By Moses Magadza

WINDHOEK – Professionals working with adolescents suffering from drug or substance disorders are honing their skills to provide family therapy. This, as research shows that children as young as nine years are among regular drug and substance users in Namibia.

Towards the end of December 2019, a team of professionals from various disciplines met to bounce ideas off each other in a three-day training as officials expressed grave concern over the early age at which some children were using drugs and substances in the country.

Mrs. Rene Adams, the Program Manager responsible for Substance Abuse Prevention, Drug Control and Rehabilitation in the Ministry of Health and Social Services, officially opened the workshop.

The United Nations Office on Drugs and Crime (UNODC) convened and funded the training dubbed ‘Booster Training of the Family-based Treatment Training Package for Adolescents with Drug and other Substance use Disorders’.

Major crisis

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Adams said a recent nationwide study by the MoHSS targeting adolescents aged between 13 and 16 years had thrown light on a disturbing phenomenon: some children younger than 10 years of age had commenced using drugs and substances.

“They start at the age of nine. Regular use of drugs and substances, not experimenting. They drink alcohol, sniff glue and smoke dagga. We need more of these trainings,” she said.

She welcomed the training, saying Namibia had a serious shortage of human resources for mental health and was struggling to cope with worsening drug and substance crises.

“We (professionals) are just a few but our country has a big problem,” she said.

Family therapy

Adams said the active involvement of empowered families was necessary to prevent more adolescents experimenting with drugs and other substances that might lead to drug use disorders.

She hoped the training would boost efforts to build a cohort of adequately trained and skilled professionals to respond to issues related to drug and substance use disorders and to work closely with families.

“We need family-based therapy for adolescents substance use disorder. We need to know and assist the families. Once a person goes for treatment and feels better, they return to their families,” Adams said.

She explained that the effects of drug or substance abuse affect not just the people using drugs, but other family members as well as those around them.

“It’s a family addiction. Back in the days, we believed that substance abuse affected at least 16 people around the patient. I think it is 16 multiplied by two. This is because our families tend to be big and include extended family members. This problem affects much more people than we initially thought,” she said.

Evidence-based responses

Signe Rotberga, the UNODC Regional Coordinator for Southern Africa, called for the use of counterfactual evidence and developing partnerships in responding to drug and substance challenges.

In remarks made on her behalf by a UNODC official, Rotberga cautioned against knee-jerk responses and over-reliance on the criminal justice system through criminalization when dealing with drug use issues.

Dr Lahija Hamunjela facilitated the training. She is an internationally certified addiction treatment professional. Additionally, she is a specialist in psychiatry and mental health.

She said the training sought to build a cadre of “baseline professionals” to help many adolescents that were presenting at health facilities with substance use disorders. According to Hamunjela, the most accessible and abused drugs and substances in Namibia included glue and oil which are sniffed, and cigarettes, dagga, cannabis “and cocaine which is now common”.

Red flags

She said there were tell tale signs that a child is using drugs or other substances. She encouraged parents to be observant and seek help early.

“When parents notice their child’s school marks going down or the child exhibiting behavioral problems, they should wonder if drugs or substances are not involved,” she said.

Parental capacity

The tragedy, Hamunjela said, was that many parents had neither knowledge nor skills to deal with a child that is using drugs or substances.

“It can be worse if the child develops drug or substance use disorders. Some parents are in denial while others attribute such a child’s behavior and mental condition to other factors, most commonly witchcraft,” she elucidated.

She said while most people were good at taking children and other people who develop substance use disorders to health facilities “to be fixed”, few were adept at supporting such patients to ensure adherence to treatment after they are discharged.

“That is why family therapy is important. It empowers every member of the family to support the patient to full recovery. It is not easy to stop once one has begun using drugs or other substances. Addiction is a chronic brain disease. The potential for relapse is high. Maintaining sobriety is not easy,” she argued.

Enthusiastic response

Most of the approximately 30 participants welcomed the training. Charles Mabulawa is the Rehabilitation Coordinator in charge of Mental Health and Special Needs Offenders at the Gobabis Correctional Facility of the Namibian Correctional Service (NCS). He found the training “very relevant” to his work.

“Young people form a significant part of offenders under our care. We call them juvenile inmates. Substance abuse is one of the factors that bring them into conflict with the law and the criminal justice system. At NCS, we are implementing rehabilitative interventions to combat the challenges of drug and substance abuse,” he said.

He hailed the training for its “emphasis on evidence-based interventions” and how families can get involved.

“The family forms part of the support system. Dynamics within the family can influence outcomes of treatment. The active involvement of families can significantly reduce recidivism,” he said.

Mabulawa said although he had vast experience in the management of substance use disorders, he still found the training unique in that it sought to build the capacity of practitioners to deal with adolescents struggling with drug or substance use issues.

“I primarily work with juvenile offenders. What I learned will boost my skills in managing young people,” he said.

Esther Nana Awuku is a Clinical Psychologist at the Mental Health Care Center at Windhoek Central Hospital. For her, the training could not have come at a more opportune time. She said lately, many young people were presenting with substance or drug use disorders.

“In extreme cases, we attend to children as young is six years. Some children begin by abusing substances that include petrol before using hard drugs. It's a big problem – a real epidemi see this most of the time. It maybe because ours is a state-run facility. We tend to serve many members of the community,” she said.

Awuku said the training had helped her engage better with clients and to carefully consider approaches to use. Additionally, it had exposed her to current and emerging issues related to substance and drug abuse.

“It was an eye-opener. It enabled me to better appreciate the work we do. I was able to pick up new skills, especially those related to motivational approaches when working with resistant or uncooperative clients,” she gushed.

Josephine Shilongo, a social worker, holds the rank of Lieutenant Colonel in the Namibia Defense Force (NDF) where she heads the Directorate of Social Services and Rehabilitation. She strongly recommended that the training becomes an ongoing process and not an event.

“Alcohol and drug use have become serious issues in our force. Many of our soldiers and recruits are young. By the time they come to us, some of them would have already begun using drugs and taking alcohol. This training has added to my knowledge. Now I can partner with families,” she said.

Atelma Thanises, another social worker with MoHSS, said she could not wait to go back to Swakopmund where she is based and share her new-found knowledge and skills with her colleagues.

“I am a member of the West Coast Association of Social Workers. I will use that platform to widely share my knowledge and skills on managing substance and disorder cases,” she enthused.

She revealed that substance abuse was one of the 10 top social problems in Swakopmund.

“It is a common feature in many cases of attempted suicide. It also features prominently in cases of marital problems and acute confusion or psychosis. It is a very rampant problem,” she said.

Drug abuse is a global challenge. The UNODC Drug Report of 2019 showed that 271 million people aged between 15 and 64 had used drugs, with about 35 million suffering from drug use disorders globally.

The UNODC supported the training under its regional Programme on ‘Making SADC Communities Free of Crime and Drugs’.