Report of 2018 NIDA International Forum, San Diego, USA

INTRODUCTION

This report was written by Ikenna Daniel Molobe, Co-founder/Director of Unified Initiative for a Drug Free Nigeria; who presented a poster of his research, with support from the UNODC, at the 2018 National Institute on Drug Abuse (NIDA) International Forum held in San Diego, California, USA. The researcher’s abstract titled “Drug Abuse and Unsafe Abortion among Teenage Girls in Nigeria” was accepted for poster presentation at the conference. The conference tagged “Building International Collaborative Research on Drug Abuse” was organized by the U.S National Institute on Drug Abuse (NIDA). Ikenna Daniel Molobe received a travel grant/sponsorship from the UNODC for the presentation of his research poster at the conference. The UNODC and European Union (EU) were acknowledged in the presentation poster.

The 2018 NIDA International Forum was held on the June 8 – 11 at the Hilton San Diego Bayfront Hotel, San Diego, California, USA. The NIDA International Forum is an annual event that attracts nearly 200 international researchers and policymakers to address the global problems of drug abuse and addiction. The forum takes place in conjunction with the College on Problems of Drug Dependence (CPDD) Annual Scientific Meeting, which attracts more than 1,000 drug abuse researchers from around the world. During the two meetings, participants network with other researchers and policymakers to discuss prospective drug abuse treatment and prevention collaborations. The NIDA/CPDD international Forum Poster Session was held on Monday 11, 2018.

The research symposium, poster session, and network-building activities focused on the range and quality of drug abuse research conducted around the world. Participants were able to meet with talented colleagues and learned about drug abuse research and policy issues in other countries as well as the NIDA-supported fellowships and other programs that can support international collaborations.

The aim of the NIDA International Forum

The aim of the forum is to share updates on emerging trends in drug use, research advances, and mechanisms to promote and implement evidence-based drug policies and interventions.

OVERVIEW AND MAJOR HIGHLIGHTS OF THE CONFERENCE

The major discussion at the conference focused on the following;

International Perspectives on Opioid Overdose Prevention – Challenges and Innovations:  it was debated that opioid overdose and abuse is at the increase globally, and this was as a result of increase in production of opium and heroin in Afghanistan. It was highlighted that the United States has witnessed an increase in opioid overdose and increase number of women using opium according to the NIDA research. The same have also been seen in UK, Norway, Finland, Turkey and Spain. It was emphasized that due to this increase there is need to increase treatment facilities in every nation. It was also stressed that drug use in prison attracts additional risk while the prison setting lacks access to services (social, health and treatment). There is also need to improve the prison services by providing public health services for the welfare of the inmates.

According to Elizabeth Saenz De Martinez of United Nations office on Drugs (UNODC) who presented a paper on “Global Epidemiology and Strategies Addressing Opioid Overdose”, mentioned that the UNODC/WHO prevention strategy is based on; improving opioid prescribing, preventing opioid use disorder, treating opioid use disorder, emergency response to overdose to create a protective community, treatment in prison, naloxone use for treatment, overdose management training, treatment as an alternative to conviction or punishment. She also mentioned that UNODC/WHO launched S-O-S (Stop Overdose Safely) initiative and people living with opioid disorder (PLWOD) have been trained under this initiative. S-O-S initiative as she described is an initiative for promoting the expanded community management of opioid overdose, launched by UNODC and WHO at the commission on Narcotic Drugs (CND) 2017. She therefore urged that any country interested in S-O-S study is welcome to join.

Robert Ali of the University of Adelaide, Australia, who presented his recent study on opioid overdose prevention program in Australia, stated that 1.3% adult Australian ever used heroin while 0.2% used heroin in last month and most commonly misused pharmaceutical are opioid. He also stated that 1,489 accidental overdoses were recorded in 2015 which revealed an increase from 981 deaths in 2001 and greater number of deaths than from road accident. Robert Ali mentioned that opium is marketed regionally in Australia. Based on his recommendation, he emphasized as follows; that government should subsidize the cost of naloxone (medication used to block the effects of opioids, especially in overdose), rescheduling of all codeine based medicine to be prescription only, and community advocacy.

On the research presentation on Opioid Overdose Prevention Program in Asia by Chitlada Areesantichai, an Associate Professor, Drug Dependence Research Centre, College of Public Health Science, Chulalongkorn University, Thailand; there were 12.3% of 460 people who inject drugs-PWID in Malaysia (RDs in 2010) and in Thailand, 30% of a sample of PWID in Bangkok have lived through at least one non-fatal overdose (Millov et al, 2009). Chitlada stated that on the assessment of harm reduction interventions among PWID that IDU champions should be trained and baseline overdose epidemiology should be conducted in local communities.

