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Mental health and drugs: A nexus

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By Emmanuel Onwubiko

Adamu Bamidele Ikokwu (not real name) is one of the sons of the very senior politician in one of the communities not far away from Lagos. He was schooled in some of the best British affiliated schools and was then enrolled into the Ivy league University in the United States of America. Few days back, the father had the reason to fly into USA to fly back with his son when the school told the Parents to quickly find a solution to the blossoming hard drugs addiction habit of this boy who is an only Son. The most disturbing aspect was that the drug habit has led to the degeneration of his mental health. So his Dad flew him in to Nigeria but almost immediately hired some of the best psychiatric doctors who are about now battling to restore the mental health of this boy.

This then brings us to the fact that Nigeria has of recent recorded dozens of cases of young people simply running towards the Lagos lagoon through the third mainland bridge and making dives to the point of no return and eventual death.

Many fortunate young people have also been rescued by either good Nigerians or the police.

This high incidence of suicide especially amongst very young people is known to have a common denominator- hard drugs and abuses of illicit substances which also dovetails into depression.

The above fact came to the fore recently when the World marked the World’s Mental Health day and then the National Drugs Law Enforcement Agency (NDLEA) headed by Brigadier-General Mohammed Buba Marwa (rtd) held series of public enlightenment events on the nexus between abuses of hard drugs and chemical substances and mental health deterioration. The NDLEA has indeed rolled out strategic interventions to stave off what is most likely to become a national pandemic.

I will return to the theme of these entire staccato of public enlightenment events by the NDLEA but first what is mental health?

To attempt any good explanation will automatically begin from relating mental health to the causative factors and in doing this, we will take the intellectual liberty to reflect on a recent piece published by the World Economic Forum on the central theme of mental health.

The scholarly piece began by releasing shocking statistics. It says that 84 million people were forcibly displaced by conflicts and natural disasters in 2021 at the same time as which, the WHO says, mental health services have been severely disrupted, and the treatment gap for mental health conditions has widened.

People with mental health conditions die prematurely – as much as 20 years earlier than the average – due to preventable physical conditions, WHO figures show. They are also more likely to suffer severe human rights violations, discrimination and stigma in some countries.

It said too that an estimated 12 billion working days are lost each year to depression and anxiety, which the WHO estimates costs the global economy nearly $1 trillion. Even where help is available, stigma and discrimination prevent many people from getting the care they need.

Besides, the United Nations’ Good Health and Well-being Sustainable Development Goal calls for 80% of nations to integrate mental health into primary healthcare by 2030. However, WHO data published in 2021 showed only 25% of nations had a system in place to do so.

It observed that young people are particularly affected by mental health issues. The WHO says almost one in seven adolescents aged 10 to 19 live with some form of mental health condition. Suicide is the fifth most prevalent cause of death in this age group – 45,800 die each year, one every 11 minutes.

Almost one in five 15-24-year-olds in a global survey for the WHO reported that they often felt depressed and had little interest in doing things. According to the UK Mental Health Foundation, half of mental health conditions are established by age 14 and 75% by age 24.

The World Economic Forum’s Uplink innovation crowdsourcing platform is helping to find new ways of helping young people with mental health conditions. Its Youth Mental Health Challenge attracted 75 solutions to tackle the issue.

The 14 winning innovations – from smartphone-delivered therapy and training for young people in conflict zones to a crisis counselling service for LGBTQI+ people – will now receive funding from initiative sponsor Salesforce to help them become operational.

Back home, mental health was on the front burner during the Conversation Conference 2022 in Abuja as the National Drug Law Enforcement Agency, NDLEA, politicians, government functionaries, and other stakeholders gathered to discuss issues bordering on kidnapping, banditry, relationship, workplace issues, among others.

 

The Chairman of the National Drug Law Enforcement Agency, NDLEA, Brig Gen Buba Marwa (Rtd) called for genuine, thought-provoking conversations that will create the social change needed to put the mental health subject matter in the country into proper perspective and catalyse mass awareness, behavioural change, institutional action and national priority on the subject matter.

 

Marwa who spoke during the forum lamented that discourse on mental health is still shrouded in secrecy, steeped in stigmatisation and self-denial even as he called on all stakeholders to create awareness about mental health issues in order to give it the priority it required.

 

Mental health problems and substance use disorders sometimes occur together. This is because:- Certain illegal drugs can cause people with an addiction to experience one or more symptoms of a mental health problem

Mental health problems can sometimes lead to alcohol or drug use, as some people with a mental health problem may misuse these substances as a form of self-medication

Mental and substance use disorders share some underlying causes, including changes in brain composition, genetic vulnerabilities, and early exposure to stress or trauma.

More than one in four adults living with serious mental health problems also has a substance use problem. Substance use problems occur more frequently with certain mental health problems, including: Depression; Anxiety Disorders; Schizophrenia; Personality Disorders

Substance Use Disorders :- Substance use disorders can refer to substance use or substance dependence.

