Background: The use of psychoactive substance is a social problem that has increased rapidly in educational institutions especially among secondary school students. Psychoactive substance use has caused significant burden to the individual and societies throughout the world. Despite the suspected high prevalence of drug abuse among adolescents in the Gambia, there are few studies on this major public health problem. Therefore, this study was conducted to determine the prevalence and patterns of drug abuse among senior secondary school students in the Gambia.

Methodology: The research was conducted among students in all-boys senior secondary school, situated in Banjul Area Council Zone within the city of Banjul, the capital of The Gambia as a pilot phase following invitation to give health education on drug abuse to the student population. The adapted WHO students’ drug use questionnaire was administered to consenting students after the permission of the school authority. Data was analyzed using Stata MP 17. Descriptive statistics were calculated and presented as frequencies and percentage distributions, whilequantitative data such as age were summarized using means and standard deviations (SD). The total score on knowledge was estimated and categorized into "good knowledge" (≥ 75th percentile) and "poor knowledge" (< 75th percentile). Associations between the outcome variables and demographic characteristics was determined using a chi-square test of independence with statistical significance set at P < 0.05.

Results: All respondents were male (100%) with mean (SD) age of 18.5(1.33) years. Most students were in grade 10 (50.7%). Lifetime Prevalence of use of any drug was 93.7%. The most used drug among the students was cigarettes (24.6%), followed by alcohol (23.3%) and cannabis (18.0%). The mean age at first use of these drugs ranged from 12-15 years. Among the participants, 44.7% possessed a good understanding of drug abuse while 33.1% of the respondents possessed a good understanding the consequences of drug abuse. There was no significant association between knowledge of drug use and socio-demographic profiles of the respondents

Conclusion: This study has shown a high prevalence of drug abuse among the students of the secondary school with initiation commonly occurring around the age of 13 years. This early onset suggests that students are being exposed to risk factors at a critical stage in their development. The findings underscore the urgent need for targeted interventions to curb this growing public health menace.