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Mental Health: Clinical Issues
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Peter Ventevogel, Peter Hughes, Claire Whitney, Benedicte Duchesne
A person with this disorder seeks to consume alcohol or other addictive substances on a daily basis and has difficulties controlling consumption. Personal relationships, work performance and physical health often deteriorate. The person continues consuming alcohol or other addictive substances despite these problems. Worldwide, alcohol is the most widely abused psychoactive substance, but its prevalence varies widely. The prevalence among forcibly displaced populations is likely to be relatively high7 because of increased availability of (illegally brewed) alcohol and the use of alcohol as a way to calm or help sleep. Other substances of abuse are opioids (e.g. among Afghan refugees in Iran and Pakistan), amphetamines (e.g. yaba tablets, which contain a mixture of methamphetamine and caffeine, in Myanmar and Bangladesh and captagon in the Middle East), tramadol (a narcotic-like pain reliever that can provide a sense of euphoria) in West and Central Africa and khat (green leaves with a stimulant effect) in Yemen, Somalia and Ethiopia.
Stimulants and psychedelics
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Substituted amphetamines are a diverse group of substances that have amphetamine as their parent compound and are often used recreationally. Cathinone, methcathinone, 3,4-methylenedioxy-methamphetamine (MDMA), and methamphetamine are examples. Methamphetamine (N-methyl-α-methylphenethylamine), and its two enantiomers, dextro-methamphetamine and levo-methamphetamine, are neurotoxic and highly addictive. They directly damage both dopamine and serotonin neurons in the CNS and can result in reduction in grey matter volume in several regions of the brain (Krasnova and Cadet, 2009; Yu et al., 2015). Methamphetamine neurotoxicity is also associated with increased risk of Parkinson’s disease (Thrash et al., 2009), and post-acute withdrawal symptoms, which persist for months (Cruickshank and Dyer, 2009). Methamphetamine is presented on the illicit market in two main forms: methamphetamine tablets and crystalline methamphetamine (‘crystal meth’, ‘ice’, ‘shabu’). Methamphetamine tablets, commonly known as ‘yaba’ in East and South-East Asia, are typically of low purity and often contain a large portion of caffeine, plus a range of other adulterants. Crystal meth is usually of much higher purity and it can be smoked, nasally insufflated or injected.
Mental health in the Lao People's Democratic Republic
Published in Dinesh Bhugra, Samson Tse, Roger Ng, Nori Takei, Routledge Handbook of Psychiatry in Asia, 2015
In 2002, lifetime prevalence of methamphetamine (Ya-Baa) use among the young reached 42 per cent; the figure among bar staff was 34 per cent and among service women 14 per cent.29 A survey conducted in 2003 by urine testing 14,260 students in 17 provinces showed that 3.7 per cent of students in urban areas had tried amphetamines; this increased to 27.6 per cent in 2005.13 The prevalence of opium use was 0.42 per cent in the ten northern provinces among those aged 15 to 64. Seventy-two per cent of opium users treated with opium tincture in the community remained free of drugs.30 As of 2009, an estimated 1.5 per cent of all drug users in Lao PDR were living with HIV. Injecting heroin increased in 2012, regrettably with little evidence of the use of sterile needles and syringes.31
The global movement towards a public health approach to substance use disorders
Published in Annals of Medicine, 2022
Kimberly Johnson, Irina Pinchuk, Marie Isabel E. Melgar, Martin Osayande Agwogie, Fernando Salazar Silva
In the past decade efforts to address drug use from the public health perspective have been implemented with the support of UNODC through the E.U.-funded project, ‘Response to Drugs and Related Organized Crime in Nigeria’. Through this project, the major stakeholders in drug control in Nigeria including the NDLEA, the Federal Ministry of Health, and NGOs have received institutional support and capacity building for the workforce. This includes the designation of 11 drug treatment centres as training hubs; the development of national minimum standards for drug dependence treatment in Nigeria; national guidelines for the treatment of substance use disorders for Nigeria; a national policy for controlled medicines and its implementation strategies [49]. After a negative review by international evaluators, the NDLEA counselling facilities increased staffing and implemented a Standard Procedures and Practice Guidelines for counsellors. Drug treatment data collection was instituted with the development and utilization of training manuals such as the TreatNet modules [53], and the Unplugged school-based prevention programme [54,55]. Similarly, the introduction of the UTC for Substance Use Disorders [56] to Nigeria by the Federal Neuro-Psychiatric Hospital Yaba, Lagos state and the Federal Ministry of Health as the focal points and the introduction of the UPC for Substance Use Disorders by Global Initiative on Substance Abuse as the focal point have significantly improved the capacity of the prevention and treatment workforce in Nigeria [51,57]. These two standardized curricula, developed with funding support by INL have been deployed as training tools and in academic programmes globally [58,59]