BY: GRACE WAIRIMU
ALCOHOL AND SUBSTANCE ABUSE
KEY WORDS AND DEFINATION OF TERMS
Drug: This refers to any chemical agent that
once taken in the body is capable of causing
psychological and physiological changes.
 According to the WHO lexicon of alcohol and
drug terms it is any substance with the
potential to prevent and cure illnesses or
enhance physical and mental welfare.
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PSYCHOACTIVE DRUG OR SUBSTANCE:
This is a substance that, when ingested, affects
mental processes, e.g. cognition(thought) or
affect(emotions).
 This term and its equivalent, psychotropic drug,
are the most neutral and descriptive terms for the
whole class of substances, licit and illicit.
 "Psychoactive" does not necessarily imply
dependence-producing, and in common parlance,
the term is often left unstated, as in "drug use" or
"substance abuse”.
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Substance: A drug of abuse, a medication or a
toxin.
 Substance use: This is the ingestion of any
chemical that affects the body. This includes
legal, illegal and medicinal substances.
 Abused substances: These are those chemicals
that alter the individual’s perception by
affecting the central nervous system (CNS).
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PSYCHOACTIVE SUBSTANCE ABUSE
It is a maladaptive pattern of use indicated by
 continued use despite knowledge of having a
persistent or recurrent social, occupational,
psychological or physical problem that is caused or
exacerbated by the use [or by] recurrent use in
situations in which it is physically hazardous
 In other contexts, abuse has referred to nonmedical or unsanctioned patterns of use,
irrespective of consequences.
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Rehabilitation: This is the process by which an
individual with a substance use disorder
achieves an optimal state of health,
psychological functioning, and social wellbeing. This follows the initial phase of
treatment which may involve detoxification and
medical and psychiatric treatment. It could be
done in residential setting or an outpatient
facility. There is an expectation of social
reintegration into the wider community.
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Relapse: A return to drinking or other drug use
after a period, of abstinence, often
accompanied by reinstatement of dependence
symptoms
DRUG STREET NAMES
Alcohol: Keroro, kumikumi, ashuashu, brown
bottle, chang’a, gauge, tindi, kanywaji, steam
 Amphetamine type of stimulants: Amp, dexies,
pep pills, wake up pills, speed, black beauties,
crack meth, fee, ice, matunguru, maharagwe
 Cannabis Sativa/marijuana: Boza, Wadada,
shada, Ndom, weed, ngawi, pot, grass, bhang,
dagga
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Catha edulis (Khat): Mirra, Veve, Njito, Ngomba,
Mbachu, Njiri, mairungi, mogoka, giza, asili,
kangeta
 Cocaine: bazooka, blance, snow, nose candy blow,
big C. snow birds, lady, star dust
 Crack cocaine: Whites, French fries, teeth, crake,
coke, flake
 Heroin: Kichuri, kiketi, horse, brown sugar, unga,
poni, poppy, mizigo, stuff, daba, usinionje
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Inhalants: Mugui, noso, bien, mangata
 Tobacco:
Fag, Ngale, Mozo, Fwaka, Fegi
Ngarasi, Cigar, Mbaki, Kiraiku, msokoto
 Sedatives: Bughizi ,Narcozep, Rohypnol,
Primun, Rohipnol, Roipnol Roofies, Valium,
piriton serepax (Date rape drug) sleeping pills.
 Hallucinogenes LSD, acid, mushrooms, PCP,
special k.
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WHAT CAUSES YOUNG PEOPLE TO INDULGE IN
DRUGS AND OR ALCOHOL
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Social/peer pressure
Stress
Fun
Curiosity
Stimulation
Easy availability of the drug
Media through advertisements
A way of relaxation and socialization
Experimentation
Culture
Poor self esteem
Dysfunctional families
Pressure to perform academically
COMMON SIGNS AND SYMPTOMS TO NOTE
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People will usually go to great lengths to
conceal their drug and or alcohol use. One has
to be very close to them to note some of the
signs and symptoms.
PHYSICAL SIGNS
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Eating habits change- depending on the drug of choice, the
person may eat too much or loose appetite for food.
Disturbed sleep partners- including over sleeping, marked
drowsiness, moodiness a fatigued appearance and
restlessness.
Frequent complains of headaches- the am sick too often i.e
hapa hapa syndrome
Chronic cough that does not respond to treatment
Memory lapses- short attention span, difficulty in
concentration
Poor physical coordination- including slurred and or
incoherent speech
Burt or stained thumbs or finger nails
Burn holes on clothing or bed sheets
 Use of medicines to relieve constipation
 Unexplained skin rash
 Excessive sweating
 Sexual problems- which ma include lack of
sexual appeal or promiscuity
 Unhealthy appearances
 Needle marks-marks due to using needles.
