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  2. 2. Drug and substance abuse is a global problem and is one of the major problems affecting the youth both in school and out of school. This problem impacts negatively on the academic, social, psychological, economical and physiological development among the abusers. The menace of drugs has strangled the youthful population reducing them to dummies, zombies and drooling figures only to waste out the prime of their lives when they are most needed to invest their energy in worthy nation building ventures. The presentation focuses on factors influencing the use of drugs of abuse among the youth . It focused on how literacy levels influence drug and substance abuse; whether gender influences substance and drug abuse; the influence of type of employment on drug and substance abuse; evaluation of the role of availability of drugs and substance in drug and substance abuse and lastly whether peer pressure is a contributing factor to drug and substance abuse among the youth . In Kenya, the drug abuse scourge has taken its toll on the society largely out of the fact that not many people treated the various substances as the source of the serious health afflictions. Evident lack of awareness, fanned by unavailability of accurate information on the adverse consequences of indulgence habits left the problem of drugs and substance abuse to permeate communities throughout Kenya. To a large extent, supply of drugs and demand complement each other, with the result being a vicious circle of drug abuse leading to compulsive use and tolerance. The various types of drugs and substances commonly abused in the country by the different communities have evolved in a cultural and social environment that tolerates and accepts consumption as a normal life style. The government initiated action by enforcing measures to control supply reduction way back in 1983 with the formation of a specialized Anti Narcotic Unit under the police force
  3. 3. Most commonly abused drugs and substances include: Alcohol Tobacco Cannabis (bhang) Khat (miraa) Opiods Sedative-hypnotics Stimulants Hallucinogens Inhalants/Solvents, petrol, glue, paint thinners etc. Prescription and non-prescription drugs
  4. 4. 0 10 20 30 40 50 60 70 80 90 AxisTitle Axis Title Male Female
  5. 5. Effects of Drugs/Substances Abuse on health ad Social Life  People indulge in drug/substance abuse due to many factors. Some of these factors are personal while some are due to external forces. It should, however, be known that for whatever reason one puts himself in this situation, drugs of abuse do not solve a problem. You never win.  It may be important to point out here that the effects of drug abuse are vast. Many as they are, these effects also depend on other factors,. Some of these factors are listed below:-  The physical and chemical properties of the substance of abuse  The user’s personality  The mode of the drug usage  The environment or the area where the victim uses it  The aim, goal or purpose for the use  The cultural attitudes and feelings of the community where the user is based  The law and the rules of the land  The genetic factors  The public control mechanisms  Going by the above, we find that the effects of drugs/substance abuse simply cover:-  The individual  The family  The community and  The National as a whole  Community of nations
  6. 6. Effects of Drugs/Substance abuse on the individual  Health Different drugs of abuse affect different parts of the human body, when two or more of these drugs are taken together, they tend to have a combined effect (synergism). most drugs of abuse affect the main organs of the body like:-  The liver  The kidneys  The heart  The lungs  The central nervous system with the brain as the center  The reproductive organs  The effects can be gradual or sudden depending on the individual, the amount taken, the duration and the environment. All these generate poor health.  With one member of the family or community getting sick gradually or constantly, other members have to care for their kin. Sometimes diseases are passed from one member to another due to drug/substance abuse. Examples of such infections include:- Human immunodeficiency virus (HIV), Hepatitis B.  Sustained stress will lead to mental problems. A sick family or community will mean reduced nutritional status, increased mortality and reduced life expectancy. The family of the abuser becomes the victim.
  8. 8. Health effects The picture shows a non smoker healthy lung and a smoker lung Complications resulting from drug abuse more frequently affect the lung than any other organ partially because of the way in which we introduce the drugs into our body. Smoking crack, heroin or cocaine deposits the substance on our lung tissue, reducing the ability of the lungs to diffuse oxygen
  9. 9. All drugs of abuse—nicotine, cocaine, marijuana, and others—affect the brain’s “reward” circuit, which is part of the limbic system. Normally, the reward circuit responds to pleasurable experiences by releasing the neurotransmitter dopamine, which creates feelings of pleasure, and tells the brain that this is something important—pay attention and remember it. Drugs hijack this system, causing unusually large amounts of dopamine to flood the system. Sometimes, this lasts for a long time compared to what happens when a natural reward stimulates dopamine. This flood of dopamine is what causes the “high” or euphoria associated with drug abuse Brains
  10. 10. Acute effects of cocaine. Cocaine affects the cardiovascular system through 2 major pathways: increased sympathetic output and a local anesthetic effect. Through increased sympathetic tone and catecholamine levels, cocaine increases heart rate, blood pressure, and myocardial contractility, all of which increase myocardial oxygen demand. Myocardial oxygen supply is decreased through coronary vasoconstriction and enhanced thrombosis. Myocardial oxygen demand may exceed myocardial oxygen supply, leading to ischemia or infarction. Cocaine affects cardiac myocytes directly by blocking sodium channels, which decreases left ventricular (LV) contractility and is arrhythmogenic.
