Transcript OVERVIEW OF SUBSTANCE ABUSE IN GHANA

OVERVIEW OF SUBSTANCE
ABUSE IN GHANA
DR J.B.ASARE
INTRODUCTION
 Historically psychoactive substances used for
centuries for various reasons including
cultural/religious and recreational purposes
 Scientific advancement leading to pharmacological
revolution has produced substances preferable for
abuse particularly by the youth
 These substances have addictive properties that
make them to be abused
INTRODUCTION
 Substance abuse a problem all over the world
 Ghana has its share of the problem but has limited
resources to tackle the problem.
 Whereas we have the problem of abuse of socially
accepted substance like alcohol, tobacco and
prescribed drugs in recent times, Ghana has been
confronted with the abuse of narcotic substances.
TYPES OF SUBSTANCES ABUSED IN GHANA
 Cannabis
Cocaine
Heroin
Amphetamine type stimulants
Alcohol
Tobacco
Inhalants
Prescribed substances
CANNABIS ABUSE
 Main narcotic substance of abuse in Ghana.
 Its cultivation is on the increase and Morocco
remains the world’s largest producer
 Prior to the production of synthetic fibre, cannabis
plant was the main source for the production of
strong fibres.
 Its abuse in Ghana associated with our soldiers
participation in the 2nd World war when they
acquired the habit and brought samples from India
CANNABIS ABUSE
 The youth and young adults over represented in its
abuse. Consumers however cut across the socioeconomic strata
 Delta-9- Tetrahydro- cannabinol is the main alkaloid
responsible for the most psychoactive effect of
cannabis.
 Its production may be related to unemployment and
the fact that it is a profitable business.
CANNABIS ABUSE
 Three illicit drugs are produced from cannabis
- Marijuana, the leaves and flowering of the cannabis
plant, dried to produce a tobacco-like substance that is
smoked.
- Hashish, THC resinous material of the cannabis plant,
collected, dried and compressed into balls, cakes or
cookie-like sheets. Pieces are broken, put into pipes
and smoked
- Cannabis Oil, extracted from the plant and used –
added to drinks or soaked into cigar/tobacco and
smoked by unsuspecting naive people.
CANNABIS ABUSE
 Effect of cannabis on users
- Palpitations ,reddening of eyes, impaired
concentration and hunger.
- Hallucinations, psychotic experiences
- Amotivational syndrome ( apathy, impairment of
judgement, memory , concentration and loss of
interest in personal appearance)associated with
long-term use
COCAINE
 Most potent stimulant of natural origin extracted from coca
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plant which is indigenous to the Andean highlands of South
America.
Trafficked from South America through East and Western
Africa to Europe. According to Interpol estimates 200300tons of cocaine is smuggled from Africa to Europe each
year.
Its abuse surfaced in mid-eighties in Ghana and there has
been escalation in its use
Illicit cocaine is usually distributed as white crystalline
powder and is expensive.
Often snorted or dissolved and injected
Crack cocaine is available in some African countries smoked
in pipes.
COCAINE
Effects on Users
 When used, a pleasurable state of euphoria is
induced and there is relief from fatigue.
 Increased mental alertness and physical strength.
 Reduction of hunger and indifference to pain.
 Large doses can cause paranoia and tactile
hallucinations( animals crawling on the skin)
HEROIN
 A substance obtained from the poppy plant and
produced from opium base obtained from this plant.
 Trafficked to Ghana from South East Asian countries in
transit to Europe and North America.
 The main routes are from Kenya, Ethiopia and The
United Arab Emirates
 Most worrying aspect is its intravenous use which leads
to the spread of HIV infection
HEROIN
 Effects on the user
The effects are general central nervous system
depression, reduction in pain perception, reduction
of fear ,lessening of inhibitions and elevation of
mood.
Produces withdrawal symptoms on abstention such as
- pains in the joints
- Shivering with diarrhoea ,abdominal craps and
vomiting
- Nasal discharge and tears from the eyes
APHETAMINE TYPE STIMULANTS
 Stimulant psychotropic drugs under strict
international control. They were initially used for
Attention Deficit Hyperactivity Disorder (ADHD)
and Narcolepsy.
