Our reporter (in blue jeans) engages a man who delivered her drugs outside Makerere
University’s main gate on April 7, 2023. PHOTO | ISAAC KASAMANI
I picked the third delivery on April 26, 2023. PK (not his real name), a drug dealer known as a plug, was out of town. He had promised to get me some ‘‘mushrooms’’, meth and cookies by the weekend but he didn’t. He probably thought I was still knocked out.
Since I was running out of time as I needed to run other errands, I decided to talk to my good friend Paul (not his real name) at around 9am. I asked if he could lay hands on some stuff for me. He said it was easy and that there were drugs everywhere. He connected me to someone he called JL (not real name), for brown sugar (heroin). We agreed to meet 11.30am at Makerere.
Well, the brown sugar delivery man went to JL’s home instead so we had to wait for a while. A few minutes after midday, the brown sugar arrived. When JL and Paul got to me with the drugs, JL asked if he could use the Shs1,000 note I was holding. I gave it to him and he then took me through the process of how to use it. He wrapped the brown sugar with the note.
He insisted on being there with me so he could see how I would react to it. He seemed worried for me but I told him I could handle it. JL left saying he was going to University Hall to get some lunch and a little sleep. Paul and I walked to Kikoni, a Kampala suburb, where I was supposed to get the other drugs that I had ordered.
It was a walk in the park because I had a very well-known middleman with me. He made a couple of calls and almost all my deliveries arrived except for one – weed tea – that Angella (a female plug) was supposed to deliver.
We got to a cocktail booth in Kikoni but were told the booth had run out of stock of the cookies I wanted. We then decided we would have lunch at a restaurant close by as we waited. We returned to the cocktail booth at about 1pm but Paul’s delivery man had not yet arrived. We waited for about three hours and he eventually came. As we had lunch, Paul spoke to Mani (not their real name), another plug who came and got us cosmos (a syrup from a pharmacy close by). We kept having conversations about drugs.
Another plug we were with had also run out of Oris (spiced tobacco), so he made an order for some. It came through even before the cookies did. We then left and went to a small kiosk for some type of drugs that are leaves and I left.
Since Angella did not deliver as promised, we agreed Paul would pick up the cookies from her and I would pick them up the next day. Paul had earlier called another female plug to bring us cookies but she wanted me to pay Shs10,000 per cookie and Shs10,000 for delivery so we had cancelled that deal.
At exactly 6:14pm, JL called to find out if I was fine. I told him I was still with my friends and I would take the brown sugar later. He said I would have the best sleep if I used it at night, and that would only happen if I followed his instructions.
National crisis
More than 30 percent of patients at Butabika hospital have a substance abuse problem, according to Dr Brian Byamah Mutamba, the deputy director and head of the Alcohol and Drug Unit at the national referral. Below are some of his insights on the issue on drugs.
Alcohol and drug use problems are brought about by the known action of the two on the mind and the body and that’s why we have a category of sicknesses or illnesses which are called alcohol and drug use disorders. It is because they come from the use of alcohol and drugs, which are mind-altering drugs, otherwise called psychoactive drugs.
Psychoactive means they act on the mind. That’s why they are of interest to us in the history of mental and addictive disorders. We are talking about those drugs that act on the mind or alter it because of their addictive properties.
Before we used to call it misuse or abuse but now, we categorise it as alcohol and drug use disorders and then the other subsets reflect the process. Some people do not use the drug as it ought to be used and that’s why they call it misuse or abuse, and then others become addicted and that is dependence on the substance.
There are a whole range of drugs, and I don’t want to mention them because if I do, people might get interested in using them. But they are known by health professionals and agencies that are responsible for controlling the trafficking and the supply of these drugs. Some are locally grown such as tobacco, marijuana, and mairunji, which is called khat. Then there are other drugs, which are manufactured (synthetic drugs), which are sold in various forms to cause addiction.
Between 30 percent and 40 percent of the people who access our services have alcohol or substance use problem. We have about 300 people who attend the outpatient department every month who are diagnosed with alcohol or substance use. Alcohol is the most used substance because it is legal and culturally acceptable. It’s widely used and is causing a lot of problems.
Majority of the people who are using these substances actually don’t come here. They are out there suffering without any form of help. It is only when they are in a crisis that they end up coming to the hospital.
We also have a medication-assisted treatment clinic. This is for people who use a different type of substance where they inject themselves and we are trying to assist them to recover by giving an alternative medicine that helps the body recover so that they don’t use that substance.
It has an enrolment of about 430, of whom about 300 come in daily for medicine. The other service we have is the mental health clinic and the general outpatient service where people come in for mental health and other services. It is mostly the young people, children in secondary school, that is 14 to about 25 years who we see coming. These are the most productive years, these people are in school and they are exposed to many things. They are also growing up and as adolescents, they are experimenting, so this is the age group that is most affected. The problem is widespread because the drugs are becoming more available. The people selling them are using all kinds of techniques to entice young people because they are impressionable.
The challenge is a lot of young people who should be receiving the service that helps them either not to start, or if they have started, to stop and recover, are not accessing the service. This is because a lot of alcohol and drug use is done in secrecy and a lot of the drugs they use are illegal.
To address the problem, it’s important that they come out and say, “I have a problem”. The most affected gender are the male but we have also noticed an increase in the number of females. One in three patients is a female. Sometimes patients come to the hospital themselves but it’s just one in five, for both inpatients and outpatients. Stigma stops these people from seeking help from Butabika. If people are not coming for treatment, then as a country we are heading for a pandemic due to drug use.
