ALCOHOL AND SUBSTANCE ABUSEBY: GRACE WAIRIMU

KEY WORDS AND DEFINATION OF TERMS

Drug: This refers to any chemical agent that once taken in the body is capable of causing psychological and physiological changes.

According to the WHO lexicon of alcohol and drug terms it is any substance with the potential to prevent and cure illnesses or enhance physical and mental welfare.

PSYCHOACTIVE DRUG OR SUBSTANCE: This is a substance that, when ingested, affects

mental processes, e.g. cognition(thought) or affect(emotions).

This term and its equivalent, psychotropic drug, are the most neutral and descriptive terms for the whole class of substances, licit and illicit.

"Psychoactive" does not necessarily imply dependence-producing, and in common parlance, the term is often left unstated, as in "drug use" or "substance abuse”.

Substance: A drug of abuse, a medication or a toxin.

Substance use: This is the ingestion of any chemical that affects the body. This includes legal, illegal and medicinal substances.

Abused substances: These are those chemicals that alter the individual’s perception by affecting the central nervous system (CNS).

PSYCHOACTIVE SUBSTANCE ABUSE It is a maladaptive pattern of use indicated by continued use despite knowledge of having a

persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use [or by] recurrent use in situations in which it is physically hazardous

In other contexts, abuse has referred to non-medical or unsanctioned patterns of use, irrespective of consequences.

Rehabilitation: This is the process by which an individual with a substance use disorder achieves an optimal state of health, psychological functioning, and social well-being. This follows the initial phase of treatment which may involve detoxification and medical and psychiatric treatment. It could be done in residential setting or an outpatient facility. There is an expectation of social reintegration into the wider community.

Relapse: A return to drinking or other drug use after a period, of abstinence, often accompanied by reinstatement of dependence symptoms

DRUG STREET NAMES

Alcohol:Keroro, kumikumi, ashuashu, brown bottle, chang’a, gauge, tindi, kanywaji, steam

Amphetamine type of stimulants: Amp, dexies, pep pills, wake up pills, speed, black beauties, crack meth, fee, ice, matunguru, maharagwe

Cannabis Sativa/marijuana: Boza, Wadada, shada, Ndom, weed, ngawi, pot, grass, bhang, dagga

Catha edulis (Khat): Mirra, Veve, Njito, Ngomba, Mbachu, Njiri, mairungi, mogoka, giza, asili, kangeta

Cocaine: bazooka, blance, snow, nose candy blow, big C. snow birds, lady, star dust

Crack cocaine: Whites, French fries, teeth, crake, coke, flake

Heroin: Kichuri, kiketi, horse, brown sugar, unga, poni, poppy, mizigo, stuff, daba, usinionje

Inhalants: Mugui, noso, bien, mangata Tobacco: Fag, Ngale, Mozo, Fwaka, Fegi

Ngarasi, Cigar, Mbaki, Kiraiku, msokoto Sedatives: Bughizi ,Narcozep, Rohypnol,

Primun, Rohipnol, Roipnol Roofies, Valium, piriton serepax (Date rape drug) sleeping pills.

Hallucinogenes LSD, acid, mushrooms, PCP, special k.

 WHAT CAUSES YOUNG PEOPLE TO INDULGE IN DRUGS AND OR ALCOHOL

Social/peer pressure Stress Fun Curiosity Stimulation Easy availability of the drug Media through advertisements A way of relaxation and socialization Experimentation Culture Poor self esteem Dysfunctional families Pressure to perform academically

COMMON SIGNS AND SYMPTOMS TO NOTE

People will usually go to great lengths to conceal their drug and or alcohol use. One has to be very close to them to note some of the signs and symptoms.

PHYSICAL SIGNS

Eating habits change- depending on the drug of choice, the person may eat too much or loose appetite for food.

Disturbed sleep partners- including over sleeping, marked drowsiness, moodiness a fatigued appearance and restlessness.

Frequent complains of headaches- the am sick too often i.e hapa hapa syndrome

Chronic cough that does not respond to treatment Memory lapses- short attention span, difficulty in

concentration Poor physical coordination- including slurred and or

incoherent speech Burt or stained thumbs or finger nails

Burn holes on clothing or bed sheets Use of medicines to relieve constipation Unexplained skin rash Excessive sweating Sexual problems- which ma include lack of

sexual appeal or promiscuity Unhealthy appearances Needle marks-marks due to using

needles.

