The Observer (Kampala)

15 January 2013

Uganda: Drug Use on the Rise - Health Experts

Ali Warsame, a resident of Mengo-Kisenyi, spends the better part of his day chewing mairungi- a common narcotic drug leaf.

For the last five years, mairungi, internationally known as khat, has been his bread and butter because it helps him beat hunger and stay awake. Indeed, looking beneath his ripped, pale blue jeans, I see a bunch of the leaves ready for chewing.

Warsame migrated to Uganda in 2007 after the Somalia civil war robbed him of his parents and siblings. He has since lived a destitute life, doing drugs and spending his nights and days in open shelters.

Although mairungi trade and consumption is considered illegal in Uganda, he takes it publically and so do his Somali colleagues. Previously, drug use was associated with casual labourers, but lately there has been gradual growth with even high-end consumers, the latest case being, reportedly, the late Butaleja Woman MP Cerinah Nebanda whose death has been linked to drug abuse.

Drug users display signs of increased alertness, excitement, energy, talkativeness, decreased appetite and difficulty in sleeping. Health experts believe drug use in Uganda is on the increase and is being propagated as 'trendy' amongst the youth and corporates. However, these drugs bear negative health effects which most users are ignorant of.

Cocaine

Cocaine, in its purest form, is white although what is sold in Uganda is usually mixed with other substances like baking soda, sugar and other drugs like CPZ lime giving it a pinkish or off-white colour. Arua park is the dealers' place.

Chris Mugarura, a peer mentor with the Anti-Drug and Alcohol Abuse Movement (ADDAM), says cocaine may be eaten, smoked, snorted or injected into one's body.

He adds that a user may be jittery and paranoid after consumption and with an overdose, a person may hallucinate, become delusional or even unconscious. In February last year, Jeffery Rice, a freelance producer of The Amazing Race reality TV show, died of an overdose of cocaine. Rice and his assistant, Katheryne Fuller were found unconscious on the Serena hotel balcony in Uganda.

According to an article on drug abuse on doctorrennie.wordpress.com, patients who use cocaine are often high, have red spots on their nose or ears and blisters on the thumb and index finger of their dominant hand and scabs or burns around the lips. It also increases the stickiness of platelets and, therefore, increases risk of heart attack or stroke.

"Due to its euphoria-inducing effects as well as its ability to increase sex drive, it usually makes people engage in more sex than they normally would, which may spread disease, especially HIV," Andrew Sempebwa, a counsellor, says.

Heroin

In its purest form, heroin, locally called embaawo, is a white powder but is mostly brown in colour because of the presence of impurities. Heroin is usually measured with an overgrown nail on the little finger and each scoop costs about Shs 20,000 whereas a gramme costs Shs 60,000.

"A tin foil containing heroin powder is heated underneath and this turns it into liquid. Users, therefore, either inhale the fumes or inject the liquid," Mugarura explains.

Heroin can also be smoked. Among the signs an addict may show include calmness when high, mental confusion, lack of hygiene, poor appetite and bright eyes. According to an article titled 'Heroin abuse and use' on www.indiaparenting.com, overconsumption of heroin may lead to weak veins, infections like HIV from infected needles and death.

Heroin is mainly produced in Pakistan, Afghanistan and India. The United Nations Office on Drugs and Crime (UNODC) estimates that 30-35 tons of Afghan heroin is trafficked into East Africa annually, most of it destined for Europe. It is traded in the appearance of soap or cake and later broken down into powder.

Marijuana/Cannabis

Marijuana or weed, enjagga, ganja or dude is smoked and dissolved in water for consumption. It is a green or brown mixture of dried, shredded flowers and leaves of the Cannabis Sativa plant. According to the police narcotics section, marijuana is mainly grown in Wakiso, Mukono, Luweero, Kalangala, Masaka, Bushenyi, Kyenjojo, Iganga, Busia and Bugiri districts.

"At only Shs 300 a stick, marijuana is easily available, making it the commonest drug in Uganda; even cops use it," Mugarura says.

