Breaking free from substance abuse

Individuals tackle life’s obstacles in different ways. Some individuals may succeed in clearing the hurdle while others wouldn’t. Those who are associated with substance abuse fail to cope up with what life has to offer them. This is the reason behind many broken families, crimes and of course unhappy lives. However it is never too late to break the chain of this vicious cycle created by substance abuse. On the positive side there is always hope and help.Dr. Jayamal De Silva, Consultant Psychiatrist at the Colombo South Teaching Hospital, Kalubowila and Senior Lecturer in Psychiatry, Faculty of Medical Sciences, University of Sri Jayawardenepuraand Dr. Udena Attygalle, Consultant Child and Adolescent Psychiatrist, shed light on the issue of substance abuse and how to get around it, minimizing the damage caused by such use and how to prevent people from falling victim to it.   

“Adopting population measures that are scientifically proven to be effective economically as well as socially will prove to be more strongly effective in dealing with and minimizing substance abuse rather than other options such as medications, legal measures like punishments, counselling and rehabilitation in the long-run. This will help prevent the diversion of the necessary services and resources on less effective alternatives and approach the issue at hand directly to ensure better results,”says Dr. Jayamal De Silva  

It is important for parents to inculcate life skills in children so that they can be assertive when the necessity arises and not be influenced by negativity that may surround them

Alcohol and tobacco?  
Substance abuse takes many forms. It includes the consumption of hard drugs such as nicotine, heroin, etc as well as the consumption of substances such as alcohol and tobacco. Alcohol and tobacco are the major substances that contribute to the overall burden of drug abuse.   

Dr. De Silva explained that substance abuse is attributable to 2 major factors in the country; the economy and secondly the mortality. “Recent studies have shown that the economic impact caused by alcohol alone is calculated in billions of rupees. Alcohol spearheads the cause behind as many as 25,000 deaths per year annually and tobacco comes close with roughly 20,000-25,000 deaths per year,” he informed. Deaths due to hard drugs like heroin, do not come close to the mortality caused by alcohol and tobacco. This signifies its harmfulness although it is common to think of substances like heroin, etc on the topic of substance abuse.  

It is needless to say that the use of hard drugs of course leads to devastating effects on the individual as well as the individual’s family among other negative and adverse complications.   

Risk groups  
The category of citizens that is most likely to be victimized by substance abuse comprise young adults. “They are the future of the country. On viewing the future customer base, the young adults of the country are targeted by such markets. The coastal belt regions and the tourism sector are vulnerable areas connected with such markets. Therefore it is important to be both mindful and aware in order to take measures in preventing and reducing incidents of substance abuse,” Dr. De Silva explicated.  

On a positive note, tobacco smoking trends are seen to be reducing within the island. Slight drops in alcohol consumption can also be observed. “Statistically speaking, it was estimated that while 40,000 heroin users existed in the mid 1980s in the island, currently there are approximately 50,000. Though it shows an increase, it is a subtle increase over the 25-30 years that have passed. This indicates some success of the control measures employed in reducing substance abuse,” he added. The introduction of population measures, spreading public awareness, bans on public smoking, increase in prices and taxes, advertisement controls, targeting the bringing down of attraction around these substances and various other controls have played their parts in contributing to the reduction of substance abuse.   

However the general public should play a vital role as well if minimizing of substance abuse is to succeed.   

Our role as the public  
“Individuals fall victim to substance abuse through the concept of what is known as gateway drugs. It is through the gateway drugs that individuals get introduced to hard drugs which then leads to substance abuse. Gateway drugs include secondary smoking and beer which later aggravate into hard drug use. Therefore preventing exposure to these gateway drugs are extremely important,” Dr. De Silva stressed.  

In terms of behavioural changes, a change of perception is quite necessary. 
The psychiatrist stressed on the fact that the public should change their ways on how they think about and perceive drugs. “It is a commonly existing misconception that when a person takes drugs several times, that individual becomes a drug addict and is regarded so by the public. The individual himself, who took drugs once or twice, would think so and host thoughts of a ruined or doomed life. That is the nature of substance abuse. However just because a person uses drugs several times, it does not mean that the individual is beyond help or that his or her life is ruined,” he explained. He continued further by adding that drug addiction is caused when the individual is exposed to such promotions constantly on a recurring basis. 

It could be environmentally conduced or due to peer pressure. However it is important not to give up and think that life has been ruined. “Addiction is caused by recurring exposure to drugs. The exposure to drugs a few times does not mean addiction. Help is available and there is hope for a healthy life,” he stressed.  

Factors that act as determinants of drug abuse should be addressed as well. Substance abuse is prevalent among the less affluent. Poverty and ignorance are factors that should be addressed in order to mitigate substance abuse successfully.   

According to Dr. De Silva, focusing on non-profitable measures can divert attention from the more effective measures in reducing drug abuse. Therefore it is important that people fully comprehend what has to be addressed specifically. “Counselling and rehabilitation are the most followed methods by way of treatment. However its effectiveness depends on the individual. It may prove successful depending on the situation. Individuals with mild cases of substance abuse may benefit from above methods, but might not deal well with some. In some cases it may create negative affects and anger in the individual. There are situations when medication is needed to help deal with withdrawal symptoms when drug use is stopped. However total dependency on medication may obstruct the individual’s ability to form skills of self adequacy,” he accentuated. Self adequacy is important as the individual should be motivated to come out of drug addiction through effort and will power.   

He highlighted that it is of importance to direct attention towards strong implementation of population measures and stronger legislation and policies pertaining to substance abuse controls.  

Protect children  
“It is important for parents to inculcate life skills in children so that they can be assertive when the necessity arises and not be influenced by negativity that may surround them” Dr. Udena Attygalle said.

Since children and adolescents become easy targets of such situations, parents play an important role in protecting them and preparing them to face life sensibly so they do not fall victim to substance abuse when life tests them by throwing obstacles in their path.   

Dr. Attygalle stated that parents have to be sensitive and aware of their children and keep up with what is going on in their lives. “If there is a problem, parents have to deal with the issue in a sensitive manner. Furthermore, it is important for parents to inculcate life skills in children so that they can be assertive when the necessity arises and not be influenced by negativities that may surround them often by way of peers,” he mentioned. Dr. Attygalle continued to explain that these skills should be developed within children in such a way that they should be able to deal with tough situations while maintaining and keeping friendships intact.   

Both males and females are vulnerable to drug abuse, but males are more exposed to sociocultural issues that contribute to drug abuse. However it is hard to generalise this issue and this does not mean that females are out of danger of falling victim to drug abuse.  Equal care has to be taken regarding females. 

Prevention is always the better option than cure, so more attention has to be paid to avoid incidents associated with substance abuse. However it is important to remember that help is always available and there is always hope for individuals fallen victim to substance abuse. An individual should never give up by resorting to thoughts that one is beyond help. Where there’s life, there’s always hope!