Drug abuse: Experts raise concern as mental illness cases triple

The 2023 World Drug Report launched by the United Nations Office on Drugs and Crime, UNODC, put the global estimate of people who injected drugs in 2021 at 13.2 million, 18 per cent higher than previously estimated.

The report further indicated that over 296 million people globally used drugs in 2021, an increase of 23 per cent over the previous decade.

Similarly, it stated that the number of people who suffer from drug use disorders has skyrocketed to 39.5 million, a 45 per cent increase over ten years.

It further showed that demand for treating drug-related disorders remains largely unmet, with only one in five people suffering from drug-related disorders in treatment for drug use in 2021 and widening disparities in access to treatment across regions.

“We are witnessing a continued rise in the number of people suffering from drug use disorders worldwide, while treatment fails to reach all those who need it.

“Meanwhile, we must step up responses against drug trafficking rings exploiting conflicts and global crises to expand illicit drug cultivation and production, especially synthetic drugs, fueling illicit markets and causing greater harm to people and communities,” UNODC Executive Director Ghada Waly said.

According to the report, 70 percent of people in treatment in Africa are under 35.

Like many other countries, Nigeria faces significant challenges in combating drug abuse and trafficking. The country serves as a transit hub for drug traffickers due to its location and extensive international connections.

The inference from this year’s UNODC report indicated that 14.4% of Nigerian citizens aged between 15 and 64 abuse drugs. This is significantly higher than the global average of 5.6%.

The Chairman/Chief Executive Officer of NDLEA, Brig. Gen. Mohammed Buba Marwa (Retd), at a UNODC’s joint press briefing held with the National Drug Law Enforcement Agency, NDLEA, on 19 June 2023, disclosed that the fight against substance abuse and illicit drug trafficking had yielded significant results in the last 29 months with the arrest of 31.675 drug offenders, 5,147 of them prosecuted and convicted, while over 6.3 million kilograms of assorted drugs were seized within the same period.

According to Marwa, ‘This year’s theme, “People First: Stop Stigma and Discrimination, Strengthen Prevention,” furthers the whole-of-society approach to taming the drug scourge.

He said that in the past two and a half years, the agency had strengthened the nation’s law enforcement efforts to cut down on the supply of drugs in society.

However, shockingly, the National Drug Law Enforcement Agency, NDLEA, reported that over 40% of Nigerian youths engage in drug abuse, contributing to the high prevalence of substance use disorders.

Reacting to the development, Mr Peter Obi of the Labour Party, LP, decried a report by the United Nations Office on Drug and Crime in Nigeria.

Obi blamed leadership failure in the country, high rate of poverty and frustration, peer-group pressure among the youths and high unemployment rate, amongst others, as factors fuelling drugs and substance abuse among the youths.

In a statement, the former Anambra State governor noted that the attendant health conditions from drug abuse are unimaginable, including an epidemic of mental health cases and incidents of suicidal behaviour among youth.

He said more needs to be done by the government to rescue the youths from a further slide into drug addiction.

Speaking Monday during the annual celebration of the United Nations International Day against Drug Abuse and Illicit Trafficking at the State House, Abuja, President Bola Tinubu advised the larger Nigerian society against social and structural stigmatisation of drug use victims which hinders them from accessing needed care and support.

Tinubu stressed that educating the citizenry on the dangers of drug abuse and the need to stop stigma and discrimination is crucial, calling for support for those affected.

“We must empower our youth with the knowledge and skills they need to make informed decisions about their lives and provide victims of drug abuse with the resources they need to avoid falling victim to drug abuse.

“We must also support those who are struggling with drug addiction, and provide them with treatment and necessary support they need to overcome their addiction.

“In the face of these challenges, it is imperative that we adopt a people-centred approach that focuses on prevention and treatment as key pillars of our response,” he said.

Meanwhile, a Consultant Psychiatrist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki and Public Relations Officer of the Association of Psychiatrists in Nigeria, Dr Okwudili Obayi told DAILY POST in an interview that the impact of drug abuse on a person abusing drugs is grave, as it could affect individual’s ability to remember, which can lead to behavioural problems.

Obayi explained that the family, society and the government all suffer from the rising incidence of drug abuse in the country.

The health expert further pointed out that the link between drug abuse and mental health is bidirectional.

He said it could affect, provoke or precipitate mental illness in somebody.

According to him, ”Yes, there’s a link between drug abuse and mental health. In short, One can say there is a bidirectional link. Bidirectional in the sense that drug abuse, or using the substance of abuse, can affect, provoke or precipitate mental illness in somebody.

“On the other hand, somebody with mental health can abuse drugs. For instance, when someone takes alcohol, loses control, and starts misbehaving, that’s the alcohol causing the abnormal behaviour.

”On the other hand, someone who has a mental illness, let’s say, someone who is depressed, low in spirit, unable to cope with challenges or whatever he or she is depressed with, can feel the way out is to use a drug to uplift his mood, he now goes and engages in alcohol. The same goes for all other abused substances, Indian hemp, methamphetamine, cocaine, and tramadol. So there’s a bidirectional relationship.

”Generally, if you look at the impact of drug abuse, the impact is much. It can be on the person abusing the drug, and it can be on the family; it can also be on the facility where the person is receiving the treatment. It can as well have an impact on society or the government at large.

