This document discusses mental illness and substance abuse. It begins by defining a drug and categorizing drugs as licit or illicit. It then provides examples of commonly abused psychoactive substances in Zambia like alcohol, cannabis, heroin, cocaine, and solvents. The document outlines various physical, social, and psychological problems associated with substance abuse like liver disease, homelessness, anxiety, and dependence. It describes signs and symptoms of withdrawal and intoxication for various classes of drugs like barbiturates, benzodiazepines, cannabis, heroin, and cocaine. Finally, it discusses the role of public health workers in preventing drug abuse through health promotion, targeting at-risk groups, and advocating for policy changes.

1. MENTAL ILLNES AND SUBSTANCE
ABUSE
Presented by Ms Ng’andu
Senior Lecturer
Chainama College

2. SUBSTANCE ABUSE
• INTRODUCTION
• Drug/substance abuse is an international
problem affecting millions of people and many
countries around the world. The effect of
drugs can either be directly or indirectly.
• A drug is defined as “substance that affects
someone physically or mentally when they
take it” (Macmillan 2007, P 455).

3. • Drugs can be categorized as
Licit (drugs that are approved by law or rules) or
illicit (drugs that are not approved by law or
rules)
The universality of drug use and its diverse
social cultural attachment makes it difficult to
group drugs into the two categories stated
above.

4. • In this discussion licit drug(s) is defined as
medicinal drug prescribed by a legal
practitioner for the sake of treating an illness.
• While illicit means drug used illegally and not
prescribed for the sake of an illness. The word
“drug” is used synonymous with psychoactive
substance.

5. • The role that drugs of all kinds play in
contemporary society is of great importance.
When working towards a drug free world.
• Some of the drugs found in the society as
Psychoactive substances are cannabis, Heroin,
alcohol, amphetamine and its derivatives,
cocaine, tobacco, solvents like glue to mention
but a few.
Range of drugs used in societies

6. • On the Zambian list one would also find
“Jenkem” a biogas formed by fermentation of
sewer affluent.
• Petrol is also snuffed especially among the
street kids (Drug-enforcement Commission
2005).
• Alcohol (local brew & others e.g kachasu,
Lager etc)
• Dagga

7. • The above drugs are used for different
purposes like recreation, religious and rituals,
pleasure.
• Long distance drivers, students, musicians and
dancers take amphetamine (stimulants) to
keep themselves awake.

8. PUBLIC HEALTH AND SUBSTANCE
ABUSE
• Substance (alcohol & drugs) bring profit to
companies, its a source of employment and
revenue for the government.
• It brings pleasure to users
• It can be part of some culture

9. Physical problems associated with
substance abuse
• Liver cirrhosis ( alcoholic hepatitis)
• Gastrilitis
• Oesophageal varrices
• Pancreatitis ( leading to diabetes mellitus)
• Pellagra ( Avitaminosis B)
• Macrocytic anaemia ( vit B 12 deficiency)
• Chronic myopathy ( wasted muscles including
the heart leading to cardiomyopathy-CCF)

10. • Chronic cerebella syndrome ( having no
balance as you walk/stand)
• Alcoholic ambyopia ( diminished colour
appreciation except for black & white)
• Hyperlipideamia (too much fat in the blood)
• Cancer ( oral cavity & throat)
• Foetal alcohol syndrome
• Alcoholic ketoacidosis ( leading to death)

11. Social problems associated with
substance abuse
• Debt
• Homelessness
• Sexual problems
• Family problems ( violence, child abuse)
• Absenteeism from work
• Theft
• Stigma

13. Psychological/mental problems
associated with substance abuse
• Seizure
• Anxiety
• Phobia
• Depression
• Paranoid states
• Hallucinations ( tactile, auditory, visual)
• Delirium tremenes
• Dependence syndrome

14. PSYCHOACTIVE DRUGS
• There three groups of drugs: stimulants,
depressants & mind altering drugs
• Stimulants are drugs which speed up the
action of the brain and the nervous system
• Examples:-
- Cocaine (‘C’ coke, charlie, snow)
-Amphetamine ( Pep, whiz, pill, speed)