In Kampala, 30 hand-rolled marijuana cigarettes cost about Shs 10,000 and it is less in rural areas.

"Signs and symptoms may include restlessness, inability to experience pleasure, fatigue, increased sleep, vivid dreams, insomnia, agitation, anxiety, drug craving and increased appetite," Sempebwa says.

He adds that overconsumption can lead to insomnia or increased sleep, depression and possible suicidal thoughts.

Kuber

It is a highly addictive tobacco product packed in sachets similar to tea leaves. This may be added to tea or just licked on its own. According to Dr Sheila Ndyanabangi, the tobacco focal point person in the Health ministry, kuber is rich in nicotine which increases incidences of heart attacks and stroke, thin hair and sudden mood alterations among others.

It is being widely consumed by secondary school students and taxi drivers. Results of a research conducted by the Uganda Youth Development Link (UYDEL) in 2011 reveal that kuber, apart from tobacco, also contains cocaine, marijuana, cannabis or combinations of these which may lead to hormonal change, impaired brain development, mental health disorders and heart problems among other effects.

Kuber is often chewed with mairungi leaves, sucked or taken with hot water as a beverage, resulting in one feeling drunk. It is sold in shops and supermarkets.

Alcohol

Roderick Ssali (not real name) first tasted beer during his S.6 vacation under peer influence. As the only one working, hence the richest in the group, his friends often lured him with 'plot' of clubs every night.

"I made friends with corporate guys I found in club and they introduced me to 'hard stuff' and those days, it was hard to find me without a hangover," Ssali narrates, adding that these friends encouraged him to kill the hangover with a colder beer.

Soon, he was caught up in the vicious cycle of boozing, so much so that he was known by the sellers who would sometimes give him booze on credit. Ssali lost his job with Eagle Air because of work backlog. Nevertheless, he never gave up on booze and went in for local brew fondly called 'Kasese.' However, with the constant counselling of his mother, Ssali overcame the vice.

Alcohol addiction is common especially among the youth. In Uganda, youth prefer strong local spirits like Royal Gin, Signature Vodka, Beckham Gin and Tyson Waragi, which are easily accessible in miniature sachets at low prices. According to the Uganda Youth Development Link Report on the state of alcohol abuse in Uganda, poisoning due to alcohol causes about 100 deaths annually.

Other substances abused include petrol and tobacco. Petrol is sniffed either from small bottles or from soaked cloth and is mostly used by urban youth and street children. Dr Possy Mugyenyi, the manager of Centre for Tobacco Control in Africa (CTCA), says that apart from cigarettes, tobacco can be consumed by eating dark chocolates, mouth fresheners and chewing tobacco leaves.

"Excessive exposure of one's body to tobacco increases the risk of oral and lung cancers and aneurysm (abnormal widening of a portion of an artery due to weakness in the wall of the blood vessel)," he explains.

High-end places for drugs

Mugarura says most of the drug dealers are found in areas of Kabalagala and Kasanga because of the proliferation of foreigners and in slums across the country. Target places where these drugs are sold include house parties, university students' hostels, private hotel parties, bars, bashes locally known as 'ebiggunda', schools and clubs, among others.

Causes of drug use and abuse

Sempebwa says that the availability of the drugs on the market and glorification of drugs on the internet, TV and bashes draws people to their use.

"Look at the people the media glorifies - celebrities. These are the people who use drugs and sometimes promote the use of drugs and many youths go in for drugs because a celebrity is using them," he says.

Also many youth experiment with substances as an acceptable part of transition into adulthood, to relieve stress, relax, to withstand cold weather and for adventure's sake.

"There is no medicine against this addiction but it is only one's willingness to stop and those around him/her should be patient and offer the necessary support," Sempebwa says.

However, Fredrick Ssekyana, the spokesman at the National Drug Authority, says there is also a considerable abuse of over the counter and prescription medicines such as slimming tablets, painkillers (analgesics), tranquilisers and cough mixtures, which needs to be checked.

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