BEHAVIOUR

Increased and inappropriate anger, hostility, excessive irritability, panic anxiety and secretiveness.

Unnecessary privacy Avoiding contact with parents and people in

authority Quarrelsome, outbursts of violence or

unexplained anti social behaviour, poathological lies, problems with police

Disappearance of money and house hold items and stealing from others

Demand for money form parents which is never enough

Leaving early morning in a hurried manner-matter of urgency

Irregular class attendance Hounding Sudden laughter outbursts for reasons

not really worth it. Disorientation in time and space

EFFECTS OF DRUG ABUSE

As a person moves into a regular pattern of drug abuse the drug takes centre stage of the persons life.

Drugs become the emotional and social focus at the expense of other interests. This gradually leads to social, emotional and physical problems. Loss of control and the breakdown of close relationships may lead to feelings of self doubt, poor self esteem, guilt anxiety and sadness, which all lead to further drug abuse as an escape. Tolerance and dependence accompany this process.

TOLERANCE

The repeated use of a drug leads to changes in the brain and nervous system to that the user needs more of the drug in order to get expected effects

DEPENDENCE

Drug dependence is an emotional and sometimes physical need experienced by the drug abuser. The drug or alcohol dependent person feels compulsion to take the drug on a regular basis, to feel its effects and avoid the discomfort of its absence. Some drugs cause physical dependence (treated through detoxification) while others cause psychological dependence (this is where the work is for a counselor)

ADDICTION

Addiction is the physical and psychological habit of feeling of need, which comes from repeated use of a drug. Drug abusers often continue to feel the need and desire for drugs after they have gone through detoxification.

WITHDRAWAL

For a drug dependent person, it is necessary to take the drug in order to maintain normal body functions. When the drug is not taken the person suffers from physical and mental discomfort. The fear of suffering fro withdrawal is like an emotional prison which make the addict feel trapped and controlled by the drug. If initially drugs were taken to experience particular sensations, in the later stages they are taken to avoid suffering the unpleasant effects of withdrawal.

COMMON DRUGS SHORT AND LONG TERM EFFECTS

TOBACCO

SHORT TERM EFFECTS OF TOBACCO

Bad breath Cough and colds Stained teeth and black lips

LONG TERM EFFECTS

Cancer of the lungs Brain damage The skin and digestive system are

affected Halitosis (bad breath) Burn of fingers which can lead to

gangrene dependency

SHISHA

OTHER NAMES OF SHISHA

narghile argileh hubble-bubble Goza Hookah

shisha tobacco" shortened to just "shisha" can, in the West, mean the molasses-based tobacco concoction smoked in a hookah.

A water pipe, single or multi-stemmed instrument for vaporizing and smoking flavored tobacco called shisha in which the vapor or smoke is passed through a water basin ‒ often glass-based ‒ before inhalation

Depending on the placement of the coal above the shisha, a hookah can be used to produce smoke by burning the shisha or used to create water vapor by melting it at a lower temperature.

A 2005 WHO report states that smoking using a waterpipe poses a serious potential health hazard and is not a safe alternative to cigarette smoking. The average hookah session typically lasts more than 40 minutes, and consists of 50 to 200 inhalations that each range from 0.15 to 0.50 liters of smoke. In an hour-long smoking session of hookah, users consume about 100 to 200 times the volume of smoke of a cigarette.

The chemical compositions of cigarette smoke and hookah smoke are different, however, as the workings of the charcoal in the modern hookah causes the tobacco mixture to be heated to a lower temperature, as opposed to the higher temperature in a cigarette where the tobacco is directly burnt. Consequently, the potential health effects of hookah smoke are expected to be very different

HOOKAH SMOKE AND CANCER

The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.

Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.

Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder, and oral cancers.

Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

OTHER HEALTH EFFECTS OF HOOKAH SMOKE

Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.

Infections may be passed to other smokers by sharing a hookah.

Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.

Babies born to hookah smokers are also at increased risk for respiratory diseases.

