SUBSTANCE ABUSE.

We'll call him Michael.

I was in my fifth year of medical schooling when I first saw him. It was an unusually uneventful day at Federal Neuropsychiatry Hospital Yaba where I underwent a large part of my Psychiatry posting. We,  my classmates and I, we're deciding among the patients on the ward who to present to our teachers for the end of posting examinations.

Then Michael walked past us.

We stopped talking and turned to follow him with our eyes. At about 6feet 2/3inches tall, INCREDIBLY "yellow-skinned", with just the right body build and this...spring...in his step, he was a gorgeous guy!
He was dressed as one of the patients and curiosity as to where he was off to made us follow him immediately. We arrived at the clinic.

"Doctor I need to leave! I am perfectly fine now and have no business being here with these other crazy people. Please discharge me now. I promise to never miss my follow up appointments!"

From the conversation that ensued between him and the junior psychiatry resident on call I was able to deduce these facts.he was about 24years old at the time, a secondary school English teacher, lived with his mother and younger siblings, had an addiction to cannabis (a.k.a "igboo", "ganja", etc) introduced and encouraged by his "friends" who lived on his street, and this was his seventh admission in 17months for aggressive and irrational behavior from cannabis use. In fact on this particular occasion which warranted his subsequent arrest and admission to the psychiatric ward thereafter, he had beat up his mother and was about to descend on his siblings before help arrived.

I was snapped out of my reverie by the resident to get him a prescription sheet when our eyes met, Michael and I. Clear grey pupils met my light brown ones. I shook my head as I left the consulting room in, I don't know, pity? Such a waste of good looks on this guy though! It was one of the highlights of my medical training I doubt I'll ever forget. Infact so much so that I wrote my dissertation on a similar issue and today it has been published in at least two international journals...

But I digress.

Substance abuse has become the "norm" in today's world. Recent estimates say that in 2008 alone, 155 to 250 million people aged 15-64, used psychoactive substances like cannabis, amphetamines, cocaine, opioids and non-prescribed prescription medication. Cannabis of course is the most commonly used (129-190 million people).

Harmful use of alcohol causes 3.3million deaths yearly, according to the World Health Organization (WHO). Alcohol is a psychoactive substance with dependence-producing properties. Yeah, bet you didn't know that!

The WHO defines substance abuse as the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. These substances eventually lead to what we call a dependence syndrome --> a strong desire to take the substance, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to the substance use than other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.

Depending on the actual substance abused, substance abuse can lead to social and health problems, unprotected sex and its attending complications, violence, death, vehicle accidents, suicides especially in adolescents, homicides...the list is endless.

And then of course, the most painful in my opinion, pushing away the people around you who actually and genuinely love you and care about you😔

If you are abusing any of these substances, or know family and friends who do, there's good news! There is actually help available! There are lots of evidence-based interventions such as motivational interviewing, exposure therapy, behavioral marital therapy, cognitive behavioral and family therapies, social skills training and so on! Of course some require intervention with medications to counter the effects of the substance.

But you can be YOU again!

Believe it or not you have a life that needs YOU back. Family that misses YOU. Genuine friends that care about YOU. Loves that want YOU without your addiction.

...

Make. The. Wise. Choice. Today.





Da'alu!