 Due to strict controls, they are produced in
clandestine laboratories and it is suspected that they
are being produced in some African countries.
 They are used by some long distance drivers to keep
awake.
 It also used by some people to suppress appetite in
order to reduce weight.
APHETAMINE TYPE STIMULANTS
 Perceived effects on users include
- Wakefulness
- Mental alertness
- Increased initiative
- Improved concentration
- Elevation of mood
- Confidence and
- Talkativeness
- Schizophrenic like symptoms have been observed in
chronic users
ABUSE OF VOLATILE SUBSTANCES
 Involves inhalation of vapours from a number of
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substances to produce rapid effects.
Its abuse is rare in Ghana
Range of substances of abuse include:Solvents such as toluene, hexanes, ethyl acetate,
acetone, methyl ethyl ketone, methylene chloride
and dichloromethane.
Commonly abused products include glue, cleansing
fluids, lighter fuels, nail polish, paint thinners and
aerosol products.
ABUSE OF VOLATILE SUBSTANCES
 The effects of volatile substances on users
- They lead to lowered oxygen levels in the brain.
- The effect is similar to alcohol intoxication but is
short lived.
- Users have slurred speech, feel dizzy stagger and
have double vision.
- Some become delirious
- Prolonged us e can lead to brain damage, as well as
damage to the kidneys and the liver.
ABUSE OF SOCIALLY ACCEPTED
SUBSTANCES
 ALCOHOL
- Alcohol use is linked with socio-cultural life of
Ghanaians.
- Alcohol abuse in Africa is largely due to ignorance
and increased efforts in its advertisement.
- There are many psychiatric complications associated
with chronic alcohol use but unfortunately many do
not receive psychiatric attention.
- Many complications of alcohol abuse find their way
to general hospitals
ABUSE OF SOCIALLY ACCEPTED
SUBSTANCES
 Tobacco
Tobacco use is one of the unfortunate habits acquired
through ignorance of its harmful effects
Efforts are being made to curb its use against
deliberate efforts by multinationals and their agents
to increase its use.
There is a need to educate Ghanaians about the role of
tobacco use in increasing the disease burden of the
Ghanaians .
THE ABUSE OF PRESCRIBED DRUGS
 Narcotic Analgesics
Pethedine and Morphine
Frequently abused by health personnel who have access to
them.
Usually abusers are introduced to these substances
through careless prescription habits by prescribers.
Withdrawal symptoms are similar to Heroin.
 Abuse of Sedative -Hypnotics
Barbiturates and benzodiazepines are abused in large
quantities in Ghana.
These drugs are not properly regulated and therefore can
be found on the parallel markets
THE ABUSE OF PRESCRIBED DRUGS
 Abuse of Anti malarias and Antibiotics
Self medication, the sale of these drugs by quack
doctors have resulted in the emergence of resistant
strains of organisms.
REASONS FOR INCREASED DRUG ABUSE IN
GHANA
 Availability of drugs of abuse – cultivation,
trafficking
 Experimentation
 Peer group pressure
 Ignorance about the efficacy of drugs
 Stresses of everyday life
CONSEQUENCES OF DRUG ABUSE
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Health related issues
Mental health problems
psychosis, withdrawal syndrome,
Depression,
Brain damage
- Physical problems
HIV infection
Liver damage
Social issues
- Theft
family problems,
violent behaviours
unruly behaviours and indiscipline
Abuse of public authority
Legal issues
Gangesterism
Arm robbery
Drug trafficking
Corruption
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RESPONSE OF GHANA TO DRUG ABUSE
 PNDC LAW 236 enacted with LI which established
the Narcotics Control Board in 1990
 Addictive unit created at Korlebu
 Psychiatric hospitals treating and offering
counselling
 Few private clinics and NGOs helping .
WHAT NEEDS TO BE DONE
 Provision of a pilot National Treatment and
Rehabilitation
 Decentralization and expansion of interventions on
drug abuse in relation to Demand reduction efforts
 Provision of a national programme
 Training of counsellors