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BEHAVIOUR
Increased and inappropriate anger, hostility,
excessive irritability, panic anxiety and
secretiveness.
 Unnecessary privacy
 Avoiding contact with parents and people in
authority
 Quarrelsome, outbursts of violence or unexplained
anti social behaviour, poathological lies, problems
with police
 Disappearance of money and house hold items
and stealing from others
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Demand for money form parents which is never
enough
 Leaving early morning in a hurried manner-matter
of urgency
 Irregular class attendance
 Hounding
 Sudden laughter outbursts for reasons not really
worth it.
 Disorientation in time and space
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EFFECTS OF DRUG ABUSE
As a person moves into a regular pattern of drug
abuse the drug takes centre stage of the persons
life.
 Drugs become the emotional and social focus at
the expense of other interests. This gradually leads
to social, emotional and physical problems. Loss of
control and the breakdown of close relationships
may lead to feelings of self doubt, poor self
esteem, guilt anxiety and sadness, which all lead
to further drug abuse as an escape. Tolerance and
dependence accompany this process.
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TOLERANCE
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The repeated use of a drug leads to changes in
the brain and nervous system to that the user
needs more of the drug in order to get expected
effects
DEPENDENCE
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Drug dependence is an emotional and
sometimes physical need experienced by the
drug abuser. The drug or alcohol dependent
person feels compulsion to take the drug on a
regular basis, to feel its effects and avoid the
discomfort of its absence. Some drugs cause
physical dependence (treated through
detoxification) while others cause psychological
dependence (this is where the work is for a
counselor)
ADDICTION
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Addiction is the physical and psychological
habit of feeling of need, which comes from
repeated use of a drug. Drug abusers often
continue to feel the need and desire for drugs
after they have gone through detoxification.
WITHDRAWAL
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For a drug dependent person, it is necessary to
take the drug in order to maintain normal body
functions. When the drug is not taken the person
suffers from physical and mental discomfort. The
fear of suffering fro withdrawal is like an emotional
prison which make the addict feel trapped and
controlled by the drug. If initially drugs were taken
to experience particular sensations, in the later
stages they are taken to avoid suffering the
unpleasant effects of withdrawal.
COMMON DRUGS SHORT AND LONG TERM
EFFECTS
TOBACCO
SHORT TERM EFFECTS OF TOBACCO
Bad breath
 Cough and colds
 Stained teeth and black lips
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LONG TERM EFFECTS
Cancer of the lungs
 Brain damage
 The skin and digestive system are affected
 Halitosis (bad breath)
 Burn of fingers which can lead to gangrene
 dependency
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SHISHA
OTHER NAMES OF SHISHA
narghile
 argileh
 hubble-bubble
 Goza
 Hookah
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shisha tobacco" shortened to just "shisha" can, in the
West, mean the molasses-based tobacco concoction
smoked in a hookah.
A water pipe, single or multi-stemmed instrument for
vaporizing and smoking flavored tobacco called shisha
in which the vapor or smoke is passed through a water
basin ‒ often glass-based ‒ before inhalation
Depending on the placement of the coal above the
shisha, a hookah can be used to produce smoke by
burning the shisha or used to create water vapor by
melting it at a lower temperature.
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A 2005 WHO report states that smoking using
a waterpipe poses a serious potential health
hazard and is not a safe alternative to cigarette
smoking. The average hookah session typically
lasts more than 40 minutes, and consists of 50
to 200 inhalations that each range from 0.15
to 0.50 liters of smoke. In an hour-long
smoking session of hookah, users consume
about 100 to 200 times the volume of smoke
of a cigarette.
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The chemical compositions of cigarette smoke
and hookah smoke are different, however, as
the workings of the charcoal in the modern
hookah causes the tobacco mixture to be
heated to a lower temperature, as opposed to
the higher temperature in a cigarette where the
tobacco is directly burnt. Consequently, the
potential health effects of hookah smoke are
expected to be very different
HOOKAH SMOKE AND CANCER
The charcoal used to heat the tobacco can raise
health risks by producing high levels of carbon
monoxide, metals, and cancer-causing chemicals.
 Even after it has passed through water, the smoke
from a hookah has high levels of these toxic
agents.
 Hookah tobacco and smoke contain several toxic
agents known to cause lung, bladder, and oral
cancers.
 Tobacco juices from hookahs irritate the mouth
and increase the risk of developing oral cancers.
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OTHER HEALTH EFFECTS OF HOOKAH SMOKE
Hookah tobacco and smoke contain many toxic
agents that can cause clogged arteries and heart
disease.
 Infections may be passed to other smokers by
sharing a hookah.
 Babies born to women who smoked water pipes
every day while pregnant weigh less at birth (at
least 3½ ounces less) than babies born to
nonsmokers.
 Babies born to hookah smokers are also at
increased risk for respiratory diseases.
