Substance abuse: A healthcare time bomb

We, therefore, need to ask ourselves when government and technocrats will institute interventional policies to curb substance abuse.

It is not uncommon to find unemployed youths in trading centres and towns around the country with zombie-like bulging blood-shot eyes playing board or card games or just being idle. Such scenes are in sync with 2008 World Bank report that puts Uganda among the countries with the youngest population and the highest youth unemployment rate of 83 per cent.

In the 2011/12 budget, the Minister of Finance acknowledged that Uganda’s economy could only employ about 20 per cent of the youths. If this is an accurate figure, it means more than 60 per cent of the country’s youth aged 18-30 are unemployed. Some of them, therefore, find temporary solace in substance abuse, which is gateway to chemical dependency.

When we talk of substance abuse/dependence, many people tend to focus only on the use of illicit drugs such as methamphetamine, crack-cocaine, marijuana, Lysergic Synthetic Diethylamide (commonly known by acronym LSD), hashish or heroin, forgetting that alcohol and liquor abuse are equally a chronic illness.

After all, a 2004 World Health Organisation (WHO) report ranked Ugandans as leading alcohol consumer in the world at 19 litres per year per capita, followed by Luxembourg at 17.5 litres and Czech Republic at 16.2 litres People who engage in substance abuse never consider or even fully understand the health consequences of the abuse that include predisposition of mental diseases prior to getting into the habit, until they are hooked.

With Uganda’s health delivery system in shambles and incapable to adequately cope with what I call ‘traditional’ diseases afflicting ordinary citizens such as malaria, TB, HIV/Aids, prenatal care, typhoid, pneumonia and cancer, the society is gradually morphing into adding extra burden on the healthcare system by fabricating substance abuse, whose implications most youths and indeed policy makers appear to be oblivious of.

Whereas there is a misconception that youth are the largest consumers of illicit drugs, the rich and famous engage in the habit, only that they conceal their practices.

The catastrophic ripple effects of substance abuse is not only limited to the drug dealers and users. They affect the entire fabric of society. For instance, for the dealers and users, there are the deaths from drug overdose and from revenge killings emanating from disputes over sharing of drug deal proceeds. But for the rest of the society who have nothing to do with the drug dealers and users, the collateral damage may even be more devastating.

We also have cases of aggravated burglaries, robberies and rape that are exacerbated by individuals’ irrational thought process and courage influenced by extreme sensory distortions, altered perceptions of reality and intense emotional states by substance abuse.

There is also the mental health aspect of substance abuse, which many youths appear to be ignorant about. Health consequences of powerful drugs often present themselves into mental health diseases-- schizophrenia -- where sufferers hallucinate and hear voices other people don’t hear, delusional beliefs of things proven to be false, paranoia and clinical depression, which commonly precipitates into suicides.

Other health issues with substance abuse are withdrawal symptoms, when the bodies of alcohol and drug addicts react to absence of the substance in their system and brain so viciously that it easily leads to seizures, cardiac arrest or death. Similarly, when the physical tolerance levels of alcohol and illicit drugs rise exponentially, it often results into death from overdose. Besides health repercussions of substance abuse to a broken-down health system, the potential of unemployed youth inebriated by alcohol and illicit drugs to be used for subversive activities is very high.

We, therefore, need to ask ourselves when government and technocrats will institute interventional policies to curb substance abuse. For example, fast-tracking establishment of vocational institutions across the country to churn out job creators could curb both youth unemployment and the permeation of illicit drug use.

There is also dire need to revise the punitive sanctions meted out to drug suspects since Uganda’s archaic drug laws are so weak that drug cartels from around the world find Uganda a conduit for their operations.

When we see countries such as China, Saudi Arabia and Singapore impose death sentences and life imprisonment on drug dealers, they send clear message to the cartels that their citizens’ welfare must be protected from drug cartels. To ameliorate social ills from alcohol and drug abuse like broken families and child abuse, domestic violence, rape, prostitution, robbery and suicides, the government must establish and fund substance abuse counseling and treatment clinics.

Without these control measures, the permeation of illicit drugs and indeed high alcohol consumption rate may soon become one of the most complex healthcare time bombs and malignant social cancers of our generation.

Mr Asedri is a medical information and substance abuse technologist based in USA.
dikumvi@gmail.com