be effective (Volkow & Boyle, 2018).

Table 1 - Strategies include decreasing risk factors and enhancing protective factors at the individual, family, community or school, and societal levels
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The development of personalized interventions to reverse or mitigate some of the deficits that have been identified is now possible because of our increased understanding of the effects of substance use on normal brain development, the deleterious effects of adverse environments, and the role of innate vulnerabilities. For instance, adverse social environments during early childhood can result in delayed prefrontal limbic connectivity, which is associated with impulsivity (Ersche et al., 2012; Govindan et al., 2010). As a result, impulsivity is a reliable indicator of increased susceptibility to SUD (Moffitt et al., 2011). However, children can be taught to improve their ability to self-regulate and, as a result, learn to control their impulsivity through training. In addition, being socially isolated and exposed to social environments with limited support are associated with lower levels of dopamine D2 receptor expression in the striatum which is linked with increased susceptibility to impulsivity as well as compulsive drug use (Martinez et al., 2010). Additionally, studies are beginning to identify changes in brain development that are triggered by early exposure to drugs such as alcohol and marijuana (Squeglia et al., 2015; Zalesky et al., 2012). Future access to standardized measures of brain development will support the development of early interventions to mitigate developmental vulnerabilities or counteract negative neuroadaptations. In this regard, the recently initiated Adolescent Brain Cognitive Development Study, which aims to study 10,000 children with brain imaging, genotyping, and deep phenotyping across the transition from childhood into adulthood, will provide valuable data for determining normal human variability in brain development and how it is disrupted by drug use and mental illnesses (National Institutes of Health, 2015). In a similar vein, the Baby Connectome Project, which is a study of brain development in children from birth up until the age of five years old (Volkow & Boyle, 2018), will provide insight into the early development of the human brain at a stage when it is most sensitive to the negative effects of adverse environmental factors, such as neglect and abuse.

Preventive therapies that do not involve the use of drugs include neural stimulation technologies, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep-brain stimulation, and peripheral stimulation devices, as well as behavioral interventions (Volkow & Boyle, 2018).


For the case of Northern Cyprus, serious efforts should be made to reduce supply and demand for drugs, to formulate and enact laws to prevent drug addiction. Studies to reduce personal and social problems arising from substance use are gaining importance in Northern Cyprus. Addiction Awareness Training activities should be carried out for the whole society. In addition, educational activities focused on creating awareness of the dangers of substance abuse should be implemented in the curriculum of educational institutions. Continuous training programs should be created and implemented in order to raise awareness of students, teachers and families about the fight against drugs.

It must be noted that the fight against drugs is a holistic process that requires simultaneous participation from stakeholders in the fields of prevention, education, treatment and rehabilitation. Hence, it is imperative that all institutions and organizations and even the society act together in order to combat drugs to win the fight. This obligation pushes the institutions concerned to apply scientific processes which ensures that the acquired knowledge and experience is transferred to the stakeholder institutions and individuals.

Social interventions and policies, psychosocial support programs, and strengthening the treatment and rehabilitation capacity in both the public and private sectors are the most important steps to be taken. With the social adaptation center prepared for the empowerment of these individuals, the integration of these individuals into the society (job, food, education, asylum services) can be ensured. In this way, the individuals concerned will develop basic life skills and be able to live a healthier, more productive life. In addition, vocational training courses can help individuals from disadvantaged socio-economic backgrounds to be gainfully employed which will help increase their self-confidence.

Substance addicts and those at risk of addiction should be supported by rehabilitation processes involving clinical psychologists and experts in the field of addiction. It is crucial to support people with programmes specially designed to cater to their needs by applying personalized psychotherapy methods, individual interviews or group therapies. Prevention programmes play a significant role in the fight against substance addiction, with the function of delaying the age of onset of substance use and making it difficult to start other substances. Therefore, it seems possible to keep individuals completely away from substance addiction with life skills that were gained at an early age through prevention programmes. Everyone has a responsibility to protect especially children and young people against the drug problem, which poses a great danger in Cyprus and in the world. Families have a great responsibility in this regard. It is a fact that family-oriented studies are important in prevention programs developed against substance use.

Considering the significant increase in drug-related crimes in Northern Cyprus in recent years, it is necessary to determine the causes and risk factors behind drug use or crimes and to identify the deficiencies experienced in the supply, use, addiction, treatment and rehabilitation of drugs. Considering the studies in the international arena, it is an inevitable necessity that the Prime Ministry Anti-Drug Commission in Northern Cyprus should be legally institutionalized. In addition, it is of great importance in the fight against drugs to carry forward the national state policy development studies initiated within the Prime Ministry Anti-Drug Commission.


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30 December 2022

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Taçoy, S. (2022). Substance Addiction Among Youth in Northern Cyprus. In A. Güneyli, & F. Silman (Eds.), ICEEPSY 2022: Education and Educational Psychology, vol 3. European Proceedings of International Conference on Education and Educational Psychology (pp. 151-163). European Publisher.