International Day Against Drug Abuse and Illicit Trafficking; Teenage Female Drug Users and Commercial Sex Work

Having a two day holiday from official work felt refreshing I really needed "quality" rest to mentally detox from the day-to-day demands of living. Yet I could not resist putting up an article when I heard that today is the International Day Against Drug Abuse and Illicit Trafficking. My enthusiasm must have been fueled by the fact that I recently developed a UNODC (United Nations Office on Drugs and Crime) technical proposal on "Community based Drug Dependence Treatment Services for Female Sex Users-Com-B" as part of an intended collaborative effort with my current host organization (SCD) and the United Nations Development Programme (UNDP) in Nigeria.

Related Post: The World Drug Problem and Public Health

Related Post; Teen Depression What Parents can do

WHY PARENTS MUST LISTEN FIRST

I decided to draw attention to teenage Females who use/inject drugs because of my experience in implementing strategic community-based intervention for Female Sex Workers (FSWs) and Family-centered intervention for Orphans and Vulnerable Children (VC) with recorded success in hard-to-reach poor rural communities in the Federal Capital Territory.

Peer pressure has been fingered as one of the primary factors that may expose female teens to in risky behavior, apart from poverty and other social pressures such as poor parenting and lack of openness and between parents and their children. This principle also applies to single parent.

The global economic crisis and social demands is making it almost impossible for parents to keep a close tap on children and monitor their behavior and association. In my opinion, the increased access to technology via the internet and social media is silently crippling the efforts of well meaning parents.

Culture and religion to a large extent in most In African society, make open discussion between parents and children especially on reproductive health, sexuality or drug experimentation as a taboo. Thus, teens are left with their gadgets that expose them to the wrong information from peers and/or from other sources which include adult population taking advantage of them.

Amanda and her mother outside of their shack. (Photo: Anders Kelto)

According to PRI, Social scientists with the South African government think poor communication may be linked to a range of problems students face – including underperformance in school, and weak social skills. Worst of all, parents who don’t communicate well with their kids may be more likely to abuse them. In 2013, the  government has began running interventions around the country to address the problem. One workshop held survey the views  of a group of tenth-graders on the question: Who can you talk to about important emotional issues – your parents, or your friends? The result revealed that;

• Most students said they trust their friends more than their parents, and what they said about their parents was incredibly negative.
• “Some of our parents are drunkards,” said one boy. “Some of the mothers are like serpents.”
• One girl said that, here in the township of Khayelitsha, many parents abandon their children at a young age.
• Another girl said you can’t tell your mother a secret because she’ll just tell it to others. “What is a mother?” she asked rhetorically. “Nothing.”

 Amanda  and her mother Mrs. Godden  had been getting into huge – and often violent – fights with her mom. “My mother is very harsh,” Amanda said. “She will beat me.” The workshop was aimed at creating a relationship between parents and teenagers,Amanda hoped the workshop would put an end to that. She had urged her mother to come.

The report further revealed that these harsh comments reflect the students' lives at home. Not only do many students distrust their parents – they hardly speak to them.They really don’t communicate with their parents,” 

HOW DRUG ABUSE BEGIN AT EARLY AGE AND CONSEQUENCES

Drug use among 15–19 year olds is an important global concern. During my face-to-face interaction with the FSWs, I found that drug abuse typically begins at adolescence with the use of common gateway substances such as Caffeine, Codeine, Tramadol, Tobacco, and Alcohol which forms the launching pad for more serious drug experimentation and abuse. Others migrate to smoking, snuffing and injecting drugs like Indian hemp, marijuana, heroin, crack or cocaine as they get older. Drug control may focus on reducing drug demand, drug supply, or both, and successful programmes usually include structural, community, and individual-level interventions.

Key Facts

• Alcohol and Drugs; Harmful drinking among adolescents is a major concern in many countries. It reduces self-control and increases risky behaviours, such as unsafe sex or dangerous driving. It is a primary cause of injuries (including those due to road traffic accidents), violence (especially by a partner) and premature deaths. It can also lead to health problems in later life and affect life expectancy. Setting a minimum age for buying and consuming alcohol and regulating how alcoholic drinks are targeted at the younger market are among the strategies for reducing harmful drinking. 
• Tobacco Use; The vast majority of people using tobacco today began doing so when they were adolescents. Prohibiting the sale of tobacco products to minors and increasing the price of tobacco products through higher taxes, banning tobacco advertising and ensuring smoke-free environments are crucial. Globally, at least 1 in 10 adolescents aged 13 to 15 years uses tobacco, although there are areas where this figure is much higher. Cigarette smoking seems to be decreasing among younger adolescents in some high-income countries.
• HIV Infection/Transmission; More than 2 million adolescents are living with HIV. Although the overall number of HIV-related deaths is down 30% since the peak in 2006 estimates suggest that HIV deaths among adolescents are rising. This increase, which has been predominantly in the WHO African Region, may reflect the fact that although more children with HIV survive into adolescence, they do not all then get the care and support they need to remain in good health and prevent transmission. In sub-Saharan Africa only 10% of young men and 15% of young women aged 15 to 24 are aware of their HIV status.