  11. 11. Acute effects of cocaine.
  12. 12. Heroin has its most profound effect on the liver through the illness of hepatitis. Hepatitis basically means the swelling and inflammation of the liver most often due to a viral infection. People can get hepatitis from using heroin regardless of the method of ingestion. Many heroin addicts get hepatitis through snorting the drug as it’s never cooked in this form. It’s also extremely common for heroin addicts to pass hepatitis from one party to another through the practice of sharing unclean needles. Hepatitis B is the most common and can be the most severe form of the virus to affect heroin addicts and others who engage in intravenous drug abuse. This is because this particular virus is generally transmitted via blood and the severity of it is linked directly to the physical health of the sufferer before they contracted the disease, and heroin addicts are notoriously malnourished and generally unhealthy Liver
  13. 13. The Effects of Drugs on Fertility If you and your partner are having difficulties conceiving, then you are probably eager to find out if you are suffering from an underlying fertility problem. Sometimes, infertility can be the result of reproductive issues caused by the use of recreational and prescription drugs. Though you may not realise it, drugs including steroids, alcohol, and tobacco, can have a very negative on both the male and female reproductive systems. In fact, it is believed that drug use plays a role in a large percentage of many of unexplained fertility cases. Most men and women are familiar with the hazards of tobacco use during pregnancy. However, few people recognise that tobacco has the potential to affect your chances of conceiving. In fact, cigarette smoking and tobacco chewing have both been related to a number of fertility problems in both men and women. Men who smoke cigarettes or chew tobacco often have low sperm counts and poor sperm motility, both of which can drastically reduce a couple's chances of conceiving. Women who smoke can suffer from reduced ovarian reserve and chromosomal abnormalities, and are at increased risk of suffering from a miscarriage or stillbirth. Children Prenatal exposure to drugs can result in an array of emotional, psychological and physical disorders. Children exposed to illicit drugs after birth may suffer significant problems that require additional care, resulting in both personal expenses and costs to society. Children exposed to drugs are at a significantly higher risk of both physical and sexual abuse as well as neglect and often have higher rates of anxiety, depression, delinquency and educational and attention problems
  14. 14. Men and women who drink more than six alcoholic beverages per day are more likely to suffer from hormonal imbalances, affecting both the generation of sperm and ovulation. Women who are heavy drinkers commonly suffer from: luteal phase defects anovulation amenorrhea Men who are heavy drinkers can suffer from:low sperm count poor sperm motility poor sperm morphology The affects of light to moderate alcohol consumption on fertility are, unfortunately, less well known. It does appear that moderate alcohol consumption can kill off some sperm-producing cells in the testicles and may contribute to impaired sperm morphology. Some studies also show that women who are light to moderate drinkers may experience some hormonal imbalances. Man woman Women Gender differences have been identified as heavy determinants in the onset of addictive behaviors, including drug abuse. Women are acutely affected by particular consequences of drug abuse, such as sexually transmitted diseases and the consequences of domestic violence, in addition to being more likely to be affected by drug-facilitated crime.
  15. 15. Social Drugs of abuse are not accepted by society. One of the reasons is that users become anti-social. They behave differently from non-users. The following may be detected: - Being solitary Irresponsible and erratic attitudes and behavior (sometimes moron- like, sometimes violent, suicidal tendencies, etc.) Personality deterioration Prone to accidents Drug users therefore are detested by society and become social misfits There is neglect of the family. This is followed by disintegration of the family or social set-up. Institutions like schools get disrupted. Those dropping out of school will increase. Violence or crime in general will equally increase. Since the social fabric is affected, social norms will also be affected. Hence, an increase in incest, homosexuality, etc. will be noticed. There will be moral and spiritual erosion.
  16. 16. Isolation Isolation is the most common social effect of drug abuse. The drug abuser eventually maintains a connection only with his drug of choice.
  17. 17. Financial  Depending upon the drug of choice, the financial strain can be devastating. Buying drugs becomes more important to the drug addict than daily responsibilities. Drug abuse leads to addiction. And when one gets to that point, he/she cannot function withiout using the drugs. Therefore most of his finannces ends up buying drugs to sustain his pusture.
  18. 18. Relationships  Close connections to the drug abuser are affected. Relationships become dysfunctional, as the co-dependent recognizes the effects of the drugs. Children who use the drugs believe to be right in every decision. Therefore anyone who differs with him becomes the enemy. This including his families, friend and relatives. Its always a hard and tough time for any parents dealing with such scenarios.
