A Consultant Psychiatrist with the Lagos State University Teaching Hospital (LASUTH), Dr. Olurotimi Ayodele Coker advocates the need to review the Psychoactive Drug Policy in Nigeria to enhance the health of Nigerians.
Coker also a senior Lecturer at the College of Medicine (LASUCOM), in a presentation on Psychoactive Substances, Prevention, Regulation and Suggestion for New Psychoactive Drug Policy in Nigeria notes that with increased urbanization and adaptation of western culture there is an increase in the use and abuse of harmful substances.
Coker who describes substance abuse as the harmful or hazardous use of psychoactive drugs, including alcohol and other illicit substances, noted that Psychoactive substance use and abuse can lead to dependence syndrome which is a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use.
“Psychoactive use and abuse can cause strong desire to take the substance, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state”, notes Coker.
However, as Coker observes, a review of Psychoactive Drug policy should have positive impact on the levels and patterns of psychoactive substance use and related harm.
According to the renowned Psychiatrist, the increasing use of Psychoactive substances especially among young persons are due to factors such as “the personality of the adolescent especially the Type A personality types, family and cultural backgrounds, persistent stressors in the life of the adolescent, emotional and psychological trauma and possible genetic disposition.
“The environmental factors include: peer group pressures in secondary and tertiary institutions, parental deprivation, availability of drugs on the streets, unemployment, childhood traumatic experience, rapid civilization and urbanization of Nigerian cities, teenagers from single parent homes or polygamous homes with sibling rivalry and joining of joining cults in schools”.
If we think there is no danger inherent in abuses of these substances, the World Health Organisation notes, in 2015 alone, about 255m people used illicit drugs, such as cannabis, amphetamines, opioids, and cocaine at annual prevalence of 5.3 % ie about five out of every 100 persons use drugs.
In 2015, harmful use of alcohol results in 3.3 million deaths and evidence points to the fact that average individual aged 15 years or older drinks about 6.2 litres of pure alcohol per year.
Injecting drugs also was reported in 148 countries including Nigeria and it is estimated that there are 12 million people who inject drugs. Cannabis is most used psychoactive substance with about 183 million users.
Some of the commonly abused substances in Nigeria according to Coker include alcohol, caffeine, codeine and nicotine (cigarettes) and tramadol, pentazocin.
“The illegal psychoactive substances include cocaine; (crack), amphetamine, opiate (morphine, heroin); Marijuana (weed, Indian hemp); LSD, PCP, Mushroom, Mescaline. Recently discovered psychoactive substances in Nigeria include lizard dung, sniffing of pit latrine, sniffing of glue, sniffing of smoke from the exhaust pipes of motor vehicles”, he added.
The pattern of use as seen in the Psychiatric clinics point to type and prevalence of drug abuse to include male gender, age, especially those below 25 years, peer pressure, paternal alcohol and cigarette use, easy availability, low socioeconomic status.
With regards to religion, the Muslims were found to have reduced prevalence of alcohol use.
Reviewing the Psychoactive Drug Policy in Nigeria argues Coker, will have positive impact on the levels and patterns of psychoactive substance use and related harm.
According to Coker, “The policy should significantly reduce the public health concerns attributable to substance use, and interventions at the health care system level that can work towards the restoration of health in affected individuals.
“The policy against psychoactive substances should be aimed at the attainment of a high level of health protection, physical and mental well-being, promote social cohesion, maximize environmental, physical, psychological and social well-being.
“The key principles of the new drug policy should include funding demand and supply reduction as well as harm reduction and drug-dependence treatment”, says Coker.
The consultant Psychiatrist also recommends that the reviewed Psychoactive Drug Policy should place less emphasis on decriminalization of drug use, possession of small amounts of drugs not for the purpose of sale; de-penalisation of small-scale offences related to drugs; and should concentrate on alternatives to imprisonment for people who use drugs for non-violent drug-related offences and non-custodial penalties for acquisition, possession and use of controlled substances in amounts for personal use.
“This policy should also include the vulnerable groups of the society such as women, prisoners, young people and poly-drug users.
“Policy should be based on evidence-informed interventions that are entrenched in local governments, states and national legislation, which are directed towards the affected populations, specifically adapted to their specific needs, such as gender and types of drug used.
“The drug policy should be developed to totally comply with international human rights standards. Those who are dependent on substances are not meant to forfeit their human rights because of their habits” says Coker.
How about criminalization of drug use? According to Coker, the criminalisation of drug use can be seen as violations of human rights which cause more harm than good. Therefore, the policy should be made to eradicate criminalisation of people who use psychoactive substances and promote their access to health and other social services in Nigeria.
“For these reasons, there should be changes in national legislation with regards to drug policies that would facilitate a reduction of the negative human rights consequences of drug control and contribute to a reduction of stigma and discrimination” he argues.
The Consultant Psychiatrist advocates that since drug addiction is a public health concern, the threat should be seen as both social and public.
“Therefore, there should be constant public education, awareness and advocacy to create possible positive impact on public health”, he notes.
He calls for adequate funds to be provided by government for academic researches to determine the magnitude of the problem as a form of needs assessment.
“Funding should also be provided for reduction of drug-related programmes, there should be availability of assistance and accessibility to health facilities that provide detoxification and rehabilitation of those who may voluntarily need medical drug treatment services in all local governments and every state of the federation and there should be legislation at the local governments, states, national levels with regards to prevention strategies. treatment and public education programmes” he adds.
The Reviewed Psychoactive Drug Policy should be transparent in its implementation and include all stakeholders and have a monitoring and evaluation procedure put in place as well.
(Cokerrotimi@gmail.com; Tel No: 08033267544)