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Drug Abuse Crisis In Kaduna State Alarming -Doctor Baka

Dr. Isah Shaedouw Baka, is a Psychiatrist at the Federal Neuro-Psychiatric Hospital, Kaduna. He was recently appointed Director-General, Bureau for Substance Abuse, Prevention and Treatment, Kaduna State.The Kaduna State Governor Mallam Nasir El- Rufai established the agency in reaction to the drug abuse crisis.

Dr. Baka spoke with Emmanuel Ado’, Host of Let’s Talk- a current affairs programme that airs on Liberty Radio,Kaduna on the increasing cases of drug abuse and how it can be contained in Kaduna State.

You are heading the newly established Bureau for Substance Abuse,Prevention and Treatment ,this must be a product of serious concern to Governor El- Rufai. How serious is the issue of drugs abuse in Kaduna state, is it an epidemic or a pandemic?

Dr. Baka:  Substance abuse in Kaduna state is a very serious problem.It is a pandemic,a problem that has crossed all borders. There’s hardly any family today in Kaduna that does not have a substance abuse related case.  And that’s why I have likened it to a pandemic. Like you said it was something the governor was convinced about,that the situation needed needed such a radical approach. I want to assure you that the process was pain staking before he came up with this Bureau. It wasn’t set up for fun or to provide employment.There use to be a Unit in the Ministry of Health, that handled the issue of drug abuse and once in a year it held anti-drugs abuse campaigns usually during the International Day for Drug Abuse. The Ministry of Health will organize seminars and workshops, and visitations to one or two organizations like, the Prison, Borstal Training Institute and the Federal Neuro-Psychiatric Hospital. What we are faced with goes beyond this.No previous chief executive of the state looked at the issue of drugs abuse and made this kind of commitment to tackle it. I must commend the governor,because it shows real concern about drug abuse,which like I said earlier is a pandemic.

Talking about a state with a population of 10million people,how true is your assertion that there’s hardly any family that does not have one drug related issue or another! If true that must be frightening. Can you expatiate on that? 

Dr. Baka:  It’s difficult to explain to the common man on the street the problem of drug abuse and it related complications. As children and subsequently as adults we use to look down on people who took alcohol and say we don’t want to be like them.But we don’t see alcohol as a drug.When you talk of substance abuse, you’re talking of a group of substances. In the academics, there are about 10 groups.  Alcohol is considered a group of itself and in this group are ethanol,methanol and others that are commonly referred to as alcohol.Of those regularly abused, most people just know beer, local brews like burukutu and palm wine, but there are others like dry gin etc they are in the alcohol category. Cocaine and related products also have their own group.There are also the less known ones like amphetamines. Amphetamines and its related products which causes stimulation of the body system, particularly the mental functions. Then there is caffeine and its related products. Then Cannabis and related products. At the bottom is organic solvents and others. All these also have sub-groups.  So there is a barrage of all kinds of substances.In recent times we have gone beyond these categories known to academics.For instance there are young men who go to the toilets especially the pit toilets to sniff nitrogen and it related products.They cover the toilets with polythene overnight and in the morning they rush and sniff the nitrogenous gases to get high.Some pick lizard dung and combine them with other things and use.The categories of substances that are being abused cannot be exhausted.

You are confirming what the National Drug Law Enforcement Agency (NDLEA), said about Kaduna state as one of the states with the highest cases of constant drug abuse in the country.  So how did Kaduna state get here?

Dr. Baka:  Well, it’s difficult to really say how Kaduna State got to where it is,as far as substance abuse is concerned.Some few years ago we were only bothered about alcohol abuse. But then other substances started trickling in.As far back as 1979, into the early 80s’ Nigeria was just a transit base. We only use to talk about hard drug,but not use in Nigeria. But by late 80s and early 90s, we started getting cases of drug abuse but they were not residents of kaduna. The few ones that got involved were those who had travelled to Lagos,Kano and ran into couriers and then they dabbled into it. A patient of mine got into the habit at Lagos,where he had attended a party. At that party they served cocaine as alcohol. He resisted but eventually he got hooked. He came to seek help primarily not because of the substance abuse, but because he was spending seriously on the drug. A small pinch at that was like N500.Imagine if he was taking the drug three to four times a day, that would amount to N2,500. So if you spend N2,500 a day on drugs, where are you going to get the money to finance it? I advised him that the only solution was for him to be admitted so he can cut off from those his friends and get clean, then he could start his life all over again. He couldn’t. Once you get hooked it is a problem, because those friends will keep coming around with the substance.If the person doesn’t have money they’re ready to give him.The problem is when that person starts again,they will begin to incur debts and would eventually start disposing their property etc.The strategy is to stop people from getting into it.