  19. 19. Family  Social effects on the family can be felt long after the addiction. The family can be dissolved, children can develop emotional issues and trust can be shattered. Drug abuse is of particular concern among street children throughout the world. Studies indicate that street children who use drugs were more likely to have been abused by their parents, have a history of arrests and engage in sex work, exposing them to sexually transmitted diseases. Drug abuse also affects children in conflict areas. In some regions, drugs are used as an instrument to engage and retain children and young people as child soldiers in civil wars, armed conflicts and regional conflicts and in terrorist activities. children and young people can become subject to physical and sexual abuse, psychological problems, addiction and other harmful consequences.
  20. 20. Professional Life  Drug abuse can lead to unexplained absences, depleted sick days and eventually job loss. The severity of the drug abuse will determine the time line  A further cost of drug abuse that is often cited is the loss in productivity that can occur when drug users are under the influence of drugs or are experiencing the consequences of their drug use (e.g., while in treatment, incarceration or hospital). Studies have put the costs of lost productivity borne by employers at tens of billions of dollars. Costs from labour non- participation Productivity losses are calculated as work that would be reasonably expected to have been done if not for drug use (a loss of potential income and output and therefore GDP) as a result of a reduction in the supply or effectiveness of the workforce. Lost productivity in the United States as a result of labour non-participation is significant:  While in treatment or when incarcerated, drug users may be unable to participate in work, education or training, adding to the economic loss, in addition to the cost of treatment or incarceration. It should be noted that these productivity costs will be lower if job opportunities are already scarce as a whole increased over the past years
  21. 21. Economic and Security Health care and hospitals  Visits to hospitals in connection with drug abuse are costly to society. Such visits occur as a result of overdoses, adverse reactions, psychotic episodes and symptoms of infectious diseases that can be transmitted through, interalia, injecting drug use, such as hepatitis B and C, HIV/AIDS, tuberculosis, and other illnesses related to drug use. Additionally, hospitals often need to treat victims of drug-related crimes and accidents  A person’s health is greatly affected by drug abuse. Economically, this manifests itself in prevention and treatment costs, health-care and hospital costs, increased morbidity and mortality. Costs of drug prevention and treatment phenomenon of drug abuse requires societies to dedicate resources to evidence-based prevention, education and interventions, including treatment and rehabilitation. Although such activities can be resource-intensive, studies have shown that for every $1 spent, good prevention programmes can save Governments up to $10 in subsequent costs
  22. 22. Impact on public safety Beyond health costs, people under the influence of drugs pose major safety risks and costs to people around them and the environment. For example, drug-affected driving accidents have emerged as a major global threat in recent years. Additionally, a greater awareness of the impacts on the environment of illicit drug cultivation, production and manufacture has emerged Drug-affected driving • abuse of drugs affects perception, attention, cognition, coordination and reaction time, among other neurological functions, which affect safe driving. Cannabis is the most prevalent illicit drug detected in drivers in Canada and the United States and Europe and Oceania. Research has found that habitual cannabis use is linked to a 9.5-fold greater risk of driving accidents, cocaine and benzodiazepines increase the risk 2-10 times, amphetamines or multiple drug use increase the risk 5-30 times, and alcohol in combination with drugs increases the risk of getting seriously injured or killed while driving by a factor of 20-200. •at increased risk also has consequences for passengers and others on the road, who may become victims of drug-affected driving.
  23. 23. Relationship with crime A generation of research has defined three major links between drugs and crime. •e .rs drugs/crime nexus relates to the violence that can be associated with the use of drugs themselves: psychopharmacological crime. Crime committed under the influence of drugs is major problem worldwide. Second drugs/crime link is economic- compulsive crime. •is the result of drug users engaging in crime to support their drug consumption and addiction.
  24. 24.  Impact on the environment illicit manufacture and disposal of drugs and pharmaceuticals cause signi.can environnemental contamination, owing to the precursor chemicals required for manufacture, the manufacturing process itself and the active ingredient or substance. Disposal introduces those substances into the environment in sewage, from where they can enter sediment, surface and ground water and the tissues of vegetation and aquatic organisms. As a result, wildlife and humans can be chronically exposed to very low doses of drugs and the chemicals used in their illicit manufacture. •at results in costs to individuals and to Governments, as they are responsible for ensuring public health
  25. 25. Low-income populations Drug abuse and poverty are often linked in multiple ways. Drug abuse may occur to relieve the stress associated with poverty, chronic social strain and other difficult events. In poorer neighborhoods, there is often less access to support systems, health care and community organizations. Additionally, the relationship between drugs and poverty can also work in the inverse direction: drug abuse can deplete users’ income, leading to a lack of care for family and loved ones and other responsibilities.