Hookah smokers may be at risk for some of the same diseases as cigarette smokers. These include: Oral cancer Lung cancer Stomach cancer Cancer of the esophagus Reduced lung function Decreased fertility

KUBER

A highly intoxicating drug which is openly sold in the name of mouth freshener and packed in plastic packets similar to tea leave sachets.

It is chewable tobacco rich in nicotine. It can also be made as tea and drunk but is usually sucked, placed under the tongue.

N.B it contains THC (tetrahydrocannibinol) an ingredient found in the cannabis sativa plant (bhang)

It s a CNS (Central Nervous System) Stimulant

It increases behavioral activity, Thought processes and alertness

Elevate the mood of the user.

EFFECTS OF KUBER

Dizziness, Headaches Sleeping Weak teeth Bleeding gums Tooth discoloration, holes on the gum line

and cervical cancer (still being researched) and sometimes women can become infertile.

It impairs memory and causes depression

America's National Cancer Institute classifies it as a brand of smokeless tobacco. According to the institute, smokeless tobacco contains 28 cancer causing agents and its users take in three to four times more nicotine (the addictive substance in tobacco) than cigarette smokers, making it that many times more addictive.

kuber is associated with 41 per cent of mouth and throat cancer in men and 11 per cent of similar problems in women world-wide because of its high content in nicotine.

CANNABIS SATIVA (BHANG, MARIJUANA)

METHOD OF USE

Smoking (plain or mixed with tobacco) cocktail

Baked (cake, cookies)-weed cake Eaten in food, processed to oil Herbal tea

WEEK COOKS AND WEED CAKE IN KENYA

EFFECTS OF USE

Giggling a lot the first time Increase in heart rate (could cause heat

attacks) Increase in blood pressure Restlessness Dry mouth and throat Thirst- drinks a lot of fluids especially

sweet drinks Walking gait changes

Bloodshot eyes Talks a lot or becomes very quiet Tense muscles slurred speech Sleeps a lot Short term memory loss Distorted sense of time, distance Personal hygiene ( most don’t take baths

and change cloths

Cancer of the lungs – cannabis has more tar than cigarettes the smoke is also held longer in the lungs

Produces extreme euphoria Extreme anxiety Depression Infertility Psychosis (if present makes it worse) Hallucinations Retardation – mentally, emotionally, sexually and

physically

ALCOHOL

EFFECTS OF ALCOHOL

IMMEDIATE EFFECTS Euphoria Self confidence increased sociability Decreased anxiety Shortened attention span Flushed appearance Impaired judgment Impaired muscle coordination

Sedation Impaired memory Delayed reactions Unbalanced walk (ataxia) Blurred vision Profound confusion Dizziness Vomiting Unconsciousness Decreased heart rate Respiratory depression

LONG TERM EFFECTS

LIVER CIRRHOSIS

COCAINE

EFFECTS OF COCAINE

SHORT TERM EFFECTS Loss of appetite Increased heart rate, blood pressure, body

temperature Contracted blood vessels Increased rate of breathing Dilated pupils Disturbed sleep patterns Nausea Hyperstimulation Bizarre, erratic, sometimes violent behavior

Hallucinations, hyperexcitability, irritability Tactile hallucination that creates the illusion of

bugs burrowing under the skin Intense euphoria Anxiety and paranoia Depression Intense drug craving Panic and psychosis Convulsions, seizures and sudden death from

high doses (even one time)

LONG TERM EFFECTS OF COCAINE USE Permanent damage to blood vessels of heart and

brain  High blood pressure, leading to heart attacks,

strokes, and death Liver, kidney and lung damage Destruction of tissues in nose if sniffed Respiratory failure if smoked Infectious diseases and abscesses if injected Malnutrition, weight loss Severe tooth decay

Auditory and tactile hallucinations Sexual problems, reproductive damage and

infertility (for both men and women) Disorientation, apathy, confused exhaustion Irritability and mood disturbances Increased frequency of risky behavior Delirium or psychosis Severe depression Tolerance and addiction (even after just one

use)

HEROIN

HEROIN

It is derived from the milk of the opium poppy plant. In its purest form is off white in colour.

The impure heroin is brown in colour ( brown sugar)

It is a highly addictive drug and tolerance and physical dependence develops quickly.

