A Social Ecological Analysis of Substance Use Trajectories Among University Students in South Africa

Abstract

Substance use among South African university students unfolds within persistent socio-economic inequality and substance-related harm. Drawing on 40 qualitative interviews with current and former students in Durban, this study examines how substance use is initiated, sustained, and intensified during higher education, guided by the social ecological model. Trajectories were shaped by financial strain, academic pressure, emotional distress, peer networks, and prior community exposure. Substances reported included alcohol, cannabis, nyaope, and methamphetamine, with trajectories differing by substance type. Early normalisation intersected with campus environments to facilitate escalation; for some, use shifted from experimentation to dependency where psychosocial support was limited, with avoidance of withdrawal symptoms becoming central to continued use. Data were collected between September 2020 and July 2021, during the COVID-19 pandemic, amplifying existing vulnerabilities. The study frames substance use as a structurally shaped social problem, with implications for multi-level, gender-responsive, substance-specific interventions.