# Biopsychosocial correlates of psychoactive substance use among student athletes in Azerbaijan

## TL;DR

This study explores how psychological, social, and biological factors are linked to psychoactive substance use among student athletes in Azerbaijan.

## Contribution

The study introduces a new four-factor PAS Risk Questionnaire and explores biopsychosocial correlates of substance use in a post-Soviet student-athlete population.

## Key findings

- Substance use was positively associated with emotional exhaustion, perceived stress, and family conflict.
- Male athletes and older students reported higher substance-use behavior scores.
- Academic stress indirectly influenced substance use through emotional exhaustion.

## Abstract

Student-athletes in transitional post-Soviet societies may experience elevated psychosocial strain across academic, athletic, and socio-cultural domains, which may be associated with psychoactive substance (PAS) use. Empirical evidence describing PAS involvement within an integrated biopsychosocial framework in this population remains limited.

A cross-sectional survey was conducted among 1,503 student-athletes aged 17–25 years at the Azerbaijan Sports Academy (ASA). PAS-related characteristics were assessed using a newly developed, exploratory four-factor PAS Risk Questionnaire capturing social environment, psychological vulnerability, substance-use behaviours, and biopsychosocial stressors (internal consistency α = 0.74–0.85). Data were analysed using descriptive statistics, Pearson correlation analyses, independent-samples t-tests, one-way ANOVA, and mediation analysis (PROCESS Model 4).

Substance-use behaviour scores showed modest-to-moderate positive associations with emotional exhaustion (r = .44), perceived stress (r = .33), and adverse social-context indicators such as family conflict (r = .37), all p < .001. Male athletes and older students (21–25 years) reported higher substance-use behaviour scores compared with their counterparts (p < .01). Mediation analysis suggested an indirect association pattern in which higher academic stress corresponded to higher substance-use behaviour scores through emotional exhaustion (indirect effect, 95% CI [0.11, 0.22]).

PAS use among student-athletes in this context appears to co-occur with interconnected psychological, social, and physical stress-related characteristics, rather than representing isolated behaviours. These preliminary, exploratory findings highlight the potential importance of culturally responsive mental health and preventive strategies within sport-education systems. Given the cross-sectional design and the exploratory, non-validated nature of the PAS Risk Questionnaire, causal interpretations and generalization beyond this context should be made with caution. Further longitudinal research and independent psychometric validation of the instrument are warranted.

The online version contains supplementary material available at 10.1007/s44192-026-00392-w.