www.chitraltimes.com

Substance Abuse in High Society

By Aamir Khakwani

Substance abuse is the overindulgence in and dependence of a drug or other chemicals leading to effects that are detrimental to the individual's physical and mental health. These substances may include alcohol consumption, over the counter drug abuse, areca & betel nut use, cigarette smoking and the use of smokeless tobacco in the form of naswar. Areca nut, with betel quid and chewable tobacco is the fourth most commonly used psycho-active substance in the world, ranking after caffeine, alcohol and nicotine (Gupta, 2004 as cited by Mazahir et al, 2006). These substances are psychoactive substances are often used as mood stabilizers and coping mechanism for depressed people to give them a few moment of relief from their problems. Nowadays, these substances are more likely to be used as a sign of rebellion and an overall fashion statement. A study done in the squatter settlement reported that 40% of the adolescent population was using at least one chewable product of betel, areca and tobacco on a daily basis. But the amount and the vast variety of these substances are increasing in the high socio economical group and especially among the adolescents and the young adults.

The use of these materials is of great importance because it leads to many health problems. Time trend analysis has suggested a rise in the incidence of oral cavity cancers in Pakistan. The incidence of oral cavity cancers in Karachi South district of Pakistan is the highest in the world. According to Mazahir et al (2006), Chewing betel, areca and smokeless tobacco products lead to discoloration of teeth, development of chronic debilitating diseases involving gingival and oral mucosa, and higher mortality among users. However the high socio economical status people consider them as too primitive and thus indulge in consumption of alcohol, cigarette smoking and drug abuse (like sleeping pills and narcotics).An interview from a few members belonging to the high socio economical revealed that they all regarded the use of cigarettes or alcohol as a fashion accessory and they were only “social” users. Friends are considered as the most influential people for teenagers and the more they tend to mingle, the more they likely are to be involved in this habit of using cigarettes and alcohol. One of the boys also said, “We are not hooked on the cigarettes. We just use them at that moment because everybody is using it at that time. I am fully aware of the consequences of smoking and that’s why I don’t use it a lot.” It is likely that the habit of one person will affect the habit of others in the same household which would lead the other younger members of the community to engage in using these substances. It was also shared that smoking is merely a way to relax after a difficult day at college or university.

The media also plays a huge role in fueling this trend of using cigarettes and other substances. It portrays this image where a TV star is using it and some of the adolescents who idealize the actor would even pick up the destructive habit. It was reported by one of the community member that seeing the advertisement and banners of cigarettes and betel nuts is inevitable and there is no option to protect the children and even ourselves from the urge to use it. It is also seen that adolescents are very curious to try out new things and that is the main reason for them to use cigarettes and alcohol when they are with their company.

To discourage the consumption and the use of these substances is the first step towards the control of epidemic of cancers in Pakistan including lung cancer and head and neck cancer and requires radical measures involving health care professionals, media, policy makers and the community. Alcohol beverages and cigarettes sponsored music videos showing TV stars using these products as a symbolic offering should be countered. Health authorities have to play a pivotal role to formulate the policies to limit the industry, import, marketing and use of these items. However, as has been experienced, it requires strong political commitment. It is recommended that health care professionals should inform the community of its hazards on health and economy and promote new coping methods to deal with daily stressors and problems.

Prevalence of use of cigarettes and alcohol is high in Pakistan with particularly high use in adolescents and young adults. Alcoholic beverages and cigarettes are gaining popularity among the youth. Policies and focused interventions can be developed taking into consideration the preferred use of products among different age groups.