OVERVIEW OF SUBSTANCE ABUSE IN GHANA

1. OVERVIEW OF SUBSTANCE ABUSE IN GHANA DR J.B.ASARE

2. INTRODUCTION • Historically psychoactive substances used for centuries for various reasons including cultural/religious and recreational purposes • Scientific advancement leading to pharmacological revolution has produced substances preferable for abuse particularly by the youth • These substances have addictive properties that make them to be abused

3. INTRODUCTION • Substance abuse a problem all over the world • Ghana has its share of the problem but has limited resources to tackle the problem. • Whereas we have the problem of abuse of socially accepted substance like alcohol, tobacco and prescribed drugs in recent times, Ghana has been confronted with the abuse of narcotic substances.

4. TYPES OF SUBSTANCES ABUSED IN GHANA • Cannabis Cocaine Heroin Amphetamine type stimulants Alcohol Tobacco Inhalants Prescribed substances

5. CANNABIS ABUSE • Main narcotic substance of abuse in Ghana. • Its cultivation is on the increase and Morocco remains the world’s largest producer • Prior to the production of synthetic fibre, cannabis plant was the main source for the production of strong fibres. • Its abuse in Ghana associated with our soldiers participation in the 2nd World war when they acquired the habit and brought samples from India

6. CANNABIS ABUSE • The youth and young adults over represented in its abuse. Consumers however cut across the socio-economic strata • Delta-9- Tetrahydro- cannabinol is the main alkaloid responsible for the most psychoactive effect of cannabis. • Its production may be related to unemployment and the fact that it is a profitable business.

7. CANNABIS ABUSE • Three illicit drugs are produced from cannabis • Marijuana, the leaves and flowering of the cannabis plant, dried to produce a tobacco-like substance that is smoked. • Hashish, THC resinous material of the cannabis plant, collected, dried and compressed into balls, cakes or cookie-like sheets. Pieces are broken, put into pipes and smoked • Cannabis Oil, extracted from the plant and used –added to drinks or soaked into cigar/tobacco and smoked by unsuspecting naive people.

8. CANNABIS ABUSE • Effect of cannabis on users - Palpitations ,reddening of eyes, impaired concentration and hunger. • Hallucinations, psychotic experiences • Amotivational syndrome ( apathy, impairment of judgement, memory , concentration and loss of interest in personal appearance)associated with long-term use

9. COCAINE • Most potent stimulant of natural origin extracted from coca plant which is indigenous to the Andean highlands of South America. • Trafficked from South America through East and Western Africa to Europe. According to Interpol estimates 200-300tons of cocaine is smuggled from Africa to Europe each year. • Its abuse surfaced in mid-eighties in Ghana and there has been escalation in its use • Illicit cocaine is usually distributed as white crystalline powder and is expensive. • Often snorted or dissolved and injected • Crack cocaine is available in some African countries smoked in pipes.

10. COCAINE Effects on Users • When used, a pleasurable state of euphoria is induced and there is relief from fatigue. • Increased mental alertness and physical strength. • Reduction of hunger and indifference to pain. • Large doses can cause paranoia and tactile hallucinations( animals crawling on the skin)

11. HEROIN • A substance obtained from the poppy plant and produced from opium base obtained from this plant. • Trafficked to Ghana from South East Asian countries in transit to Europe and North America. • The main routes are from Kenya, Ethiopia and The United Arab Emirates • Most worrying aspect is its intravenous use which leads to the spread of HIV infection

12. HEROIN • Effects on the user The effects are general central nervous system depression, reduction in pain perception, reduction of fear ,lessening of inhibitions and elevation of mood. Produces withdrawal symptoms on abstention such as • pains in the joints • Shivering with diarrhoea ,abdominal craps and vomiting • Nasal discharge and tears from the eyes

13. APHETAMINE TYPE STIMULANTS • Stimulant psychotropic drugs under strict international control. They were initially used for Attention Deficit Hyperactivity Disorder (ADHD) and Narcolepsy. • Due to strict controls, they are produced in clandestine laboratories and it is suspected that they are being produced in some African countries. • They are used by some long distance drivers to keep awake. • It also used by some people to suppress appetite in order to reduce weight.

