by Dr Taha Baasher.
Throughout the history of mankind, nearly all countries and cultures have had problems with the use and abuse of drugs. Since the earliest recorded times, drugs have been used for different reasons – mainly religious, medicinal and pleasure. For example, alcohol and opium were both well known in ancient Egyptian culture. Cannabis was commonly used in Hindu ceremonial rites as well as in Indian and Chinese medicine. Drug related problems, therefore, are not new.
Today, drug problems have become more varied, becoming both more complicated and more global in character. Natural drugs – such as cannabis, cocaine, khat (qat) and opium – which had previously only been used in certain cultures and within traditional ways of life, have been increasingly exploited and their use now reaches epidemic level. Also, manufactured drugs such as amphetamine, barbiturates and a wide range of sedatives and tranquillisers have become more easily available, both through legal and illegal markets.
Added to these is the growing habit among young people in some countries of sniffing solvents in paints and glues. Levels of drug abuse are rising in most countries. Drugs are taken more often and in greater quantities. There is also a trend towards using a mixture of different drugs or combining drugs with alcohol. Cocaine misuse needs special attention. It is the most dependence-producing drug available. Currently its misuse is reaching epidemic levels in some parts of the world and it is rapidly spreading to other areas. Traditional coca chewing in the Andes is being replaced by coca paste smoking in cities in South America. Opium eating among rural cultures in South Asia has developed into the much more dangerous use of heroin in the form of smoking or by injection.
The drug scene brings with it a wide range of social and economic problems, including crime, violence and neglect of family life. Concern is growing in many countries over levels of drug abuse.
In order to prevent drug abuse it is important to identify the main reasons for using a drug. Next, practical efforts should be made to overcome this motivation. The reasons for using drugs are very varied within each culture. Even within the same country, preventative programmes may need to vary according to local problems.
In north east Afghanistan and in some areas of Pakistan, India, Myanmar and Thailand where rural health services are lacking, opium is used as a household remedy and for overcoming pain and discomfort caused by cold weather and the hardships of life. Emphasis must therefore be given to these priority needs before the drug problem can be dealt with.
What should be prevented? Who should do the preventing? On an official level there are international agreements to control the movement and export of drugs. On a national level, control depends on the police and customs and government measures. On the whole, the best preventative measures are those which are developed by people within their own culture and social life. Religious groups can play an effective preventative role against the abuse of alcohol and tobacco through their teaching about moral values and self discipline.
Drug abuse problems are among the most damaging menaces of modern life. Their effective prevention calls for huge efforts from government authorities, widespread education and awareness raising campaigns and active community participation.
Dr Taha Baasher is a consultant in mental health. He was formerly Regional Adviser in Mental Health for WHO in Alexandria. This article first appeared in WHO’s publication, World Health.