15. • Depressants- These slow down the brain & the
nervous system
• Examples:-
-Barbiturates (phenobarbitone) ( Barbs,
sleepers)
- Tranquilizers ( valium –DZ, librium )
- Heroin (‘H’)
- Morphine (‘M’ Morph)
- Cannabis (Marijuana, Herb, weed, charge)

16. • Mind altering Drugs- These alter the senses
and make one see or feel things differently
and abnormally. At times they are called
hallucinogens
• Example:-
- Lysergic Acid diethylamide ( Acid, microdot)
- Volatile solvent, glue, nail polish remover,
lighter fluids, petrol, jenkem, typex

17. Barbiturates signs & symptoms
• Confusion and drowsiness leading to deep
coma
• Slowed pulse & respiration
• Low blood pressure & temperature
• Nystagmus
• Tremors of the tongue and lips
• Collapse of periphery circulation and
respiratory failure leading to death

18. Benzodiapine( minor tranquilizers)
signs & symptoms
• Apart from sedative effects, minor
tranquilizers can bring about withdrawal
effects when used for a long time and you
stop using them.
• Signs & symptoms:_
• Suspiciousness
• Weakness & dizziness
• Tremor & muscle twitches

19. • Palpitation
• Headache & sweating
• Nausea & anorexia
• Abdominal discomfort & diarrhoea
• Perceptual ataxia(tilting in visual field leading
to unsteadiness)
• Tinnitus & unusual tactile sensation
• Blurred vision/facial burning/increased
sensitivity to light, sound, smell and taste

20. Cannabis signs and symptoms
• Dreamlike state/Euphoria
• Rapid speed answers considered as brilliant,
easily formed with surprising clarity but is
often dull & confusing to listeners
• Distortion of time sense
• Hallucinations/Tremors, twitches
• Light-headness & unsteadiness, sensation of
floating in air and buoyancy ( lightness of
limbs)
• Photo phobia

21. Heroine signs and symptoms
• Anxiety
• Sweating
• Restless sleep
• Running eyes & nose
• Muscle twitches
• Abdominal cramps
• Vomiting
• Increased pulse & blood pressure
• Tremors & convulsions
• Poor attention & concentration

22. • Feeling of depersonalization & derealization
• Distortion of shapes & intensification of
colours
• Hallucination of flashes of light, human faces
or complex pictures
• Wondering away with subsequent amnesia
• Emotional excitement may lead to mania

23. Cocaine sign & symptoms
• Symptoms can be seen in two stages
• Stage 1:-
-feeling of great well being
-Heightened pleasure/ hyperactivity
- Increased speed of intellectual functioning
- Impulsive behaviour & disinhibition
- Prone to accident

24. • Stage 2:-
At this stage cocaine levels are falling:
- Depression, misery, apathy
- Anxiety & irritability
- Restlessness and hostility
Cocaine hallucination:-
-Misperceptions ( harmless objects & noises
appear to be threating leading to hyper
vigilance & increasingly concerned

25. • Lights sparkling at the periphery of the
vision(snow lights)
• Voices calling a person’s name
• Insects crawling under the skin
• Talkativeness & restlessness
• Every day events are misinterpreted in a
delusional fashion

26. Role of public health worker
• As public health worker we have a big
challenge ahead of us
• We need to prevent drug related problems like
-Alcoholism which can lead to cancer, cardiac
problems even mental illness.
• We can work with the Government by
recommending that licensing law, access etc
are worked on to reduce this burden.

27. • Different appropriate massage should be
given to the public.
• Health promotion massages
• Tackle the problem from all fronts e.g
environment, biological and other
confounding factors ( personality attributes).
• Identify those that are at higher risk and
intervene.

28. conclusion
Drug use has both merits and demerits
• Merits
-Being awake for a little longer time for a
student studying, that driver on the road
would be beneficial
-Psychoactive drug use is symbolic among
certain subcultures and this draws them
together as a sign of identity

29. Demerits
-Drug dependence
-poor judgement
-Damage to essential organs (liver, kidney)

30. THANKS FOR LISTENING
ROSE NG’ANDU