Effect Of Drug Abuse Among Women Or Pregnant Mothers

Medical and Health Science Project and Seminar Material

Abstract

The study involved the investigation of the causes, effects and remedi of drug abuse among pregnant women with reference to Winners clinic, Lagos, Nigeria. A case research strategy wa because the investigation involved a real life problem which cannot distanced from the main agents and therefore it was important to identify which could fulfill the research objectives or answer the research exhaustively. Methods of data collection were observation, in-depth into distribution of questionnaire.

The data obtained were presented by u histograms, and frequency polygons. Data were analyzed and interpret based on the patterns reflected by the statistics. The statistical pa debated and challenges to the current practices and the following ‘ every family is vulnerable to drug abuse by pregnant women regardless of m lack of adequate time for socialization amongst family members control abuse among pregnant women, drug abuse among pregnant women can start as early a years of age. It was concluded that drug abuse can be eradicate collaboration between families, community, government and hospitals that it has been recommended that pregnant women should go to school roaming around, be involved in sports to avoid idling, be selective in peers and be inspired with parents’ ideals and ethics. Among others,

Chapter One

Introduction

1.1 Background of Study

Pregnant women who misuse substances (alcohol, tobacco, and prescription and illicit drugs) are positioned at the nexus of public health and criminal justice intervention. The impact of their substance use on their personal health and the health of their fetuses is a public health concern, as professionals in this field are dedicated to improving maternal and infant health. In addition, the past three decades have seen prenatal substance use become a criminal justice issue as the fetal protectionism movement spurred the increasing use of criminal sanctions forsocioeconomic brackets, are subject to increased surveillance and may face arrest, prosecution, conviction and/or child removal (Banwell&Bammer, 2006; Boyd, 1999; Chasnoff et al. 1990; Figdor&Kaeser, 1998; Murphy & Rosenbaum, 1999; Paltrow, 1999; Paltrow & Flavin, 2013; Roberts, 1991).

Figures from the most recently-published report from the National Survey of Drug Use and Health (Substance Abuse and Mental Health Services Administration, 2012) state that, of pregnant women aged 15–44, 9.4% reported current alcohol use, 2.6% reported binge drinking, and 0.4% women in the same age group has decreased slowly but significantly each year. Of pregnant women aged 15–44, 5% report current illicit drug use, a proportion notthat represents a small, nonsignificant increase from the 2009–2010 and 2008–2009 findings. The percentage of pregnant women in this age group who report smoking tobacco in the last month has not changed significantly in the last decade, while tobacco use among nonpregnant significantly different than in the previous study year. The rate of illicit drug use varies widely with the woman’s age. Teenaged pregnant women have the highest rates of illicit drug use (15–17, 20.9%), followed by young adult women (18–25, 8.2%) and adult women (26–44, 2.2%). There are no reliable nationwide estimates of the annual number of infants born after prenatal substance exposure. For example, the CDC website reports that the rate of Fetal Alcohol Syndrome (FAS) is 0.2-1.5 cases per 1,000 live births (CDC, 2014), although this estimate appears to be based on research from the 1990s. A recent study found the rate of FAS in one Midwestern community to be 6–9 per 1,000 children, and more general Fetal Alcohol Spectrum Disorder (FASD) as high as 24–48 per 1,000 children (May et al. 2014). Some infants prenatally exposed to opioids exhibit symptoms of Neonatal Abstinence Syndrome (NAS), including hyperirritability and dysfunction of the nervous system, gastrointestinal tract, and respiratory system (Finnegan &Kaltenbach, 1992). Between 2000 and 2009, the incidence of NAS among hospital-born newborns increased from 1.20 to 3.39 per 1,000 live births per year. Total hospital charges for NAS during this time period are estimated to have increased from $190 million to $720 million, adjusted for inflation (Patrick et al. 2012). While it is possible that some of the increase in NAS diagnoses could be attributed to growing recognition of NAS symptoms and increased surveillance of pregnant women, it appears that prenatal exposure to substances is a significant public health problem.

