Drug and Substance Abuse – Life skills notes KNEC


Drug and Substance Abuse


A substance is considered abused if it is deliberately used to induce physiological or psychological effects or both, for the purposes other than therapeutic ones, and when its use contributes to health risks, the disruption of psychological functioning, adverse social consequences or a combination of them.

A drug can be defined as a substance, which may be chemical, synthetic or natural, which when taken in by a living organism may modify or affect one or more of its functions

Drug misuse is considered to be the misuse of medicine and incorrect use of drugs or medicines with the intention of causing body changes. It can also be said to be taking of medicine/drugs without the doctor’s prescription

Commonly Abused Drugs and Substances

The most commonly abused substances are alcohol and tobacco. They are in fact termed as gateway substances to other drugs.


Alcohol includes wine, spirits, beer, “busaa”, “muratina”, “mnazi”, “changaa” and others such as “kumi kumi” “machozi” etc). Alcohol is considered a depressant which slows and lowers the functions of the brain, e.g. thinking, concentration, and recognition, making decisions and initiating reasoned actions. The effect of alcohol on the brain make people feel relaxed, stop worrying about what other people think of them, and have a good time.

The initial effect of alcohol makes one feel stimulated, become talkative and more active. As some continue taking more alcohol, mood and social behavior changes, some people become depressed and remorseful; others become belligerent (become abusive or violent)

Depressive drunks may slow down, stumble, loudly confess their sins and failures and slur in words. The Amoral drunks may pick up quarrels and fights and other reckless behaviors. When they fall asleep they wake up with a hangover which includes fatigue, headache and nausea. They may also feel restlessness during the day and this can affect their productivity


Tobacco contains 4,000 different chemicals many of which are harmful. Nicotine, carbon monoxide and tar are the three main chemicals that affect the human body and cause diseases. Tobacco can be smoked, snorted or chewed

Effects of Tobacco

The tar in the cigarette is deposited in the lungs causing lung damage and even lung cancer. Carbon monoxide present in cigarettes also affects the chemical activity of the heart, which encourages deposits on the walls of the arteries leading to blockage that may cause blood circulation problems.

For pregnant women this reduces the amount of oxygen reaching the baby during pregnancy. Smoking can also cause spontaneous abortion and other complications during pregnancy, low birth weight babies and stillbirths as well as prenatal mortality in women

Smoking also leads to increased incidences of severe coughing, sneezing and shortness of breath on exertion. Peptic ulcers in the stomach and duodenum, cancer of the mouth, nose, throat, esophagus, pancreas, bladder, cervix and leukemia are other diseases caused by smoking

Economically, although smoking contributes to a country’s revenue, it eats into the family budget. It is also very costly in the treatment of diseases associated with smoking

Cannabis Sativa

It is also known as Bang, Marijuana (street names – grass, weed, pot, jive, reeter, and ganja. This drug is rolled into cigarette and smoked; and can also be chewed. It can also be processed into more potent form known as hashish.

Effects of Marijuana

  • Problems with memory and learning
  • Trouble in thinking and problem solving
  • Loss of coordination
  • Increased heartbeat, anxiety and panic attacks
  • Some people can make stupid mistakes at work place
  • It leads to unsafe sex and spread of HIV&AIDS
  • It can lead to cancer, respiratory problems, immune system and reproductive system problems
  • It may lead to use of other illicit drugs
  • It may lead to confusion and psychotic behavior


Health Risks

  • Nausea, vomiting, blackouts and heart problems that can be fatal
  • Squirting gas products down the throat may cause the body to produce fluid that floods the lungs and this can cause instant death
  • Risk of suffocation if the substances inhaled from a plastic bag over the head
  • Accidents can happen when the user is high because their senses are affected
  • Long term abuse of glue can damage the brain, liver, and kidneys

Effect of Glue

  • Users feel thick-headed, dizzy, giggly, and dreamy
  • Users may hallucinate
  • Effects do not last very long. But users can remain intoxicated all day by repeating the dose

Khat (Miraa)is a stimulant

Causes of drug and substance Abuse

The following are some of the common causes of drug and substance abuse

  • Pressure to perform well in examination
  • Work / academic overload
  • Family problems like rejection and a shaky family background
  • Poverty
  • Peer pressure
  • Curiosity
  • To escape from problem at home or workplace
  • Boredom
  • Poor parenting in terms of modeling as well as laxity among the parents hence loosing influence over their children’s lives.
  • Media influence
  • Social economic conditions and background, for example coming from “miraa” growing area
  • Failure to develop prosocial values in early life
  • Religious and cultural influences e.g. Rastafarianism.
  • Desire to have a another sense of holiness
  • Learners with excess pocket money may be tempted to abuse drugs

