A paper presented at the 2015 Nigerian Bar Association Annual General Conference at the International Conference Centre, Abuja on the 25th of August, 2015.
Introduction
The use and abuse of substances of natural origin has been known for ages. For centuries man has tried to escape from the unpleasant features of life, whether real or imaginary, by using fermented liquors or plant products. On the basis of archaeological evidence, it would appear that alcohol for example has been in use since the prehistoric times. In other words, no one knows the exact date of the discovery of alcohol, but many writers indicate that alcohol has been in use around 6400 B.C. The first written report of tobacco smoking was in the fifteenth century where Christopher Columbus indicated in his log book of October 12, 1492 that the natives of San Salvador gave him tobacco leaves. Similarly, 2737 B.C. is cited as earliest reference to Marijuana (Cannabis) by Emperor Shen Nung. Also, opium and its derivatives have a history of their medicinal use dating back almost six thousand years. Opium is a unique compound taken from the juice of the poppy plant (Papaver Somniferum). Cocaine which is the main alkaloid of the coca leaf was first synthesized in the 1850’s. What therefore has changed? What has changed is the new trend, age of onset (which reports have put at 8 years), indiscriminate use, predisposing and precipitating factors, pattern of use, new discoveries and spiral consequences. 2 Today, substance abuse is one of the most significant medical, psychological, social and economic problems facing mankind. More worrisome is the fact that substance abuse is no longer isolated within professional groups, cultural groups and geographical region but has permeated various national and continental boundaries. Substance/drug abuse related problems therefore, affect practically all nations, all classes of the society, people in all walks of life, types of jobs and all ages. Society pays a heavy toll for substance/drug abuse both in economic as well as in human endeavours.
Classification of Substances of Abuse
Different substances have different pharmacological compositions as well as effects on the users. This has caused misclassifications of substances of abuse. For the purpose of this presentation, substances of abuse shall be grouped thus:
- Stimulants
These are substances which speed up the central nervous system. Examples are nicotine (cigarette), caffeine (kola nut), cocaine, pemoline, amphetamines etc.
- Depressants
These are substances which slow down the central nervous system. Examples are alcohol, narcotics (opium and its derivatives, tramadol, cough syrup containing codeine), benzodiazepines (valium, Librium and lexotan), barbiturates (Amytal and phenobarbital), methaqualone etc.
iii. Hallucinogens
The hallucinogens are mostly synthetic products. They cause changes in perception and consciousness. Examples are Cannabis, Lysergic Acid Diethylamide (LSD), Phencyclidine (PCP, Angel Dust), Mescaline (Lophohora Williamsii), Dimethyltryptamine (DMT), Methylene 3 Dioxymethamphetamine (MDMA), Methylene Dioxyamphetamine (MDA) and Psilocybin (Psylocibe Mexicana).
- Non-Conventional Drugs
These are substances that can neither be classified on the basis of their pharmacological composition nor on their effects on the users. Examples are volatile solvents (inhalants) such as correction fluid, rubber solution, nail polish removal, kerosene, petrol, hair spray, paints/paint thinner, furniture polish, butyl nitrate, formaldehyde, formalin; Datura metel (“Zakami”), lizard dung/excretes, paw paw leaves, and soak away/pit toilet fumes (bio-generic gas).
- Anabolic Steroids
Anabolic Steroids are mostly used/abused by sports men and women to enhance their performance. Donabol Anawar, Android
- Licit and Illicit Substances
These are drugs which have been established to be safe, effective and given under the direction of a medical practitioner for medical purposes only. Examples are over-the-counter drugs (can be purchased without a doctor’s prescription e.g paracetamol, multivitamins, etc.) and prescription/controlled drugs (can produce adverse side effects when improperly used and must therefore be used under the prescription of qualified medical personnel. These include benzodiazephine – valium, mandrax, lexotan etc).
These are drugs/substances whose manufacture, sale, distribution, purchase, possession or use is prohibited by law e.g. Cannabis, Cocaine, Heroin, Amphetamine Type Stimulants (ATS) etc.
Predisposing Factors to Substance Abuse
Some of the predisposing or enabling factors to substance abuse are:
- Peer pressure
- Curiosity
iii. Availability
- Drug Subculture
- Personality
- Ignorance
vii. Frustration
viii. Stress
- Depression
- Nature of job
- Mental health disorder
Stress
The story of stress is the story of humanity. In other words, the entire life of man from beginning of creation is characterised by alternating periods of stress and the quest for happiness. Stress rather than being considered as a stranger, is in actual sense, an integral and indivisible part of man. It is like the marital vow of “till death do us part”.
Generally, stress is first experienced early during life in the womb. The future human being even before conception passes through several stages of stress from fertilization to implantation on the walls of the uterus. As pregnancy advances, internal factors such as organ formation, growth and development, becomes sources of stress to the baby. Also, external factors such as mothers’ nutritional status, physical activity and even sickness are reflected on the child as stressors.
