Alcohol, Drug and Substance Abuse: A cause for concern

BY ALPHIOUS MUGARI

Alcohol, Drug and Substance Abuse, also known as Substance Use Disorder (SUD), is a mental health condition in which an individual has a problematic pattern of substance use that causes distress and/or impairs their life. Media reports in Zimbabwe paint a picture of a worrying and escalating state of substance use with substances such as methamphetamine (crystal meth, mutoriro or guka), broncleer, and marijuana being the commonly abused.
There is undoubtedly an escalating prevalence of Alcohol, Drug and Substance Abuse in Zimbabwe, with over half of the people admitted to inpatient mental health units such as Ngomahuru, Ingutsheni and Chikurubi Psychiatric Unit reportedly experiencing a substance use disorder. As government, healthcare professionals and advocacy groups strive to combat drug abuse, it is crucial to shed light on the causes, effects and potential solutions to this ever-growing problem. Full implementation of the, Zimbabwe National Drug Master Plan (2020-2025) will significantly help in the fight against drug abuse.

Major Drivers of Alcohol, Drugs and Substance Abuse
The major causes of Alcohol, Drug and Substance Abuse among young people are peer pressure and the desire to experiment. This however ends up leading to drug tolerance, dependence and addiction. Young people are often victims of a psychological phenomenon called deindividuation; they leave their personalities, values and beliefs while adjusting to their peers’. Drug abuse may start as a way to socially connect and most people use drugs for the first time in social situations due to the strong desire to fit in to the group.
When one spend time with a loved one, the body releases a chemical called dopamine, which makes one feel pleasure. It becomes a cycle; you seek out these experiences because they reward you with good feelings. Alcohol, drugs and substances, in the same manner also send massive surges of dopamine through your brain, leading to a person desiring more of these drugs or substances thereby leading to drug dependence and addiction.
The ease access and exposure to alcohol, drugs and substances in Zimbabwe’s towns and suburbs has also contributed to the increase in substance use disorder. Access to psychoactive substances is a significant environmental risk factor to drug abuse. The risk is further worsened by having a family member or peer who uses drugs and substances. Unemployment and economic hardships may trigger some youths to abuse drugs as a maladaptive coping mechanism. It is also worrying to note that most of the major suppliers of the illegal drugs are well known in most communities but they continue to ‘miraculously’ escape the ‘long arm of the law.’
Adverse childhood experiences (ACEs) is another risk factor for Alcohol, Drug and Substance Abuse among young people. ACE, refers to stressful, or traumatic events during childhood which can include childhood abuse, neglect, dysfunctional families, witnessing domestic violence as well as parental incarceration. Lack of household stability, income or employment for a parent may increase stress on the family and its vulnerability, pushing marginal individuals to find “solutions” or solace in drugs. Poor support systems emanating from dysfunctional families also pose a risk for drug abuse.
Effects of Alcohol, Drug and Substance Abuse
Young people who constantly abuse alcohol, drugs and substances often experience a myriad of problems, including academic problems, health problems (including mental health), poor inter-personal relationships, and involvement in criminal activities. Additionally, there are effects for family members, the community, and the entire society. In most cases, substance abuse drains a family’s financial and emotional resources.
Alcohol, Drug and Substance Abuse often lead to both short and long-term health effects. The Physical problems of drug abuse include increased risk of physical health issues, including heart disease, organ damage, cancer and stroke. On the other hand mental health problems of Alcohol, Drug and Substance Abuse usually include impaired cognitive functioning, hallucinations, personality changes as well as drug induced psychosis. Young people abusing drugs are at higher risk for mental health problems, including depression; conduct problems, eating disorders, sleeping disorders (insomnia) , personality disorders, suicidal ideation, attempted suicide, and even suicide. 
Alcohol, Drug and Substance Abuse also increases the chances of risky behaviours which can threaten a person’s life. The risky behaviours include driving while intoxicated which may cause accidents, or engaging in unprotected sex which can result in unwanted pregnancies, and sexually transmitted infections which include HIV. Drug addiction can also result in criminal activities such as stealing and violent behaviours which can result in imprisonment. Most young people who abuse drugs such as crystal meth (mutoriro) end up selling their belongings or stealing to get money to support their addiction.
Another major challenge that arises from Alcohol, Drug and Substance Abuse is dependence. Drug dependence refers to the strong desire to use the drug despite any related deterioration in one’s health, work, and social activities. Any attempt to stop using the drugs will result in withdrawal symptoms. Eventually, drug abuse can consume one’s life, stopping social and intellectual development. The uncontrollable craving to use drugs grows more important than anything else, including family, friends, career, and even one’s own health and happiness.
Declining grades, absenteeism from school, social activities, and increased potential for dropping out of school are some academic problems associated with adolescent substance abuse. Consequently, the community drug abuse challenge is brought into the workplace. Impaired performance, Intoxication at work, lateness, disciplinary issues, absence from work and finally dismissal will come with substance use disorder. Without doubt, drug abuse leads to decline in productivity at individual, family, community, and national level.

