DRUG ABUSE AND PUBLIC HEALTH CONCERNS IN NIGERIA

By Rekpene Bassey

PART 2
Substance abuse has equally been implicated as one of the leading causes of the hepatitis C virus (HCV) infection. The virus is transmitted commonly through exposure to infected blood via injection drug use.
Another public health concern that has been linked to substance abuse is mood or affective disorder(s). such disorders which manifest commonly in bouts of depression and bipolar disorders have been noted as common psychiatric comorbidities among persons involved in substance abuse. The opinion of experts is that the pathological effect of mood or substance abuse disorder may increase the risk for the other. The outcome of related research findings shows that substance abuse and mood disorders have genetic links.

As investigators on the subject have also found out, the abuse of inhalants like fuel, glue, paint, pit toilets, markers and sprays among others has dire health consequences on chemical dependent persons. Most inhalants produce effects that resemble alcohol intoxication with initial excitation, then drowsiness, disinhibition, light-headedness and agitation. The outcome of empirical exposure to toxic substances such as toluence, butane, propane, paint-thinners and aerosol sprays is capable of causing serious damage to major parts of the human organs like the brain, kidney, heart and lungs. Abuse may also lead to loss of sensation, unconsciousness and depressed reflexes, confusion, delirium and what is known as sudden sniffer’s death (SSD).

Empirical inquires also link substance abuse to a plethora of other risk factors. Some of the other risk factors for substance abuse include biological, psychological or behavioral and social (or environmental) characteristics such as family history of substance abuse, depression or antisocial personality, or drug-neighbourhood exposure. Drug Demand Reduction (DDR) practitioners are of the opinion that the more risk factors a child or youth experiences, the more likely it is that s/he will experience substance abuse problems in adolescence or young adulthood.
At this point, let us examine some of the ways to tackle this problem. In this regard, we are going to look at our drug law policy, education, media activities, social/alternative activities and therapeutic communities.

There is urgent need to review the nation’s drug law policy. This point cannot be overemphasized and it is without disregard for the level of impact of the present policy on youth drug abuse. It is also imperative to ensure a balance between enforcement and persuasion or as Barbra Rambery puts it, to achieve synergy ‘between sanction and incentives’ in drug law policy. This persuasion particularly addresses the provision in section 6(1) (c) of the NDLEA Act 1989 which makes possession of illicit substances an offence under the Act.

Whereas the counselling function of the National Drug Law Enforcement Agency (NDLEA) as provided for under section 6 (c) of the NDLEA Act is significant and therefore noteworthy, the very fact that the agency has oversight for this service minimizes the extent of success that can be achieved. The main concern here is the provision in sub-section (1) (b) of the same section 6 which confers criminal status on every user and/or individual possessing illicit substance; and invariably substance abuse itself. Amendment of this part of the law will no doubt foster or rather engender NDLEA’s substance abuse prevention services beyond the present level of success. Otherwise an entirely new agency saddled with drug demand reduction (DDR) – – for prevention education, treatment, rehabilitation and/or after-care support should be created under the oversight of the Federal and State Ministries of Health; while NDLEA focuses strictly on interdiction, to wit: arrests, investigations, search and seizure and prosecution. That way the agency, if well supported by government, would be able to maximize its law enforcement capacity.

Let us at this point examine issues in drug education. The essence of drug abuse prevention education is to keep non-drug users from becoming involved in the consumption of illicit substances. At the heart of prevention approach is the need to ensure that information provided to the target group for drug prevention education is simple, clear and correct. It should be noted that overemphasizing the dangerous nature of illicit drug could stir the interest of adventurous youth and thereby undermine the credibility of the lessons intended to be taught. In the light of the aforesaid, it is strongly recommended that drug education intervention should take into account social and cultural issues within the given target group in order for it to be effective.

Similarly reinforcing the cultural and prevailing norms of the environment where the group is located will enhance drug prevention education among the target group. Integral parts of such drug prevention education policy will be the introduction of drug education in the school curriculum, and the encouragement of drug-free societies in educational institutions across Nigeria.
Having regards to media activities, it is imperative that deliberate effort is made at putting up policy that addresses this concern by introducing best practices that completely exclude media social advertisement of any substance of abuse. On the other hand, recognizing the power of the media, social media in particular, its potential as a potent vehicle of mass communication should be fully harnessed to raise awareness about the dangers and/or the consequences of abuse.

Let us bring this subject to conclusion by looking at social activities and therapeutic communities. One of the propelling factors for the prevalence in drug trafficking and by implication substance abuse is the denigrating level of moral decadence in our society. Unemployment is also implicated here. It is therefore strongly recommended that prevention intervention programmes should aim at alleviating unemployment and the boredom that facilities delinquency and illicit drug use through the provision of recreational, sporting and cultural alternatives in schools and community neighbourhoods.

Finally, one aspect of drug demand reduction, and by implication prevention intervention that is obviously scarce in Nigeria is therapeutic communities. Therapeutic communities are settings in which persons with similar problems (in this case, substance abuse) meet to provide mutual support to help overcome their problems. These communities usually offer a range of treatment for residents for periods varying from a few weeks to several months.
Detoxification is a pre-requisite for entry into therapeutic communities. Integrated into programmes offered by therapeutic communities are psychotherapy and behavior treatment provided on individual basis to help clients and/or victims (as the case maybe) overcome their drug addiction challenges, with attendant effect on relapse prevention.

Rehabilitation and after-care support are essential components of substance abuse prevention. The focus of rehabilitation and after-care support is relapse prevention which, for the most part, depend upon support networks which also rely on spiritual guidance and self-help groups like the therapeutic communities. In this light, government drug law policy should consider, make for and support the establishment of such communities as integral parts of prevention intervention programmes covered by policy as part of action for healthy communities without drug.
The measures articulated above, if implemented proficiently in a sustainable manner backed by strong political will on the part of government would go a long way in helping to ensure substance abuse prevention towards healthy communities in Nigeria.

Part 1


REKPENE BASSEY
PRESIDENT, AFRICAN COUNCIL ON NARCOTICS (ACON)
P.O. BOX 18914, GARKI, ABUJA