PREDICTORS OF SUBSTANCE USE AMONG ADOLESCENTS AND YOUNG POPULATION IN SAUDI ARABIA: A SYSTEMATIC REVIEW

Substance use remains a significant public health concern among adolescents and young people in Saudi Arabia. This systematic review synthesizes available evidence on the prevalence and predictors of substance use in this population. It critically appraises study quality to identify gaps and future research needs. Following PRISMA guidelines, a systematic search of PubMed, ScienceDirect, and Google Scholar was conducted for English- and Arabic-language articles published between 2015 and 2025. Eligible studies were independently reviewed and analyzed. Qualitative synthesis generated thematic findings, while meta-analysis estimated pooled prevalence and odds ratios. Study quality was assessed using the Newcastle–Ottawa Scale. A total of 24 studies were included, encompassing psychiatric patients or individuals with Substance Use Disorders (SUDs), students, and population-based samples. The pooled prevalence of substance use was 26.0% (95% CI: 14.5–42.4%) among psychiatric patients and 18.9% (95% CI: 9.2–31.0%) among students. Amphetamines, cannabis, alcohol, and heroin were most common among patients, whereas alcohol, tobacco, hallucinogens, and inhalants predominated among students. Predictors of substance use spanned six domains: demographic factors, comorbidities and psychopathology, smoking behavior, family factors, peer influence, and attitudes toward substance use. Peer influence, smoking, family conflict, and comorbidities consistently increased risk, while parental support was protective. Methodological limitations included a lack of longitudinal designs and theoretical frameworks. These findings inform targeted prevention and policy initiatives addressing youth substance use in Saudi Arabia.