These stressors manifest clinically as foetal distress and intrauterine growth retardation. Sometimes when the stress is overwhelming on the body, it leads to either its death while in the womb or its forceful and premature separation from the mother, what is commonly known as spontaneous abortion or miscarriage. So, life starts with stress from the womb through delivery to infancy, academic and other stress at childhood to early adulthood, then executive to family stress which is common among working class including Lawyers.
It is important to state that stress is not all about negative; that is why it is referred to as being a “friend and an enemy”. A reasonable level or moderate stress is good and beneficial as it enables us to adapt to situations and tackle challenges.
Stress and Stressors
What is pleasant to us may as well be another person’s worst nightmare. It is therefore important to emphasis individual differences when addressing the issue of stress and stressors. This is defined by two major factors: Risk factors and Aggravating Factors
- Risk Factors Factors that predispose an individual to develop stress are called risk factors. This vulnerability could be due to genetic or some environmental influences. In other words, the person who carries such vulnerability has greater chances of developing stress-related disorders than others.
These factors are:
- Personality trait
- Poor defence mechanism
- Pre-existing mental disorder
- Genetic predisposition
- Certain medical disorders 6
- Early childhood trauma
- Beliefs
- Aggravating Factors
Aggravating or precipitating factors increases the rate of progression to stress
. · Substance abuse
- Occupation
- Inadequate rest
- Overambitious target/high expectations
- Hostile environment
- Conflicts (marital, financial etc)
- Poor social network
The cost of stress in terms of human suffering, social and occupational impairment and illness are enormous. The need to better understand and manage stress should be a high priority to everyone. It is therefore important that we know how to manage stressful situations for positive living. That executive stress is becoming a major health issue in Nigeria is also a major source of concern.
Stress Management Techniques
- Relaxation response: Breathing, Progressive muscle relaxation
- Meditation
- Exercise
- Diet
- Time management
- Goal setting
- Problem solving skills
- Assertiveness skills
- Cognitive techniques
- Stress management course.
Depression
Depression is a biopsychosocial disorder characterized by emotional, cognitive, physiological and behavioural symptoms. The primary emotional symptoms are profound sense of sadness and low mood. Irritability, frustration and anger often accompany the low mood. Cognitive symptoms include a sense of hopelessness, helplessness, worthlessness, and guilt. Depressed individuals often have difficulty concentrating or making decisions (including drug use decisions). Physiological symptoms include changes in appetite, sleep, fatigue, and concerns about ache and pains. Diminished sexual interest is also common among depressed individuals. Behavioural symptoms include decreased activity and loss of interest in activities that previously were interesting and pleasurable. Depression is a serious illness much more severe than an occasional case of sadness or unhappiness. It affects the whole body, energy level, appetite and concentration and should be left for professionals to manage.
The Link between Office Chaos, Depression, Stress and Substance Abuse
Office chaos is simply a state of complete disorder, disarray and confusion, a total lack of organizational order; an environment of discordant tunes. Going by the discussion so far, it is obvious that there is a close association or link between stress, depression and substance abuse. A good percentage of drug dependent patients or clients are diagnosed with depressive, stress and substance use disorders. This is usually referred to as dual diagnosis or co-morbidity. Each of the three disorders is capable of predisposing and precipitating each other and continues in a vicious circle. In other words, stress and depression alone or both predisposes substance use. The same way, the end product of substance abuse is stress and depression. Some people resorts to the use of different substances to deal with stress and depression. Unfortunately, substance abuse is not a solution to depression or stress. One is more depressed and stressed especially when the effects of substance use wears off. A combination of the three disorders in an office environment is a complete state of workplace chaos with severe consequences.
Consequences of Substance Abuse in the Workplace
Drug/Substance abuse cut across all ages particularly between the ages of 8 and 65 years. While indiscriminate substance use is common among the young people, coping with frustration and executive stress are major precipitating factors among older people. According to a 1995 report by the United States, out of an estimated 12.8 million drug users, about three quarters (about 9.6 million) were employed, either fully or at least part-time. These drug users, no doubt, are most likely to manifest deviant behaviours in the workplace whether they use drugs while on duty or off duty, the direct or hangover effects will always reflect on the job performance. The consequences are:
- Absenteeism: Substance abuse employees absent themselves from work on an average of three times more often than non-drug-using employees. Reasons for absenteeism are usually for vague ailments, implausible reasons or hangover. While at work, they are more absent at duty post than non drug using employees. In addition, their activities are associated with tardiness.
- Accident: Substance abuse employees are three to four times more likely to be involved in an on-the-job accident, injuring themselves and co-employees. Operating machinery under the influence of drugs for example is clearly a high-risk. According 9 to United States Occupational Safety and Health Administration publication, 65% of workplace accidents are caused by substance abuse.