The addicts would usually say, ‘usinionje’ ‘bibi mwarabu’ ‘monkey on the back’

HOW IT IS USED

Smoked ( cocktail cigarette, or marijuana)

Injected Sniffed Chasing the dragon( placed in a spoon

and burnt over a candle flame and snorted).

EFFECTS OF HEROIN USE

Initially it produces a very goof feeling of warmth, through out the body and a feeling of drowsiness (kuyoyoma)

Vomiting may occur on first use. Constriction of the pupils Cold moist skin Dreamy, detouched euphoria Difficulty in breathing

LONG TERM EFFECTS

Bad teeth Inflammation of the gums Constipation Cold sweats Itching Weakening of the immune system Coma Respiratory (breathing) illnesses Muscular weakness, partial paralysis

Reduced sexual capacity and long-term impotence in men Menstrual disturbance in women Inability to achieve orgasm (women and men) Loss of memory and intellectual performance Introversion Depression Pustules on the face Loss of appetite Insomnia Risk of HIV/AIDS infections due to sharing needles Death

WITHDRAWAL EFFECTS/SYMPTOMS

Withdrawal takes place with 8 hours of the last dose. Yawning continuously Sneezing and running nose Nausea Abdominal cramps (like electric shock) Vomiting and diarrhea Fever/chills Sweating a lot Blood pressure goes up goose bumps on the skin

KHAT

HOW IT IS USED

It is mainly chewed TYPES Giza, asili, kangeta. Mogoka. alele

SHORT TERM EFFECTS

Alertness Lack of fatigue Lack of sleep Increased blood pressure Lack of appetite Thirst Libido increases Constipation Dilated pupils/reddening of eyes

LONG TERM EFFECTS

Addiction Dental problems (gums and teeth) Inflammation of the intestines anfd stomach Anorexia Halitosis (bad breath) Reduced muscle relaxation Anemia Impotence Spermatorrhea Mental illness

OTHER DRUGS

Inhalants (paint, glue/gum, petrol, paint thinner) They are usually inhaled through the nose or mouth.

Prescription drugs: these are the drugs that are normally prescribed to you by a doctor, they include sleeping pills, sedatives, one that is being abused a lot is rophenol, its effects are the same as those of heroin but it is more addictive.

INTERVENTIONS

Rehabilitation This is the process by which an individual with a

substance use disorder achieves an optimal state of health, psychological functioning, and social well-being.

This follows the initial phase of treatment which may involve detoxification and medical and psychiatric treatment.

It could be done in residential setting or an outpatient facility.

There is an expectation of social reintegration into the wider community.

During rehabilitation the drug addict under goes detoxification, counseling (individual and family). S/he is taught life skills to prevent relapse (going back into use of the dug/substance). But the client is the driver and needs to chart the way forward in terms of where s/he would like to be.

They are introduced to other addicts and work in self help groups like the Alcoholics/Narcotics anonymous groups

TWELVE STEP PROGRAMMES

Alcoholics Anonymous/Narcotics Anonymous: This is the largest self help program and has been a model for the other 12-step programmes. They stress abstinence and contends that nothing can really happen until “the cork is in the bottle.” The goals of each individual within AA vary widely: simply abstinence to adopting a whole new way of life are the ends of the continuum. 

Step 1: We admitted we were powerless over alcohol- that our lives had become unmanageable

Step 2: Came to believe that a power greater than ourselves could restore us to sanity

Step 3: We made a decision to turn our will and our lives over to the care of God as we understood Him.

Step 4: We made a searching and fearless moral inventory of ourselves

Step 5: We admitted to God and to ourselves and to another human being the exact nature of our wrongs

Step 6: We were entirely ready to have God remove all these defects of character.

Step 7: Humbly asked him to remove our shortcomings.

Step 8: Made a list of all persons we had harmed and became willing to make amends.

Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.

Step 10: Continued to take a personal inventory and when we were wrong promptly admitted it.

Step 11: Sought through prayer and mediation to improve our conscious contact with God as we understood him, praying only for knowledge of his will for us and the power to carry that out.

Step 12: Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

 

Prevention is better than cure. It is cheaper to prevent than to treat.

If you have not started don’t, if you have started, try and stop or seek help.

Tell other about the danger of drug addiction and let them know there is a way out.

It is affecting everyone, young and old, user and non user.

THANK YOU