”Now, on the individual, the impact can be physical. For instance, somebody using drugs can develop or precipitate the onset of hypertension; that is physical. It can also be psychological or mental, and it can also be social. Socially, a large number of things are coming to play. It can kill a relationship. It can make people exhibit odd behaviours in society, break laws and not maintain traffic regulations or follow the laws in society.”

He added that: “The impact on mental health for somebody who is vulnerable and predisposed or has the chance of developing mental illness is that using drugs can make the illness either come earlier or worsen the illness. It can even make the person who has the mental illness not recover.

”Someone may have any type of mental illness like depression or what we call psychotic disorders such as schizophrenia, which is what ordinary people see as the actual mental illness, in which the person is no longer in touch with realities; he doesn’t understand anything.

“When that person has a precipitate to develop it, the drug can help both in the onset and perpetuation, even after treatment and while on treatment. Even when someone is on treatment, it can also slow recovery and make the person break down.”

He further explained that ”The impact of drug abuse on an individual’s psyche is large. For instance, someone who abuses drugs can engage in other conditions that invariably would worsen or lead to mental problems.

“For example, someone who abuses drugs goes to steal, is arrested, is incarcerated in the correctional centre, and develops a mental illness. Or someone who uses drugs that affect his ability to care for himself in terms of good health, either by feeding, exercising or other things he should do to remain healthy.

“It can as well worsen or trigger all the medical conditions, which invariably can now also lead to mental illness. So it’s really large and an issue to contend with.

”In addition, the use of drugs can affect memory and an individual’s ability to remember, which can lead to behavioural problems. It can also create room for other diseases that affect the brain or worsen mental illness.”

”And the family is not left out either. The family goes into spending money and goes into anxiety and all that. Of course, somebody who abuses drugs cannot function well in society as he cannot contribute meaningfully.

“It could as well be a politician taking decisions on behalf of the people, in which case many people will be harmed. Again, the government is also spending money because the people that abuse drugs generally use the facilities in the hospitals that would have been used for other purposes,” he said.

On the treatment of drug abuse, the Psychiatrist stressed that drug abuse should be seen as a brain disease and that its treatment is dependent on the condition type, the impact level and the place.

He said, ”Drug abuse can be seen as a brain disease. And if it is seen as a brain disease, it should have treatment. One, it is usually said that prevention is better than cure.

“However, preventing drug abuse is the best approach in any sane society that wants progress. But when someone has a problem already, either the person is using the drug and using it excessively despite the person has no other problem, or the person now becomes dependent and addicted that he cannot do without it, or the person using it has led to other consequences, be it medical conditions such as hypertension or diabetes or psychological problem like any form of mental illness, or problem with the society or with the law, that person needs treatment.

”Treatment depends on the condition type, the impact level and the place. Also, treatment can be received in the hospital, and it could be given while the person is at home, coming to the hospital. It all depends on the nature of the problem the person has and the stage at which the person is presented at the hospital, as long as the motivation is to withdraw from the substance.

“Unfortunately, a good number of young people, when they start using drugs, will not even believe that it is causing them any harm; even when they find themselves in the hospital, they will argue it is not the drugs that are causing their problem or that it does not affect them in any way.

“But when they eventually realise, they might be willing to stop, but it is not usually easy. That is why people already dependent on drugs are better treated in the hospital on admission, but it has its challenges”.

Lamenting about the lack of awareness on the part of those suffering from the dangers of drug abuse and the ignorance associated with it, the health expert said that most people wrongly assume drug abuse is caused by evil.

He also stated that many families don’t have the patience to allow their persons to undergo full stages of treatment when brought to the hospital.

”The individual may not know he has a problem; that is one thing. If the individual knows, he may not even know that drug problems can be treated in a hospital.

“Even when they come to the hospital, they threaten to leave. At times, because such treatment is given in psychiatric hospitals, many would always complain that they are not supposed to be there.

“This is because they might see other people with other forms of mental illness, whether drug-related or not, but might look more severe than their own, and they will say, ‘Oh, nothing is wrong with me; I am not supposed to be here’.

”Then a good number of individuals with such problems have caused harm to their family members or the people may not have money again to finance the treatment. All these are part of the challenges for the drug user.

”On the part of the family, when they have persons using drugs, the first thing is to believe that it is the evil people who do not like the family’s progress that have made the person continue to abuse drugs. That is even after being angry with the person, depending on how they perceive the cause.

“Emphasis is usually on the cause. In that case, bringing the person to the hospital is a problem. And if they eventually come, they find it difficult to stay for the person to receive adequate treatment.

“The person might be violent before he comes, and when he comes to the hospital, you give the person medications, and the person becomes calm; they will now tell you, ‘Oh, the person is now okay.’

”Meanwhile, he has not even started the real treatment that he is supposed to go through for him to understand the impact the drug has had on him and the need to stop and make up his mind to go through the steps that can help him stop so that when he goes home, he remains drug-free.

“Many families don’t have the patience to go through the treatment process. Again, finance is another issue. Treatment for drug-related illnesses normally takes time, so families will usually complain that they don’t have money.

“So it is a big challenge. Also, just a few hospitals in the country can render adequate service. Some of these hospitals are tertiary hospitals, often owned by the federal government, and they are far from the community where many people use these drugs.

“So availability is a challenge, but where you have the hospitals, facilities are low, and manpower becomes an issue too.

”Also, society does not care for the person that uses drugs. He is easily written off and easily stigmatised.

“On the other hand, the government is trying but needs to do more. It needs to ensure that treatment facilities are available, including in our secondary and primary health care facilities,” he said.