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Hookah smokers may be at risk for some of the
same diseases as cigarette smokers. These
include:
 Oral
cancer
 Lung cancer
 Stomach cancer
 Cancer of the esophagus
 Reduced lung function
 Decreased fertility
KUBER
A highly intoxicating drug which is openly sold
in the name of mouth freshener and packed in
plastic packets similar to tea leave sachets.
 It is chewable tobacco rich in nicotine. It can
also be made as tea and drunk but is usually
sucked, placed under the tongue.
 N.B it contains THC (tetrahydrocannibinol) an
ingredient found in the cannabis sativa plant
(bhang)
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It s a CNS (Central Nervous System) Stimulant
 It increases behavioral activity, Thought
processes and alertness
 Elevate the mood of the user.
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EFFECTS OF KUBER
Dizziness,
 Headaches
 Sleeping
 Weak teeth
 Bleeding gums
 Tooth discoloration, holes on the gum line and
cervical cancer (still being researched) and
sometimes women can become infertile.
 It impairs memory and causes depression
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America's National Cancer Institute classifies it as
a brand of smokeless tobacco. According to the
institute, smokeless tobacco contains 28 cancer
causing agents and its users take in three to four
times more nicotine (the addictive substance in
tobacco) than cigarette smokers, making it that
many times more addictive.
 kuber is associated with 41 per cent of mouth and
throat cancer in men and 11 per cent of similar
problems in women world-wide because of its high
content in nicotine.
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CANNABIS SATIVA (BHANG, MARIJUANA)
METHOD OF USE
Smoking (plain or mixed with tobacco) cocktail
 Baked (cake, cookies)-weed cake
 Eaten in food, processed to oil
 Herbal tea
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WEEK COOKS AND WEED CAKE IN KENYA
EFFECTS OF USE
Giggling a lot the first time
 Increase in heart rate (could cause heat attacks)
 Increase in blood pressure
 Restlessness
 Dry mouth and throat
 Thirst- drinks a lot of fluids especially sweet drinks
 Walking gait changes
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Bloodshot eyes
 Talks a lot or becomes very quiet
 Tense muscles
 slurred speech
 Sleeps a lot
 Short term memory loss
 Distorted sense of time, distance
 Personal hygiene ( most don’t take baths and
change cloths
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Cancer of the lungs – cannabis has more tar than
cigarettes the smoke is also held longer in the lungs
Produces extreme euphoria
Extreme anxiety
Depression
Infertility
Psychosis (if present makes it worse)
Hallucinations
Retardation – mentally, emotionally, sexually and
physically
ALCOHOL
EFFECTS OF ALCOHOL
IMMEDIATE EFFECTS
 Euphoria
 Self confidence
 increased sociability
 Decreased anxiety
 Shortened attention span
 Flushed appearance
 Impaired judgment
 Impaired muscle coordination
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Sedation
Impaired memory
Delayed reactions
Unbalanced walk (ataxia)
Blurred vision
Profound confusion
Dizziness
Vomiting
Unconsciousness
Decreased heart rate
Respiratory depression
LONG TERM EFFECTS
LIVER CIRRHOSIS
COCAINE
EFFECTS OF COCAINE
SHORT TERM EFFECTS
 Loss of appetite
 Increased heart rate, blood pressure, body temperature
 Contracted blood vessels
 Increased rate of breathing
 Dilated pupils
 Disturbed sleep patterns
 Nausea
 Hyperstimulation
 Bizarre, erratic, sometimes violent behavior
Hallucinations, hyperexcitability, irritability
 Tactile hallucination that creates the illusion of
bugs burrowing under the skin
 Intense euphoria
 Anxiety and paranoia
 Depression
 Intense drug craving
 Panic and psychosis
 Convulsions, seizures and sudden death from high
doses (even one time)
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LONG TERM EFFECTS OF COCAINE USE
 Permanent damage to blood vessels of heart and brain
 High blood pressure, leading to heart attacks, strokes,
and death
 Liver, kidney and lung damage
 Destruction of tissues in nose if sniffed
 Respiratory failure if smoked
 Infectious diseases and abscesses if injected
 Malnutrition, weight loss
 Severe tooth decay
Auditory and tactile hallucinations
 Sexual problems, reproductive damage and
infertility (for both men and women)
 Disorientation, apathy, confused exhaustion
 Irritability and mood disturbances
 Increased frequency of risky behavior
 Delirium or psychosis
 Severe depression
 Tolerance and addiction (even after just one use)
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HEROIN
HEROIN
It is derived from the milk of the opium poppy
plant. In its purest form is off white in colour.
 The impure heroin is brown in colour ( brown
sugar)
 It is a highly addictive drug and tolerance and
physical dependence develops quickly.
