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Clement Nhunzvi Features Correspondent
Harmful use of substances has multiple direct effects on young adults.

These could be unemployment, physical health problems, dysfunctional social relationships, suicidal tendencies, other mental illnesses and even lower life.

In the most serious cases, harmful use of substances can lead to a vicious cycle in which damaged socio-economic standing and inability to develop adaptive relationships feed substance abuse.

Signs to watch for if you or your loved one are having a substance use problem are:

Decreased involvement in activities the person used to enjoy

Trouble managing responsibilities at work, school or home

Problems with relationships related to substance use

Increase in risk-taking behaviours

A lot of time spent seeking the substance, or dealing with its after-effects (e.g., hangover)

Inability to stop using the substance or change behaviour, even when the problems above are present

In some cases, physical or psychological signs may be observed as well

Slurring speech, clumsiness and lack of balance

Inability to focus

Mood swings

Increased irritability, agitation and paranoia

Decreased hygiene

Very fatigued or difficult to wake up

Change in sleeping habits

There is hope in early identification and early treatment.

Public mental health facilities and some private players provide recovery-oriented services in multidisciplinary teams that include psychiatry, occupational therapy, clinical psychology, mental health nursing and clinical social work.

A tailored sobriety and recovery plan considering your personal, occupational and environmental realities is known to provided sustained results.

It is also prudent to note that addiction – an advanced stage of substance use disorders with neurobiological changes is more difficult to manage and follows a chronic and relapsing route.

Although the specifics of every individual’s substance abuse and recovery journey differ, a somewhat common trajectory can be established.

The first bold step is to reflect and admit your substance use is now a problem; the second step is to find support, this could be from mental health service providers, someone to talk to or self-help support groups like Alcoholics Anonymous (AA).

The third step is to move into detox to begin your sobriety journey, here you will need professional help to manage associated withdrawal syndromes.

Reorganising your life away from substance abuse and developing new routines with the help of your occupational therapist is the fourth stage.  Once you are settled in your new substance free life, practice constant vigilance to avoid relapses.

For Zimbabwe, the recovery journey can be more challenging because of resource constrained setting. In the face of the few strained rehabilitation services, there are reports of high rates of relapses.

Most of the relapses can be traced to an unsupportive discharge context, stressful lives being led by those affected and limited opportunities to transition into productive recovery.

This situation calls us to invest more into research that can examine the implications of our socio-economic situation on health and social well-being in light of the substance abuse problem. A call for alternative views

Problematising substance abuse without considering the broader health and social care needs of young people has not brought in resounding solutions, but rather made society more judgemental, stigmatising and putting all the blame on the one carrying the label of an abuser.

However, in a study in which I used an occupational perspective (considering importance of what people do every day which they find meaningful), exploring subjective experiences and interpretations by the one using substances, the fin dings showed insights which can aid the service providers and society to be less judgemental, more holistic and person-centred in approach.

There were issues of identity crisis, search for meaning and subjective well-being to be considered when helping someone with a substance use problem.

As a way forward, more research is needed, expanding on the work African Mental Health Research Initiative (AMARI) has started.

Evidence-based rehabilitation interventions with a community focus is also needed.

For a supportive environment, authorities are called to act in order to provide a socially inclusive and just society, where young people can access resources and opportunities supporting health, well-being and a good quality of life.

The substance abuse scourge is a problem we can not afford to ignore in a context of high HIV prevalence given the risky sexual behaviours and impaired judgement that go with it.

Clement Nhunzvi is an Occupational Therapist; a PhD fellow with the African Mental Health Research Initiative (AMARI) and a lecturer at the University of  Zimbabwe.