So the NDLEA statistics is true?

Dr. Baka:  Of course NDLEA is right.  Virtually every kind of substances is being abused today in Kaduna.And there are so many cells – there are cells in Kawo, Anguwar Dosa, Anguwar Rimi, Barnawa, Sabon Tasha, Rigasa, Tudun Wada etc. where they meet and use substances.They move from one cell to another.Each has its speciality,what you don’t have you go to the other to get. For example, in Kawo there is a particular place they sell Marijuana. At Ungwar Dosa their speciality is Tramal. In each of these cells there is a principal substance considered as their exclusive preserve. Diazepam for example is a drug we use in the hospital,but it is being abused.Diazepam is in tablet and injectable form.For beginners the first she or he sleeps off.Young girls do get abused,because once they take it they sleep off.

They will rape her?

Dr. Baka: Well we can’t call that rape,because she’s no longer in her senses. In some places they combine marijuana with other types of substances,to produce new products that are unknown to medicine.They combine these substances and abuse them in different ratio.

As a Psychiatrist, you must be worried about the abuse of prescription drugs – Bernylin and Codeine, and now Diazepham and several others?

Dr. Baka:  Yes we are. The Pharmaceutical Society of Nigeria (PSN), and NDLEA have classified these drugs as ‘DDA’ drugs that can be administered only on prescription. Our problem are the Patent Medicine shops,they dispense these drugs to obvious abusers without prescription.A patient once went to buy her prescription,but they refused her,because she forgot her prescription. She was so happy. She left believing that was the situation,only for her to go to that same shop a few days later to see them dispensing these controlled drugs to some youths whom she was sure were certainly going to abuse the drugs. She was naturally sad.

Kaduna is sitting on a time bomb…

Dr. Baka: That’s the situation we’ve found ourselves unfortunately.Now for instance codeine has been banned,but it’s found in cough syrup,so they have moved to such drugs that contain it.The problem is that these are prescription drugs that people need.

How can we effectively tackle this issue since banning has not worked?

Dr. Baka: I don’t think it is right to say banning hasn’t worked.Banning has worked but It’s just that some few people don’t understand the implications of selling these substances without prescriptions to youths. Secondly, the companies producing the products need a strict line of distribution so that it doesn’t get into the hands of hawkers.

But again drugs you know is money.There’s so much money to be made….

Dr. Baka: Agreed! But these companies need to help the society.

(Cuts-in). No, they’re making good money not from those using it to get well, but from those using it for destructive purposes.

Dr. Baka: Agreed!  The hawker uses it to destroy the abuser because the person using it doesn’t know he’s destroying himself. So it is a vicious system that’s going to consume everyone ultimately.A hawker doesn’t know what it means to use a drug judiciously,but it’s the company that will ensure that their drugs don’t get into the hands of hawkers,but to a licensed pharmacist,who is aware of the potential for destruction.

Considering what you’ve just said, Kaduna is in a serious crisis, and you’ve been charged with the responsibility of prevention and treatment..

Dr. Baka: Some years back the Pharmaceutical Society of Nigeria (PSN),made some rules and regulations about the opening of pharmacy shops. They are expected to have Supervisory Pharmacists on ground,but that is not the reality.You find at best trained Community Extension Health workers,who dispense not knowing exactly the import of what they’re dispensing.A pharmacist if for any reason you forget your prescription,can use his judgement to know if you need it for a medical condition or not. And in that case he will take down your particulars.He will be professional,he knows the implication.Some years back NDLEA use to go round pharmacy shops to ensure that these drugs are properly dispensed. But today in Kaduna,people hawk bernlyn with codeine, so it’s difficult to control it. We have to do something drastic,to stop access to prescription drugs.And we are going to do that.

Sir, you have been charged with the responsibility of preventing people from abusing drugs, how would you go about this assignment?

Dr. Baka: Recently the State Government tried to close down patent medicine dealers’ shops but they took the government to court. The case has been lingering since Senator Ahmed Mohammed Makarfi’s era ….we are talking of about 16 years. And the court for whatever reason has kept adjourning the case.And as long as the case is still pending the patent medicine shop dealers are in business.

What effort has the Ministry of Health taken to stop these patent medicine shops selling….

Dr. Baka: (Cuts-in).  The ministry wanted to regulate the patent medicine dealers so that only those people who meet the condition would operate.They wanted to sanitize the market!if you like regulate it with some form of licensing.Many of them don’t have licence or if they have one it was fake.That was why the Ministry embarked on the progamme.The patent medicine shop dealers ganged up and took the government to court and they have made sure the case is dragging.

