EPIDEMIOLOGY AND CONTROL OF SUBSTANCE ABUSE IN NIGERIA

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PREFACE
Judged by reports in the popular media, accumulating research evidence in scientific journals, and the increasing tempo of anti-drug activities by Federal and State Ministries of Health, private, non-governmental organizations, and concerned individuals, Nigeria today has a growing drug problem. The problem initially came to the attention of researchers and health care experts as far back as the early 1960s. In hospital-based studies, a pattern of
psychiatric morbidity implicating Cannabis (Indian hemp) abuse was demonstrated by researchers, most of whom were psychiatrists. What the researchers found was that high proportions of patients “admitted into hospitals because of acute psychotic reactions“ had histories of cannabis abuse. Most of these patients were young students, unemployed urban
residents, and low-skilled workers.

Analyses of hospital data tend to support the view that Indian hemp is the most
abused illicit drug in Nigeria today. The substance has been implicated in more cases of drug-related mental illness all other drugs combined.

Even though Indian hemp is associated with many health and social problems,
alcohol is the substance with the highest ‘index of harm‘. It is also one of the most available drugs in the country. Alcohol is consumed in different forms ranging from traditional beverages (e. g. burukutu, pita, palmwine, ogogoro) through westem lager beer and wine, to spirituous liquors (including brandy, whiskey and gin). The brewing industry has recorded a major success story during the last two decades of industrial development in Nigeria. Only
a few of the thirty states in the country do not have at least one brewery. Increased production has resulted in increased consumption. Even the ever rising cost of beer does not seem to have a significant effect on the behaviour of committed drinkers. And, as is often the case, high consumption rates have led to simultaneous increases in problems related to alcohol. There is evidence that most of the problems associated with alcohol (e. g. accidents,
violence, alcoholism, liver cirrhosis, hypertension) are on the increase in Nigeria today.

Other drugs have also been popular among Nigerians for some time now.
Stimulants, especially the amphetamines, were widely used by students as far back as the early 1970s and were associated psychological disturbances. Traditional stimulants, e.g. kolanuts and coffee, are widely used by students and workers who yearn for long hours of wakefulness, alertness and maintenance of energy. Unfortunately “brain pills” and “sleepless pills“ (as amphetamines are often called) are associated with anxiety, paranoia and
hallucinations. Stimulants continue to contribute signi?cantly to psychiatric hospital admissions in Nigeria.

One of the great drug stories of the past decade in Nigeria has been the arrival of cocaine (a potent stimulant) and heroin (a narcotic drug) on our shores. The story started with the arrest of a cocaine courier in 1982 at the Murtala Mohammed Airport in Lagos. Since then thousands of cocaine and heroin traffickers have been arrested and the country has woken up from a state of shock to wage a ‘war’ against drug traf?cking.

A new reality is emerging in the Nigerian drug scene. The country is not only a
transit point in the import-export cocaine/heroin trade. The old observation that what comes in does not always go out is playing out in the country. Nigerian adolescents and young adults are increasingly abusing cocaine and heroin as these drugs become more readily available than could have been imagined less than a decade ago. And the signs are there to show for it. In a recent survey of admissions into four psychiatric hospitals, there was a steep rise in cocaine and heroin cases from 1984 to 1988 especially in Yaba and Aro Psychiatric hospitals in the Lagos area. The drugs were used more often in combination with cannabis and alcohol.

In that study as in others, cases of abuse of or dependence on several other drugs were found. Nigerians are now exposed to almost all well-known drugs of abuse including hallucinogens (e. g. LSD), non-narcotic analgesics, sedatives, and inhalants. Smoking of cigarettes is also a widely favoured behaviour as shown by a recent study of the general population in Northem Nigeria.

The articles in this book address most of the issues related the drug problem in Nigeria-from trafficking to abuse and dependence, to the treatment of alcohol and drug dependence, and drug control policies. These articles are revised versions of some of the papers presented at the First Biennial National Conference on Alcohol, Tobacco and other Drugs in Nigeria, organised by the Centre for Research and Information on Substance Abuse
(CRISA) in Jos, Nigeria, from 24 — 27 June 1991. The major Theme of the conference was “Approaches to Demand Reduction” but, as it is clear from the chapter listings, papers were presented on a broad range of issues. We hope that this book will serve as a source of information on topics that are much discussed but poorly understood. The book should be of great interest to students, drug abuse researchers, prevention and treatment experts, policy
makers and the educated public.