Concerns about fetal drug exposure have given rise to new laws and applications of existing laws that seek to deter women from using substances during their pregnancies and to punish those who do. The enforcement of these laws raises questions of fetal personhood and the extent to which the government may regulate pregnant women’s bodies. Substance abuse during pregnancy is considered child abuse under civil child welfare statutes in seventeen states, and in three states (Minnesota, South Dakota, Wisconsin) it is grounds for civil commitment (Murphy, 2014). 36 states recognize embryos or fetuses as potential victims of crime, although 24 of these expressly exempt pregnant women from prosecution for causing injury to their own fetuses (Murphy, 2014). In many cases, prosecutors have used laws written to target for child abuse, child neglect, contributing to the delinquency of a minor, causing the dependency of a child, child endangerment, delivery of drugs to a minor, drug possession, assault with a deadly weapon, manslaughter, and homicide (Paltrow, 1992) despite, in some cases, the aforementioned provisions protecting pregnant women from punishment (Flavin, 2009; Paltrow & Flavin, 2013). In some states, the protection from prosecution is incomplete, e.g. in Arkansas, women are exempt from being prosecuted for the homicide of their own fetuses, but may be prosecuted for battery of their fetuses (Murphy, 2014: 865).
In South Carolina, the ruling in Whitner v. State affirmed the conviction of criminal child neglect for a mother whose newborn tested positive for cocaine metabolites. The South Carolina Supreme Court stated that “the plain meaning of “child” as used in [the child endangerment statute] includes a viable fetus” (Whitner v. State, 1997). The court reaffirmed its stance on the issue in State v. McKnight (2003), when it upheld Regina McKnight’s 2001 conviction for homicide by child abuse after her pregnancy ended in a stillbirth attributed to Knight’s use of crack cocaine. In 2008, the same court unanimously ruled that McKnight did not have a fair trial, recognizing that McKnight’s counsel failed to make use of existing evidence from “recent studies showing that cocaine is no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor” (McKnight v. State, 2008). McKnight was released from prison after serving more than eight years (NAPW, 2008). McKnight’s case is similar to the ongoing case of Rennie Gibbs of Mississippi, who was indicted in 2007 for “depraved heart murder” when she delivered a stillborn daughter whose blood showed traces of a cocaine byproduct. Gibbs was only 16 at the time. Experts who later examined the autopsy reports concluded that the more likely cause of death was umbilical cord compression. Murder charges against Gibbs were dropped in April, 2014, after more than seven years of legal entanglements. Charges were dismissed without prejudice, leaving the possibility for charges to be refiled (Fowler, 2014).

In 2013, Alabama became the second state to explicitly allow pregnant women who use drugs to be charged with criminal child abuse when the Supreme Court of Alabama held that a viable fetus is considered a “child” for the purposes of the state’s criminal statute prohibiting the chemical endangerment of a child (Murphy, 2014: 862). Most recently, in April, 2014, Tennessee became the first state to explicitly criminalize drug use during pregnancy through legislation.

1.2 Statement of the Problem

Drug abuse in Nigeria is growing problem although there is no national data to provide exact figures on the magnitude of this problem, (Possi, 1996:178). Problems associated with drug abuse include among others, significant morbidity and mortality, (Drug Control Commission Report, 2010:2). Globalization and growth of information technology has increased access to amplified drug abuse among pregnant women. In addition, report from Prime Minister’s Office (2005:1) mentioned that Nigerian Government has laid down strategies which will be used to minimize the problem of drug abuse.

The strategies have been categorized into long term and short term. Long term strategies deal with supply which is on strengthening observation/security of its boundaries and arresting drug smugglers, provision of severe punishment to the sellers and provision of health education and treatment for the addicts. Short term strategies lie on doing frequent operations in areas which grow illicit drugs and burning of illicit plants. On looking to the above theories and knowledge, there is a strong need of solving the problem of drug abuse among the pregnant women by going direct to the users that are individuals, groups, communities and society at large, interviewing them and develop theory and knowledge basing from the results of interviews rather than relying on knowledge borrowed from western countries which does not meet local needs of indigenous populations.

Also according to the study which has been carried out at Lagos Municipality and Zanzibar earmarked that pregnant women from age 10 – 19 years uses cigarette, alcohol and sniffing cannabis and the reason for first use is acceptance curiosity enjoyment, health stress relief, hunger fatigue, religious customs and sex boosting. Mdeme, quoted police antidrug unit (2002:34). This study sought to look at pregnant women abusing drugs and come out with the causes, effects and remedial measures which will assist in drugs informing individual, group and community at large so that they can avoid abusing.

1.3 Objectives

Main objective

The main objective of this study was to explore the causes and effects and recommend remedial measures that can help to solve the problem of drug abuse.

Specific Objectives

To identify the causes/factors which make pregnant women abuse drugs in Ikeja. in Lagos, Nigeria.
To find out the impacts of drug abuse among pregnant women in Ikeja.
To recommend remedial measures of drug abuse among the pregnant women in Ikeja.

1.4 Research Questions

These are the issues that the study seeks to answer.

What are the causes of drugs abuse among pregnant women at Ikeja?
What are the effects of drug abuse among pregnant women at Ikeja?
What are the probable remedial measures that can be engaged in controlling and preventing drug abuse among pregnant women?

1.5 Significance of the Study

The study is relevant to pregnant women, parents, social workers, educators, counselors, psychiatrists, policy makers and NGO’s which dealing with drug abuse.

