COMMUNIQUE FROM KANO ROUNDTABLE ON DRUGS AND SUBSTANCE ABUSE #SenateTacklesDrugAbuse (Monday, December 18th to Tuesday, December 19th 2017)
Following expert presentations, analysis and deliberations leading up to, during and following the roundtable, the following key observations regarding the expected outcomes were made:
1. There was a critical paucity of data on drug use, prevalence, trends and patterns in Nigeria, and there is an associated near absence of institutional structures to collect, analyze and report such data. There are however consensus positions bolstered by non-structured observations that suggest the following:
a. Particularly in Kano, and the North-Western Geo-Political region of Nigeria, there is a high prevalence of use of licit, controlled medications particularly opioids such as Codeine containing cough syrup, and tramadol. There also appears to be an increase in diversity of methods of drug use, with “Shisha” which was traditionally reserved for the inhalation of tobacco, now increasingly used for other psychoactive substances.
b. Commonly abused psychoactive substances are generally easily accessible, regardless of their legal classification. All drugs legal and illegal are available and affordable to any interested member of society, regardless of age and health, risk (e.g. driving under the influence of alcohol) etc. The same can be said of most psychoactive substances.
c. In the course of implementation of its Project NGAV16 — “Response to Drugs and Related Organized Crime in Nigeria”, the UNODC carried out an assessment of attitudes on drug prevention, treatment and care among law enforcement agency operatives, the general public’s attitudes on drug prevention, treatment and care (DPTC) and the effectiveness of current outreach and advocacy programs. The result of these assessments revealed a low general awareness of drugs and their effects, difference between drug use and dependence and understanding of drug prevention, treatment and care. The majority of people generally have a negative attitude towards drug users and as a result this often leads to discrimination and stigma towards those using drugs.
d. It is generally understood that there is a critical need and shortage of specialized professional evidence-based facilities for the treatment and or rehabilitation of people with substance use disorders, and very little in place to address underlying psychosocial predisposing factors that place individuals at risk of drug use and dependence. These issues are even more pronounced with regards to Female drug users, a population which is generally agreed to be on the rise.
2. The Nigerian Government through a number of MDAs have the capacity to; limit access to psychoactive substances, thereby decreasing the use of and dependence on these substances. For psychoactive substances which have medical uses, particularly opiates, control systems are outlined in policies to allow access for medical and research purposes and limit recreational use. However, indicators point to the failure of such control systems. The Government and Civil Society also have the capacity to develop and implement interventions that prevent the initiation of psychoactive substance use, treat drug use disorders, address psychosocial issues related to drug use and provide rehabilitation and reintegration of individuals who are dependent on drugs. Through these initiatives, Government and Civil Society can decrease the demand for psychoactive substances. However, the outcomes of such initiatives are hardly encouraging. There are also sadly very limited deliberate efforts on the part of Government and Civil Society in the absence of treatment and rehabilitation services, to provide public health, harm reduction services to drug users, often times favouring a criminal justice approach which criminalizes the drug user rather than providing the needed help.
3. A key observation at the roundtable was the confusion of mandates of the various MDAs working on different aspects of drug control. Law Enforcement and regulatory agencies were effectively always able to site some law or policy that excused their actions (or inactions), and effectively shifted the blame for the consequences of such to another agency. While simultaneously requesting more resources to carry out what they understood to be their statutory mandate. Civil Society Organizations were largely found to be frustrated by what they viewed generally as deliberate actions by the government and its agencies to promote the prevalence of drug use in their communities. Yet there seemed to be an absence of laws and policies that regulate the activities of Civil Society Organizations, ensuring that services offered are done to ethical and professional standards, based on evidence of efficacy, and do no harm to the individuals they claim to help, and the communities they function in.
On the Basis of these Key Observations, the following Actionable Outcomes are Proposed:
Outcome 1: Develop a Coherent Legislative and Policy Context to address both the Control of Drugs (Psychoactive Drugs), and Interventions for People Who Use Drugs.
Output 1: National Drug Control Bill
· Sections of various different legislations and policies that deal with Drug Control Should be pulled together and harmonized into ONE drug Control Bill, with clear mandates for the various law enforcement and regulatory agencies like NDLEA, NAFDAC, Nigerian Police Force and framework for interagency cooperation towards Drug Control.
· As the name implies, the Drug Control Bill will NOT address issues of Prevention, Treatment and Care of Drug Users, particularly as the policy context shifts towards decriminalization of drug users.
Output 2: Nigerian Mental Health and Substance Abuse Bill
· “Mental Health” refers to a state of psychosocial well-being in which the individual realizes his or her own abilities, copes adequately with the normal stresses of life, displays resilience in the face of extreme life events, works productively and fruitfully, and is able to make a positive contribution to the community. When one considers this definition, it is clear that issues related to Mental health, are the primary reasons why individuals initiate and continue drug use, resulting in drug use disorders.
· Through the Mental Health and Substance Abuse Bill, the Nigerian Government will commit itself to promoting the well-being of its people, ensuring that mental health is valued, promoted, and protected and that mental health conditions which often predispose vulnerable individuals to Substance abuse and dependence, are treated and prevented and that timely, affordable, high quality and culturally appropriate mental health care is made available to the public. This Bill would:
I. Strengthen effective leadership and governance for mental health and Substance Abuse by, among others, formulating, developing, and implementing national policies, strategies, programs, and regulations relating to mental health and substance abuse;
II. Develop and establish a comprehensive, integrated, effective, and efficient national mental health care system responsive to the psychiatric, neurologic, and psychosocial needs of the Nigerian people;
III. Protect the rights and freedoms of persons with psychiatric, neurologic, and psychosocial health needs;
IV. Strengthen information systems, evidence and research for mental health and Substance abuse; and
V. Integrate strategies promoting mental health (and minimize the impact of Substance abuse) in educational institutions, the workplace, and in communities.