Recommendations
The global focus on mental health, coupled with the need to achieve equitable access to mental health services, are major factors behind an urgent need to urgently address drug and substance abuse at all levels. A myriad of evidence based interventions to fight substance use disorder have emerged.
The primary focus in fighting drug abuse must be on prevention, community involvement whilst taking an ecological perspective with a view to achieve social justice. Community initiated prevention strategies are crucial in combating substance abuse. The prevention strategies must focus on strengthening “protective factors,” such as well-developed social skills, strong family bonds, attachment to school, and active involvement in the community and religious organizations. They must also reduce “risk factors” that increase vulnerability to drug abuse.
Sport and recreational facilities must be availed at community level to keep young people occupied. There is a great need of more vocational training centres to equip young people with life skills. Resilience training is also an important factor; even in high risk, adverse circumstances, many people are able to resist drugs. On the other hand, the government must increase funding for mental health programs and anti-drug abuse initiatives. More community based rehabilitation programs must be introduced to help those struggling with drug abuse.
Law enforcement agents must work with local communities to fight drug peddling and drug abuse to improve quality of life. Police must show their commitment to fight drugs through arresting ‘real drug peddlers’ and not engage in ‘catch and release fishing’. On the other hand, deterring anti-drug laws must be in place to make drug peddling more risky. Penalty for stock theft is very harsh (long jail sentence) yet selling drugs which destroys human life like crystal meth can be punished through community which is quite paradoxical.
Schools can play a powerful role in drug abuse prevention. Teachers and administrators are the often the first to detect warning signs such as poor school attendance or declining academic performance. Effective school programs teach young people to resist drugs through, developing personal and social skills that include decision making, stress management, communication, social interaction, conflict resolution, and assertiveness. The schools also have a role to refer those at risk of drug abuse for professional help.
Charity always begins at home; hence parents have a role to instil moral values (unhu/Ubuntu) in their children. The more parents talk with their children about the dangers of drug abuse, the less likely it is that their children will experiment with them. In the African spirit of unhu/Ubuntu, it should take the whole village to raise a child rather than the Western individualistic approach which makes young people more unaccountable. Prevention programs must also focus on enhancing parent-child communication and improve other family skills.
With proper support and treatment, one can counteract the disruptive effects of drug abuse and regain control of life. There is need for counselling services from professional counsellors, psychologists and psychiatrists to help those struggling with drug abuse as well as those at risk. Those in need of rehabilitation will be referred for appropriate services. Rehabilitation should be seen as a means to help persons overcome addiction, not a form of punishment
Educating young people through awareness campaigns on the dangers of drug abuse is also crucial in fighting drug abuse. The mass media can also be employed in awareness campaigns and programmes. The objectives of mass communication efforts must be very clear and with specific outcome goals for them to be effective. Media such as television, radio, newspapers, posters, brochures may reach a large number of people with behaviour change and anti-drug campaign information. Role models who have recovered from drug abuse can be used as anti-drug abuse ambassadors to young people.
Conclusion
The battle against Alcohol, Drug and Substance Abuse is a complex and multifaceted challenge that requires collective efforts from individuals, communities and the government. Through prioritizing prevention, education and support systems we can work towards a future where substance use disorder is no longer a menace. A healthier and brighter future is only possible through collaboration and commitment whilst upholding the African spirit of unhu/Ubutntu.

Alphious is a registered Intern Community Psychologist – AHPCZ (A/PSY0796)
mugarialphy@gmail.com
0773 227 688

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