Impact of Drug Dependence

• Psychoactive Affect; Regardless of the age, substance dependence has both psychoactive and physiological affect that may cause significant harm to their physical abilities and mental health. With repeated drug use, dependence develops when the neurons adapt to the repeated drug exposure and only function normally in the presence of the drug. Withdrawal syndrome can also occur when a drug is withdrawn by the user with several physiologic reactions. These can be mild (e.g., for caffeine) or even life threatening (e.g., for alcohol). In the case of heroin, cocaine withdrawal can be very serious and the abuser will use the drug again to avoid the withdrawal syndrome (National Drug Institute (NDI).
• Physiological Affect; Some drug-related harm may be health-related, such as blood borne viruses such as HIV, hepatitis, sexually transmitted infections, tuberculosis and overdose, or social harms such as violence, stigma and discrimination, criminalization, and mental health disorders such as depression, sucidality, borderline personality disorder, post-traumatic stress disorder which have been reported among female drug users (Akanni OO, Adayonfo EO, (2015), Correlates of psychoactive substance use among Nigerian adolescents, Sahel Med J 2015; 18:192-9; Roxburgh, A. et al. (2005), Mental health, drug use and risk among female street-based sex workers in greater Sydney, Sydney: National Drug and Alcohol Research Centre.).
• Depression; Through observation and face-to-face interview, I found that a cross section of over 100 HIV positive FSWs in the project areas, experience psychological symptoms such as depression, hopelessness, weakness, low energy, anxiety, alcohol, drug abuse, and suicidal thoughts. This may result in poor risk perception to use/inject drugs. Despite being a priority population for HIV interventions globally, prevention, treatment and support programmes among FSWs in Nigeria have historically neglected research on mental disorders, particularly among those diagnosed with the HIV virus as well as FSWs using/injecting drugs

 BEING EMOTIONALLY AVAILABLE FOR YOUR CHILDREN

Drug prevention is cheaper that spending scare resources on drug treatment and management which may be affordable for some. In Nigeria, government owned drug rehabilitation centres are centrally located in the city and few in number with private individuals filling this gap. The bills is high.

Therefore, young people need to know how to protect themselves and must have the means to do so. The role of effective parent child communication cannot be overemphasized. Many parents have invested all their time in their children’s physical needs while neglecting their emotional aspect of child development. Despite the daily demands of providing for these same children, protection from harm/risks must also be a priority for all parents. The trick is to be emotionally available for your kids.

This may be challenging given our own parental upbringing and other factors mentioned above. Starting early to maintain the bond between you and your child clearly paves the way for sustained open communication throughout adolescence and across lifespan. Persistence is the key.

Treat every child differently and avoid comparing your child to others. This will only make them withdraw into their shell as they get older, especially if they sense that you constantly criticized them or bring them down in front of “everyone”. A child will learn to appreciate “constructive criticism” If he/she have been accustomed to praise, rewards and generous commendations from their parents for good behavior. This is not to say a child should not be disciplined when a behavior is unacceptable. Proper discipline tailored/appropriate for the temperament and age must be put into consideration for effective results. 

Spending quality time with your children should be a priority in this ever demanding world. Planning in advance and self discipline will enable you pull through. Being emotional available for your kids demands that you follow up or any changes in behaviour or mood.

Using open-ended questions will encourage the child to talk more and help you reach your child’s heart. Close ended questions seem rather interrogatory and will keep the child on the defensive. However, your body language, tone and general lifestyle speaks volume more than you say. Positive non-verbal /body language is a tie breaker for effective communication.

What if your Child is giving you a Hard Time?

If you are having difficulty communicating with your kids-give it time. If it persists- seek professional help from a Psychologist. Parents are most definitely prone to physical and mental exhaustion. Knowing what is at stake, it is important to listen first to child especially when it seemed that they are not making any sense and all you want to is rest!!! Look at the positive side, allowing them approach you freely and express their wide and sometimes “silly” imaginations at an early age will pave way for a stronger bond and feeling of emotional security as they get older.