Signs and Symptoms of Drug and Substance Abuse

Physical Signs

These include:

  • Slurred speech, staggering walk due to lack of co-ordination body movement, blurred and double vision, bloodshot eyes, watery eyes and drowsiness, unusual rashes and sores around the mouth and nose
  • Sudden change in eating habits such as loss of appetite or eating too much Burnt fingers, burnt holes in clothes ans injection marks
  • General poor health
  • Dry mouth or constant licking of lips Persistent cough
  • Emergence of gangsterism with same mannerisms, for example , hair cut Untidiness-becoming untidy or tidy all of a sudden
  • Gathering in groups in isolated places or dejected buildings

Psychosocial signs

 These signs include:

  • Withdraw from the family members and friends. Being involved with other company and that is of suspicious behavior
  • Mood swings. Victims may sometimes become violent, excessively excited or argumentative
  • Confused conversation, impaired judgment and lack of proper concentration given tasks
  • Behavior change where some may present extreme changes in behavior and
  • personality e.g. being untidy or very neat all of a sudden
  • Others may present blank, dreamily expressions, fear of lack of sleep Truancy and refusal to go to school
  • Despair and loss of interest in life, which may lead to depression
  • Mental sickness may set in. Victims experience hallucinations and delirium such as seeing things that are not real.
  • Drugs could also lead to suicide Compulsive drug seeking

Effects of Drug and Substance Abuse

A drug abuser undergoes several stages

Stage one: Tolerance

 A person starts abusing drugs for the first time and more into habitual use where the drug takes the central stage of hi/her life. This repeated use leads to changes in the brain and nervous system so that the user needs more of the drug to get the expected effect

Stage Two: Dependence

The body of the drug abuser demands that he takes more drugs. The abuser is noe in the stage of psychic or physical compulsive desire to continually use the drug, either to experience the desired effects or avoid the consequences of withdrawal. The suffering from withdrawal is like an emotional prison trapping the drug abuser.

Stage Three: Addiction

The user is now a victim of drugs and can not help himself or herself. He/she has now developed physical and psychological need for the drug for the body to function normally. This may lead to damage of vital organs in the body such as lungs, liver, central nervous system etc. and the work output may deteriorate

The user lives in denial and has little concern for future life. The use may manipulate other people to get what he/she wants so as to maintain the habit.

Relationship between Substance Abuse and HIV & AIDS

  • Sharing of needles by substance abusers can lead to HIV infection and AIDS
  • Substance abusers stand a high risk of spreading HIV &AIDS through sexual intercourse
  • Substance use is known to impair a person’s judgment and for this reason the person may expose himself/herself to the virus
  • The uncontrollable properties of psychoactive substances lead to sexual and other high risk behaviors that individuals might otherwise avoid

Management of Drug and Substance Abuse

Detoxification Process

This is getting the drug out of the person’s system and seeing him/her through the withdraw system, where drugs dependency starts


Characteristics of clients who are motivated to change

  • Accept the diagnosis given
  • Uncomfortable about the behavior
  • Talk about change willingly
  • Agree with the counselor
  • Follow the course of action
  • They will start, continue and try to sustain change

NB: The counselor’s role is to motivate the client and affirm any small achievement

Effective Motivation Strategy

Motivation is a state of readiness or eagerness to change, which may fluctuate from one time situation to another. This stage is one that can be influenced. Prochaska & Diclemente developed a wheel of change model that shows the stages through which clients pass in course of changing a problem. These include:

i.  Pre-contemplation 

  1. A person is not considering change, has not contemplated having a problem or needing to make a change. People are very defensive here
  2. People seldom present themselves for treatment but they are made under coercion
  3. They need information and feedback to raise awareness about the problem and the possibility of change

ii. Contemplation

  1. Awareness is already raised but the client considers change and rejects it. They are ambivalent
  2. When they talk about self, they go back and forth between reasons for concern and justification for unconcern (caused by pathological personality traits or defense mechanisms)
  3. The counselor task at this stage is to help tip the balance in favor for change
  4. People come for consultation in the contemplation stage. As a counselor practice motivational interviewing