Many people and organisations contributed to the success of the conference and, therefore, to the publication of this book. We are especially grateful to the following for their ?nancial support: The Military Governors of Bauchi and Benue States, the National Drug Law Enforcement Agency (NDLEA); Chairman, Directorate for Social Mobilisation (MAMSER), Professor Jerry Gana and the Plateau State Director of MAMSER, Dr. Jonathan S. Zwingina. Our thanks go to the Military Govemor of Plateau State, who accepted to
declare the conference, and the Vice-Chancellor, University of Jos, Professor Para Mallum for the hospitality he extended to our invited guests. We also thank the United States Information Service (Lagos and Kaduna Offices) for the support we received. We acknowledge the encouragement and support received from many individuals, including Professor T.A. Lambo, of Lambo Foundation, Lagos; Professor A.O. Odejide, Director, Demand Reduction Unit of the NDLEA; Rev. Fr. Jacob B. Yali, Director of Our Lady of Victory Rehabilitation Centre, Jos; colleagues in the department of Psychology, and other associates of CRISA in the University of Jos. Finally we wish to thank all the participants who, in spite of difficulties, were able to attend the conference. As a non-profit organisation, CRISA will continue to work with all interested individuals and organisations to achieve its objectives of providing factual and accurate information on alcohol and other drugs to the Nigerian public, and promoting the development and maintenance of a drug-free lifestyle among Nigerians.

Isidore Silas Obot, PhD., MPH.
Jos, Nigeria.
June 1993.

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CONTENTS

Part 1: Some Basic Issues
1. Narcotics Trafficking, Abuse and Control in Nigeria by Erannibi E. O. Alemika

2. The Concepts of Alcohol Use, Abuse and Dependence by A. B. Mamman

3. Capitalism and Drugs: A Critique of Conventional Theories of Substance Abuse by Mohammad J. Kuna & Dr. T. M. Bande

4. Adolescent Pressures to Experiment with Drugs and Sex by K. J. Ibanga & A. Zwandor

5. Understanding the Nigerian Drug Problem: A Methodological Note by E. O. Olumodeji

6. Supply of Alcohol: A Major Determinant of Alcohol Consumption and Abuse by A. O. Akerele

7. Nitrite Content in Beer by Juliet Egbunike & A. B. Mamman

8. Drugs and Sports by Olatunde O. A. Makanju

Part 2: Epidemiolgy of Alcohol and other Drug Abuse
9. The Epidemiology of Tobacco and Alcohol Abuse in Nigeria by Isidore Silas Obot

10. Trends in Alcohol Consumption Among Nigerian Undergraduates by B. Y. Oladimeji & Amos K. Fabiyi

11. Women, Children and Alcohol: A Study of Local Brewers in Jos, Nigeria by
Ochinya O. Ojiji, Zubairu K. Dagona & Fred I. Tamen

12. Alcohol Consumption Among Nigerian Brewery Workers by Amos K. Fabiyi & B. Y. Oladimeji

13. Pattern of Substance Abuse in the Psychiatric Unit of Jos University Teaching Hospital: A Prospective Study by P. U. Ikwuagwu, J. C. Nafziger & H. U. Isichei

14. A Survey of Alcohol Consumption Among Hospital Patients by J. C. Nafziger & Fred Tamen

15. The Pattern of Alcoholism in Jos, Nigeria and Castrop-Rausel, West Germany: A Comparative Study by H. U. Isichei, P. U. Ikwuagu & J. O. Egbuta

16. Drugs Mothers Prescribe for Newborn Babies by O. A. Abosede & E. J. Edoho

17. Personality Variables Among Alcohol and non-Alcohol users by Felix A. Oluwatelure

18. The Family Environment and Personality Characteristics of Children of Problem Drinkers by Haruna Karick

Part 3: Prevention, Treatment and Rehabilitation
19. Drugs and Mental Illness by Tolani Asuni

20. Management of Drug Abuse in Nigeria: What Really Works? by O. A. Sijuwola

21. Running a Drug Rehabilitation Centre by Jacob Yali

22. Drug Abuse in Nigeria: Nature, Extent, Policy Formulation and the Role of the NDLEA by A. O. Odejide

23. The Nature and Problems of Mental Hospitalisation of Alcohol and Drug Abusers by Gray Goziem Ejikeme

24. Is a Ban on Smoking in Public Places the Answer to the Unhealthy Habit? by C. J. G. Orjioke & C. C. Asadu

25. The Role of the Media in Drug Abuse Control: A Content Analysis of Four Nigerian Newspapers by Chris O. Okwudishu

26. Folklore of Alcoholism, Alcohol Drinking and Drunkenness by J. O. Ojoade & A. B. Ojoade