A drug expert and consultant psychiatrist, Dr Victor Makanjuola, has described substance addiction as a chronic disease just like diabetes and hypertension that needs treatment that those affected cannot overcome by will power.
Dr Makanjuola spoke at the May 2019 Continue Medical Education edition of Nigerian Medical Association Oyo State branch, with the theme “Emerging Opioids Addiction Epidemic: A Ticking Time Bomb.”
The mental health expert said brain scans have shown that changes that take place in the brain of persons that abuse substance are not different from that seen in persons with other chronic diseases like diabetes.
According to him, although the initial use of the drug is voluntary, it’s subsequent use captures and rewires the brain to prioritise drugs over every other thing.
Dr Makanjuola declared that the chances of addiction vary from one individual to another based on their genetic makeup and other environmental factors such as stress, early physical or sexual abuse, witnessing violence, having parents who use drugs and their availability.
He added: “the fact is that the genes play a role. Addiction is out of the control of the individuals. That is why an addict cannot just quit and that is why treatment is essential.”
Dr Makanjuola stated that most people initiated drug use initially in the pursuit of pleasure, due to peer pressure or experimental use but continued because of its feel-good effect, to ameliorate pain, to boost their energy to work and have an underlying psychiatric disorder like anxiety.
“Some people use it when there is a background psychiatric problem; substance abuse begins as a means to alleviate symptoms of mental illness. Also, the same problem in the brain that is making the individual to use substance also causes a mental health problem to develop,” he added.
According to him, drugs user increases the vulnerability of developing mental disorders such as psychosis, depression, anxiety and panic attacks.
The expert described opiates as drugs derived from or related to opium such as cocaine, codeine, tramadol and morphine, adding that non-medical use of opioids has become a major threat to public health and law enforcement worldwide.
According to him, overall, men are three times more likely than women to use cannabis, cocaine or amphetamines, whereas women are more likely than men to engage in the non-medical use of opioids, sedatives and tranquillizers.
He added: “in Nigeria, one in seven persons aged 15 to 64 years had used a drug (other than tobacco and alcohol) in the past year. Among every four drug users in Nigeria, one is a woman. Also, one in five people who had used drugs in the past year is suffering from drug use disorders.”
The mental health expert listed the consequences of substance use to include physical health issues such as hepatitis B and C, HIV and ulcers; disruption of family life, divorce/separation, loss of job/status, disruption of academic career and sudden death from its overdose.
He warned that already in the USA, President Donald Trump had declared opioid crisis a ‘health emergency’ given that between 2000 and 2014, deaths from overdose of prescription opioid increased about three times.
“They do not even have a clue on how to address it, even when they have all the resources. Nigeria does not have the resources to address it, so we need to prevent people from going this way
“So, the best place to start is doctors being more mindful in their prescribing pattern, making sure that we do not prescribe opioids to those who do not need it.
“We are beginning to see the onset of deaths occurring in Nigeria due to opioids too. People are dying in our universities. That is why we need to act now.
Prevention is the most important thing, treatment is expensive. We need to educate the people. Every patient should get some drug abuse prevention education when they come to the hospital,” he added.