Drug abuse poses various kinds of problems impacting the user, their families and the community at large. The broad impact of drug use on families is tremendous. It is the family to which the dependent user turns to in times of emotional or physical distress or crisis. Relationships suffer, financial sources get depleted, health costs increase. There are greater employment stresses. When the drug user stops taking responsibilities on account of drug use, common family responses include depression, stress and resentment. The non-drug using partner may also take to drugs or alcohol for solace. Those closest to a drug-addicted individual are hardest hit. One can observe common patterns emerge within families where at least one individual is addicted to drugs.
The destructive consequences of drug abuse are often significantly higher for families in poverty-stricken circumstances. There is a serious risk of transmitting HIV, sexually transmitted diseases, and other blood-borne viruses to partners of infected drug users. Sexual relationships can become adversely affected. Drug use is also often associated with domestic violence, which aggravates the physical and emotional distress of the family. Within the family, it is often the woman, in the role of wife or mother who is most affected by the individual’s drug use, and has to bear a significant part of the family burden. The impact of such burdens becomes more obvious in a developing country like Nigeria, where women are already disadvantaged.
The aspect of drug use among Nigerian women has received little attention. Like many societies, the Nigerian society is in transition. Changing roles, increased stress and alterations in lifestyle bring with them newer problems. Although the problem of drug abuse among women in Nigeria is becoming increasingly recognized, it is not reflected in most official drug statistics. This is partially due to cultural constraints and societal discrimination on women. Despite the increasing number of women in substance abuse, there are worse consequences for women as a result of drug abuse. It is therefore important to develop alternate methods to identify women with problems related to drug abuse in order to understand its impact on the individual as well as the gender perspective.
Burden on Women due to Drug Abuse by Family Members
There is a perceived burden on women relatives of male drug users and understand the social, familial, economic health and psychological consequences on these women. The drug abusers in the families of these women were all male, with more than two-thirds between the productive ages of 16 to 35 years. A large number (55%) had a history of drug abuse since their teens and 67% had been using drugs for more than 5 years. Although a majority was poly-drug users, the primary drug of abuse was codeine and tramadol (68%). A majority of the women in the study were wives (56%) or mothers (35%) of drug abusers. Almost half of the women were between 20 to 55years of age. A fifth of them was illiterate, and at least 45% had incomes. Forty-four percent were housewives. Many lived in extended families.
A large proportion of the drug users were unemployed (65%). While a majority of those employed spent a sizeable proportion of their income on procuring drugs, many users depended on their families to support their drug addictions. Many of the women were forced to part with their money or goods to support the drug user’s habits. The women usually gave money because of coercion, or because they could not tolerate the desperation faced by the drug user during cravings. Some of the women did not know for what purpose the money would be used. Most women paid back loans made by the drug user, and also their properties such as pieces of jewellery are being stolen and sold for drug use. Only a few women reported themselves occasionally using drugs with the user.
Unemployment or diversion of money for drugs created a huge economic burden, especially in families with low incomes. Some of the women were themselves working and faced tremendous hardship within and outside the house. A considerable number of women in the study were forced to give up large parts of their own earnings to support the drug user’s habit. Some women responded to this by concealing their money, which then led to arguments as well as domestic violence leading to further distress.
One of the major burdens faced by the women was that of the blame of being responsible for the drug use in the family member, the blame of hiding the issue from others, and blame of not getting timely treatment. Thus the woman often became the victim of not just the drug abuser, but also society. This often led to feelings of guilt, shame, embarrassment, depression, anxiety and isolation, and frequent suicidal thoughts. In addition to emotional distress, many of the women faced various health problems including weight loss, aches and pains, and insomnia. A majority of them had not sought any help for these problems or for associated health problems like hypertension or diabetes. Most of them felt that their health problems would vanish if the drug abuser gave up his habit. Many of them had attempted to take the drug abuser for treatment but were overwhelmed by the high costs. Physical violence was reported by 43% of the women and verbal aggression by 60%. Physical abuse ranged from ‘slaps, being pushed around, punched and kicked, being hit against the wall’. Disturbances in the sexual area were apparent, and the awareness and protection against sexually transmitted diseases appeared low.
The lack of social supports was another important observation, with more people living in extended families, relatives shying away especially when there were monetary expectations. Lack of support from the family of origin together with the blame for the drug addict all seems to put an overwhelming burden on these women. And yet, they were still taking on the major responsibility for the family and the drug user.
Substance Abuse among Women
Half the women from northern Nigerian are housewives and unemployed as some are illiterate. Very few had received any technical or professional training. A few of the women were employed, thirty-one percent of the women across the sites were single, and 32% were divorced. Friends had introduced drugs initially of the respondents, whereas, introduction to drug use was by the husband or partner. More than half of the women reported initiation of drug use on account of humiliation, shame, anger, and lack of freedom of choice as a response to their situation. With the married women, marital conflict and abuse of prescription drugs was a common initiating factor of drug abuse. Most of the women are currently using codeine and anti-depressants. The women commonly reported both physical (insomnia, menstrual irregularities) and psychological problems (depression and anxiety about their current and future lives).
Among the women with children, there was a sense of guilt for neglecting the children. About 10 had suffered miscarriages or undergone medical terminations on account of their drug use. About half of the drug-abusing women had been exposed to a drug or alcohol-abusing family member. Domestic violence was often reported by non-drug abusing husbands of the women. Sexual intimacy within the relationship was reported as poor, as was emotional closeness.
The drug-abusing women received little support from their relatives, husbands or friends. While most of the drug-abusing women have not been in contact with treatment services, specific issues that interfered with treatment included concerns for children unattended at home, fear of exploitation, fear of stigmatization, fear of withdrawal, and a lack of supportive systems.
In conclusion, substance abuse is an epidemic and a ticking time bomb that needs urgent attention and systematic approach in our society and also recognizing its impact on mental health.
Ms Iyayi is the founder of Wagner Aid Foundation (WAF) & NOPDER