Have you brought this to the attention of the Governor?

Dr. Baka:  The governor is aware of it and he wants the issue to be decided once and for all.

So what steps are being taken…

Dr. Baka:  The ministry of health has been working on the issue,with the ministry of justice.I can tell you, that we have a serious situation on our hands.Many of the small roadside shopkeepers selling cigarettes are also selling bernlyin, how they get their supply is what I can’t tell; but we know for a fact that these people are selling had drugs in their stores.They sell diazepam…..the tablets and injectable. They sell rohypnol , I’m not sure you’ve heard of these drugs.Rohypnol is just like diazepam it helps people with sleep disorders, it is supposed to be taken for just 2-4 days and when the sleep disorder is normalized the patient discontinues the drug. But people are abusing rohypnol and diazepam. That’s why we always insist that unless the problem is serious,don’t get yourself into a big problem,that could become a nightmare. People get hooked in such circumstances.

The Judge handling this case just like so many other people does he understand how serious this situation is?As a Psychiatrist what is our role as guardians,parents. The NDLEA says in the North-West 6 million bottles of Codeine are sold daily.Is that figure……

Dr. Baka:  Maybe even more.That’s a conservative figure… in North-West you’re talking of 7 states, we have Kano, Kaduna, Jigawa,Sokoto, Kebbi, Zamfara and Katsina states.I think that is conservative. It is more considering the number of cases we are seeing.

Meaning the figure is small?

Dr. Baka: Most likely, particularly in Kaduna and Kano and of course Kebbi and Sokoto.People are really abusing bennylin with codeine Codeine. It is serious.These people take 2 – 3 bottles a day,not a tablespoon, and each bottle costs about N800. So, if they take 2 bottles of Bennyline a day you’re talking of N1,600.How many workers can afford to spend N1600 for Benniline with Codeine on a daily basis, but that is the amount the people taking it spend. So they take to crime to meet their needs. I think 6 million bottles of Benniline with Codeine is conservative….it comes down to just hundreds.On the conservative estimate research has shown that people who abuse substances on the conservative estimate ranges between 30 -70 percent of the population. For example, Kaduna state population is about 10million ….so if 30 percent of the people in Kaduna State are using substance, we’re talking about 3million, right? Let’s say of these 3million people,maybe 1.5million are abusing alcohol primarily and its related products; then the other 1.5million are abusing other substances – cocaine,trammel,bennylin,piriton and etc.So that’s why I want to believe that 6million bottles of bennylin is a conservative figure.

What new factors in addition to broken homes, abusive relationships, and peer groups influence are contributing to the increase in drug addiction. Now that we’re in a recession is there cause for alarm?

Dr. Baka:  Recession, yes!

 Okay, back to the question I asked earlier on the recession, are we…

Dr. Baka:  The recession should ordinarily mellow down the rate of abuse but it doesn’t normally work that way, because the people who suffer during a recession are descent people like you and me, but not the drug users.The avenue for their supplies of these drugs are still there ….crime they will harass you and I. They will snatch your handset and sale it for peanuts,break into your car and steal your laptop.Recession naturally should bring down the rate of abuse. But again in a recession people are going to lose their jobs, stress…Economic and social stress is likely going to be on the increase and It will spur more abuse naturally.

Now how are you going to work on this? We’ve agreed we’re sitting on a time bomb in Kaduna, and part of what we’re doing is to let people know, we may live in self-denial ,but the truth is that Kaduna State has drug issues.  It’s you duty now to tell me how …
Dr. Baka: (Cuts-in).  Immediately the Governor was sworn in he created an agency KASTELEA and more than 2000 youths were employed by the ministry of education.Part of the problems of drug abuse is unemployment.Youths who are not gainfully employed engage in drug abuse.So the more youths that are taken away off the streets, the better for us all. But we won’t stop there. We are going to embark on an aggressive enlightenment campaign like this programme so that people would know that substance abuse has serious debilitating effects on the life of the abuser, the family and relations and the society at large.

Presently we have only the Federal Neuro-Psychiatric Hospital.  Have you impressed in it on the Kaduna State Government to build a treatment centre?

Dr. Baka: Presently the Federal Neuro-Psychiatric Hospital is the only functional treatment centre.I know for sure that Kaduna State government is planning to build more rehabilitation centres. The Governor has indicated this to quite a number of specialists that he wants to build more centers. One of the major problems with substance abuse treatment is that the law allows an individual to opt out of treatment. Not only in Nigeria thing but internationally.So what we intend to do is to encourage people to get treatment,it is for their benefit that they subscribe to treatment and quite the habit.

