What Protects At-Risk Young People in India From Using and Abusing Substances? A Photo-Led Study of Lived Experience

Youth substance abuse is widespread in India. Data is needed to inform the focus of prevention approaches. Our aim was to understand the perspectives of Indian young people about what protects them from substance (ab)use, and our study followed protocols approved by UK and Indian university research ethics committees. We recruited 15 Indian adolescents from Assam (seven males, eight females) aged 15 to 18 years at elevated risk because they had family/friends who were substance addicts. Participants took part in a photo-led interview in which they represented visually and narratively their experience of resisting substances (ab)use. Data were analyzed by a UK-India team using reflexive thematic analysis. Seven dominant protective factors were expressed by young people, including nurturing and communicative relationships with parents; up close and personal observations around addiction which left participants fearful of substances; protective mindsets and resolutions emerging from participants’ reflection on drug culture; staying away from “bad” company; being repulsed by substances; having healthy ways to cope at difficult times; and having something that mattered more than using substances. Findings show the resilience of Indian adolescents and suggest that prevention approaches in India should focus on augmenting individual, school and family mechanisms which appear dynamic and cumulative.