- Low Productivity: Low productivity by substance abuse employees arise from a number of interrelated factors such as poor health condition, family problems, problems with law enforcement, hangover, emotional instability, loss of job advancement, and impaired judgment. Low productivity also arises from missed deadlines, errors due to inattention, lowered job efficiency, and spasmodic work pace.
- Shared Burden: Substance abuse employees put a potentially heavy burden on colleagues and employers due to frequent accident, working at minimal capacity, increase in the workloads of others, lower productivity, compromise product quality, and tarnish company’s image. They reduce competitiveness and profitability thereby weakening the companies and threatening everyone’s job security.
- Violence and Destruction: Substance abuse employees are likely to engage in a fight because of their high level of intolerance and engage in destructive activities in the workplace.
- Workplace Prostitution: This is mostly applicable to female substance abuse employees. Due to their insatiable drug craving, they are prone to financial difficulties. This makes them borrow money from their colleagues and in most cases they are not able to pay back in cash. In the same way, their frequent breach of organizational rules and regulations exposes them to their male bosses who take advantage of them.
- Financial mismanagement: It is very common for substance abuse employees to divert company money entrusted unto them due to their high craving for drugs.
- Loss: Loss from drug abuse employees arise from outright theft/diversion of company’s resources, loss from low productivity, damage and poor equipment handling, management and carelessnes.
- Education, Training and Development: Substance abuse affects cognition, perception, attention and retentive memory. Drug abuse, therefore impedes staff training to cope with present job and development for future task. Drug dependent employees find it difficult to benefit from the task of training and development.
- Employee Turnover: Where cases of substance abuse employees in the workplace are not well managed, it leads to loss of job. Studies show that it costs a business an average of $7,000 (about #1,575,000.00) to replace a salaried worker.
Substance Abuse Prevention in the Workplace
From this presentation, it is obvious that substance abuse in the workplace creates problems that affect the management and every employee in any organization and should be the concern of the management and all employees. There are a number of ways in which management and employees can collaborate to prevent substance abuse in the workplace to avoid office chaos. A comprehensive drug-free workplace programmme is therefore very important in preventing, detecting, and dealing with substance abuse. Such programmes generally include the following elements:
- Written Policy: Documentation of drug use policy is a very important tool for substance abuse prevention and management in the workplace. This should be supported by top management, understood by employees and well publicized.
- Employee drug education: There should be a regular drug abuse preventive education programme for employees that will focus not only on the consequences of drug abuse but also on coping skills and the availability of help for users.
iii. Identifying drug users: This requires capacity building for identifying and managing drug users in the workplace and support for referrals services.
- Drug abuse testing: This is the introduction of appropriate drug use testing facility, designed to prevent and identify employees who use illicit drugs and as part of a comprehensive programme for recruitment. This should be done in line with organizational drug policy without infringing on employees fundamental human rights and breach of labour laws.
- Identify enabling factors: There are a number of enabling factors that encourage substance use in the workplace. One of these factors is availability of these substances in our organizations’ neighbourhood. Unfortunately most organizations don’t bother about what happens in their neighbourhood. Another enabling factor is the nature of the job. There is a limit of work (especially the unskilled type) that an individual can handle within a specific period of time. If an employee does more than that regularly, there should be need for investigation. These and other enabling factors should be identified and addressed.
- Beyond the Employees: Substance abuse prevention should go beyond the employees to immediate family. The personal lives of employees profoundly affect on-the-job performance. A happy, balanced home life extends into the workplace, encouraging both enthusiasm and high quality work. On the other hand, personal concerns, particularly if they are severe and extended over time, can have just the opposite effect, rendering an employee tense, depressed, unfocused and often unable to fulfill job responsibilities. A child with a drug
problem places their parents (employees) in this ctegory. Failure to assist not only diminishes the value of troubled employees, but also reduces profitability and morale. It affects the entire office environment as other staff members try both to help and take up the slack of the affected individual.
vii. Promote Healthy living: Employers should provide/encourage general health awareness programmes, which should include periodic medical check-ups, on the spot tests, sport activities and provision of recreational facilities.
viii. Reduced Workplace/Executive Stress: Frustration is one of the predisposing factors to substance abuse. Frustration could be caused by a number of factors. Management should ensure that the work environment is devoid of high level stress and frustration. The workplace environment should be made conducive, good welfare services for workers, family support programmes, eg, housing projects, educational loans, car loans, etc should be provided.
Conclusion
According to the latest drug information from the National Institute on Drug Abuse (NIDA), substance abuse cost the United States over $600 billion annually in health care treatments, lost productivity and crime. Stress is inevitable but substance induced stress is avoidable. Depression is a biopsychosocial condition but must not be aggravated by substance abuse. Substance induced office chaos is avoidable. The task to avoid substance induced office chaos, societal chaos and national chaos is for you and me.
Thank You
