Tackling menace of drug abuse in Nigeria

The case of drug abuse in Nigeria is rather rising than declining despite efforts by the governments, the medical community and the civil society to arrest the situation. As the United Nations marks the 2016 International Day Against Drug Abuse on Sunday June 26, The Guardian revisits the issue especially among the youths in Nigeria and the danger inherent in the illicit habit. ALERO BINITE, VICTORIA OLISA and STEPHEN TANBA report.

A 19-year-old Jide Sodeke (pseudo name) is often fascinated by the glitz and glamour displayed by the celebrity idols on television, he told The Guardian. He would sit enthralled before the TV watching his larger-than-life -heroes as they gulp assorted drinks from slim cans or soda bottles, and getting high. When he finds out from friends that what the youthful glitterati sometimes drink is a mixture of codeine and beverages, he tries it too, and loves the feeling. That is how Jide’s journey to drug addiction begins. “I call the mixture my African cocktail, ’’ he said.

Shina Bamiduro (pseudo name), 22, is also a lover of “African Cocktail”. He started with cigarettes, and then his friends told him smoking is dangerous because it can kill, so they introduced him to a more “harmless” drug, which is codeine mixed with Fanta.

But Omowade Osagie (pseudo name), 20, a third year student in a Nigerian university, has a taste different from Jide and Shina’s.He prefers cocaine to a blend cough syrup and soda. He even peddles the drug secretly to other addicts. But whenever, he runs out of stock, he goes for Cocacola mixed with codeine.

Little surprise then that Osagie has started to exhibit signs such as slurred and incoherent speech, unhealthy appearance, bloodshot eyes, dilated pupils and indifference to hygiene and grooming.

The National Institute on Drug Abuse United states of America (NIDA) explains that “the excessive use of drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug abuse that marks addiction’’

Osagie has been expelled from school for displaying erratic behavior, which results from the use of hard drugs and for selling it.When asked why he uses hard drugs Osagie said, “To get away from my parents stress, they fight a lot so when I smoke I don’t hear any sound and my brain is calm and I feel good, just good.’’

Studies have shown that use of prescription drugs is a serious problem with teenagers and young adults. According to a National Drug Law Enforcement Agency (NDLEA) study, a teenage is more likely to have abused a prescription drug more than an illegal street drug.

Drugs often abused
Though Codeine is a drug normally used in the management of pain and diarrhea, published reports show that it is widely abused because of its potential to produce euphoria (high mood) when consumed in excess. Hence, codeine abusers consume large quantities of cough syrup containing codeine, which leads to adverse effects like dependence, tolerance, sedation and euphoria. Other adverse effects may include constipation, dizziness, vomiting, headaches and dry mouth, the reports say.

Other pain relievers, which are also sometimes abused, include morphine, pentazocine (fortwin), tramadol and pethidine. NDLEA listed drugs commonly abused in Nigeria such as marijuana, depressants, dissociative anesthetics, hallucinogens and stimulants.

This includes paracetamol, a household name that comes in different popular brand names such as Panadol, Boska and M&B. Due to its analgesic, antipyretic and anti-inflammatory properties, paracetamol are widely used – and frequently abused – for the treatment of fever and ache. Although relatively safe, especially when compared with other painkillers, if consumed in excess, it brings adverse effects such as nausea, vomiting, abdominal pain and rashes. Therefore, patients are usually advised to consult the doctor if symptoms persist.

Another commonly abused drug is Aspirin. Aspirin belongs to the group of drugs called Non-steroidal anti-inflammatory drugs (NSAIDs), which are often used in the treatment of migraine, menstrual pain, rheumatoid arthritis, osteoarthritis and other causes of pain. The brands include Alabukun and Phensic and others. The most common adverse effect of aspirin is peptic ulcer.

Antibiotics such as tetracycline, flagyl and Cyprotap are equally widespread abuse in Nigeria. Taken in excess, it could cause nausea, vomiting, abdominal pain, headache, dizziness and rashes among others. Flagyl in particular has been linked with adverse effects like loss of appetite, diarrhea, vomiting, dizziness, headache, seizures, tremors and slurred speech.

Sedatives/Hypnotics refer to drugs commonly used in the treatment of sleep and anxiety disorders. Some of the common examples are Valium, lexotan etcetera. A prolonged use of these medications could cause respiratory depression, confusion, tolerance, dependence, visual disturbances, reduced libido (sexual drive) and headache.Interestingly, most Nigerian youths seem unaware of the danger of abusing drug.

Danger of abusing drugs
A study that examined the perception of drug abuse amongst Nigerian undergraduates living off-campus shows that most students have limited knowledge of abusing drugs, except for the use of marijuana.
Meanwhile, a consultant psychiatrist of the Department of Psychiatry Lagos University Teaching Hospital (LUTH) Idi Araba Lagos, Dr Campbell Elizabeth Adebola, has said all drugs do damage, including codeine, alcohol and tramadol if they are abused.

