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| EDITORIAL |
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| Year : 2020 | Volume
: 20
| Issue : 1 | Page : 1-2 |
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Challenges and control of drug abuse among youths in Nigeria
PO Onifade
Drug Addiction Treatment Education and Research Unit, Federal Neuropsychiatric Hospital, Abeokuta, Ogun State, Nigeria
| Date of Submission | 03-May-2022 |
| Date of Decision | 10-Jun-2022 |
| Date of Acceptance | 10-Jun-2022 |
| Date of Web Publication | 26-Aug-2022 |
Correspondence Address:
Dr. P O Onifade
Drug Addiction Treatment Education and Research Unit, Federal Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/njhs.njhs_13_22
How to cite this article:
Onifade P O. Challenges and control of drug abuse among youths in Nigeria. Niger J Health Sci 2020;20:1-2 |
The British Broadcasting Corporation's documentary titled 'Sweet Sweet Codeine' in 2018 brought to the Nigerian sociopolitical lights the scourge of substance abuse in the country. Soon after, the problem continues in the background despite the coordinated efforts of relevant law enforcement agencies in the country. In Nigerian households, the highest rate of substance use is in the age group of 25–39 years. About 2.9 million are substance dependent.[1] Substance use is understandable because it has benefits for the individual, community, nation and the world at large. This reality is the beginning and, at times, the end of the story; often, however, the result is the progression to a pattern of use that reverses all the gains and causes deficits in every sphere of human life. The difficulties in curtailing substance abuse among the youths in Nigeria are related ultimately to the forces seeking to promote substance use for its desirable effects on the parts of both the user and the supplier, and the limitations of prevention and treatment strategies in the country.
A force that makes controlling substance abuse difficult is the sense of well-being, a fundamental human need and ultimate lure for substance use. Every initiation and maintenance of substance use, as is the case with all adaptive and maladaptive human behaviours, starts with the goal of attaining an acceptable sense of well-being, which is largely subjective and based on the individual's interpretation of internal and external experiences. Emotions, such as anxiety, depression, boredom, despair and dejection are internal states that an individual seeks to eliminate and replace with positive ones. Physical pains, discomfort or disease, interpersonal conflict or rejection, loss, failure, marriage and divorce are some of the numerous life events which may be transformed into distressing internal states depending on the personal meaning given to them. The use of substance will not address the life events; rather it overrides their emotional impact with a sense of well-being and of self-efficacy by altering the brain activities in certain ways. As for illicit substance suppliers at any level, their well-being is promoted with improvement in economic, social and political status which comes from the lucrative job of producing, distributing or selling substances, not minding the potentially destructive effects on the user.
Another challenging factor in the control equation is the paradox that surrounds the willingness and the ability to stop substance use. At the onset, the use of a small dose is enough to produce the desired effect and gives little or no untoward experience. The ability to stop the use is the highest, while the willingness to do so is understandably near zero. With time, an increasing amount is required to produce the same 'good' experience. Unfortunately, the higher the dose, the higher the risk or the more the experience of negative mental, physical, social, occupational, family and legal consequences. Now, the user is highly willing to stop but is less able to do so because the experienced damages disrupt their sense of well-being, calling for more substance intake to 'restore' it, and because the repeated use changes the brain function and structure in such a way that reduces self-efficacy, thus maintaining the vicious cycle.
A prevention strategy can tilt the balance of control positively by preventing or delaying the initiation of use or by preventing the progression of use to abuse. However, Nigeria has the challenge of non-availability of effective strategies to do this among the youths. In 2015, funded by the European Union, the Federal Government of Nigeria piloted and tested the impact of 'Unplugged,' a Social-influence substance abuse prevention program among 2685 secondary school pupils. It was effective in reducing the prevalence rate of recent alcohol but not those of cigarette and marijuana use.[2] Therefore, there is a need to further adapt the program and test it on a larger scale. However, it is not certain that either the European Union or the Nigerian government will fund such a project. In addition to unplugged, some universities in Nigeria practice no-drug-use-policy-based prevention strategy which consists essentially of information giving, counselling, routine urine drug screening and suspension to obtain treatment or outright rustication for those who screen positive.[3] This may have the effect of reducing the rate of positive screen on the long run, but not necessarily due to a decrease in the rate of substance use among the students.
Treatment for persons with substance abuse as a means of controlling the problem is another area of challenge with an inadequate number of treatment programs (TPs) and the non-existence of an integrated treatment system (ITS) in Nigeria. On one hand, TPs focus on primary outcomes[4] of treatment, namely reduction or cessation of substance use. There are only eleven model treatment centres for an estimated 3 million[1] people living with substance abuse in the country. On the other hand, ITS addresses intermediary outcomes of treatment which are the multi-domain problems associated with the causes or the consequences of substance abuse, such as medical, mental, family, education, occupational, housing and legal problems. ITS is a working partnership of professionals in a group of interrelated, or interdependent treatment and rehabilitative 'elements' (such as general medical, housing, employment and legal services) that form a combined response to substance abuse problems in a defined region or country.[5] Although the services are available in the Nigerian communities, there is no recognized collaboration among them for the purpose of holistic substance abuse treatment. During and after treatment, patients with substance abuse and their relatives are practically left to negotiate many of these related agencies on their own to obtain the needed complementary services.
In conclusion, though the ravaging effects of substance abuse may be regarded as a challenge to the youths in Nigeria, the real challenge is in finding the overall strategy to promote a sense of well-being and self-efficacy among the youths without recourse to substance abuse; to promote the socio-economic welfare of the populace as a whole thereby reducing the risk for drug peddling; to promote the idea and skill of self-rescue among those living with substance abuse in an ITS.
| References | |  |
| 1. | |
| 2. | Vigna-Taglianti F, Mehanović E, Alesina M, Damjanović L, Ibanga A, Pwajok J, et al. Effects of the “Unplugged” school-based substance use prevention program in Nigeria: A cluster randomized controlled trial. Drug Alcohol Depend 2021;228:108966.  |
| 3. | |
| 4. | Onifade PO. Substance dependence treatment endpoint and intermediate outcomes. MOJ Addict Med Ther 2017;3:2-3. |
| 5. | United Nations Office on Drugs and Crime. Drug Abuse Treatment Toolkit A Practical Planning and Implementation Guide. Vienna: UNODC; 2003. |
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