Abuse not limited to illicit drugs – Medical practitioner

By Hadiza Abdulrahman

Drug abuse is a global concern that transcends borders and affects societies. Nigeria has not been immune to this predicament. In recent months the media has been awash with news of the NDLEA confiscating various drugs either in an attempt to be imported into Nigeria or exported to other countries.

There have also been reports of increase in the abuse of both illicit and prescription drugs with cannabis, cocaine, heroin, methamphetamine, and other synthetic drugs prevalent on the streets. Codeine-based cough syrups, such as “Lean” or “Sizzurp,” have gained popularity among young people, contributing to a concerning trend known as “pharmaceutical drug abuse.”

This practice involves the misuse of medications like tramadol, diazepam, and Rohypnol, leading to addiction and potential health hazards.

Extent of Drug Abuse in Nigeria

The prevalence rate of drug abuse in Nigeria is alarming. According to media report, the National Drug Law Enforcement Agency (NDLEA), estimated that 14.3 million Nigerians between the ages of 15 and 64 abuse drugs, representing about 14.4% of the population. These figures indicate a significant increase in drug abuse cases over the past decade. The most commonly abused drugs in Nigeria include cannabis, opioids, cocaine, amphetamines, and codeine-containing cough syrups, according to the United Nations Office on Drugs and Crime (UNODC).

In this interview with Dr Tobi Turaki of Sir Yahyah Memorial Hospital Birinin-Kebbi, Kebbi State, she talked about the different types of drug abuse, consequences and treatment for victims.

Question: What is drug abuse?

Dr Turaki: Drug abuse is not limited to hard drugs alone. It can also involve the misuse of prescription drugs. It is less about the substance consumed. In drug abuse the substance used or consumed or its frequency is put into consideration, likewise the type of drugs.

People have to understand the consequences of this drugs and how it affects lives, for instance, if one is treated for an ailment and has reoccurring symptoms and decides to purchase the same drug without the doctor’s recommendation or purchase the drug over the counter without seeking medical prescription; it is abuse.

“Nowadays abuse of painkillers, sleep pills and tranquilizers are on the rise, which is also regarded as drug abuse.

Question: A lot of the times the society perceive persons that engage in drug abuse as bad, is that always the case?

Dr Turaki: There are no bad people but bad actions. Referring to them as bad people is discriminatory and that is why many don’t speak up.  

Certain circumstances can lead people to such behaviour for example their childhood background, environment, exposure or personalities. People from unstable or broken home are likely to be victims, or being amongst people or friends who abuse drugs.

Some people have high tendency to engage in one form of drug abuse or the other; some understand the risk factors while others don’t.

Question: What are the likely consequences of drug abuse?

Dr Turaki: Drug abuse poses severe health risks and has wide-ranging social implications.

Physically, drug addicts may experience deteriorating mental health, cognitive impairment, cardiovascular problems, liver damage, and increased susceptibility to infectious diseases such as HIV/AIDS.

Socially, drug abuse contributes to crime rates, including theft, violence, and drug trafficking. Families are torn apart, communities suffer, and the productivity of the nation is hindered as individuals struggle with addiction.

Question: What are the options/solutions for victims of drug Abuse ?

Dr Turaki: The patient is the most important person in the management not the expertise of physician or psychiatrist. It is the victim’s decision, and he must have a good perception; understand the fact and realising that he has a problem is the beginning of the solution. In psychiatric, we call it “insight” if you have a conversation with them for instance, those that understand they have a problem and have recognised they need help or want to be drug free. There are different approaches to getting the patient free.

Family circle approach: The family also matters; they need an accountability partner ” sometimes not even people related to them. Show love to patients and not discriminate or criticize them.

Group circle discussion works:” Interacting with one who has gone through the same problem and free or those who are still victims and trying to be free. They share opinions on how they have been coping.

Withdrawal method: ” We do not completely take the patient from the drug; we have to know the certain drug they were abusing because of withdrawal symptoms. It’s a gradual process and can be really bad. We reduce the dose till they are drug free. some patients can die if you stop them instantly.

Cognitive behavioural therapy: it’s a substitution, replacing bad habit with good ones, they are also taught some skills, asking them what they like or are good at and using a person who the patient is close to, to assist them. Keeping them busy keeps them off drugs.

Solution starts with the person, working on their cognitive behaviour, letting them know these drugs are not good for them. Their environment matters too because they are often influence due to peer pressure. they also need to be disconnected from dealers. They must be carefully monitored even when they are drug free for 6 months to one year. Patients must also be given follow up management. Those with very good insight have low chance of relapse compared to people with bad insight.

It is also very important that the root cause be addressed. For example, “may be the patient started using drugs after the death of a loved one, academic purpose or whatever reason, these issues must be resolved otherwise the person might return to such habit.

Stance of UNODC on drug abuse

Due to the complexity of drug abuse, the United Nations Office on Drugs and Crime (UNODC) set aside June 26 of every year to strengthen action and cooperation in achieving a world free of drug abuse.

The aim of the 2023 campaign is to raise awareness about the importance of treating people who use drugs with respect and empathy; providing evidence-based, voluntary services for all; offering alternatives to punishment; prioritizing prevention; and leading with compassion.

The campaign also aims to combat stigma and discrimination against people who use drugs by promoting language and attitudes that are respectful and non-judgmental.

“People first: stop stigma and discrimination, strengthen prevention” is the theme for 2023.