DRUG USE AND COMMERCIAL SEX WORK
There are multiple contexts within which females use/inject drugs. Evidence suggests that sex work and drug use overlap. Drug use is sometimes a central part of the interaction between Female Sex Workers (FSWs) and their client. Some clients invite sex workers they hire to share their drugs. Some specifically seek sex workers who provide a part of service, which involves the client and sex worker using drugs together. Some sex workers experience pressure to use drugs with clients, while others view the encouragement or acceptance of drug use at work as an advantage that contributes to a comfortable working environment. For many, drug use is independent from sex work, but for some it is intrinsically linked. 

Some are motivated to sell sex in order to generate money to buy drugs, which is most frequently associated with drug dependence. Some people also trade sex for drugs, which has been associated with higher-risk behaviors like unprotected sex and unsafe injecting. Some consider sex work their occupation and not simply a means to generate money to buy drugs. These populations overlap, and people move between them as they stop and start using drugs or selling sexual services. The high prevalence of injecting drug use among FSWs makes them susceptible to HIV infection, and is a threat to their clients, families, especially those who fall pregnant or have children (World Health Organization (WHO), Where Sex Work, Drug Injecting and HIV Overlap: Practical Issues for Reducing Vulnerability, Risk and Harm, Sex Work/Drug Use Program Guidelines, WHO, 2005).

HIV Prevalence, illicit Drug Use and Commercial Sex Workers

The intersection between illicit drug use and female commercial sex work has been identified as an important factor responsible for rising HIV prevalence among female sex workers (FSW) in several northeastern states of India(Jagadishá Mahanta et al; BMC Public Health201212:273). There is a strong relationship between drug-using FSWs and male drug-using clients and non-client partners. Therefore, a community based harm reduction intervention to prevent drug use initiation among non-drug-using FSWs and harm reduction among drug-using FSWs are urgently needed in the Federal Capital Territory (FCT).

Vulnerable Children, Drug Use/Sell and Prostitution

Most trafficked victims are mostly orphans and other vulnerable children. Many children of the Female Sex Workers who use/inject drugs (FIDUs) are not enjoying their childhood because they have been become vulnerable to both physical (sexual exploitation, child labor/trafficking, poor nutritional health) and psychological abuse (verbal and non-verbal). Others are orphaned by HIV/AIDS and other causes that have limited their opportunities to right to survival, development, protection and participation. Furthermore, these children who have lost one or both parents in several cases are left entirely on their own, leading to an epidemic of orphan-headed households. When they drop out of school to fend for themselves and their siblings, they lose the potential for economic empowerment that education can provide. Alone and desperate, they sometimes resort to use/sell of drugs, transactional sex or prostitution to survive, and risk becoming infected with HIV themselves. In most cases, the OVC pose a great burden on grandparents and the extended families, creating, in effect, vulnerable families further deteriorating the situation. 

DRUG FIGHT IN NIGERIA AND POLICY IMPLEMENTATION

Currently, existing HIV and harm reduction programmes tailored to female who use drugs and sell sex at the community level is limited if not unavailable in FCT and Nigeria as a whole. Where services are available, it is within a more formal healthcare setting with peculiar barriers for community based FSWs to access.

The National Drug Enforcement Agency (NDEA) has been at the forefront in curbing the menace. One of the strategic approaches used by NDEA has largely been punitive which is not yielding the desired sustainable results. A 2017 report released by the International Narcotics Control Board (INCB) has indicated an increasing number of women involvements in drug abuse. The yearly report indicates an alarming increase in the number of women arrested for drug related crimes throughout the world. 

However, in Nigeria the fight against drug abuse is being affected by lack/shortage of accurate and reliable data on the scope of usage, ratio of users with drug related health problems due to but not limited to funding for public health experts and professional mental health care researchers, community level and family-centered approach to diagnosis, treatment, preventive care and support. 

The International Day against Drug Abuse and Illicit Trafficking recognises the severe impact that illicit drugs have on health, development, peace and security. Around 190,000 people die due to illicit drugs every year. But the damage visited upon lives and communities does not stop there. Drug use damages health in the form of debilitating HIV, hepatitis and tuberculosis, while drug trafficking nourishes money laundering, and deadly terrorism. Corruption, the great enabler of organized crime, exists throughout the drug supply chain. 

The recently released World Drug Report 2017 examines another worrying phenomenon: the nexus between drugs, crime and terrorism and reveals a shifting pattern of relationships,terrorists and non-state armed groups profit from the drug trade. By some estimates, up to 85 per cent of opium cultivation in Afghanistan occurs in Taliban-influenced territory. As new threats appear, including spreading methamphetamine and new psychoactive substances, old ones continue to thrive. Business models are evolving too, with cybercrime and the darknet increasingly playing a role.

What is the next step? Why not share your thoughts with me via the comment section or

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