Substance Use Disorders

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Alcohol

Alcohol is addictive. Some of the warning signs include:
1. You need a drink to start the day or to function
2. You shake, sweat, and feel anxious / tense a few hours after your last drink
3. You can drink a lot without becoming drunk
4. You need to drink more and more to get the same effect
5. You find it difficult to stop even if you try
6. You continue drinking even though you can see it is interfering with your work, family and relationships
7. You forget events that happened when you were drunk.
Dealing with Alcohol Addiction
1. Acceptance
One of the biggest problems for anybody with a drinking problem is the acceptance that they have a drinking problem. 2. Keeping a Diary
Be truthful to yourself on how much or often you drink by either keeping a diary of past behaviour (preferably) or by trying to recount your past drinking behaviour.
Record at least the following:
• The type or types or subtypes (name them) of alcoholic drinks that you take
• How often you drink them in a day or week or month
• How much you drink
• Where you drink and with whom
• How it has affected your health, family, finances, work, relationship, maybe issues with the police
• Why you actually drink
• Why you actually cannot stop drinking
If the above simple questions about yourself are dealt with sincerely and honestly when you are alone, this may go a long way in delineating more clearly the issues involved around your drinking.
3. Making a Decision
Many people who make individual decisions not to drink can successfully stop drinking on their own or with the assistance of family or close friends, especially if their drinking habits/behaviour began early in their lives. However, there are those who will not be able to do so by using the initial stages described above. Such people need help.

Cannabis/ Marijuana /Bhang

Cannabis is taken primarily for its pleasant effects of feeling high, which include a sense of relaxation, happiness, sleepiness, increased intensity of colours, and a better appreciation of music. However, Cannabis has its own unpleasant effects that occur 1--10 minutes after intake. These include confusion, hallucinations, anxiety, and suspiciousness. A mixture of pleasant and unpleasant effects is common depending on the prevailing mood and circumstances. Although these effects are temporary, the drug itself may remain in the body for weeks. Cannabis acts like a long-term depressant and may reduce motivation of the person.
Educational impacts
Besides the above effects that are felt by the user, cannabis can have profound effects on the educational and learning capabilities and potential in an individual. These include reduced concentration, ability to organize and utilize information. Some studies have suggested a link between cannabis use in young people and poor school performance. The explanation for this is complex and may not be straightforward since children who abuse cannabis may be living in conditions that are not very conducive to excelling in school work.
Impacts on adult users
For the same reasons that cannabis users may have impaired educational and learning capabilities, working adults may have poor work output because of absenteeism from work and poor concentration. It can have a similar effect on social life. During flight simulations (not real flying), cannabis has been shown to affect the pilot’s concentration, leading to more mistakes (minor and major) in those who had smoked cannabis up to four hours before the start of the experiment, compared to those who had not taken cannabis. The effects could last up to about 24 hours. The same has been observed in drivers; those who use cannabis are involved in more major and minor accidents.
Effects of Cannabis on the Brain
Various parts of the brain are affected leading to various signs and symptoms.
• The pleasure causing parts of the brain---leading to sensations of relaxation, painlessness and well-being, and eventually addiction in some people.
• The cerebellum---concerned with coordination of body movement and therefore marijuana can lead to manifest limpness while walking.
• The hippocampus that is linked to the limbic system concerned with emotions, leading to emotional disturbances.
• Forebrain---concerned with our intelligence and judgement.
• Note that the parts of the brain that are damaged by marijuana are the parts that control emotions, memory, and judgement.
• Development of mental illness---cannabis can induce various types of mental disorders such as unusual beliefs, thinking,
• Suspicion, and hallucinations---the so-called cannabis psychosis.
• Absenteeism from school and deviant behaviour in children.
• Interference with driving skills and therefore risky driving.
• De-motivation syndromes in long-term use, characterized by loss of interest in all meaningful or productive activities so that all that the patient is concerned with is obtaining and smoking marijuana.
Treatment for Addiction
This involves two phases:
1. Detoxification---that is, taking the person off the drug and treating the signs and symptoms caused by the withdrawal. Detoxification can take place in outpatient facilities or in the community. If the symptoms of withdrawal are severe, then the patient can be admitted. Increasingly, detoxification uses anti-doses of the hard drug, either given as tablets, syrups, injections, or implants.
2. Rehabilitation---When people are detoxified, they are helped to maintain abstinence through skills that help them to stay off the drug. Rehabilitation can take place in rehabilitation centers but increasingly in the community with favorable results. Community detoxification can be highly cost-effective. It also includes self-help groups such as the Alcoholics Anonymous.
Self-Help Tips to reduce substance use
1. Try decreasing or abstaining from those substances e.g. alternate between drinking alcohol and other liquids such as water, juice or soda; try to chew gum / find something to keep your hands and your mind busy instead of smoking a cigarette or using any substance.
2. Try avoiding the places, people or occasions that trigger you to use more alcohol or other addictive substances.
3. Pay attention to your emotions – they can also trigger you to use more. Counselling, exercise, and a healthy lifestyle can help you manage your emotions better and use less.
4. When you are tempted to use alcohol or other substances, think about the negative consequences that come with your use: negative health, social and financial consequences are common with addictive substance use.
5. Seek help if you have difficulties: Ask your friends, family and professionals for help in staying away from those substances.
In Kenya, the following organizations offer counseling, support and referrals in dealing with addiction.
The National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) – They have a free Helpline, open 24hours a day every day. Call 1192
Alcoholics Anonymous (AA) Kenya
They also have a free helpline and hold free weekly support group meetings. Call 0700153832 or write to inquiries@aa-kenya.or.ke For meeting schedules visit: www.aa-kenya.or.ke