Battling drug addiction in Nigeria

Dr. Biodun Ogungbo

Many of my patients do not smoke or drink alcohol, which is great. However, you would be lulled into a false sense of comfort about addiction unless you talk to the right people. The right people are doctors and nurses who are managing cases of drug use and abuse among Nigerians on a daily basis. In Nigeria, drug abuse does not make headline news but it is still wreaking havoc within families and destroying lives.

Here is a case report to consider:
There is a 29-year-old married banker with a long history of trying out different things such as cigarettes, alcohol and marijuana. Approximately, three years ago he was introduced to cocaine at a party by a close friend. Some friend! Cocaine made him feel more relaxed and able to concentrate better, he says. He said he could also drink beer for longer periods when he used cocaine. He subsequently became a regular user of cocaine typically in the privacy of his home and would snort between 1-2grams most evenings.

He had depleted the family joint savings account to fund his addiction to cocaine before agreeing to seek help.
Recently, during one episode of cocaine use he suffered a torrential nosebleed and went to the emergency room where he was diagnosed with a perforated nasal septum. He had also recently begun to notice chest pain whenever he used cocaine.

Cocaine abuse
Cocaine is a type of drug that functions to increase the availability of the neurotransmitter dopamine in the brain. Dopamine is associated with the generation of ‘euphoric’ emotions, the regulation of movement, and the processing of reward in the brain. However, it is also associated with a considerable potential for addiction, dependence and abuse. Cocaine abuse comes with an increased risk of:
Psychiatric disorders
Heart Disease
Hypertension and stroke
Death
Someone using cocaine will display agitation, reckless behavior with loss of social inhibition, increased movement and activity (cannot sit still) and increased common cold-like symptoms and/or nosebleeds. One of the most serious effects of cocaine abuse is damage to the heart. This can lead to serious conditions such as heart attacks and cardiac arrhythmias, which may be fatal. Cocaine-induced heart failure or damage may also increase the risk of stroke, or brain damage resulting from interruptions in the blood supply available to the brain.

Cocaine and the brain
Cocaine abuse is also associated with changes in brain chemistry over time. These changes are associated with the increased ‘need’ for cocaine over time, as well as behavioural oddities that may result from taking cocaine. The bad behaviour associated with cocaine’s effects may include erratic behaviour, promiscuity, psychosis, acute lunacy and increased risk of accidents. Long-term cocaine use is also associated with deficits in cognitive performance, attention and decision-making abilities.
There are also significant risks of blood-borne infectious conditions such as HIV or hepatitis C (HCV). These risks are related to the injection of cocaine, and the adverse effects of irresponsible and non-sterile needle use.

Treatment
There are many treatment options available for cocaine dependence and abuse. These may be delivered in inpatient facilities such as in Synapse, Wuse 2, which accommodate the treatment-seeker for the duration of their therapy. Alternatively, the patient may make regular appointments at a center or clinic to receive outpatient treatment.

Prevention is better
It does seem that you can get drugs such as crack cocaine in Nigeria. If you know where to look! Thank God, it is not sold openly on the streets as in America but we need to be careful and keep vigilance. Our porous borders, poor customs and immigration services need to be strengthened and enlightened to actively search for and detect drug trafficking.
There are other drugs being abused such as cough syrups and many others. They equally do harm and have been known to cause deaths. These drugs are easily available at our chemists and can even be got without a prescription from the doctor. So much is wrong with our healthcare that these self-inflicted problems are best prevented within each family setting.
To prevent drug abuse in your teenager, it is important to talk about substance abuse openly and with confidence.

We need to practice ‘Information, Education and Communication’ (IEC). Encourage your young ones to recognise the signs of drug use and abuse and how to avoid friends or relatives exhibiting same. Encourage the ability to talk to you openly about their fears and concerns at a young age and continue the conversation. Make sure they understand the dangers of both illicit and prescription drugs, and monitor their behaviour, friends, and habits for sudden changes. This also goes for husbands and wives.
If abusing drugs: Monitor. Detect. Refer to a specialist.
NB: For more information: Contact Dr. Chinyelu Ikeako, an Addiction Specialist in Abuja. She is interested in Addiction, adolescent and child psychiatry, public health psychiatry, schizophrenia research and women’s mental health. Dr Ikeako can be reached on 08096728523. Please send text only.