Symptoms of substance use disorders may include:- Behavioral changes, such as: Drop in attendance and performance at work or school; Frequently getting into trouble (fights, accidents, illegal activities);

Using substances in physically hazardous situations such as while driving or operating a machine.

Engaging in secretive or suspicious behaviors; Changes in appetite or sleep patterns.

Unexplained change in personality or attitude; Sudden mood swings, irritability, or angry outbursts

Periods of unusual hyperactivity, agitation, or giddiness; Lacking motivation.

Appearing fearful, anxious, or paranoid, with no reason; Physical changes, such as:- Bloodshot eyes and abnormally sized pupils.

Sudden weight loss or weight gain; Deterioration of physical appearance Unusual smells on breath, body, or clothing.

Tremors, slurred speech, or impaired coordination; Social changes, such as:- Sudden change in friends, favorite hangouts, and hobbies.

Legal problems related to substance use; Unexplained need for money or financial problems.

Using substances even though it causes problems in relationships.

Recovering From Mental Health Problems and Substance Use:- Someone with a mental health problem and substance use disorder must treat both issues. Treatment for both mental health problems and substance use disorders may include rehabilitation, medications, support groups, and talk therapy.

 

One good aspect as aforementioned is that this time around, the National Drugs Law Enforcement Agency has successfully incorporated substance abusers’ recovery and treatment programmes into its overall Mandates and has also established call centres for distressed members of the society. This is a demonstration of the mantra that “action speaks louder than words”.

The National Drug Law Enforcement Agency, (NDLEA) has similarly revealed that over 12,000 drug users underwent treatment and counselling in the past 20 months.

The Chairman/Chief Executive Officer of NDLEA, Brig. Gen. Mohamed Buba Marwa (retd) disclosed this in his speech at a conference on Mental Health organised by Intersect Consortium in Abuja.

He said there had been a sharp increase in reported cases of depression and suicides, which were symptomatic of mental health determination.

He explained: “The NDLEA has 26 treatment facilities across the country. In the past 20 months, over 12, 000 drug users have benefitted from brief intervention, counselling, treatment and rehabilitation in NDLEA facilities.”

General Marwa said the agency was also tackling other pertinent issues in treatment.

According to Marwa statistics have shown that drug use disorder sufferers were disproportionately female due to stigmatisation and other social constraints.

“Earlier in June when the opportunity came to have members of the Nigeria Governors’ Wives Forum in Drug Use Prevention, Treatment and Care (DPTC) training, NDLEA and the State first ladies were able to reach landmark resolutions, one of which was the need for primary healthcare centres to extend counselling and treatment to those with drug use disorder as well as the necessity of having treatment centres exclusively for female patients.

“Indeed, our society cannot afford to be nonchalant towards mental health issues. Already, it has entered into the stream of everyday conversation. You sometimes hear young people talk about maintaining their mental health.

“Whether or not they fully understand what that means is a different matter entirely. What we do know for a fact is that there has been a sharp increase in reported cases of depression and suicides, which are symptomatic of mental health determination,” he said

Quoting statistics by the World Health Organisation, (WHO), the NDLEA boss said before the advent of COVID-19, an estimated 970 million people around the world were living with mental disorders.

He explained that the figure translated to one in eight people of the 7.7 billion global population at the time.

“All around us today are aggravating conditions or factors of mental health degeneration, from economic depression to wars, from political oppression to social discrimination and from widespread insecurity to a self-destructive drug addiction lifestyle.

“No wonder that halfway into 2022, the world already has about one billion people living with mental health problems according to the World Health Organisation (WHO),” he said.

Marwa who only recently got a national honour from Nigeria bestowed on him by the appointing authority and the President Muhammadu Buhari, added that what was most disheartening was that one of seven sufferers was a young person.

There is therefore the nationalncrisis of breakdown of mental health and the most affected persons are the youngsters who ought to be at the centre of the National economy and productivity. Mental health issues caused amongst other factors by hard drugs will also affect the national and food security and will also affect the quality of politicians we recruit and elect to govern Nigeria at all levels. This is exactly why there is the need to address the issue of poor funding of the health sector and such critical institutional platforms as the National Drug Law Enforcement Agency that is currently being revitalised, reinvigorated, revolutionised and reformed comprehensively by the Chairman and Chief executive officer of the NDLEA Brigadier-General Mohammed Buba Marwa (rtd) and his able management team. Government needs to therefore prioritised the strategic management of issues relating to mental health of Nigerians and avenues for creating awareness must be escalated and formidable supported.

  • Mr. Onwubiko is head of the HUMAN RIGHTS WRITERS ASSOCIATION OF NIGERIA (HURIWA) and one time National commissioner of the NATIONAL HUMAN RIGHTS COMMISSION OF NIGERIA.

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