By Mwarianesu G. Makosa
THE ‘SILENT’ PANDEMIC
‘Kutsomwa[1]’, and ‘ubanjiwe’, are some of the trendy
vernacular terms used to describe the dire intoxication states experienced by
substance abusers in our teapot-shaped nation.
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| Image credit - Global Press Journalism |
The
malignant cancer that is substance abuse has been ravaging the country for
decades now, with the youths being the most affected demographic. Worldwide,
about 36.3 million people suffered from drug use disorders in 2019. The World
Health Organization (WHO) reports that about 500 000 deaths are attributable to
drug use on an annual basis.
Between
July and September 2021, at least 100 young men and women appeared at the
Harare Magistrates Court on the back of charges of either possession or dealing
in the infamous crystal meth[2]. Further, during the month
of August 2021, detectives from the Zimbabwe Republic Police (ZRP) nabbed three
students from a local university whom they had found in possession of crystal
methamphetamine worth about US$ 15, 000 and a further 108 grams of cannabis.
These
statistics show how rampant substance abuse is. Whenever the question pops up,
the mind rushes to think about marijuana, alcohol, and tobacco, but are these
the only substances being abused? Why is our generation held hostage by drug
abuse? What are the consequences, if any, the mental health and legal
implications, and what measures should be put into place to nip the ‘silent
pandemic’ in the bud? I will succinctly address these questions in this
article.
What is substance abuse?
· Substance
abuse refers to the harmful or hazardous use of psychoactive substances,
including alcohol and illicit drugs[3]. Psychoactive substances
include alcohol, caffeine, nicotine, marijuana, and specific pain relief
medicines. Cannabis (mbanje/yinsango[4]),
crystal methamphetamine (mutoriro/ntash[5]),
unprescribed broncleer and cocaine are the most common illicit substances
within the Zimbabwean setup. The abuse of these substances is usually marked by
a physical dependence on them and recognised by a tolerance to, and withdrawal
symptoms from the drug of abuse[6].
Why substance abuse?
Bla Tino[7],
a popular character in the ghetto suburb where I grew up always sat by the
corner smoking with his ‘soldiers’ who idolised him because of his ability to
arrange a quick fix. I always wondered why? I was fortunate enough to have
dodged this scourge because of the values instilled in me at tender age. Even
though this was my case I often wondered why?
On
a rare occasion I spoke to Bla Tino
and he narrated his ordeal to me. He spoke of how he had graduated from college
five years prior and had never gotten gainfully employed. Him being 30-years-old
and still living with his parents who expected him to take care of them when he
was even failing to take care of himself didn’t make his situation any better.
Bla Tino’s
situation is reflective of a majority of drug abusers in Zimbabwe, who take
illegal substances as a form of escapism from the pains and troubles of the
day, particularly unemployment. With the economy in dire straits and the
presence of thousands of unemployed graduates, empathising with substance
abusers and addicts is quite understandable.
Development
experts such as Henry Hamandishe[8] have reiterated that the
country’s harsh economy spurs drug abuse, which is a sentiment I agree with. For
some, it stems from curiosity and one ends up hooked to the addictive
substances. For others, particularly with drugs such as meth, it begins with regular
usage as a means of sustaining consciousness over long periods, but the
continued use usually breeds abuse and addiction to the detriment of the user. With
substances such as alcohol, one may indulge for recreational purposes to gain “Dutch
courage”, but the unregulated use becomes problematic for reasons I will detail
later. The list of reasons I have given is inexhaustive but provides a clear
picture of the depth of the problem at hand.
Red flags of substance abuse
Due
to their proximity to substance abusers, family members, friends, and
colleagues are usually quick to notice behavioural changes or other physical
alterations in these victims, which point to substance abuse. I’ll just outline
a couple of the common red flags. Meth addicts tend to lose weight rapidly due
to the drug’s hunger-suppressing components and may sleep for longer hours than
usual. As such, unexplained weight loss might be a substance abuse red flag.
Some substance abusers withdraw themselves from their normal associations
without reason. When this happens, those close by should be swift in seeking
help for the victim. Bloodshot eyes, bad breath and shakes, are examples of physical
changes that should never be ignored but be promptly acted upon.
Mental health implications
Abuse
of hazardous substances may have significant short and long term mental health
implications. This is a serious cause of concern particularly in an already
overwhelmed and underfunded mental healthcare sector. As of 2021, the country
had about 23 practising psychiatrists serving a population of close to 15
million, with the majority of them being in Harare.
The
probability of a poor drug addict living in Chisumbanje getting attended to by
a psychiatrist is close to zero. These health care professionals are
overwhelmed and are unable to serve a bulging population of drug abusers. Some
of the short term effects of substance abuse include changes in cognitive
abilities, a temporary state of euphoria, slurred speech and loss of
coordination. The dangers of chronic drug abuse range from depression, anxiety,
panic disorders, paranoia and hallucinations.
The
current COVID-19 pandemic has not made life any easier for substance abusers
and Zimbabwe’s mental health system. The WHO[9] reported that the COVID-19
pandemic has disrupted critical mental health services in 93% of the countries
around the world, showing just how difficult it has become to access these
vital services during the past two years. With African countries spending just
1% of their budgets on mental health[10], victims of drug abuse
are left in a precarious position concerning their rehabilitation and treatment
within the country’s mental health institutions.
