The time bomb of illicit drugs, alcohol abuse

Feb 12, 2019

A study on drug and substance abuse in schools found that between 60 to 70 per cent of the students used illicit drugs with alcohol

By Prof. George B. Kirya
 
To many patriotic Ugandans, it has become very worrying and astonishing to see that the general public in Uganda behaves as if they are not aware of how serious the problem of illicit drugs and alcohol abuse is in the country today! It is even more worrying when we consider our children in schools, the youths and adolescents in universities and other tertiary institutions, both the employment and unemployed, who seem to be the target of drug and alcohol sellers, especially in sachets and powder forms in the case of marijuana and njai among others. Many of the parents and guardians of these children also seem to think that their children are alright and are far from ever indulging in drugs abuse.
 
In 2017, Catherine Abbo et.al. asked 2902 students aged between 12 to 24 years from Gulu and Kampala schools, whether they had ever used alcohol and illicit drugs, 70 per cent of them said that they had ever used alcohol and illicit drugs. And 39.1 per cent said that they regularly used substances of abuse. 
 
In some schools around Kampala, when questioned, all students in the schools said that they knew about the existence of the illicit drugs and had seen some people using them and some 20 to 30 per cent had themselves used drugs. The most common drugs used are tobacco in form of cigarettes, Shisha and Kuber, Marijuana (Weed), Mairungi (Khat), and some children from affluent families get access to cocaine and heroin.
 
In 2013 Agnes Namaganda said that Substance Abuse is the leading cause of students' drop-out of school. Eighty per cent of all clients at the National Care Centre (NCC) are school drop-outs between 18-23 years of age. NCC is one of the few private drug rehabilitation centres in the country. In the same year, Violet Nabatanzi said that 45 per cent of school children in the country take Marijuana, Alcohol and Heroine and the number of victims is increasing.
 
A study on drug and substance abuse in schools found that between 60 to 70 per cent of the students used illicit drugs with alcohol and cannabis taking the biggest percentage.
 
The extent of the use of illicit drugs has increased tremendously in Uganda. Children are falling out of school due to the habit and too much alcohol all over the place. This has also contributed a lot to the increase of crime, and disruption of society.
 
In 2014, the World Health Organization's Global Status on Alcohol and Health Report indicated that Uganda was the highest consumer of alcohol for each person( per capita) in the entire  East African Region. What is more worrying is that almost 90 per cent of Ugandans consume unregulated and illegally sold alcohol. Those who consume pure alcohol, are said to consume 23.7 litres per person per year. Rwanda and Burundi follow, each registering 22.0 litres per capita per year. Kenyans follow with 18.9 litres of alcohol consumed per capita, while  Tanzanians consume only 18.4 litres per capita. American drinkers, in comparison, drink 13.3 litres per capita yet they have the money and better brands. As a consequence, 10 per cent of males and 1.5 per cent of females in Uganda have an alcohol-related disorder.
 
Gilbert Kidimu in 2013 said that drug and substance abuse is today, more than ever before, far and wide in Uganda.  One can easily count the family, friends and loved ones completely lost to these terrible addictions mostly attributed to peer pressures, more pronounced among teenagers than in any other age group.
 
In May 2013, my article titled:  "Illicit drugs a time bomb"  Alluded to Uganda having become a transit country for the dangerous drugs or  Narcotics including cocaine, heroin, cannabis, methamphetamine and amphetamine, to other countries especially  Europe and Asia. In 2008, it had also become a known secret that Uganda had also become a very active and significant consumer of these dangerous drugs.
 
Christopher Jones-Cruse says that smugglers of the illicit drugs are now said to be transporting large amounts of drugs through Uganda, including heroin and cocaine to Europe. Some of the illicit drugs are also sold in Kampala and this is what has led to an increase in the number of Ugandans who are addicted to these substances of abuse. These addicts are also at risk of becoming infected with HIV through injected drugs or unprotected sex.
 
In March 2013, Uganda was ranked 8th in the world and the 1st on the continent in taking alcohol, with Waragi taking the top position.
 
Inhalants like paint thinner and glue are also common among street and slum youths. Chewing of Mairungi (Khat) has also spread rapidly in the country. Abuse of heroin have also been reported in the country. Kids on the street think that drugs improve their lives. But it is a major risk for risky sexual behaviour with the enhanced transmission of HIV/AIDS and other sexually transmitted diseases.
 
Hellen Byomire (2013) of NDA said that Ugandans need to know how much all of us have been affected by drug abuse. If you have not used drugs, at least there is someone you know or care about who has been a victim. Uganda has been robbed of important citizens, talented, bright and promising students who have dropped out of school, Professors, Doctors, Fathers and Mothers, among others have been destroyed because of using drugs and excessive alcohol. It is a real danger in society as these days drugs and alcohol are no longer obscure like they used to be. They are now everywhere and they come in varieties.
 
