Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Leslie A. Curry

Second Advisor

Nathan B. Hansen


Background: Substance abuse has a significant impact on the health and well-being of post-conflict populations; however, little is known about substance use in Liberia. Available evidence was generated during the immediate post-conflict period or has not focused on the populations at greatest risk. Because patterns of substance use may have shifted 10 years after the end of the conflict, this study aims to outline the current patterns of substance use and the risk factors for and consequences of substance use among high risk groups in Monrovia, Liberia. Methods: A qualitative design using in-depth, in-person interviews with current and former substance users (n=20) and key informants (n=21), representing a variety of organizations. Interviews were audio recorded, transcribed, and analyzed by a multidisciplinary team of four, using the constant comparative method. Results: Findings characterize the key war-related, economic, social, and individual risk factors for substance use in Liberia. Participants also described the consequences of substance use for individuals (dependence, physical health and social consequences) and for broader communities (crime, violence, and sexual risk). A conceptual model was developed to depict the relationships between risk factors for and consequences of substance use, as described by participants. Finally, this study provides basic information about the substances most commonly used in Liberia captures the terminology employed by substance users in Liberia. Conclusions: This study describes the implications of substance use for development, health and safety in post-conflict Liberia. The conflict directly contributed to an increase in substance use; however, there are additional related risk factors present for substance use. Findings provide a contextualized foundation to inform future quantitative research to estimate the magnitude of the problem and test the associations between risk factors and consequences. Given the scope and nature of substance use in this already vulnerable setting, recommendations for substance use-related policies and programs are provided.


This is an Open Access Thesis.