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The following Mackay Day lecture was delivered by Dr. David Basangwa, Commissioner Butabika Hospital. It was published in The Anchor, a publication of Mackay Memorial College, volume 5, 2008.

Drug abuse; a sure deal for societal destruction

A drug by definition refers to any chemical agent that is used in the body for treatment or diagnosis of disease. In the context of misuse, a drug refers to a chemical agent whose main area of action is the brain. Such drugs have the potential to cause mood change which makes individuals to take the drug on a continuous basis. It is the continuous and uncontrolled use that eventually constitutes addiction and it is for this very reason that such drugs are said to be addictive.

Drug abuse is a common problem the world over and now known to be a major source of public health concern. About 180 million people are said to be abusing narcotic drugs worldwide (UNODC). WHO (2004) further estimates that about 2 billion people use alcohol globally and that alcohol causes more than 1.8 million deaths per year from the over 60 diseases that it causes including accidental injuries.

Uganda now has evidence of an increasing drug abuse problem. Studies so far done in schools show that a number of students admit to use of alcohol, tobacco, marijuana and wide range of other drugs ( Basangwa, 1994). One study indicated that 89% of secondary school students used alcohol, the problem being bigger for day than hoarding schools (UYDEL, 2005). Hospital based studies generally show a hight number of patients admitted with alcohol/drug related problems. In Butabika hospital for example, 20% of admissions are alcohol/drug related.

Police records further show an increasing trend of drug seizures and drug related crimes. Uganda which was in the past said to be a transit country for narcotic drugs is now known consumer of these substances especially heroin and cocaine. Cannabis sativa, locally known as Enjaga (A.K.A. Njaye, bangi or ekikoola) is the most widely abused narcotic the world over. In the case of Uganda, besides alcohol, which is a legal product, cannabis is the most widely produced, abused an trafficked drug. As grapple with the many narcotic drugs, use of the licit substances like alcohol is also on the increase in the country.

WHO/FAO (2004) put the capita consumption of alcohol in Uganda at 19.47 liters, which was the highest in the world. Much as this figure may not have been very accurate, it does demonstrate to us the Uganda clearly has a big alcohol problem.

Following the above scenario, many people have asked the question: "Why does Uganda continue to suffer wide spread increase in drug abuse?" We may not have an easy answer but what we know is that among the many possible reasons, the following do make significant contribution.

From the health and social point of view, drugs contribute immensely to health and social consequences.

Health related issues include road traffic accidents, cancers of various organs in the body, susceptibility to infections like HIV/AIDS and other STDS, to mention but a few. Others include diabetes, tuberculosis, high blood pressure and a wide range of neuro-psychiatric syndromes.

Some of the common social consequences include domestic violence, poor school performance or school drop out, divorce, street children, chld abuse and loss of employment.
In the area of crime, drugs lead to thefts, robberies, rape and even murder in certain situations.

How to recognize a drug addict

Common symptoms for students on drugs include but not limited to the following:

What needs to be done?

The problem of drug abuse is multifaceted. It touches every person in the country and therefore efforts towards control call for a multidisciplinary team. We all need to be aware of the problem and begin to take action. Community empowerment in this regard is essential. Unless communities own and participate in the interventions, sustainability and success can't be achieved. In addition, controlling drug abuse is beyond the Health or Education ministries. It calls for joining hands with all sectors, NGO's and UN Agencies. Ultimately it is the sustained and coordinated effort of all the mentioned players that will help in addressing the problem. It is also important for all people especially the youth to note that drug abuse is a chronic and dangerous disease, which they should endeavour to avoid at all costs. For those that have just started the habit, the advice is that they should stop forthwith. Those that are already addicted, help can be found at the nearest health facility where they can either receive the treatment or be referred to other centers.