These are syndromes arising out of repeated maladaptive use of substances. A substance is defined as any chemical with brain altering properties. Substance abuse disorders are characterized by significant impairment in psychological,
social, and occupational functioning as observed over a 12-month period.

Commonly abused substances in sub Saharan Africa include tobacco, Cannabis sativa (bhangi), khat (miraa), opioids (heroin), cocaine including crack cocaine, and solvents (glue, petrol, wood varnish).

Substance-related syndromes include intoxication, dependence, withdrawal, psychosis, mood disorders, anxiety, sleep
disorders, and sexual disorders. Those at high risk include children aged 12–20 years and patients with primary mental disorders.


  • Substance specific detoxification
  • Patient/family education/counselling
  • Alternative leisure activities
  • Work/school rehabilitation
  • Involvement of community agencies, e.g., religious organizations, Alcoholics Anonymous, Narcotic Anonymous where available.
  • Refer for long-term management by psychiatrist.