Better Knowledge for Better Care: Changing Substance Use Treatment and Prevention Narratives in Nigeria

Published by
Fatima Abiola Popoola
Publication Date
UTC Training participants at a training session, November 2019, Lagos Nigeria
Fatima and another participant, Photo taken during a UTC Training, Lagos Nigeria.

                                 International Day against Drug Abuse and Illicit Trafficking

                                                        Better Knowledge for Better Care

                        Changing Substance Use Treatment and Prevention Narratives in Nigeria

The United Nations International Day against Drug Abuse and Illicit Trafficking is observed annually on 26 June, since 1989. Part of the purpose is to raise awareness of the major problems that illicit drugs represent to the society. This day is supported by individuals, communities and various organizations all over the world. Stakeholders in the fields of drug abuse, addiction and mental health are concerned about Nigeria not having a standard National Policy on Drug/Substance Abuse, Addiction and other co-occurring Mental and Medical Disorders which addresses types of treatments, availability and affordability, stigmatization, human rights of People Who Use Drugs, treatment requirements, reintegration processes, family Involvements among others.  

According to the United Nations Office on Drugs and Crimes, the Theme for this year’s United Nation’s Drug Day is “Better Knowledge for Better Care”, the international organization further reiterated thatThe field of addressing the drug problem has been 'plagued' by misinformation of many kinds; people, policy makers and sometimes service providers work on the understanding that drug use disorders are not a multi-factorial health issue as agreed by the Member States in the Outcome Document of the 2016 United Nations General Assembly Special Session  (UNGASS) on the World Drug Problem, but a moral failure or a crime to be punished, moreover, what is not understood is that drug use disorders are the result of a complex interplay of factors that are very much out of the control of the individual, including factors in the genetics, mental health, and environment. Drug use disorders should not therefore be considered as self-acquired and do not deserve to be punished”. Nigeria’s legislation on drug control revolves around the U. N. International Conventions on Drugs as well as specific responses to local problems; this is why even where section 11(d) of the NDLEA ACT  (“Knowingly possess or using the drug popularly known as cocaine, LSD, heroin or any other similar drugs by smoking, inhaling or injecting the said drugs shall be guilty of an offence and liable on conviction to imprisonment term not less than 15years but not exceeding 25 years”) has not been repelled, the Agency does not prosecute drug users but refer such to its drug demand reduction department for counseling and rehabilitation (as specified in the conventions which Nigeria is a signatory).

Substance Use Disorders: Treatments in Nigeria: According to Al-Jazeera news of October 2, 2019 World Health Organization reports showed that there are less than 150 (One Hundred and Fifty) psychiatrists in the country of about 200 million population, the global health organization estimates that fewer than 10 percent of mentally ill Nigerians have access to the care they need. The National Drug Use Survey 2018 explained that drug use is estimated at 14.4% corresponding to 14.3 million people aged 15-64 years who had used a psychoactive substance for non-medical purposes in their lifetime, out of this 14.3million people 376,000 are high risk drug users, about 75,000 (1/5 of 376,000) of this are injecting drug users and about 150,000 (40% of 376,000) wanted treatment but could not get it because (a). They cannot afford treatments (b). The fear of being stigmatized (c).Treatment services not available, (d). No information about treatment availability. In the years 2019, some illegal and unprofessional rehabilitation centers (Kaduna, Kano, Katsina, Kwara, Oyo e.t.c) were raided and closed down by the Nigeria Police across the country for illegal detention, torturing, chaining, abuse of some children and adults on ground of mental illness and other substance use related treatments. According to Channel Television report of November 18, 2019, one of the owners of an illegal rehabilitation center that was discovered at Rigasa area of Kaduna State claimed that “the people were brought to the facility by their parents to undergo rehabilitation from drug abuse and other mental challenges”, this goes further to confirm that the inadequacies of psychiatric/substance use personnel and treatment centers may be one of the reasons to seeking alternative solutions from these unprofessional sources.