General reports show a great cause of concern as the situation is already out of hand, where illicit drugs and alcohol have infiltrated communities in suburbs, schools, universities and other higher institutions. There is, therefore, need for the general public to know and be aware of the situation and take responsibility, as everybody has an important role to play.
 
Uganda happens to be one of those rare countries where alcohol and drugs are sold and bought anywhere any time and to anyone, regardless of age. When one moves in the villages and towns upcountry and some areas in Kampala, one finds, as early as 10 am, people in groups, especially men and the youth, playing Ludo, Drafts, Omweso taking alcohol with drugs up to very late in the night, almost on a daily basis.
 
What is very disturbing is to know that in these areas there are leaders who are even facilitated to do their work. It is, however, very sad and surprising that these leaders allow such a situation to happen in their areas of responsibility without taking any measures to curb irresponsible behaviour. 
 
One has to give credit to those districts which decided to set up "By-Laws" controlling times when bars and places of recreation have to open and when to close and also putting age limit to those who can enter those places and also take alcohol. They also banned any alcohol to be sold in sachets in their districts.
 
Discipline is very important in development. The countries of Singapore and South Korea are good examples.
 
Dangers of Illicit Drugs and Alcohol Abuse
 
Illicit drugs and alcohol can have very negative effects on one's life. This can include altered brain chemistry, health complications, infections, legal issues, financial problems, accidental injuries and death. The fact is that while the drugs make one feel good, they are naturally causing long-term damage and one is definitely better off without them.
 
Drug and alcohol use impact nearly every part of one's body from head to toe. Some drugs can also stop your bones from growing properly, while others may cause muscle cramps and general body weakness. For the pregnant woman, effects are highly marked on very small babies and other abnormalities.
 
When you are under the influence of drugs or alcohol, you may forget to engage in safe sex practices, which increases the chances of contracting sexually transmitted diseases. Sharing of needles to inject certain drugs can give one diseases like Hepatitis C, Hepatitis B, and HIV.
 
Drug and alcohol abuse can also have legal consequences that you may have to deal with for the rest of your life. They make you more likely to experience physical injuries or be involved in motor accidents. There is also an increased risk of death through both suicide and killing others.
 
Drug-related deaths are on the rise in Uganda. Alcohol specifically results in 5.2 million accidental injuries and 1.8 million deaths worldwide each year. According to WHO it is estimated that for every 4 deaths one (25%) is caused by drugs and alcohol. No wonder we have so many motor accidents in this country. How about the increasing rates of domestic violence and recent murders in the country?*
 
The use of alcohol and illicit drugs during adolescent and early adulthood has become a very serious public health problem in Uganda.
 
Many of the worst alcohol-related illnesses are neurological. One common neurological disease is dementia which presents with poor memory. Others include damage to nerves leading to difficulty in moving (paralysis), swallowing (Dysphagia) and speaking (Dysarthria). 
 
The consequences of alcohol and drug abuse are strongly correlated with poverty. Alcohol not only prolongs poverty but poverty also promotes alcoholism. Impoverished people without hope of improving economically are more likely to spend their money on instant pleasures like alcohol and drugs than on, investments, for a future they do not think exists.
 
Drug and alcohol abuse, almost always lead to social problems like the serious violence commonly witnessed these days, the terrible motor accidents on our roads, suicide cases especially among adolescents, rapes which usually end up in killing the victim, rampant child abuse, the terrible domestic violence witnessed these days and assaults*.
 
Substance abuse and addiction have become very prominent among the youth of all social classes in Uganda and the bad habits start as early as in primary schools. Many families are found to suffer greatly. A survey shows that in many urban schools 1 in 3 high school students are drug users. 1 in 2 high school students report using Marijuana.
 
The National Mental Health Hospital, Butabika, shows that 40 per cent of hospital admissions these days are related to drug abuse. Chewing  Mairungi (Khat) is also spreading rapidly.
 
There is ample evidence that people with alcohol and/or drug dependence are on sick leave more frequently than other employees. Heavy drinking at work may also reduce productivity. Workplace accidents and fatal accidents at work may also be linked to alcohol or drug abuse. There is no doubt that drug use in Uganda is on the increase, which is becoming tragic among the youth and the corporate.
 
There are many possible risks and dangers involved when using drugs and excessive alcohol. People experience problems with drug use because of other people's responses to them. There are conflicts in families, and other personal relations, getting thrown out of school, college or work, getting a criminal record, getting into debt to pay for drugs, violence with drug dealings, terrible accidents and so on.
 
Danger of Sachets
 
It is suspected that the horrendous behaviours we see in Uganda which we never used to witness in the past, like a man cutting off the head or arm of his wife during domestic violence,  a group stoning  someone to death, also ironically called "mob-justice" and burning the body of the victim, or individual killings, defilement, child sacrifice and the increased rate of HIV infection in specific places, are being associated with increased use of the illicit drugs and alcohol in this country which is distributed all over the country in sachets.
 