 The addicts would usually say, ‘usinionje’ ‘bibi
mwarabu’ ‘monkey on the back’
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HOW IT IS USED
Smoked ( cocktail cigarette, or marijuana)
 Injected
 Sniffed
 Chasing the dragon( placed in a spoon and
burnt over a candle flame and snorted).
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EFFECTS OF HEROIN USE
Initially it produces a very goof feeling of
warmth, through out the body and a feeling of
drowsiness (kuyoyoma)
 Vomiting may occur on first use.
 Constriction of the pupils
 Cold moist skin
 Dreamy, detouched euphoria
 Difficulty in breathing
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LONG TERM EFFECTS
Bad teeth
 Inflammation of the gums
 Constipation
 Cold sweats
 Itching
 Weakening of the immune system
 Coma
 Respiratory (breathing) illnesses
 Muscular weakness, partial paralysis
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Reduced sexual capacity and long-term impotence in men
Menstrual disturbance in women
Inability to achieve orgasm (women and men)
Loss of memory and intellectual performance
Introversion
Depression
Pustules on the face
Loss of appetite
Insomnia
Risk of HIV/AIDS infections due to sharing needles
Death
WITHDRAWAL EFFECTS/SYMPTOMS
Withdrawal takes place with 8 hours of the last dose.
 Yawning continuously
 Sneezing and running nose
 Nausea
 Abdominal cramps (like electric shock)
 Vomiting and diarrhea
 Fever/chills
 Sweating a lot
 Blood pressure goes up
 goose bumps on the skin
KHAT
HOW IT IS USED
It is mainly chewed
 TYPES
 Giza, asili, kangeta. Mogoka. alele
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SHORT TERM EFFECTS
Alertness
 Lack of fatigue
 Lack of sleep
 Increased blood pressure
 Lack of appetite
 Thirst
 Libido increases
 Constipation
 Dilated pupils/reddening of eyes
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LONG TERM EFFECTS
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Addiction
Dental problems (gums and teeth)
Inflammation of the intestines anfd stomach
Anorexia
Halitosis (bad breath)
Reduced muscle relaxation
Anemia
Impotence
Spermatorrhea
Mental illness
OTHER DRUGS
Inhalants (paint, glue/gum, petrol, paint
thinner) They are usually inhaled through the
nose or mouth.
 Prescription drugs: these are the drugs that are
normally prescribed to you by a doctor, they
include sleeping pills, sedatives, one that is
being abused a lot is rophenol, its effects are
the same as those of heroin but it is more
addictive.
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INTERVENTIONS
Rehabilitation
 This is the process by which an individual with a
substance use disorder achieves an optimal state of
health, psychological functioning, and social well-being.
 This follows the initial phase of treatment which may
involve detoxification and medical and psychiatric
treatment.
 It could be done in residential setting or an outpatient
facility.
 There is an expectation of social reintegration into the
wider community.
During rehabilitation the drug addict under goes
detoxification, counseling (individual and family).
S/he is taught life skills to prevent relapse (going
back into use of the dug/substance). But the client
is the driver and needs to chart the way forward in
terms of where s/he would like to be.
 They are introduced to other addicts and work in
self help groups like the Alcoholics/Narcotics
anonymous groups
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TWELVE STEP PROGRAMMES
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Alcoholics Anonymous/Narcotics Anonymous: This is the
largest self help program and has been a model for the
other 12-step programmes. They stress abstinence and
contends that nothing can really happen until “the cork
is in the bottle.” The goals of each individual within AA
vary widely: simply abstinence to adopting a whole new
way of life are the ends of the continuum.
Step 1: We admitted we were powerless over alcoholthat our lives had become unmanageable
Step 2: Came to believe that a power greater than
ourselves could restore us to sanity
Step 3: We made a decision to turn our will
and our lives over to the care of God as we
understood Him.
 Step 4:
We made a searching and
fearless moral inventory of ourselves
 Step 5: We admitted to God and to ourselves
and to another human being the exact nature
of our wrongs
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Step 6: We were entirely ready to have God
remove all these defects of character.
 Step 7: Humbly asked him to remove our
shortcomings.
 Step 8: Made a list of all persons we had
harmed and became willing to make amends.
 Step 9: Made direct amends to such people
wherever possible, except when to do so would
injure them or others.
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Step 10: Continued to take a personal inventory
and when we were wrong promptly admitted it.
 Step 11: Sought through prayer and mediation to
improve our conscious contact with God as we
understood him, praying only for knowledge of his
will for us and the power to carry that out.
 Step 12: Having had a spiritual awakening as a
result of these steps, we tried to carry this
message to alcoholics and to practice these
principles in all our affairs.
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Prevention is better than cure. It is cheaper to
prevent than to treat.
 If you have not started don’t, if you have
started, try and stop or seek help.
 Tell other about the danger of drug addiction
and let them know there is a way out.
 It is affecting everyone, young and old, user
and non user.
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THANK YOU