Evidence Based Practice: Prevention and Treatment are two sides of the same coin when it comes to substance use disorders. Treating People Who Use Drugs with substance use disorders and other co-occurring mental and medical conditions require some “know how”, it is a misnomer for a person (because he has the resources) to just wake up one day and decided that he wants to be drug prevention and/or treatment specialist; This required knowledge should and can be accessed at the right sources; the evidence base practice is universal and accessible if one is interested, the Universal Prevention Curriculum was designed to meet the current demand for a comprehensive training package in the field of drug use prevention based on evidence-based principles and the Universal Treatment Curriculum is aimed at reducing the significant health, social and economic problems associated with substance use disorders by building international treatment capacity through trainings and expanding the professional global treatment workforce. These two curriculums are informed by the International Standards on Drug Use Prevention developed by the United Nations Office on Drugs and Crime (UNODC) in 2013 and several teams of international developers with overall coordination by the International Centre for Credentialing and Education of Addiction Professionals (ICCE). To bring about the importance and meaning to this year’s United Nation’s Drug Day, it is pertinent on practitioners in the field of substance use to acquire better knowledge to be able to deliver better care to “our clients”.

Conclusion: All fields of human Endeavour requires knowledge in such fields to become successful, the Theme of this year’s U.N. Day “Better Knowledge for Better Care” is a clarion call to all persons who are involved in the services of providing care and services for mental and substance use disorders to be well equipped in evidence based knowledge so as to provide treatments and services that are scientifically and empirically proven to yield positive results. Drug control Interventions in Nigeria is based on the premise of Supply Suppression and Demand Reduction activities which focused on interception and seizures of illicit drugs and demand reduction programmes through drug education and public awareness, counseling, treatment and rehabilitation of people who use drugs, capacity building through trainings and research. These interventions will not bring about required success where drug use and addiction is still seen as a crime, moral failure, demonic attacks, spiritual problems and lack of willpower. I personally think that punishing drug users through incarceration, forced treatments and torture is part of fighting drug war which has been considered to have failed over the years, “as an investment the war on drug has failed, if it were a business, it would have been shut down long time ago, this is not what success looks like, Richard Branson (2016).

Recommendations:

  1. There is the need for a holistic approach to solving drug abuse and trafficking problems in the country; it is time to have a balanced approach of recognizing the human rights of people who use drugs on one hand and a functional criminal justice system to deal with drug traffickers on the other hand. (b) Most of the provisions of our drug laws are not compatible with contemporary views; these laws should be looked into, amended and repelled where necessary. (c) Stakeholders should not “rest on our oars” in advocacy and campaigns towards having a standard National Policy on Drug Abuse, Addiction and Mental Health in the Nigeria society; it takes a lot of resilience to get politicians to do the bidding of the citizens (d). Treatment for mental and substance use disorder should be based on the principle of Evidence Based Practice, this is a step towards protecting both the client and the service provider and will bring about a better and desired result. (e). Collaborations and synergy among stakeholders will bring about a lasting success in providing a better care for substance use disorders, everyone is important in this laudable process.  (f). Drug use problems is a global problem, it is a global emergency, the government of should give substance use problems the type of massive publicity that was given during the time of HIV/AIDS, Ebola and the COVID-19 pandemics. (g) The vulnerable population is very important (children and young people who have never experimented drug use), Evidenced Based Prevention Intervention should be directed towards this population, “a stitch in time saves nine”. While wishing Nigeria a wonderful Drug Day celebration we should all continue to do no harm but good.

Reference:

Al, Jazeera. "Traditional Healers Fill Nigeria's mental healthcare gap"www.aljazeera.com. Retrieved 22 January 2017.

World Drug Day 2020 Campaign Concept Note: www.unodc.org

National Drug Control Master Plan (NDCMP) 2015-2019

National Drug law Enforcement Agency, Federal Republic of Nigeria 2015 Annual Report.

National Drug Survey 2018, National Bureau of Statistics (NBS) and Center for Research and Information on Substance Abuse supported by United Nation’s Office on Drugs and Crimes. UNODC. 2019.

Fatima Abiola Popoola

Drug addiction Counselor, Researcher, Kaduna State, Nigeria

abiolaodus9 [at] gmail [dot] com