Therefore the significance of this study will be the following: –

The study will contribute to knowledge among various stakeholders, such as Nigeria Drug Commission, Winners National Hospital and other hospitals in Nigeria which are involved in provision of treatment and care of pregnant women affected with drug abuse.
The study will stimulate parents, government and non-governmental organizations working with pregnant women to address the causes that compel pregnant women to misuse drugs.
The study is expected to show the effects of misuse of drugs and thus stimulate awareness of the tragedy generally known to the public.
The study is a requirement for fulfillment of the award of Higher Degree of Masters of Social Work offered by the Open University of Nigeria.

1.6 Limitations of the Study

Some of the target pregnant women are found in dangerous groups and precarious geographic locations. Moreover, the majority of them are petty thieves and dangerous. In order to overcome such adverse situations it is important to cooperate with the local leaders who can provide escort and ascertain security to the researcher.

The pregnant women have their own colloquial languages and terminologies which have to be learnt speedily, in order to cope with them during the interview process. The researcher managed to learn the language used by pregnant women during the pretest. Some common Swahili words such as (“kuyoyoma”) which means the actual taking of drugs; Cannabis (ganja in Swahili), chasing, the actual taking of heroin. Heroin is (sukari guru) in Swahili), (Arosto) denotes withdrawal which means the client is in need of some more heroine to curb the craving and pain, red eyes which means the child has used cannabis. Also the drug abusers have common ideas “Noma Uionewewe” means they do not feel shy, shyness is on the side of the observer, therefore they can do anything they wish to without fear of being arrested and punished.

Due to the fact that most of the pregnant women, are at primary schools at their early ages it was difficult for them to understand the research guiding questions involved in interview process and then took a lot of time to educate and to interview individual pregnant women. The elimination to this was that the researcher explained about the subject matter to the participants prior to the main stream research fieldwork and continued to make the questions clear to the respondents (where) the answers were not
satisfactory.

Chapter Five

Summary, Conclusion and Recommendations

5.1 Summary

The World and Africa in particular are witnessing rapid and wide ranging socialeconomic and political changes which come along with the emergence of large numbers of pregnant women abusing drugs. In Lagos, at Winners clinicif Ward in Ikeja, drug abusers are known by type of drug they abuse; “mlaunga” is a heroine abuser, “mtumia ganja” is cannabis abuser, “chapombe” is an alcoholic. By whatever name they are called, the pregnant women who abuse drugs are ignored, beaten up, killed and misunderstood by the society and government. This is due to their antisocial behaviors such as early sexual practices, stealing, raping, sodomy and the like.

Therefore, identification of the factors associated with drug abuse among the pregnant women at Winners clinicif Ward, Ikeja, Lagos is crucial not only in terms of availing knowledge but also in terms of informing the respondents and the local administration about the causes, effects and remedies of drug abuse basing on findings from their own locality. According to the empirical findings, there is great likelihood of getting pregnant women who abuse drugs from families with the following characteristics as reported by respondents: First characteristic is from families with marital conflicts such as quarrels, separations and divorce. Secondly, parents who are less concerned with their pregnant women weather employed or self employed as they have limited time to socialize their pregnant women. Thirdly, families of the deceased parents where grandparents are taking care of the orphans. Fourthly, families selling alcohol within the borders of their households. Lastly, families with parents who consume alcohol and drugs.

Also drug abuse by pregnant women is influenced by the following; Firstly, peer influence which seventy (70%) of the pregnant women agreed that peer influence accelerates the problem of drug abuse among pregnant women. It was also found that in ghettos, many boys and girls meet and enjoy variety of drugs ranging from mirungi, heroin, cocaine and alcohol. Secondly, learning from parents with the hope that they are good role models while they are not. Thirdly, poverty which incline pregnant women towards early love making, joblessness which result into idling and the consequential (tabula rasa) brain status which accepts any observation, event, style, fashion and group acts.

In addition, according to the empirical findings the side effects of drug abuse among pregnant women are: coughing and chest pains, self denial, societal denial, loss of weight, early pregnancies, prostitution, mental illness, harassment by police force, lack of decision making capability, HIV and AIDS infections, school drop out etc.

Finally, the study revealed that there are remedial measures for drug abuse among pregnant women as follows: Firstly, provision of treatment and rehabilitation to addicts. Secondly, creation of family awareness on the side effects of drug abuse. Thirdly, creation of societal awareness on the side effects of drug abuse and law enforcement for limitation of supply and control of use of drugs.

On looking to the whole findings of this study, drug abuse among pregnant women is a complex phenomenon. It needs teamwork in managing the conditions such as psychologists to deal with psychological problems, social worker to deal with psycho-social intervention, psychiatrist to deal with mental illness, medical practitioner to deal with medical conditions such as HIV, TB, etc and lastly, occupational therapists to deal with restoration of the capacity of doing works and become functional like ordinary child.

