The Escalating Crisis of Narcotics Use Among Youth in Mogadishu, Somalia A Community Based Mixed Methods Study

Background Narcotics use among youth is a significant global public health challenge, particularly in conflict-affected regions like Somalia. Somali youth, comprising a substantial portion of the population, face myriad vulnerabilities amplified by political instability and limited opportunities. This study aimed to investigate the prevalence, patterns, and contributing factors of narcotics use among youth in Mogadishu, Somalia, to inform targeted public health interventions. Methods A community-based mixed-methods study was conducted in Mogadishu from September to December 2023. The quantitative component involved a survey of 420 youth aged 12–25 years, selected via multistage random sampling from four districts. Data were collected using a structured, interviewer-administered questionnaire. The qualitative component consisted of semi-structured in-depth interviews with seven purposively selected homeless youth who use narcotics and seven key informants from relevant sectors. Quantitative data were analyzed using descriptive statistics and logistic regression, while qualitative data underwent thematic analysis. Results Quantitative findings indicated that among the surveyed youth, lifetime use of specific opioids was reported, with self-reported addiction rates of 6.9% for oxycodone and 8.3% for pethidine. Homelessness was strongly associated with the use of hydromorphone (Crude Odds Ratio 30.3, p < 0.001), oxycodone (COR 25.9, p < 0.001), and pethidine (COR 44.6, p < 0.001). After adjustment for potential confounders, these associations remained statistically significant. Qualitative analysis revealed that peer pressure, widespread unemployment, pervasive drug availability, and the use of narcotics as a coping mechanism for stress and trauma were primary drivers of use. Participants reported easy access to opioids through pharmacies and social networks. Conclusions The study underscores an escalating crisis of narcotics use among youth in Mogadishu, fueled by complex socioeconomic factors, drug availability, and peer influence, with homeless youth being exceptionally vulnerable. There is an urgent need for multisectoral interventions, including strengthening legal and pharmaceutical regulations, expanding education and employment opportunities, and establishing sustainable, youth-friendly, non-stigmatizing rehabilitation programs. Comprehensive policy responses must address the socioeconomic determinants of youth drug use in Somalia.