Substance abuse A challenge to the mental health status in Uganda Semulimi Andrew Weil M MBChB III Makerere University College Of Health Sciences andrewweil89@gmail.com

outline Background significance Objectives Methods Results Discussion Conclusion Recommendations outline

Mental health: a successful performance of mental function resulting in productive activities, fulfilling relationships with other people and the ability to change and cope with society. Substance abuse; a maladaptive pattern of use of a substance that occurs repeatedly even in the presence of overtly harmful physical, psychological and social effects on the user. Substance abuse has been adopted by the DSM as a blanket term to include 10 separate classes of drugs, including alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants; tobacco; and other substances. In Uganda, the most commonly abused substances include alcohol, khat, tobacco, marijuana, cocaine, heroin and prescription drugs such as methamphetamines. Background

Sustainable development goals 2030 agenda, goal 3 ‘ensure healthy lives and promoted wellbeing for all at all ages’ goal 3.5; strengthen the prevention and treatment of substance abuse 5th major cause of poverty, road accidents due to alcohol use have increased, one of the leading causes of HIV/AIDS and other STIs and STDs One of the leading causes of death, domestic violence Producers, consumers and traffickers NCD, substance abuse disorder significance

To describe the cause, prevalence and effects substance abuse poses to the mental health status in Uganda. Method used: literature review. Newspaper articles, eHMIS, UYDEL report on substance abuse, WHO-AIMs report 2006 Objectives and method

According to the HMIS surveillance report, the MoH recorded 85000 cases of drug and alcohol abuse between 2010 and 2014 with the central region having the highest, 39%. 57000 cases of alcohol abuse and more than 27000 cases of other drug abuse are reported countrywide. Butabika mental referral hospital received 829 drug abuse cases and 778 alcohol cases between February 2014 and March 2015. 25% of the mental cases were due to drug abuse. According to the UYDEL report of 2010, of 264 students considered,76.5% had the first alcoholic drink between 15 to 20 years of age, 30% before 14 years. 150 students were introduced to alcoholic drinks by their parents, 83 students by their friends and 1 student by other persons2 results

Discussion The large number of cases are mainly due to the; The poor implementation of the existing laws and poor facilitation of law enforcers and poor policy on the context of drugs, and possibly an issue of corruption. Social influence e.g. cultural gatherings, musicians, Adverts…..attractive alcohol promos Money Increased stress Discussion

Conclusions Substance abuse in the central region is high. The number of mental cases admitted at Butabiika National Referral hospital due to substances abuse are relatively high. Most students are not only influenced by their parents to drink alcohol but also have the first alcoholic drink in their late teens. Conclusions

Strong laws should enacted and implemented well for example the tobacco act that was recently amended. introducing special licenses at all the alcohol selling places and this should be enforced by the local governments through regular surveillance and issuing of specific licenses to alcohol dealers. More facilities should be set up on top of Butabika National Mental Referral Hospital and outreach clinics in Nkokonjeru, Kitetika, Nansana, Kawempe and Katalemwa. Six Mental health units have also been constructed in Lira, Jinja, Mbale, Masaka, Mubende and Moroto hospitals as well as the National Referral Hospital – Mulago Efforts to combat drug smuggling and production in the country are inadequate Recommendations

Electronic health management information system surveillance report Uganda Youth Development Link state of alcohol and substance abuse in Uganda, 2013 Basangwa D. Prevalence of alcohol and drug use among secondary school students in Kampala. Kampala: Dissertation for Master of Medicine in Psychiatry of Makerere University, Department of Psychiatry; 1994. WHO Uganda country report website references

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