SUBSTANCE ABUSE RELATED DISORDERS

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.

Management

  • 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.