iii. Determination Stage 

This is a window of opportunity. The counselor helps the client to match i.e. helping client to find a change strategy that is acceptable, accessible, appropriate and effective

iv. Action Stage

  1. This is what most people think is therapy
  2. The person engages in particular actions intended to bring about change
  3. These changes may or may not be assisted by formal counseling. the goal during this stage is to produce a change in the area

v. Maintenance Stage

  1. the challenge is to sustain the change accomplished by previous action to prevent relapse
  2. maintaining change may require a different set of skills and strategies e.g. quitting a drug, reducing drinking or loosing weight is an initial step followed by the challenge of maintaining assistance or moderation

vi. Relapse

Help the client to renew the process of contemplation, determination and action stages without becoming stuck or demoralized because of the relapse

Motivational Interviewing

What is motivational interviewing?

Motivation is defined as a probability that a person will enter into, continue and adhere to specific change strategy. It is the counselor’s responsibility not only to dispense advice but also to motivate – to increase likelihood that the client will follow a recommended course of action to change. A counselor is like a salesman and motivation is inherent and central part of the professional task.

Principles of Motivation Interviewing

  • Some people need this, once unstuck, no longer immobilized by conflicting motivations, they have the skill and resources they need in order to make a lasting change
  • Important to people who are reluctant to change and endure ambivalent in changing
  • For others, motivational interviewing is a prelude to treatment
  • It creates openness to change which paves way for further therapeutic work Responsibility for change relies on the individual
  • This does not denote that therapists are powerless or helpless, they exert a lot of influence
  • The strategies are more persuasive than coercive, more supportive than argumentative ( the therapist creates a conducive environment for change)
  • The therapist is increasing client’s intrinsic motivation, so that change arises from within rather than being imposed from without
  • Done properly, client presents the argument for change, rather than therapist.
  • Motivation interviewing employs a variety of strategies especially derived from person centered therapy
  • Counselor may appear relatively active
  • But the motivational interviewing proceeds with a strong sense of purpose, clear strategies and skills for pursuing that purpose and a sense of timing to intervene in particular ways at particular moments.

Motivational Interviewing Approach

  • Systematically directs the client towards motivation for change Offers the counselor’s own advice and feedback where appropriate Empathic reflection is used selectively to reinforce certain processes
  • Seeks to create and amplify the client’s discrepancy in order to enhance motivation for change
  • De-emphasis on basis of labels; acceptance of “alcoholism” or other labels seen an unnecessary for change
  • Emphasize on personal choice and responsibility for deciding future behavior Therapists conduct the objective evaluation, but focuses on eliciting the client’s
  • own concerns
  • Resistance is seen as interpersonal behavior pattern influenced by therapists behavior
  • Resistance is met with reflection
  • Treatment goals and change strategies are negotiated between the client the therapist, based on data and acceptability. Client’s involvement in the process and acceptance of goals are vital

Treatment Approaches

  1. Individual approaches
  2. In patient counseling
  3. Participation in AA (Alcohol Anonymous) support groups
  4. Change can be enhanced by Cognitive approaches, Behavioral modification, Person centered Therapy, Solution Focused Brief Therapy


  • Counseling dysfunctional families and children – they suffer from shame, anger, distorted thinking
  • The clients need to appreciated and accepted by the community to help them become productive members of the society

Preventive Measures to Drug and Substance Abuse

  • Proper education on factors that contribute to the problem and deal with them There is need to educate the public on proper use of legal drugs
  • Create awareness in the community, at work place, in schools and places of worship. Educating people about drugs removes ignorance
  • Media campaigns to highlight negative effects of drug use
  • Effective parenting helps to raise a drug free child. Functional families nature a normal child.
  • Occupational therapist to train workers how to cope with stress at work place Teach life skills and other skills related to their jobs e.g. interpersonal skills, assertiveness etc.
  • To detect the drug users and, help them through drug counseling, treatment and rehabilitations
  • Effective government policies on drug trafficking

Life skills Necessary in the Prevention of Drug and Substance Abuse

  • Assertiveness
  • Self-awareness
  • Self-esteem
  • Communication
  • Decision-making

Values Necessary in the Prevention of Drug and Substance Abuse

  • Integrity
  • Love
  • Freedom
  • Responsibility

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