Substance Abuse

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Introduction
A drug is a chemical substance that alters mood, behaviour, perception or mental functioning, or any chemical substance, which brings about a change in a person’s emotional state, body functioning or behaviour. These definitions include many substances, which might not be termed a drug.
Throughout history, many cultures have found ways of altering consciousness through the ingestion of substances. These psychoactive substances exert their effects by modifying chemical or physiological processes in the brain.
The rate of drug abuse or misuse has been on an increase all over the world and more particularly in Nigeria. Due to increase in unemployment and economic downturn of developing countries, more youths are getting involved in substance abuse. As the saying goes, an idle mind is the devil’s workshop.
The negative consequences of Drug abuse in the society are enormous including; Increase in crime rate, school drop outs, social miscreants, Money laundering, terrorism, prostitution, cultism, child abuse, separation and divorce, HIV and other viral illnesses to name but a few.

Epidemiology;
According to the World Health Organisation (WHO); at least 15.3 million persons have drug use disorders. Injecting drug use is reported in 148 countries, of which 120 report HIV infection among its population. The harmful use of alcohol results in 3.3 million deaths each year. On the average, every person in the world aged 15 years or older drinks 6.2 litres of pure alcohol per year.

Classification of substances;
Substances could be legal or illegal.
Legal drugs are allowed by law with or without age limit or only allowed to be used for medical purposes. For example; coffee, kolanut, cigarettes, Alcohol, Shisha, prescription drugs like Nitrazepam (Lexotan), Diazepam (Valium), Benylene codeine, Tramal/Tramadol, Pentazocin, Morphine, and so on.
Illegal drugs are drugs that are out rightly prohibited. Examples include; cocaine, heroin, LSD, Cannabis (Indian hemp/Marijuana/Igbo), etc

Drugs can also be classified according to their mechanism of action as follows;
a. Opiates: Heroin, Pentazocine, Morphine, Pethidine, Tramadol, Benylene codeine.
b. Stimulants: Caffeine (Coffee, Kolanuts), Cocaine, Nicotine (Cigarettes), Cannabis.
c. Hypnosedatives: Benzodiazepines, Rophenol, lexotan.
d. Barbiturates
e. Alcohol
f. Volatile solutions: glue, petrol, fumes from soak away or pit toilets, aerosols, ether, fumes from correction fluid and marking pens, pawpaw leaves, cow dung, lizard excreta.
These substances are used either by inhalation, Ingestion, Parentally (injection), or absorbed through the skin.

Substance abuse vs. Dependence
There are various stages of drug abuse which include;
1. Experimentation stage
2. Regular use
3. Substance abuse/risky behaviour
4. Addiction or Chemical dependence.

A person is said to abuse a substance when he meets 1 or more of the following criteria in a 12-month period;
i. Recurrent use of substance resulting in failure to fulfill major role or obligation at work, home or school.
ii. Recurrent use of substance in physically hazardous situations.
iii. Recurrent substance related legal problems.
iv. Continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the substance.
A person is said to be dependent on or addicted to any substance when he meets 3 or more of the following criteria in a 12-month period;
i. Tolerance (marked increase in amount of substance or marked decrease in effect of substance).
ii. Characteristic withdrawal symptoms; substance taken to relieve withdrawal.
iii. Substance taken in larger amount and for longer periods than intended.
iv. Persistent desire or repeated unsuccessful attempt to quit substance.
v. Much time/activity to obtain, use, or recover from substance use.
vi. Important social, occupational, or recreational activities given up or reduced.
vii. Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role or obligation, use when physically hazardous).

The warning signs for substance dependence include;
a. Dramatic weight loss or gain.
b. Loss of interest in hobbies or work.
c. Change in relationships.
d. Emotional instability.
e. Financial issues.
f. Noticeable decrease in academic performance amongst students.

Management/Treatment of Substance abuse
Treatment will involve;
a. Detoxification,
b. Pharmacotherapy
c. Psychotherapy
d. Rehabilitation

What can be done to prevent Substance abuse?
Prevention of Substance abuse involves the family, school, community and government. Research confirms the benefits of parents providing consistent rules and discipline, talking to children about drugs, monitoring their activities, getting to know their friends, understanding their problems and concerns, and being involved in their learning. Also, the inclusion of prevention studies into classroom curriculums at a young age has been shown to help break early behaviors that could be signs of drug abuse in the future. Policies which influence the levels and patterns of substance use and related harm can significantly reduce the public health problems attributable to substance use.
In conclusion, the menace of drug abuse amongst the youths cannot be over emphasized. There is an urgent need for all the stake holders to wake up to their responsibility in order to reduce the devastating effects of drug abuse among our youths and the society in general.
For more information and help, contact Center for Information and Prevention of Mental Disorders (CIPMED) on: www.cipmed.org.ng; Email: info@cipmed.org.ng. You can also follow us on Facebook @cipmedinternational

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