I have treated patients who have abused tramadol a pain killer of high dose 250mg.” The doctor wonders where drug abusers get this high dose of drugs from when only hospitals are allowed to give them to patients.

Another way of abusing drug is the smoking of weed, said Dr. Campbell. A 55years old man, Mr. Stanley Emiebor, in an interview with The Guardian, said he started smoking cigarette when he was 12 and later graduated to smoking Indian hemp. Explaining his reason for regular intake he said, “Hemps bring out the best in me and takes me to a realm I always want to be.”

The World drug report 2015 by the United Nations Office on Drugs and Crime (UNODC), estimated that a total of 246 million people, or 1 out of 20 people between the ages of 15 and 64 years, consumed an illicit drug in 2013. Out of this number, problem drug users, those who have most difficulties with drug consumption, account for around 27 million that is one in every 200 people.

Explaining the dangers of excessive use of prescription drugs, Dr. Campbell said, “It causes the liver to have to work harder, possibly causing significant damage or liver cancer ’’.

She also explained that it could lead to reckless driving, mental illness, and poor judgment, destroys homes, schizophrenia and leads to depression.People who live with substance dependence have a higher risk of all bad outcomes including unintentional injuries, accidents, risk of domestic violence, medical problems, suicidal and death’’.

But individuals such as Mr. Emiebor seem to mind less. “Something must kill a man. Smoking or not, we all must die someday,” he reasoned.This kind of rationalization may have explained why many commercial taxi drivers abuse drugs.

Lagos State government statistics published 2014 show that 50 percent of Lagos bus drivers take illegal drugs. This finding was arrived at after 442 drivers tested positive for illicit drugs such as cocaine, morphine, opiate, ketamine and marijuana, out of 801 tested.The survey discovered an increase in the cases between 2014 and the previous year. In 2013, out of the 434 commercial bus drivers tested for

The use of hard drugs, 74 of them were found to be driving under the influence of cocaine, marijuana and others.Also, in 2012, of the 820 drivers screened for hard drug intake, 215 of them tested positive and test conducted in three motor parks showed that of the 929 drivers screened, 202 of them tested positive for taking alcohol while driving.

Campbell told The Guardian understand that most abused drugs directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. When drugs enter the brain, they can actually change how the brain performs its jobs. These changes are what lead to compulsive drug use.

According to the doctor the reason youths take drugs is for gratification when people take it there are benefits but the consequences outweighs the benefits.She added that using these prescription drugs for social or recreational use is a serious problem today. “In my ward out of 26 or 27 bedded patients, eight are been treated for drug abuse a little above one third, it is quite huge and majority are youths’’.

Campbell also spoke about security officers not helping fight the drug war. Some officers of the law see youths smoking Indian hemp and taking drugs but they do not arrest them instead they go to meet the drug users and collect bribe and walk away. “It is a menace in the society. Benzodiazepine, which is an opioid, acts to relax muscles. Yet people abuse this strong drug. It acts on the brain so once you take it you will want to take it again and again.’’

She also explained how Rohypnol that is another dangerous drug being abused. Some users crush the pills and snort the powder, sprinkle it on marijuana and smoke it, dissolve it in a drink or inject it.‘’Many youths that you see around carrying a bottle of soft drinks especially the ladies and you think it is just an orange drink but they have been mixed with cough syrup.’’

When asked the challenges the doctors are facing, Campbell said ‘’Most of these patients are not motivated and to get patients motivated they need to be clean for a long time and then you continually have psychotherapy to interview with them, which we call motivational interviewing. Parents most times are in a hurry because after a period of what we call detoxification, which is around 6 weeks, we then encourage them to go to a rehabilitation (Rehab) facility but there are limitations’’.

Campbell explained the limitation of the rehabs she said, “the Government owned rehabs is over populated and then drugs are still been sneaked into the wards, there are also a few psychiatrist like in Lagos State for instance they are very few psychiatrists but a few of my colleagues I have interacted with. I know they don’t supervise the rehabs. The rehabs are under the ministry of social works and sports but I think social workers and some other people supervise them but I don’t see how effect it can be without the specialist in the field.

The private owned rehabs are expensive as much as 500,000 a month and is not within the reach of an average Nigerian.Campbell advised the Government to look into drugs stores like chemist and pharmacies as well as women selling local drugs in bus parks and garages.

The government should put restrictions on prescription drugs not all drugs should be sold over the counter. Only licensed pharmacists should be allowed to open up a drug store. Parents should also enlighten their children at an early age on the negative effect of drug abuse.

A 44 year old musician resident in Festac Lagos who attributed success of his music career to taking drug said he started taking cocaine about 18years ago while in the United State of America but made a U-turn few years back when he embraced Christianity.

“I will never advice my enemy to engage in the use of hard drugs in any form. You can kill just to get cracked. I sold my properties and got involved in some questionable acts,” he told The Guardian.