People become less and less productive. One wonders how much productivity Uganda is losing per capita, due to the excessive taking of illicit drugs and alcohol, taken any time of the day in sachets. This is why countries like China are very strict and ruthless with people who are caught and are proved to deal in drugs. They face the firing squad or life imprisonment. These countries know and fear the consequences of allowing their population to indulge in drugs.
 
Uganda has become an all-important transit point for drugs on their way to the destination countries especially in Europe and Asia.
 
Unfortunately, not all the illicit drugs that come in Uganda necessarily go out. The use and purchase of drugs goes on in the late hours of the night in the city, the urban and suburbs of the country. This shows that Uganda has seriously transformed from a transit hub to a hub of big consumers. Because illicit drugs in large quantities are very expensive, beyond the reach of the common Ugandan, any narcotics make it to the open market through networks of small local dealers who make it available to the consumers in small pocket-friendly packages. Uganda has become the source of illicit drugs and alcohol, in the region, especially Waragi and Gin sold in sachets.
 
School children in boarding schools have found these sachets very convenient to smuggle into their dormitories and classrooms. Many use their Foam mattresses and cut them in the middle and stuff them with as many sachets of alcohol and sachets of illicit drugs as they can afford. Female students may use packets of their sanitary towels like "Always" and push in the sachets of alcohol or packs of drugs.
 
 Different drugs give rise to different signs and complaints (symptoms). Weed or Marijuana makes one very thirsty, eats without getting satisfied, they get disorganized and isolate themselves. The hard drugs drive someone into confusion when they do not get access to them; they will lie, will steal, make up stories to get money to maintain their expensive habit, because these drugs are always expensive in big quantities that is why the traffickers pack them into smaller units for easy buy.
 
Control of Illicit Drugs and Alcohol Abuse
 
The longer we wait to curb using illicit drugs and too much alcohol in Uganda the more we are to be doomed. And I can say that the "Time Bomb of Illicit Drugs and Alcohol abuse" in Uganda is already ticking. We need to act now before the explosion takes place, which will be disastrous to our Pearl of Africa.
 
While fighting the Non-Communicable Diseases (NCDs), we should take Illicit Drugs and excessive alcoholism in Uganda as enemy number one. We need to carry out aggressively the teaching of behaviour change of Drug and Alcohol abuse through constant behaviour change communication to the communities, especially the youth, all over the country. This should start at home, then schools, Churches and all big gatherings.
 
There is a suggestion that in order to stop illicit drugs entering boarding schools, Head Teachers should start hiring Sniffer dogs to go through all school dormitories at the beginning of each term and the mid-term to smoke out those students who smuggle-in these dangerous substances. There should also be effective counselling and mentorship starting at home.
 
Those who are already addicts can be helped by counsellors in schools, hospitals or churches. But rehabilitation of these people may not help them get well completely. Some of them relapse and sometimes give up completely.  In case of extreme conditions, that is when they need Mental Health Professionals in a facility like the Butabika National Referral Hospital, where there is a special Alcohol and Drug Unit (ADU) to deal with these people.
 
One wishes the government would realize, sooner than later, the damage sachets of alcohol and drugs are causing, not only to the general community but also to our children in schools, universities and other training Institutions. Sachets are contributing a lot to the terrible road accidents we see on our roads, the danger in our offices, in some of our Boardrooms and even our homes.
 
We need to enact and also make sure we implement a strong law to address this big danger of illicit drugs and alcoholism, that have easily invaded our community, especially the youth through sachets. All sachets must be banned with immediate effect.
 
Neighbouring Kenya, Rwanda and Tanzania have increased their efforts to end the transport of illicit drugs into their countries. In comparison, Uganda's laws under the National Drug Authority are very weak, compared to those in our neighbouring countries.
 
 The maximum conviction under the NDA law of three years in prison and a fine of not more than 2 million Uganda shillings, makes it by far the weakest punishment within the East African Region, where Kenya, has a life sentence for traffickers and fines up to three times the value of the illicit drugs one is caught with. They also have a time limit when bars and recreation places open and close. Traffickers in Rwanda face life imprisonment, while those in Tanzania get lengthy sentences and hefty fines.
 
The lenient sentences and fine in Uganda do not come anywhere close to deterring traffickers. Often those caught insist on being taken to court almost immediately and they plead guilty and pay the fine. For someone trafficking drugs worth tens or hundreds of millions, a two million fine is nothing
 
It is high time our leaders in all levels of Government showed serious concern about the situation going on in the country with this illicit drug abuse and the rampant alcoholism everywhere. Parliament should also take interest in coming up with more effective laws and pass them soon.
 
A new law on Narcotics was recently passed by Parliament and assented to, but it has never been put to force, thus the reason why Uganda still lags behind in drug control in the region.  The concerned Ministry of Internal Affairs should take interest in ensuring that the law is made operational sooner than later. The relevant Ministries of  Health and Trade should also work on Alcohol control through relevant laws and policies.
 
Writer is a Professor of Medical Microbiology, chairman of Butabika National Referral Hospital Management Board and former vice-chancellor, Makerere University.

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