For a drug addict who is at danger to himself, the society and government is spending scarce resources to rehabilitate him/her ….opts out…

Dr. Baka:  The person does not know he’s a danger to himself,talk less of the society.

Is it possible for the Kaduna State Government to make treatment compulsory?

Dr. Baka: It is the responsibility and desire of government that every abuser gets treatment.The governor has made my job easier,because the law gives us the power to go to court and get a restraining order if need be to ensure treatment.This is a novelty. And when the person’s case is reviewed and if there is still the need,all we need do is to get another restraining permit.

Good to hear this.

Is the increase in number of drug cases an indication of breakdown of family solidarity? In the light of this, is the Bureau going to set up counseling centres where people can get help?

Dr. Baka:  In fact that’s what we’re planning, One of the major programme we intend to pursue is education. Our first target are the schools.The idea is to prevent abuse.We intend to sensitize community leaders, engage Pastors and Imams.They are strong voices.

Are you seeing more women addicts?

Dr. Baka: There has been an increase in the number of women abusing substances. Problem is treatment,because they are hardly brought for treatment.For some reasons which I don’t understand women now abuse substances. It wasn’t this bad in the past.

What are the signs parents should look out for in their children?

Dr. Baka:  Incidentally, the traditional symptoms we use to see in the hospitals are no longer there. But If your child begins to stay out late that’s a warning sign.  That’s the first warning sign – why is he staying out late? Who is he staying out late with?
Then changing behavioural patterns like no longer being interested in academics.  He might be eating more because most of those who take substances particularly Marijuana eat more. It’s only when he’s been on it for long time that the interest in food begins to decline. The child becomes talkative and gradually begins to withdraw,avoids the family etc.  Then at home you see little things disappearing (pilfering) ….that child is into drugs.These are all signs.

Speaking of treatment, what is the range?

Dr. Baka:  It depends of the level at which the patient is rescued.If for example the person is just taking the substance and it has not already impacted on his behaviour, and he hasn’t started pilfering.  He works for the money to buy the substances. It is also a warning sign if a responsible child begins to bring money home. He is not stealing so no questions are asked until he begins to suffer some mental disturbances – hearing voices of people, getting angry at the slightest provocation, fighting etc.The treatment depends whether the abuser has already started developing mental illness in which case he needs to be kept in the hospital for treatment and then rehabilitation.If it is just a problem of substance abuse,he needs reorientation.It can take up to a year to treat a patient.The minimum in the first instance is 3 months.If there is need,another 3 months.

There’s hard work!

Dr. Baka: Plenty of work.

The cost of combating drugs abuse is high.  What’s your budget like?

Dr. Baka:  Like I said the Governor is planning to build more rehabilitation units.
The Federal NeuroPsychiatric Hospital built a new rehabilitation Unit for about N50million. Now with changing cost of everything you can imagine what it will cost to build to rehabilitation centres in Kaduna, Kafanchan and Zaria.Which is why our strategy is prevention. Treatment is expensive.

But Kaduna state needs those rehabilitation centres..
Dr. Baka: Certainly! The peculiar thing about Kaduna situation is that we are treating not only Kaduna state citizens or residents.Quite a substantial number of patients are trooping in from Federal Capital Territory (FCT), Abuja, Minna and of course Katsina and Kano; quite a number of patients are from these states particularly the FCT.

We’ve talked about alcohol, how about sex enhancing drugs? Do you define that as drug abuse too?
Dr. Baka:  Of course!  Anything that is prescribed by a doctor and you take to it to enhance bodily function is likely going to be abused.Let me give you examples, alcohol enhances sex, cannabis, even bernlylin with codeine though in the armaterium of Pharmaceutics it is a depressant but when a person takes it in low doses it stimulates. So most substances of abuse has a tendency to enhance sexual behaviour at the beginning but when the person continues using, it depresses sexual desires; but with it also comes several other complications.  I think, but I may be wrong, you are talking about substances like Viagra, Amphetamine because these are stimulants. Viagra is not a stimulant but purely a sex organ enhancing drug however people tend to combine them.  Viagra helps a user to procure a sustained erection.People take these substances that remove anxiety to enhance performance ….you take a tablet because you want to have sex it is an abuse.  Go to the doctor and tell him your problem let him examine you and tell you why you can’t get an erection and advice.Hawking of these drugs is dangerous.

Will that be a thing of the past now that your Agency has taken off?

Dr. Baka:  By God’s grace

Our problem is lack of standard..

Dr. Baka:  That is true.  We lack standard but much more we lack information.  People are not informed and so we conclude that since everyone is doing it,why cant I do it.

Doctor thank you for your time.
Dr. Baka: You are welcome!

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