It is an open fact that between 162-324 million people used illicit substances at least once in 2012, according to United Nations Office Drugs and Crime (UNODC) World Drug Report of 2014. In Botswana, the problem is rampant as well. According to an article in Botswana Gazette dated 25 October 2016, “substance abuse disorders account for 15.95 of psychiatric admissions nationwide and 6% outpatients attendances.” In addition, the Botswana Youth Risk Behavioural Surveillance survey of 2012 indicated that 14.9% reported having used marijuana, 5.7% used sextasy, 5.6% used cocaine whilst 3.7% used ecstasyThe gravity of substance use disorders (SUDs) can therefore not be gravely underestimated. There is dire need to address the problem even though there are pitfalls that can be avoided. I would like to highlight two issues that will be the departure point of this discussion.MSN News website (www.msn.com ) recently reported that hundreds of ‘drug addicts” escaped from a compulsory rehabilitation centre in Vietnam. It is reported that the individuals used sticks and fire extinguishers to break out. The communist government of Vietnam has taken a stance by enforcing two years of forced rehabilitation at government centres.Another article by the Guardian newspaper (www.guardian.com) quotes Phillipines President Rodrigo Durtete as having threatened to kill people with substance use disorders. He stated that “if you know any addicts, go ahead and kill them yourself as getting their parents to do it would be too painful.”These two articles without doubt are stigmatising the addiction problem. People with substance use disorders in the above countries have their basic human rights trampled upon. It is not only governments with mundane policies that are entirely responsible for harbouring stigma tendencies, individuals have also adopted a stern and immoral approach of looking at the substance use problem. Those on the flipside of the addiction problem are viewed in disdain and called by derogatory and inhuman names like “letlhapelwa, letagwa, yoo pekisiwang ke motokwane, drug addict, drug pusher” to name but a few. As a society we often criminalise those with substance use disorders, alienate and brand them as “demon-possessed” at charismatic churches. This culture of name calling and shaming is not entirely helpful as it has dire consequences as will be realised later.Addiction, as defined by the National Institute on Drug Abuse, is a “chronic, relapsing brain disease that is characterised by compulsive substance seeking and use, despite harmful consequences.” Addiction to substance use should therefore be treated like other chronic medical condition affecting our society.Stigmatisation is quite a bad practice and a stumbling block in assisting people with substance use disorders. People with SUDs should not be treated as outcasts. They should not be treated in disdain like those suffering from leprosy in archaic societies! An individual with a SUD is somebody’s girlfriend, boyfriend, husband, wife, parent or sibling thus need be treated in a dignified manner! An individual with SUD is equally capable at the workplace provided he is given support!The act of stigmatising and criminalising those with substance use disorders lead to them not willing to enroll in treatment, counseling and/or rehabilitation. Stigma may interfere with effective treatment outcome for those already on treatment. Stigma facilitates the development of serious brain and/or mental disorders, high death rates, high rates of crime and even prison incarceration. In finding refuge from the rampant stigma and discrimination, people with SUDs may have their situation further compounded as they continue with the drug habit.Institutions and government departments should put in place policies that counter the spread of stigma and discrimination. Advocacy groups and individual community members should advocate for systems that promote long term recovery from substance use disorders. Recovery from substance use disorders should be nurtured and supported. No one can recover from such ordeal without adequate family support, an accommodating community attitude and favourable government legislation. Recovery involves rejoining and rebuilding a life in the community as a matter of fact!Distigmatising addiction includes but not limited to the following – Advocacy; Avoid labeling names like “addicts, abusers”; and displaying non-judgemental attitude.
DAVID SIDNEY MANGWEGAPE