Climate variability, poverty and substance use disorders: Exploring maladaptive coping mechanisms in climate-stressed communities of Northwest Nigeria.

BACKGROUND: Northwest Nigeria is highly vulnerable to climate variability and heavily dependent on rain-fed agriculture, which exacerbates existing socioeconomic vulnerabilities. AIM: This study aimed to explore the link among climate-induced stress, poverty, and mental health outcomes, particularly substance use as a maladaptive coping mechanism, in this region. SETTING: The study was conducted in Kano, Kaduna, and Katsina in Northwest Nigeria. METHODS: A cross-sectional study was conducted among 20 000 adults aged ≥ 18 years from 40 randomly selected communities. Data were collected using validated instruments: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Kessler Psychological Distress Scale (K10), the Coping Strategies Inventory-Short Form (CSI-SF), and a Multidimensional Poverty Index Questionnaire. Robust statistical analyses, including multivariable logistic regression with cluster-robust standard errors, were employed. RESULTS: The prevalence of high-risk substance use (ASSIST ≥ 27) was 18.5% (n = 3700). Cannabis was the most commonly misused substance (12.4%, n = 2480), followed by prescription opioids (9.1%, n = 1820) and alcohol (7.8%, n = 1560). High psychological distress (K10 ≥ 20) was identified in 45.2% (n = 9040). Over 85% (n = 17 000) were multidimensionally poor. Maladaptive coping strategies were strongly correlated with both poverty (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.85-3.42) and high psychological distress (OR: 4.85, 95% CI: 4.48-5.25). CONCLUSION: This study reveals a concerning syndemic of climate-related stress, profound poverty, poor mental health, and substance use in Northwest Nigeria. Associations suggest substance use may function as a maladaptive coping mechanism in the context of climate-induced economic hardship, though causal inference is limited by the cross-sectional design. CONTRIBUTION: Findings underscore the critical need for integrated public health interventions that address mental health and substance use disorders within the context of climate adaptation and poverty reduction strategies.