Say No! To Drug Abuse

Dr. Olubukola Adenubi, a member of the Nigerian Women in STEM (NWiSTEM) and the Acting Head, Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine (COLVET), Federal University of Agriculture, Abeokuta (FUNAAB), Ogun State, has been selected as a temporary adviser of the Vector Control Action Group of the World Health Organisation (WHO). This article was featured in our Yuletide season’s special edition 2019.

The Yuletide season is a time often associated with vacations, family reunions, merry-making and giving back to communities. It is also a time that can be very stressful and there is an increase in criminal activities such as theft, accidents (domestic and automobile) and drug abuse. Drug abuse (substance abuse) is a patterned, illegal, non-medical use of a drug, which has properties of altering the mental state of an individual.   Some of the side effects of drug use are sometimes considered as anti-social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or at the minimum, culture-alien. The buying and selling of illegal drugs is linked to other criminal behaviours and can fund illegal ventures.

Mental health, according to the World Health Organisation (WHO), the global foremost health body, is a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to contribute to his or her community.

Generally, mental ill health (mental illness, psychiatric disorder) is a behavioural pattern that causes significant distress or impairment of personal functioning or those around them. This condition may be experienced in a manner that is persistent, relapsing, remitting, or it may occur as a single episode. Sometimes with a known trigger but also without an obvious cause.

Consequences of mental disorders, in terms of lost health, are huge as one in four people in the world will be affected by mental disorders at some point in their lives. Approximately, there are 450 million people currently suffering from such conditions and placing mental disorders among the leading causes of ill-health and disability worldwide.

Depression is also ranked by WHO as the single largest contributor to global disability (7.5 per cent of all years (all ages?) lived with disability in 2015).  It is the fourth leading cause of the global disease burden while anxiety disorders are ranked sixth (3.5 per cent). Depression is expected to rank second by 2020 (behind ischaemic heart disease), and is a major contributor to suicide deaths with mortality rate close to 800 000 per year.

Types of drugs that can contribute towards increased mental illness, include cannabis (ganja, marijuana, pot and weed), alcohol (bevvies, booze), stimulants such as mephedrone (meow meow, mcat and drone),  sedatives such as liquid ecstasy (GHB, legal E), hallucinogens such as N-bombs (smiley paper, Bom25 and 2-C-I-NBOME), synthetic cannabinoids such as black mamba, amphetamine and methamphetamine (crystal meth, ice, phet, whizz and yaba), tranquilisers (benzos, blues, downers, vallies), cocaine (crack, coke, charlie), ecstasy (MDMA, MD, pills), heroin (brown, smack) and LSD (acid, blotter and micro-dots).  It’s the cycle of drug use, crime to fund the drug use, social exclusion, guilt, anger, addiction, hopelessness, alterations to the chemicals within the brain and many other components that lead to increased mental ill health in regular drug abusers.

Drug abuse and mental disorders such as depression, anxiety and bipolar disorder, are closely linked. According to reports published in the Journal of the American Medical Association, approximately 53 per cent of drug abusers have at least one mental disorder, which is referred to as “dual or co-occurring diagnosis”. People often abuse drugs to ease the symptoms of an undiagnosed mental disorder, to cope with difficult situations, or to temporarily change their mood.

Unfortunately, this abuse causes side effects and often worsens the symptoms the drugs initially helped to relieve. The short term euphoria and ‘buzz’ created is seen to the user as a fair price to pay for the long term ill effects caused by using the drugs. Common symptoms of depression include feelings of helplessness, loss of interest in daily activities, changes in eating or sleeping habits, frequent outbursts of anger, physical pain and reckless behaviour. Common symptoms of anxiety include excessive tension and worry, irritability, nausea, dizziness, loss of concentration and insomnia. Common symptoms of bipolar disorder are feelings of euphoria or extreme irritability, impaired judgment and impulsivity, hyperactivity and frequent outbursts of anger. Other mental disorders that commonly occur alongside drug abuse include schizophrenia, borderline personality disorder and post-traumatic stress disorder. 

The most effective treatment for drug abuse and mental disorders is an integrated approach, where both the drug abuse problem and the mental disorder are treated simultaneously. Most experts say that a well-informed patient (it can be difficult to get a drug user with a mental ill health to co-operate with an effective treatment plan) is probably the best judge of what treatment suits him or her best. Treatment may include psychotherapy, medications (antidepressants and anxiolytics), individual or group counselling, healthy lifestyle changes and coping skills and peer support.  All of these require finance, which is often unavailable.

People with drug addictions and mental ill health are often effected by a social stigma, discrimination and neglect which often prevents care and treatment from reaching them. The WHO states that the responsibility for action lies with national governments. Shockingly, more than 40 per cent of countries globally have no mental health policy and over 30 per cent have no mental health programme. Around 25 per cent of countries have no mental health legislation. There is an urgent need for governments and law makers in every country to put in place and improve upon the appropriate policies and laws to enable all those individuals who wish to improve their mental health and a chance to feel well and free. Supporting everyone in our lives to live without fear of judgement and stigma, support them in making healthy choices and get the help that may be available to them whilst being by their side and giving them love and a helping hand. This should indeed be our New Year resolution!