SUBSTANCE ABUSE

By Dr. Onwah Uzuazo

Have you ever used a controlled substance? Do you personally know anyone who has?
There isn’t a lot of reliable information on drug use in Nigeria, but according to the UNODC in 2007, over 10% of Nigerians consume Cannabis (Indian Hemp, Igbo) at least once in their lifetime. That would be a little under 20 million Nigerians.
Drug abuse is more common among males than females, and most people use for the first time between 10 and 29 years of age. Other drugs commonly abused are volatile solvents like glue, petrol, acetone and toluene; cocaine, heroin and tobacco.

Effects of abuse
Drug abuse is usually associated with crime, and in fact is a crime itself which is punishable by law. According to the NDLEA Act, the unlawful use or possession of these substances is punishable with up to 25 years imprisonment.
More importantly, illicit drug use causes direct harm to the user. Generally, most of these illicit drugs are addictive. This means that it is hard to use them only once. Every drug causes changes in an individual who uses them, some reversible, some permanent, and with repeated use these changes are amplified.

Cocaine use can lead to sudden death from cardiac arrest or respiratory arrest, and seizures. Crack cocaine, which is cocaine that can be smoked, is most times adulterated with levamisole to give it that ‘smokable’ consistency. Levamisole causes agranulocytosis – bone marrow depression.
Heroin use can lead to dependence. It can also cause abscesses, infected heart valves, blood-borne infections, constipation, and pneumonia, usually from the needles used to inject it. Heroine is also the leading cause of deaths from drug overdose worldwide.

Marijuana, also called we-we, ganja, igbo, indian hemp, is a gateway drug. It contains more cancer-causing chemicals than tobacco smoke.
Tobacco, contained in cigarettes, cigars, snuff, pipe tobacco and chewed tobacco, can lead to heart disease, lung cancer and emphysema, peptic ulcer disease, and stroke.
Continuous use of volatile solvents (mostly abused through inhalation by youngsters between 10 – 18 years old), can lead to acute kidney failure.
Tramadol and Cough Syrup abuse can cause loss of memory and impaired respiration.

Causes of abuse
In spite of all these, why do people still use these drugs?
Commercial sex workers, labourers, commercial drivers and even law enforcement agents believe that narcotics increase their energy for long working hours.
According to a recent WHO/FMOH/University of Ilorin study on drug abuse in Lagos/Nigeria, Injecting Drug Use (IDU) is now common among street youth or ‘area Boys’.
The general poverty level increases the pressure for survival and at the same time the vulnerability of street children, who turn to these substances for some form of relief.
Continuous use of these addictive substance leads to dependence, where withdrawal of the drug in question leads to several physiologic reactions, aka withdrawal syndrome, which can range from mild to severe. Sometimes the effects are so serious that the abuser uses the drug again to avoid the withdrawal syndrome, continuing the vicious cycle.

Remedy
So, what’s the solution?

Successful treatment involves:
– Detoxification (the process by which the body rids itself of a drug)
– Behavioral counseling.
– Medication (for opioid or tobacco addiction)
– Evaluation and treatment for co-occurring mental health issues such as depression and anxiety.
– Long-term follow-up to prevent relapse.
Currently, treatment and continuing care is offered at hospitals and some NGOs and faith-based organizations.
Abstinence is key, but is only practicable with counseling and harm reduction services. NDLEA offers counseling at its state commands across the country.
There needs to be more sensitization and drug prevention programmes. Drug users are stigmatized, and it’s worse for those who develop mental illnesses as a result. Drug users, when discovered, are more likely to be taken to prison than to a hospital, even though the cause of their problem is medical.
People who abuse drugs need to know that they can find help in hospitals, and among family. It is safer to go to a doctor before the police comes for you.
There are at least 19 medical sites in Nigeria offering drug dependence treatment, but a lot more needs to be done about remedies for substance abuse.
You can help create awareness by talking to people about it, and spreading the right information about the need to focus more on treatment for substance abuse, than on punishment.

Reference: Dr. Onwah Uzuazo

Dr. Onwah Uzuazo is a practicing physician in Public Health.He loves literature and education, and hopes to make health information more accessible in an accurate and yet interesting form.
You can reach him on twitter @ouzuazo

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