CHAPTER ONE
INTRODUCTION
1.1    Background of the Study
         Adolescence is “the period of life that starts with the biological, hormonal and physical changes of puberty and ends at the age at which an individual attains a stable, independent role in society", (Balocchini, Chiamenti, & Lamborghini, 2013). During adolescence one is vulnerable to engaging in a lot of risky behaviours. Substance abuse is one of such set of behaviours. Adolescents experience many problems , including teen pregnancy, alcohol and drug use and violence, school failure and eating disorders (Callaham, 2003, Stein, Jaycox, kataoka, Rhodes; & Vestal ,2003).
         Adolescence is a period when people usually begin using substances such as alcohol and other kinds of drugs, (Chia, et. al. 2015). Adolescence is also a period of intense brain development, and mind-altering substances could potentially have more of an effect at this stage compared with other age groups. The use of psychoactive substances by adolescents has been the topic of extensive research activity over many decades. Adolescence is also seen as a critical period both for starting to smoke, drink or use other drugs and for experiencing more harmful consequences as a result.
         Substance use is when someone consumes alcohol or drugs. Drug use is a broad term to cover the taking of all psychoactive substances within which there are stages: drug-free (i.e. non-use), experimental use, recreational use and harmful use, which is further sub divided into misuse and dependence. This definition does not discriminate between alcohol, tobacco, caffeine, solvents, over the counter drugs, prescribed drugs, illicit drugs, rather it focuses on changes in the body and/or behaviour brought about through the use of such substances. These substances are also referred to as psychoactive drugs, meaning that they affect the central nervous system and alter mood, thinking, perception and behaviour.
         Equally, the definition makes no distinction between the legality, social acceptability or ‘value’ of drugs. Blanket definitions which attempt to cover these areas as well as the substance/user/affect nexus often have weak logic underpinning their meanings, making them vulnerable to challenge, particularly in terms of highlighting inconsistencies. For example, if alcohol and tobacco are not defined as drugs, what does that say about adult society which approves and endorses their use, (not minding the health and social costs they can both incur) but disapproves of the use of cannabis and ecstasy by young people.
         The use of multiple substances, sometimes termed poly-use, is perhaps the most disturbing. There are several theories that can account for the clustering of substance-use behaviours. On a biochemical level, frequent use of one substance may alter the dopamine system, and hence the reinforcement value of substances. On a psychological level, a positive evaluation of a used substance may generalize to other substances, including those not consumed before. Adolescents who smoke and drink regularly have more positive attitudes towards illicit drugs and higher odds of using them than non-smokers who do not drink . Factors like family cohesion and friends condoning substance use seem to have similar influences on adolescents’ indulgence in smoking, alcohol and marijuana use. Different forms of substance use may also have a common function. For example, both alcohol and cannabis can counter feelings of depression, and help to manage the after-effects of other drugs .
         Drinking, marijuana use and delinquent behaviours could all serve the function of ‘maturity landmarks’, or allow the adolescent to break societal norms.  Sensation seekers derive positive consequences from new experiences. For some, high-risk sports provide excitement; others are inclined to experiment with psychotropic substances. Finally, it is likely that substance-use behaviours co-occur because they occur in the same context. In many bunks, people drink alcohol and smoke. Expectancy-value theories, on the other hand, state that the immediate determinants of use are substance specific. For example, according to the theory of planned behaviour (TPB)  and related models, marijuana use is predicted by thoughts and feelings concerning marijuana use. If an adolescent happens to use a second substance (e.g. alcohol), intra- and interpersonal factors specific to alcohol use are the most important variables.
         Within an Irish context, young peoples' experimentation with drugs will often feature alcohol and/or tobacco, given their prevalence and the ease of access to them. Availability (particularly alongside curiosity), anticipation of effects, youth culture and current fashions regarding substance use each play a role in young peoples' experimentation with drugs. For the majority of people, experimentation is confined to those drugs which are socially acceptable. Experimentation with substances does not automatically lead to recreational drug use or, indeed, dependent use and may cease once the initial motivating factors have been satisfied.
        Issues of abortion for adolescents are embedded in the status and meaning of abortion in the country in which they are living. Unwanted pregnancies and abortion have existed since time immemorial. The seminal work of George Devereux in 1976 on the history of abortion around the world points to the frequency of abortion across cultures and time. Chinese, Greek and Roman cultures all developed systems of dealing with unwanted pregnancies and regulating population growth in their respective societies. The Egyptians were some of the first to create abortion techniques, which were discussed and reported in some of their first, and our oldest, medical texts (Devereux 1976). Today, abortion is one of the most common gynecological experiences; perhaps the majority of women will undergo an abortion in their lifetimes (AËšahman and Shah 2004). Despite its existence across time and its persistence across geographic location, the impact of abortion on women, families, communities and societies differs drastically across the world. Safe abortions – those done by trained providers in hygienic settings – and early medical abortions (using medication to end a pregnancy) carry few health risks (World health organization 2003). However, every year, close to 20 million adolescents risk their lives and health by undergoing unsafe abortions (Sedgh, G., S. Henshaw, S. Singh, E. Ahman, and I.H. Shah. 2007). Twenty-five percent of these women will face a complication with permanent consequences and close to 66,500 women will die (WHO, 2007). The majority of these women live in the developing world and half of those who die are under the age of 25 years (WHO 2007).