By Wendy Wokoma

The National Bureau of Statistics produced the 2018 Drug Use of Nigeria report earlier this year. Some of the key findings from the that report were: One out of every seven persons aged 15 – 64 years has abused a drug (excluding alcohol and tobacco), one out of every four drug users is a female and topping the list of drugs abused are cannabis, opioids and its derivatives such as tramadol, codeine and cough syrups1.  Additionally, the age group with the highest prevalence is 25 -29 years while 40% of high-risk drug users could not access treatment even though they desired it. It is of interest to consider the ripple effect on sexual health, HIV transmission, infant morbidity and mortality since one out of every four drug users is a female. Research has shown that risky sexual behaviours are often associated with drug abuse2,3,4 which then poses the question “what happens to the growth and development of a country if the supposed most productive sub-population account for the highest users of drugs?”

 

Although there has been an increase on the ‘say no to drugs’ campaign in the form of various outreaches, awareness walks, talks and the like by various groups and agencies, it will take much more than these efforts to combat the menace in Nigeria. Numerous and fragmented approaches and campaigns have been launched by various organisations to combat this menace of drug abuse especially among the youth however, little data is available on the impact evaluation of these campaigns. One is left to wonder if it is all a waste of resources or just a short-term plan?

 

As the popular saying goes – ‘prevention is better than cure’; the reality is that prevention is not just better, it is also cheaper than cure! How can you prevent something if you don’t address the underlying causes and risk factors? Research has identified certain risk factors on one hand and protective factors on the other against drug abuse5. These factors are further categorised into individual and environmental factors5. The environment here refers to both the physical and social as both have significant impact on behaviour. Factors at the individual level relate to personal characteristics such as gender, age, life skills and health status; while at the environmental level relates to the prevalent culture, social support system in the family and community, social services, media and governing policies and laws.

 

More efforts should be geared towards prevention and the goal should be to minimise the modifiable risk factors while promoting the protective factors. Prevention programmes should involve community-based approaches targeted at equipping parents with parenting skills and adolescents with life skills. Such programmes can be delivered via school settings, religious and traditional settings. The provision of youth centres where young people can engage in different sports and skills as well as volunteer is worth exploring. There is a need for more adolescent friendly health centres; where young people can access non-judgmental health care on issues relating to stress, mental health and sexual health.

 

Public and private collaboration is needed for the establishment of more standard treatment centres for the rehabilitation of drug users across the country. Some centres are dilapidated, are under-staffed or have poorly trained staff, thus possibly affecting utilisation. I recall a story by a member of staff from the National Drug Law Enforcement Agency (NDLA) during an engagement session against drug abuse where a parent expressed disgust at the state of the facility. They refused to have their child admitted there for treatment due to the state of the facilities. Unfortunately, some weeks later a report came that the parent was deceased – killed by the very child under the influence of drugs.

 

Some of the drugs abused are legitimate and required for medical purposes, thereby suggesting the need for regulations and restrictions on the distribution and supply. There should be firm enforcement of punitive measures for illegitimate suppliers and irresponsible licensed suppliers who supply anyone willing to pay.

 

Building a drug free Nigeria is more like a combination of a relay and marathon. Involving different stakeholders at different levels and a multidisciplinary approach which all feed into each other. Recently, I visited the only standard, registered private rehabilitation center in the South-South Region, 180 Degrees Center.

 

‘It seems that the NDLEA pitches a competitive tent’ says the CEO Christie B. Ogbeifun, explaining that her requests for collaboration to the NDLEA in the region yielded no response. Key challenges noted are a shortage of skilled human resources and money. They benefit from the United Nations Office on Drugs and Crime (UNODC) training at least once a year.

 

Shouldn’t efforts by both public and private institutions be complementary with a focus on meeting the need for proper rehabilitation? With drug abuse being a brewing epidemic, parents and teachers can be sensitised on early signs, when and where to seek for help.

 

In order to be sustainable and impactful, a three-pronged approach involving prevention, treatment & care, regulation of supply of the pharmaceuticals is needed.

 

 

References

1Drug use in Nigeria 2018. National Bureau of Statistics, Nigeria.

2 Alcohol use and sexual risk behaviour:  A cross-cultural study in eight countries (2005). World Health Organization, Geneva

3Cavazos-Rehg, P. A., Krauss, M. J., Spitznagel, E. L., Schootman, M., Cottler, L. B., & Bierut, L. J. (2012). Brief report: pregnant by age 15 years and substance use initiation among US adolescent girls. Journal of Adolescence, 35(5), 1393-1397.

4Clayton, H. B., Lowry, R., August, E., & Jones, S. E. (2016). Nonmedical use of prescription drugs and sexual risk behaviouWokors. Pediatrics, 137(1), e20152480.

5A participatory handbook for youth drug abuse prevention programmes, United Nations. New York, 2002