SUBSTANCE ABUSE: IT’S ABOUT MORE THAN SELF CONTROL
One of the common issues bedevilling our society, especially as regards youth mental health, is substance abuse. In recent times, its incidence has increased exponentially, and it calls for attention. However, it is difficult to fight a demon you don’t know.
What is substance abuse?
Substance abuse, in the simplest definition, is the excessive use of psychoactive substances such as alcohol, pain medications and illegal substances that can lead to physical, social and emotional harm. Such substances include club drugs (molly, rophynol), stimulants (cocaine, meth), hallucinogens (LSD), inhalants (poppers), marijuana, opioid pain killers (codeine, morphine, heroin), prescription drugs and cold medicine, sedatives and anti-anxiety medication, steroids, tobacco/nicotine, etc.
In the 2018 National Drug Use Survey, about 14.4% of Nigerians (14.3 million) aged 15–64 years were found to use psychoactive drugs for non-medical purposes. The 2021 World Drug Report further discovered that in the past 24 years, an additional 40% of adolescents do not perceive some of these drugs as harmful. This is particularly worrisome because it means that young people are becoming more likely to use these very harmful substances.
Substance use disorders
Humans are biologically inclined to seek rewards, and these rewards can come from healthy behaviours, like pleasure from spending time with loved ones. It is a cycle — we seek out these experiences because they reward us with fuel for other activities.
Psychoactive substances also send massive surges of dopamine through the brain, but instead of feeling motivated to do the things you need to do to survive, like eat and work, such dopamine levels can lead to damaging changes affecting thoughts, feelings and behaviours.
Although these substances are different from each other, they all strongly activate the addiction centre of the brain, so their consumption is habit-forming. People who indulge in psychoactive substances feel intoxicated after using, but over time, their brains become desensitised such that greater amounts of the drugs must be used to produce the same effect.
This leads to a downward spiral where the person consumes more and more, having gotten used to being in that intoxicated state of mind. He or she feels there is something wrong when they are not under the influence and may become obsessed with the need to recapture the original feeling.
There is therefore a resultant spectrum of substance use disorders, the most severe of which is an addiction to that particular substance. In addiction, the drugs so affect your brain that it is difficult to stop taking them even if you want to. Simply put, it is the loss of control of use despite the worsening consequence of that use.
Noticeable symptoms of substance use disorders include
- bloodshot eyes and looking tired;
- changes in appetite (usually eating less);
- craving drugs;
- difficulty completing tasks at work, school or home;
- engaging in risky behaviours;
- looking ungroomed or with poor complexion;
- issues with financial management; and
- weight loss, etc.
Some factors may also predispose one to drug addiction, including genetic makeup, gender (two third of those affected are males), ethnicity, already-existing mental health issues, environmental stress, peer pressure, physical or sexual abuse, early exposure to drugs and age (teenagers are more at risk).
Addiction is not a problem of willpower or morality — it is a powerful, complex disease. People affected by addiction to drugs cannot simply quit; they require care and therapy, sometimes for life.
Drug addiction therapies
Several therapies exist for treating drug addiction: detoxification, medication to control cravings and relieve withdrawal symptoms, behavioural therapy and contingency management. The first use of a drug is a choice, but addiction can develop, affecting the decision-making ability to stop.
Sometimes, there can be a relapse as people who are in recovery have a high chance of reusing. Recurrence can happen even after years of abstinence. To prevent relapse, patients need ongoing treatment and regular reviews of their treatment plan. Prescription drugs should also be monitored.
Substance use disorders could be fatal as one can die from an overdose or engaging in dangerous behaviours under the influence of these substances. It is crucial, then, that people are aware of these possible therapies and that substance users are encouraged to seek professional help.
We can, however, avoid substance use disorders by staying away from psychoactive substances completely.
This article was written by Oluwadara Blessing Madariola, a 300-level medical student at the University of Ibadan.