  26. 26.  Drug addiction is a complex disease. It is a chronic, relapsing brain disease and involves a combination of ecological, physiological and historical factors. It is not voluntary behavior and is often a fatal illness. Addiction treatment and rehabilitation in Kenya is largely a private sector and NGO affair dating back to 1978. Treatment and rehabilitation centers are few, operate in a policy vacuum and are expensive for the majority of Kenyans. The development of the National Standards by NACADA and stakeholders, training of professionals on treatment and counseling and developing the credentialing system for addiction professionals are milestones in treatment and rehabilitation. Treatment services and opportunities may include detoxification, substitution or maintenance therapy and/or psychosocial therapies and counseling. Remember,  No single treatment is appropriate for all individuals  Effective treatment attends to multiple needs of the individual, not just his/her drug use  Treatment must address medical, psychological, social, vocational, and legal problem TREATMENT
  27. 27. Medical Detoxification Detoxification safely manages the physical symptoms of withdrawal and any symptoms of psychiatric and emotional disorders. It is only the first stage of addiction treatment. Alone, it does little to change long-term drug use. The Focus on stabilization and takes a couple of days, usually 3 to 10 Rehabilitation Refers to the process by which a person presenting with a substance related problem achieves an optimal state of health psychological functioning and social well being devoid of substance abuse. The process may also be rehabilitation depending on clients needs. Typically follows detoxification and, if required, other medical and psychiatric treatment occurs. It encompasses a variety of approaches which may include psycho education ,group therapy, family therapy, specific behavior therapies to prevent relapse, involvement with a self-help group, residence in a therapeutic community or halfway house, vocational and survival skills training. There is an expectation of social reintegration into the wider community. The approaches used often depend on the model used. Medications for drug addiction Buprenorphine Methadone Naltrexone Antabuse/ disulfiram Nicotine Replacement Patches Gum
  28. 28.  Aftercare  A broad range of community-based service supports designed to maintain benefits when structured treatment has been completed.  It may involve a continuation of individual or group counseling and other supports, but usually at a lower intensity and often by other agencies.  Self-help groups such as Alcoholics Anonymous and Narcotics Anonymous are important providers of aftercare services
  29. 29. Jane story Heroin cut me off from the rest of the world. My parents kicked me out. My friends and my brothers didn’t want to see me anymore. I was all alone. From the day I started using, I never stopped. Within one week I had gone from snorting heroin to shooting it. Within one month I was addicted and going through all my money. I sold everything of value that I owned and eventually everything that my mother owned. Within one year, I had lost everything. I sold my car, lost my job, was kicked out of my mother’s house, debt, and living on the streets. I lied, I stole, I cheated. I was raped, beaten, mugged, robbed, arrested, homeless, sick and desperate. I knew that nobody could sustain a lifestyle like that very long and I knew that death was imminent. If anything, death was better than a life as a junkie. Drugs equal death. If you do nothing to get out, you end up dying. To be a drug addict is to be imprisoned. In the beginning, you think drugs are your friend (they may seem to help you escape the things or feelings that bother you). But soon, you will find you get up in the morning thinking only about drugs.Your whole day is spent finding or taking drugs. You get high all afternoon. At night, you put yourself to sleep with heroin. And you live only for that. You are in a prison. You beat your head against a wall, nonstop, but you don’t get anywhere. In the end, your prison becomes your tomb.
  30. 30. My brother's addiction My older brother is 19 and has been using since he was in high school. I always knew about it, but was too afraid to say anything to my parents about it (i was in middle school at the time). In the past year it has gotten a lot worse. He has switched from marijuana to other drugs like Oxycontin. My parents eventually found out and tried to get him to go to rehab, which lasted about 3 days. The only friends that he has are drug addicts too, and this past month his friend died from an overdose. A week after that, he was high on some sort of pain killer that I have never heard of before and crashed his car into a street lamp. It did a lot of damage and he would have been dead if he had not been wearing his seat belt. Whenever I saw him at the hospital, he finally broke down and promised that he would stop. He didn't stop and now he has dropped out of college with no job. He has tried stealing my mothers jewelry for money. My mom tells me how its driving a wedge in her marriage with my dad, because she wants to kick him out and my dad won't let her. She has also become depressed trying to hold all of her feelings inside and needs to start talking to a therapist. What really scares me the most is that i have a younger brother who I see going down the same path. I have really distanced myself from my older brother and we don't have a close relationship at all, but I wonder if telling him everything that he is doing to our family would make him stop (I have actually never spoken a word to him about his addiction). I could really use some advice on what to do about him, my younger brother, mom or anything! My family sometimes pretends like there isn't a problem and I don't really have anyone to talk to about this.