Legal Consequences
Unlawful
possession, use, trafficking or dealing in illegal substances will more often
than not have detectives from the Zimbabwe Republic Police breathing down your
neck. This is understandable, since illicit drug dealers and traffickers are
fuelling the substance abuse pandemic at an unprecedented rate. And also given
the fact that almost every modern capitalist state, developed or underdeveloped,
mimics America’s ‘War on Drugs’.
However,
it is unfortunate that only the small fish are caught in the net whilst the
giant white sharks are left to roam the oceans, undeterred. The
challenge with legal enforcement or prohibition is that the trade in drugs has
become an ecosystem which many people benefit from – we are talking about high
level politicians to lowly vendors who sell airtime. As a result, to disturb
such a setup will have unfavourable consequences.
Regardless,
one should always be aware of the criminal penalties that accrue when one is
found guilty. The courts will sentence anyone convicted of unlawful dealing,
possession or use of dangerous drugs from anything between a fine to twenty
years in prison. Before one considers engaging in any of these illicit
activities, they should have been cognisant of these dire consequences.
Solutions & recommendations
It
is difficult to suggest solutions and recommendations aimed at preventing
substance abuse. This is due to the plethora of reasons that fuel this
pandemic. The first step to solving this pandemic would be addressing the
national question. One would be pardoned for suggesting the availing of
employment opportunities as a method to curb the rampant substance abuse. There
is also a need to establish community-based support systems that assist men and
women in navigating life’s challenges which more often than not lead to
substance abuse.
Once
there is mention of the establishment of such support systems, it becomes
impossible to omit the pertinence of adequately funding Zimbabwe’s mental
health care sector. This becomes a long term solution to curbing substance abuse.
Substance abuse prevention programs which are backed by scientific evidence are
also an effective way of dealing with the problem. Such programs can target
families, schools and the workplace environment. Government, civil society organisations and
other private players should direct investment towards anti-substance abuse
awareness campaigns using different platforms that include but are not limited
to social media, seminar presentations, radio and television shows.
Such
campaigns should be inclusive of substance abuse survivors. The Ministry of
Education should also make a deliberate effort to increase material within its
curriculums dealing with substance abuse prevention. Furthermore, the Ministry
of Health and Child Care must fund preventative initiatives such as behaviour
change programs in community health centres. Like the reasons behind substance
abuse, the solutions for the same cannot be exhausted.
On
a tad radical note, other viable solutions that may be considered include decriminalization
and legalization. These should be implemented with the goal towards killing the
black market. The latter is responsible for many other social ills that flow
from illicit drug trade such as crime, lethal drug overdoses, and violent enforcement
of drug prohibition laws. Decriminalization involves a partial repeal of drug prohibition laws for example allowing the
sale of designated drugs while outlawing recreational use. Legalization means
the total repeal of drug prohibition laws with a broader scope to change
attitudes about substance use for the better.
Where can one get help?
Several
centres around the country assist persons fighting substance abuse and
addiction. The assistance they give comes in the form of counselling and
rehabilitation services. Highlands Halfway, Ruwa Rehabilitation, Tariro
Rehabilitation Centre, Harare and Tirivanhu Rehabilitation are some
institutions that provide such support. Besides these rehabilitation centres,
the Ministry of Health and Child Care runs the following psychiatric
institutions: Sally Mugabe Psychiatric Unit (Harare), Parirenyatwa Annex
Psychiatric Unit (Harare), Ingutsheni Psychiatric Hospital (Bulawayo) and
Ngomahuru Hospital and Halfway House (Masvingo). In addition, the Friendship
Bench which mainly operates within Harare uses the talk therapy model in
helping substance abuse victims and other mental health care users. Substance
abusers should approach these institutions in order to acquire alleviation of
their conditions.
Conclusively,
substance abuse is a severe societal vice that needs to be prevented, managed
and eradicated. Its effects are far-reaching and present significant challenges
to all those affected. Dealing with substance abuse is not a one-man job, but
requires a multi-stakeholder based approach, which, if effected will change the
fortunes of the ailing victims. The mental health cost is unimaginable, and the
legal consequences dire. Something has to give lest the silent pandemic
obliterates an entire generation.
Author:
Mwarianesu G. Makosa (A registered legal practitioner passionate about human
rights and mental health who writes in his personal capacity).
References
[1] In Shona & Ndebele: Terms
common amongst Zimbabwe’s youth which describes a state of extreme intoxication
wherein the user experiences drug-induced hallucinations and an inhibition of
normal body functionality.
[2] https://allafrica.com/stories/202110010068.html accessed 12 January 2022
[3] https://www.afro.who.int/health-topics/substance-abuse accessed 12 January 2022
[4] Shona and Ndebele equivalents of
cannabis/marijuana
[5] Shona and Ndebele equivalents of
crystal methamphetamine
[6] https://www.addictioncenter.com/drugs/illicit-drugs/ accessed 13 January 2022
[7] Pseudonym
[8] Jeffrey Moyo, Zimbabwe grapples with mental illness amid
rampant drug abuse, Anadolu Agency, August 2021
[9] https://www.weforum.org/agenda/2021/08/4-facts-mental-health-africa/ accessed 14 January 2022
[10] Supra
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