The Senate has conducted public hearing on the matter and existing laws are being reviewed and new ones crafted to combat the present and future danger associated with drug abuse. I am aware that the Minister of Health has set up a committee to investigate what can be done to reduce or eliminate access to some of the drugs that are being abused. Some organizations, like the Pharmaceutical Society of Nigeria (PSN), have also activated different machineries to help the society combat the problem.
The problem is much bigger than we can imagine, and we are probably waking up a little late in the day but certainly not too late. It may not be too much to speculate that there is not one of our tertiary educational institutions or even the primary/secondary ones, that is free of drug abusers. We will be deceiving ourselves to think or believe that the situation is limited in geography or age.
There is practically no major city in Nigeria that does not have hideouts or joints or clubs or ram-shackles where the young ones gather to buy or use drugs of different descriptions to feel good. Before 2013, Nigeria was only considered as a transit nation for illicit drugs but now, we are an internationally recognized user nation. We should be wary of the iceberg phenomenon or effect that this subject may present.
Drug abuse, according to Wikipedia, is a ‘patterned use of a drug in which the user consumes the substance in the substance in amounts or with methods which are harmful to themselves or others’. It is the inappropriate use of substances including alcohol, prescription medication, illegal drugs for purposes such as pleasure, to feel or perform better in certain situations, or to change one’s perception of reality. Drugs are chemical substances that are used in measured amounts to confer health benefits on the user.
Whenever these substances are used in manners that are not consistent with the prescribed standard, then abuse or misuse set in. The danger, however, is that drugs, in performing their roles in the body; tend to alter the physiological pattern of behavior of the system and if the exposure is prolonged, can lead to physical, psychological and physiological damage. Abuse of drug can lead to drug addiction (and drug dependence) and for ease of comprehension, they are both regarded as Drug Use Disorder.
Abusing substances creates both changes in behavior and in the way the brain works, specifically in the areas governing judgement and reward
Anyone can become a drug abuser and current information indicates that all ethnicities, social groups and genders can have drug abuse problems. It should be noted that drug abuse is not a character flaw but rather it is a medical condition that has developed over the
time. There is no established fact that drug abuse runs in the family. However, there are theories which tend to explain the predisposing factors. In the personality theory, there are some personality traits, including inability to delay gratification, low tolerance for frustration, poor impulse control, high emotional dependence on other people, low self-esteem and others; that could make an individual to abuse drugs.
The learning theory on the other hand relates drug abuse as arising from learning such as in conditioning, instrumental or social. In the biological factor theory, individuals may abuse drugs due to biological or genetic factors which make them to be vulnerable. For the social cultural theory, the abuse of drug arises from the social cultural environment of the people involved. For example, certain cultures or beliefs permit the consumption of alcohol, others do not. It is important to know that no theory fully explains the etiology of drug abuse because of individual differences and it can only be treated as acquired disorder and such acquisition depends on a plethora of factors including personal inclinations, environmental factors and others that some scholars have packaged together as the ‘triadic reciprocity involving behavior, environment and the person’. Apart from these theories, the causes of drug abuse, according to many sources, can be linked with factors including experimental curiosity, peer influence, parental influence, socio-economic conditions, extra energy requirements by youths engaged in hard prolonged labour at early ages, drug availability (ease of access) and the pain of withdrawal (withdrawal syndrome) which motivates further abuse.
The drugs that are commonly abused include but not limited to: i) Legal, over the counter drugs (Alcohol, cigarettes, caffeine, inhalants, etc) ii) Legal, prescription drugs (Benzodiazepines, barbiturates, Methadone, oxycodone, Tramadol, codeine, Morphine etc) iii) Chemicals iv) Illegal drugs (cannabis or marijuana, opiates, heroin) v) Stimulants (methamphetamines and cocaine) and hallucinogens. Drug use disorder is a common problem affecting about 5% of the world population on the average and estimated 8% in the USA. Figures from the National Survey on Drug Use and Health (NSDUH) showed that approximately 27 million Americans or 10.2% of the population over the age of 12 used illicit drugs in 2014. In Nigeria, it was reported recently that about 3 million codeine containing cough preparations are consumed daily in Kano and about 6 million bottles in the Northwest.
