DRUG ABUSE AND PUBLIC HEALTH CONCERNS IN NIGERIA

PART 1

Substance abuse is one of Nigeria’s most pressing social concern presently. This concern has been implicated in the local and transnational crime index, beside health and other social maladies. Attempt has been made here to examine substance abuse in context against the background of the current situation in Nigeria which is somewhat similar to what obtains elsewhere in the global community; a situation that is rather disconcerting. This presentation also analyses some specific health issues and risk factors in substance abuse and wind up with recommendations on actions for healthy families.

Most people generally use the words drug abuse to describe substance misuse. Both mean the same thing and would be used interchangeably here. Substance abuse is simply the use of psychoactive substance outside of medical prescription; or maladapive pattern of the use of mind altering substances.
The use of substances, the world over, to induce psychoactive feelings is of ancient antecedents. Anthropologists report that almost every known society has some ferment, brew or portion that is capable of influencing behavior, for health or recreational purposes, and often religious rituals. Many substances are derived from natural plants that have been used for years for medicinal purposes. For example, the Aztecs and other native tribes in Mexico, the Kiowas, Comache and others in the United States and Canada generally use peyote. This dates back to 1500BC.

Research findings show that there is relatively long tradition of substance abuse in Nigeria. One consistent finding, for instance, is that in Henshaw Town in Calabar, Nigeria, popularly called Nsidung, the sale and consumption of Akpetesi (local spirit) is pretty famous. This settlement was also famous for slave trade in the 18th and 19th centuries, when human cargo was exchanged for imported spirits. There is a prevalence of the similar situation in many large cities in Nigeria presently not precluding semi-urban settlements. In fact, the situation in the North Eastern part of the country having regards to the drug problem is extremely frightening and pretty much debilitating.
Concerns pertaining to the use of other drugs in urban settlements in Nigeria can be traced to the end of the Second World War (WW II) in 1945 when some Nigerian Army veterans returning from WW II brought back seeds of cannabis sativa also known as Indian hemp or Igbo in the local parlance. The climatic condition in Nigeria favoured its cultivation hence it flourished well for widespread consumption particularly before, during and after the Nigerian civil war between 1966 and 1969.

Decades after, Nigeria has witnessed an upsurge in the consumption of other drugs such as Lysergic acid diethylamide (LSD), cocaine and heroin most of which were illegally introduced into Nigeria as a fall out of the involvement of Nigerians and the use of Nigerian territory as transshipment corridor for the movement of these drugs to America, Canada, Britain, European and others.
One of the consequences of local and transnational drug trafficking is evident in multi-drug use normative pattern among a range of users of illicit substances and addicts in Nigeria presently.

Having regards to health issues, the use and/or abuse of illicit substances is associated with diverse dangers depending on the type, dose and purity of the substance and the personal chemistry of the individual using the drug. For instance, even the use of simple alcohol has been implicated in high risk activities such as impaired driving, vehicle crashes, homicide, suicide and drowning. Besides cases of casual sex with the risk of unwanted pregnancy (that may lead to abortion), transmission of sexual diseases such as HIV, and other vices like date rapes and domestic violence among the youth are also associated with drug misuse.

Problems of defects and adverse birth outcomes have also been linked to the abuse of alcohol, tobacco and other drugs during pregnancy. According to the US Centre for Substance Abuse Prevention, babies whose mothers drink during pregnancy, especially those who drink heavily, may be born with fetal alcohol syndrome (FAS).
The most debilitating aspects of FAS documented in literature are mental disabilities and hyperactivity. These problems may lead to challenges in learning, attention, memory and lack of coordination. Learning problems in such cases sometimes persist into later stages in life.
Using imaging research techniques to observe drug action and the consequences as they occur and persist in the brains of drug addicts showed ‘diminished cortical grey matter, most prominently in Prefrontal Cortex (PFC) in alcoholic patients.’ Similarly, substance abuse investigators reported reduced brains, prefrontal cortical and parietal cortical grey matter compared with controls in alcohol – dependent individuals.

Experts in nuclear medicine have also used Magnetic Resonance Spectroscopy (MRS) to discover substance abuse related biochemical changes that show damage to brain cells. For instance, ‘methamphetamine abusers have reduced concentration in their basal ganglia and frontal white matter, compared to non–abusers of drugs.’ This perspective correlates the cognitive difficulties that amphetamine abusers usually experience.
Cocaine dependent persons have also been found to suffer neuron damage. Similarly, researchers evaluating interactions between HIV and substance abuse found that methamphetamine abuse and HIV decreased neuronal cells health addictively.

Some other studies have shown that abuse of stimulants reduces cellular activity in the Orbital Cortex (OFC), – – an area of the brain vital for making vital judgment and strategic decisions. Besides poor judgment, other consequences of damage to OFC is aggressiveness.

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