14. APHETAMINE TYPE STIMULANTS • Perceived effects on users include • Wakefulness • Mental alertness • Increased initiative • Improved concentration • Elevation of mood • Confidence and • Talkativeness • Schizophrenic like symptoms have been observed in chronic users

15. ABUSE OF VOLATILE SUBSTANCES • Involves inhalation of vapours from a number of substances to produce rapid effects. • Its abuse is rare in Ghana • Range of substances of abuse include:- • Solvents such as toluene, hexanes, ethyl acetate, acetone, methyl ethyl ketone, methylene chloride and dichloromethane. • Commonly abused products include glue, cleansing fluids, lighter fuels, nail polish, paint thinners and aerosol products.

16. ABUSE OF VOLATILE SUBSTANCES • The effects of volatile substances on users • They lead to lowered oxygen levels in the brain. • The effect is similar to alcohol intoxication but is short lived. • Users have slurred speech, feel dizzy stagger and have double vision. • Some become delirious • Prolonged us e can lead to brain damage, as well as damage to the kidneys and the liver.

17. ABUSE OF SOCIALLY ACCEPTED SUBSTANCES • ALCOHOL • Alcohol use is linked with socio-cultural life of Ghanaians. • Alcohol abuse in Africa is largely due to ignorance and increased efforts in its advertisement. • There are many psychiatric complications associated with chronic alcohol use but unfortunately many do not receive psychiatric attention. • Many complications of alcohol abuse find their way to general hospitals

18. ABUSE OF SOCIALLY ACCEPTED SUBSTANCES • Tobacco Tobacco use is one of the unfortunate habits acquired through ignorance of its harmful effects Efforts are being made to curb its use against deliberate efforts by multinationals and their agents to increase its use. There is a need to educate Ghanaians about the role of tobacco use in increasing the disease burden of the Ghanaians .

19. THE ABUSE OF PRESCRIBED DRUGS • Narcotic Analgesics Pethedine and Morphine Frequently abused by health personnel who have access to them. Usually abusers are introduced to these substances through careless prescription habits by prescribers. Withdrawal symptoms are similar to Heroin. • Abuse of Sedative -Hypnotics Barbiturates and benzodiazepines are abused in large quantities in Ghana. These drugs are not properly regulated and therefore can be found on the parallel markets

20. THE ABUSE OF PRESCRIBED DRUGS • Abuse of Anti malarias and Antibiotics Self medication, the sale of these drugs by quack doctors have resulted in the emergence of resistant strains of organisms.

21. REASONS FOR INCREASED DRUG ABUSE IN GHANA • Availability of drugs of abuse – cultivation, trafficking • Experimentation • Peer group pressure • Ignorance about the efficacy of drugs • Stresses of everyday life

22. CONSEQUENCES OF DRUG ABUSE • Health related issues • Mental health problems psychosis, withdrawal syndrome, Depression, Brain damage • Physical problems HIV infection Liver damage Social issues - Theft family problems, violent behaviours unruly behaviours and indiscipline Abuse of public authority Legal issues Gangesterism Arm robbery Drug trafficking Corruption

23. RESPONSE OF GHANA TO DRUG ABUSE • PNDC LAW 236 enacted with LI which established the Narcotics Control Board in 1990 • Addictive unit created at Korlebu • Psychiatric hospitals treating and offering counselling • Few private clinics and NGOs helping .

24. WHAT NEEDS TO BE DONE • Provision of a pilot National Treatment and Rehabilitation • Decentralization and expansion of interventions on drug abuse in relation to Demand reduction efforts • Provision of a national programme • Training of counsellors