5.2. Conclusion

Problem of drug abuse among pregnant women in Nigeria, is one of the major social problems. It affects significant number of pregnant women and therefore intervention is required.. It is within this context that the researcher embark purposefully on the study of “factors associated with drug abuse among the pregnant women in Nigeria”.

Methods used in collecting data were interview, observation and distribution of questionnaires to respondents. Additionally documentary materials, such as books, newspaper, internet, leaflet, journals related to alcohol and drug abuse among pregnant women were reviewed. Data obtained were analysed by using stastical package for social science (SPSS). This package was used because the study was explorative and it draws conclusions, opinions and confirmation from nature.

According to empirical findings, the causes of drug abuse among the pregnant women are evident amaong: Families with marital conflicts such as quarrels separations and divorce, parents who are employed and work until late hours and thus have limited time for socialization of their pregnant women, families of the deceased parents where grand parents are taking care of the orphans, families selling alcohol within the confines of the households families with parents who consume alcohol and drugs etc.

Also respondents mentioned that drug abuse among pregnant women is influenced by the following: Peer influence, blindly copying from drug-abuse-parents with the hope that they are role models, poverty inclining pregnant women towards early love, early pregnancy, and joblessness which result into idling and the consequential (tabula rasa) brain status which accepts any observation, event, style, fashion and group acts. In addition the empirical findings revealed that the effects of drug abuse among pregnant women are: Coughing and chest pains, self denial, societal denial, loss of weight, early pregnancies, prostitution, mental illness, harassment by police force, school drop out, lack of decision making HIV/ AIDS infection etc. Remedial measures for drug abuse among pregnant women as elucidated by the empirical findings are: Social rehabilitation, medical rehabilitation, creation of family awareness on the side effects of drug abuse, creation of societal awareness on the effects of drug abuse law enforcement etc. Therefore, the researcher recommends as shown below.

5.3. Recommendations

Based on the findings a number of recommendations have been made and directed to the different stakeholders as follows:

5.3.1. Recommendations to Pregnant women

Pregnant women should be taught how to select peers.
Pregnant women should be exposed to good manners, ethics, ideals and discipline so that they can get to know what to learn from parents, teachers and other behavior shapers.
Pregnant women should learn how to control their surrounding environments e.g. schools, homes, recreational areas etcas means to prepare themselves for their future expectations.
Pregnant women should be made to understand the dangers of drug abuse such as early love among girls and the associated HIV gynecological risks, and mugging, the possibility of being butchered as is often observed in Lagos etc.
Pregnant women should be busy studying, assisting parents with light duties in order to avoid joblessness which often results into idling that incline pregnant women towards engaging into the readily available means of socialization and social enjoyment.

5.3.3. Recommendations to Government

Knowledge of drug abuse should be included in primary schools curricula.
Primary schools curricula should include good manners, ethics, ideals and discipline
At schools pregnant women should be taught how to keep themselves busy either through sports/games, gardening, fine arts, cooking and the like.
At schools pregnant women should be exposed to the dangers of drug abuse such early love among girls and the associated HIV gynecological risks, mugging and the possibility of being butchered as is often observed in Lagos etc.
At schools pregnant women should be taught how to keep themselves through studying, assisting parents with light duties in order to avoid joblessness which some times results into idling that incline pregnant women towards engaging into the readily available means of socialization and social enjoyment.
The government should strictly enforce the drug laws.
The government should make sure that all the alcohol selling areas are licensed and such areas should be outside the residences.
Government should control production and trafficking of drug as Nigeria has been identified as big agent in drug trafficking and drug abuse
Government should provide more training opportunities for vocational skills to the available VETA schools so as to absorb maximum number of pregnant women who complete their primary education and secure no chances of secondary education.

5.3.4. Recommendation to Hospitals

Hospital workers (nurses, social workers, doctors,) should do outreach education at schools, national annual exhibitions, publications on the evils of drug abuse among pregnant women which can contribute to prevention as prevention is better than cure. The drug addicts while attending medical treatment can be imparted with knowledge and be converted into ambassadors of drug abuse.

5.3.5. Recommendations to Community

Communities should identify drug dependence individuals, and refer them to hospitals for treatment. Pushers and sellers are well known by community members; therefore the community can identify them and send them to court and be charged for possession of illegal drugs. Community through community organization should invite educators and raise awareness about drugs and their effects especially on socially abused substance such as alcohol and nicotine.
Also community members should know the signs and symptoms of pregnant women who abuse drugs and should be able to counsel them or refer them to the appropriate centres for treatment and rehabilitation.

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