The National Drug Law Enforcement Agency (NDLEA) report of 2010 showed that over 11% of people in the Northwest zone use drugs. In May 2016, the NDLEA Director-General reported that 40% of Nigerian youths engage in drug abuse. The signs and symptoms of drug abuse are easy to recognize if one is observant enough.
The Adolescents and Health Information Project (AHIP, 2001) gave the following as the watch list: possession of drug related paraphernalia such as pipes, rolling paper, small decongestant. Odour of drugs, smell of incense or other cover up scents, identification with ‘Drug Culture’ e.g. having drug related magazines, slogans on clothing and displaying hostility in discussing drugs, signs of ‘Physical Deterioration’: Memory lapses, short attention span, difficulty in concentration, poor physical coordination, slurred or incoherent speech; unhealthy appearance, indifference to hygiene and grooming, bloodshot eyes, dilated pupils and changes in behavior (distinct downward performance in school, place of work, increased absenteeism or tardiness, chronic dishonesty, lying; cheating and stealing, having trouble with the police and other law enforcement agencies, frequent change of friends, evasiveness in talking about new ones and increasing and inappropriate anger, hostility, irritability, secretiveness, etc).
The consequences of drug abuse are varied and devastating for the individuals involved, the family, nation and the international community. There are medical problems associated with drug abuse which include mental disorder, liver cirrhosis, lethargy, irritability, cardio-vascular disorders, etc. The social consequences are numerous: school dropout, cultism, violence, armed robbery, lawlessness, cultural disorientation, rape, assassinations, loss of productivity, etc. The cost to the society is humongous. It was reported that drug related issues cost about £20billion a year in UK and $181billion in USA in 2002.
There is no single test that can definitively diagnose someone with a drug use disorder and healthcare professionals rely on information gathered from family and medical history and follow up physical examination and laboratory tests. It is important to know that drug addiction is treatable and can be successfully managed. It can also be prevented, and it is in our collective interest to join hands in finding a lasting solution the problem of drug abuse in our society.
Drug abuse is worse than any other issues confronting us as it can destroy everything we have now and severely constrain our future.
To combat this resurgent menace, a multi-dimensional approach is recommended which will involve: i) The Family: parents should create enough time to attend to the needs of their children and guide them properly to adulthood. They should handle them with empathy and avoid putting unnecessary pressures on keeping with the high society demands. The family size should be limited to reflect the socio-economic status for a total well-being. Ii) The Community/Religious groups: The religious/community leaders should take active part in resolving the crisis at hand and help to prevent further occurrences through their utterances and action.
To combat this resurgent menace, a multi-dimensional approach is recommended which will involve: i) The Family: parents should create enough time to attend to the needs of their children and guide them properly to adulthood. They should handle them with empathy and avoid putting unnecessary pressures on keeping with the high society demands. The family size should be limited to reflect the socio-economic status for a total well-being. Ii) The Community/Religious groups: The religious/community leaders should take active part in resolving the crisis at hand and help to prevent further occurrences through their utterances and action.
They should also ensure that the family unit is kept intact. There should be effective communications and may be the time has come for the setting up of ‘Drug abuse vigilante groups’ for early detection and containment iii) Youth Groups: To positively use peer pressure to move their colleagues away from drug abuse and prevent new cases from occurring iv) Government: There is urgent need to empower the relevant agencies through adequate funding to discharge their duties appropriately. The agencies should be alive to their responsibilities and ensure that drugs do not find their ways into wrong hands.
Government must ensure that the drug distribution system is sanitized and access to dangerous drugs is severely restricted. Everybody involved in the handling of drugs must be brought under regulatory control.
The economy must be stimulated to provide jobs for the unemployed and the teeming population joining the labour market every year. An alternative means of engagement (e.g. through sports) must be provided to take the youths out of the street v) Professional and trade groups: Everybody must be involved in the efforts to educate the youths and limit the availability of drugs to professionals only.
The Pharmaceutical Industry comprising of all the manufacturers, importers, distributors and retailers have a big role to play. They must be extra vigilant in the handling of sensitive drugs that are prone to abuse by youths.
Drug abuse is a self-destructive indulgence that leads to significant problems and distress. It has suddenly assumed an alarming proportion among youths in Nigeria and could get worse if care is not taken. We must do something now to stem the tide before it brings calamity on our society.
Lolu Ojo, Consultant Pharmacist
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