Family member perspectives on substance use among adolescents and young adults in Zimbabwe

Abstract Adolescent and young people’s substance use is deeply embedded within family systems, yet the experiences and needs of family members are often overlooked, with greater emphasis typically placed on their role in supporting treatment. Drawing on the stress–strain–coping–support model, this study explored how families experience and respond to youth substance use in a low-resource setting. An exploratory qualitative design was employed, with 19 family members of individuals under the age of 24 receiving treatment for substance-related conditions at a tertiary mental health facility in Harare, Zimbabwe purposively recruited. In-depth semi-structured interviews were conducted in Shona or English, audio-recorded, and transcribed verbatim. Data were analysed using codebook thematic analysis in NVivo 12. Participants described youth substance use as both a family and community issue, shaped by broader social and structural contexts. Families experienced chronic stress and strain across multiple domains, including financial hardship, relational conflict, and emotional distress. Responses to these challenges were complex and dynamic, ranging from active engagement and support to tolerance and withdrawal. While many participants reported feelings of helplessness, others described developing adaptive coping strategies over time. Participants also highlighted unmet support needs and offered recommendations for more responsive prevention, treatment, and rehabilitation services. These findings underscore the significant and multifaceted impact of youth substance use on family systems and highlight the importance of family-centred, contextually grounded interventions that address both individual and systemic factors in low- and middle-income African settings.