HIV/AIDS rates linked to drug abuse

Drug abuse in Uganda is a complex and unique issue where people use more than one drug which is very dangerous and hard to treat, according to experts. PHOTO BY ALEX ESAGALA

What you need to know:

  • Dr Brian Katungi of most at-risk populations (MARPs) Network says as a result of use of such drugs, people related indiscriminately and end up having unprotected sex which makes them vulnerable to HIV.
  • Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need.

Seeing him walking, Robert appears sickly. He is hardworking and active.
But talking to the 29 year old, his words are not legible. He smokes marijuana and cigarettes and drinks alcohol (waragi). Because he is always drunk, Robert is feared and cannot stay with his family members nor the woman he had eloped with.
He spends nights in his single room and or in drinking places where he interacts with people indiscriminately.
He is one of the hundreds involved in drug abuse. Drugs include all substances and chemicals which when injected or taken affects the brain.
These include; Sisha, miraji, marichan, cannabis (marijuana), opium, cocktail of tobacco and marijuana commonly known as akagolo.
These are injected, smoked or swallowed. The mostly mixed drugs are; marijuana and alcohol, kuba and alcohol, marijuana, fuel and alcohol, among others and used inter-changeably which causes harm to the brain.
Dr Brian Katungi of most at-risk populations (MARPs) Network says as a result of use of such drugs, people related indiscriminately and end up having unprotected sex which makes them vulnerable to HIV.

Health survey reports show an estimated 221,000 Injection Drug Users (IDUs) in sub-Saharan Africa are HIV positive representing 12.4 per cent of all injecting drug users in the region.
“The probability of HIV transmission through injection drug use is estimated at 0.0100 compared to 0.0009 through heterosexual sex,” says the report.
In Uganda, alcohol and drug use is highlighted as one of the risk factors driving the HIV epidemic as reflected through the modes of Transmission and Prevention Response Analysis.
Most prone

Dr Katungi says in Uganda, Most At Risk Population (MARPs) include drug users, sex workers and their clients comprising of long-distance truck drivers, uniformed services men and women, men who have sex with men (MSM) and fishing communities.
He says HIV prevalence rates among MARPs are almost 3-4 times higher than the national average for adults aged 15-49 years where fisher folk average between 23-35 per cent, Sex workers at 35 per cent, and MSM at 13.7 per cent but no statistics on drug users.
Dr Katungi says drug use in Uganda is a complex and unique issue where people use more than one drug which is very dangerous and hard to treat.
“The Ugandans scenario to tell the mostly used drug is challenging because they mix different types of drugs making the problem more serious and difficult to handle unlike other countries where a person uses one type of drug,” says Dr Katungi.

He adds that drug- sharing is a common habit among drug users because the cost of buying drugs is high making them put the money together and buy the drug which they put in one syringe to maximally use it.
“Sex addiction is liable to drug use since drug users share needles and drugs, they end up having sex together believing everything in between them can be shared. Sex workers on the other hand say drugs empower them to approach any person easily without fear or minding about their health status,” Dr Katungi explains.

Effects of drug abuse, addiction

Drugs are chemicals. Different drugs, because of their chemical structures, can affect the body in different ways. In fact, some drugs can even change a person’s body and brain in ways that last long after the person has stopped taking drugs, maybe even permanently.
Injuries
More deaths, illnesses and disabilities stem from substance abuse than from any other preventable health condition. Today, one in four deaths is attributable to illicit drug use. People who live with substance dependence have a higher risk of all bad outcomes including unintentional injuries, accidents, risk of domestic violence, medical problems, and death.

Health Problems
The impact of drug abuse and dependence can be far-reaching, affecting almost every organ in the human body. Drug use can:

Weaken immune system
This in turn causes cardiovascular conditions ranging from abnormal heart rate to heart attacks. Injected drugs can also lead to collapsed veins and infections of the blood vessels and heart valves.
Drugs cause nausea, vomiting and abdominal pain as well as seizures, stroke and widespread brain damage.

Effects on brain
Although initial drug use may be voluntary, drugs have been shown to alter brain chemistry, which interferes with an individual’s ability to make decisions and can lead to compulsive craving, seeking and use. This then becomes a substance dependency.

Behavioral Problems
Paranoia, aggressiveness, hallucinations, addiction, impaired judgment, Impulsiveness, loss of self-control, birth defects

Overcoming addiction

1/Different across:
Everyone’s needs are different. Drug addiction treatment should be customised to your unique situation. It’s important that you find a program that feels right.

2/More than just drug:
Addiction affects your whole life, including relationships, career, health, and psychological well-being. Treatment success depends on developing a new way of living and addressing the reasons why you turned to drugs in the first place.

3/Commit and follow:
Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need. And in all cases, long-term follow-up care is crucial to recovery.

EXPERTS SAY
Tinka Zarugaba, a superintendent of police “no Police officer would arrest a mad and sick drug user and put him or her in prison but since there is no proper rehabilitation place, they are kept in prison.” The available private rehabilitation centres for drug user victims are expensive and most of the drug abusers we arrest are poor and cannot afford them neither their parents.
Twaibu Omara the executive director of Uganda Harm Reduction network (UHRN); ‘We have started a campaign to support people using drugs not to be seen as criminals but as patients.