Daniel Goonan, an executive of the Manchester New Hampshire Fire Department (MFD), discussed on their Safe Station program. Based on his presentation, he mentioned that MFD responded to 2, 600 opioid overdose from 2015 – 2017, while methamphetamine, crack and alcohol overdoses double these response number. The Safe Station turns fire stations into a point of first contact for people seeking help in their struggle with addiction. The program continues to receive referrals and walk-in from around the state and the country.

International Consortium of Universities for Drug Demand Reduction (ICUDDR): the presentations and discussion on this session emphasized the need to increase addiction studies and drug abuse curriculum/courses in the universities/higher institutions. Roger Peters of the Department of Mental Health Law & Policy of University of South Florida, spoke on the Global Network of Coordinating Centers for the UTC and UPC Curricular. He said that the International Society of Substance Use Professionals (ISSUP) has developed the Universal Treatment Curriculum (UTC) and Universal Prevention Curriculum (UPC), and there is need to identify universities to implement and disseminate both curricula to ensure best practice in the treatment and prevention of addiction and drug use. According to Kimberly Johnson of ICUDDR, there is also need to support addiction studies through research, and need to develop feedback loops between research, education and practice.

The professor of Psychiatry of University of California, Igor Koutsenok, spoke extensively on the challenges and potentials in addiction medicine training in medical schools. The following were the challenges and the bases for the need to improve addiction training in medical schools;

• More than 50% of patients reported that their primary care physician did not address their substance use.
• More than 40% of patients stated that their physician missed the diagnosis of a substance use disorder.
• Adequate knowledge is not given to medical students on addiction medicine.

Therefore, he concluded that in addition in implementing training strategies focus should be placed more on public health than psychiatry, psychology, addiction medicine, etc, and training should not only be in clinical services but training in research practices.

POSTER PRESENTATION

Joint NIDA International Forum and CPDD workshop poster presentation session was held on Monday 11th June 2018 from 7pm – 9pm. More than 100 international research posters were displayed during this session. Researchers and delegates during this session learned about researches conducted outside of the United States and met NIDA staff and colleagues from around the world for networking and collaborative opportunities..

Abstract on the Research Poster presentation on “Drug Abuse and Unsafe Abortion among Teenage Girls in Nigeria” by Ikenna Daniel Molobe, Co-founder/Director of Unified Initiative for a Drug Free Nigeria

Background: The incidence and risk of unsafe abortion among teenager in Nigeria has been linked to drugs and substance abuse.

Methods: The study methodology adopted the use of qualitative and quantitative approach. Focus Group Discussions (FGD) were conducted among secondary school students in five selected communities in Lagos state. In-depth interviews were conducted with volunteer victims of unsafe abortion and key informant interviews with selected identified institutions (NGO, CBO). There was also a desk review of records and case reports and questionnaire administration among institutional staff for quantitative evaluation.

Results: Findings revealed the most abortion substances used by the teens; herbal mixtures (38%), synthetic substances (25.6%), psychotropic drugs (25.6%), prescribed drugs (10.2%). Several of the affected teens that have committed an unsafe abortion are experiencing post abortion syndrome while passing through physical and emotional trauma thereby resort to drugs abuse, and some had educational setback. It was made known that in some attempt to abort a baby by use of psychotropic medications and other substances which failed has led to birth of deformed baby. The male partner responsible for the unwanted pregnancy influences the use of these drugs for the induced abortion. It was also found that these teen surf on the internet to discover abortion pills and have been able to obtain these pills from the pharmacy shops without doctor’s prescription.

Conclusion: Teens are experimental and engage in abuse and misuse of drugs and substances. This affects the body functionary system which may lead to infertility and damage to vital organs. Sexual Reproductive Health education and interventions should be coupled with drugs and substance abuse prevention to reduce the risky behaviors associated.

COMMENTS AND REACTIONS FROM OTHER DELEGATES ON THE ABOVE RESEARCH POSTER

• This is also a problem in other countries and preventive education and advocacy should be improved in Nigeria and globally.
• Government should start considering the policy to legalize abortion in order to reduce drug abuse which poses harm to the body.
• The research is very interesting and researcher should seek for international collaborative partnership to conduct a broader aspect of the research topic.