Ad­dress drug, sub­stance abuse by youth

Daily Nation (Kenya) - - OPINION -

BBC Africa re­cently aired Sweet Sweet Codeine, an in­ves­tiga­tive piece by Ruona Meyer on the abuse of codeine in Nige­ria.

Ruona got in­ter­ested in the sub­ject af­ter watch­ing her brother strug­gle with codeine syrup ad­dic­tion. Through the fea­ture, she goes un­der­cover to show how se­nior sales ex­ec­u­tives from big phar­ma­ceu­ti­cals in Nige­ria strike deals with peo­ple look­ing to sell codeine to youth, the ef­fects of the drug and the state of the ex­ist­ing re­ha­bil­i­ta­tion and men­tal health fa­cil­i­ties where some of the addicts end up.

An es­ti­mated three mil­lion bot­tles of codeine are con­sumed daily in one of the states in Nige­ria. Fol­low­ing the fea­ture, Nige­ria banned the syrup. In Kenya, about 90 peo­ple die from opi­oid over­dose (in­clud­ing codeine).

Through the Phar­macy and Poi­sons Board, the gov­ern­ment has banned the pur­chase of codeine with­out a pre­scrip­tion. Man­u­fac­tur­ers have been asked to put warn­ing la­bels on pack­ag­ing and in­clude pa­tient in­for­ma­tion leaflets, high­light­ing the risk of ad­dic­tion to medicines that have codeine.

Although these mea­sures are good at­tempts at re­duc­ing ac­cess to codeine, they are not enough to pre­vent deaths and wastage of young peo­ple across the con­ti­nent.

Be­sides at­tempt­ing to cut off the sup­ply of the syrup, there is a need to stop those who sup­ply it — es­pe­cially in the black mar­ket — through heavy penal­ties to those found sup­ply­ing.

More im­por­tantly, gov­ern­ments should cut off the need for the sup­ply. They should not rely on “cold-turkey­ing” ev­ery­one on codeine, but de­vise com­ple­men­tary ways of deal­ing with the prob­lem. A good start­ing point would be find­ing out why young peo­ple are get­ting hooked to codeine and other forms of drugs and sub­stances.

Re­ports from Nige­ria say the price of codeine in the black mar­ket has shot up since the ban. That means the sup­ply is still there and, if the “why” is not ad­dressed, the so­ci­ety will ei­ther have to deal with an al­ter­na­tive drug or a spike in rob­beries and kid­nap­pings as addicts look for ways to get money so as to af­ford the now more ex­pen­sive codeine.

Re­ha­bil­i­ta­tion and rein­te­gra­tion

Gov­ern­ments also need to think about those who are ad­dicted and re­vamp re­ha­bil­i­ta­tion and rein­te­gra­tion av­enues.

In Kenya, the use of med­i­cally as­sisted ther­apy (MAT) in the main men­tal health re­fer­ral and train­ing hos­pi­tals — such as Mathari Na­tional Teach­ing Hos­pi­tal in Nairobi, and in Malindi — has gone a long way in as­sist­ing those who were pre­vi­ously de­pen­dent on hero­ine. The pro­gramme of­fers methadone and coun­selling through out­pa­tient ser­vices.

Such ser­vices, as well as form­ing part­ner­ships with the me­dia to do a se­quel that gives in­for­ma­tion to the so­ci­ety, will go a long way in pro­vid­ing care for the af­fected.

Es­tab­lish­ing cham­pion pro­grammes, where those who have re­cov­ered are part of the awareness cam­paigns and par­tic­i­pate in ex­plor­ing “the why” and “the what next”, will also help in re­duc­ing the chances of more young peo­ple get­ting into drug and sub­stance abuse or look­ing for al­ter­na­tives.

Issues such as un­em­ploy­ment, lack of skills and cap­i­tal to cre­ate own jobs and dif­fi­culty in ac­cess­ing mar­kets for ser­vices and prod­ucts by young peo­ple need to be ad­dressed. The min­istries of Labour, Trade and Ed­u­ca­tion ought to be present dur­ing such de­lib­er­a­tions to explore how to make coun­tries more youth-friendly.

Youth-friendly health­care and, more im­por­tantly, men­tal health ser­vices should be pri­ori­tised along­side con­tin­u­ous awareness pro­grammes that make youth com­fort­able enough to seek help and not look for al­ter­na­tive solutions to issues.

SITAWA WAFULA A good start­ing point would be find­ing out why young peo­ple are get­ting hooked to codeine and other forms of drugs and sub­stances.”

Ms Wafula is a TED Speaker and an Aspen New Voices fel­low, who runs an in­cu­ba­tion pro­gramme on men­tal health in Africa. learn @the­men­tal­healtha­cademy.org

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