The World Health Organization has warned that many young Africans are turning to substance abuse. The UN predicts that by 2030 the number of drug users in Africa will have increased substantially.
An increasing number of drug users are injecting substances, but needles and syringes can transmit viruses Image: MUJAHID SAFODIEN/AFP
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A bizarre sight welcomes anybody who enters the home of Asia Bianca and her husband in the Kenyan coastal town of Malindi. An infant's slippers, strewn with cigarette waste and drug paraphernalia. This is no ordinary home.
The slippers belonged to their little daughter, who died six months after she was born.
"When we went to bed, she was fine. Then when I woke up, she was foaming at the mouth. So I got scared and hoped when I was high on heroin that I hadn't placed my hand or leg on her, causing her to suffocate," a visibly downcast Bianca tells DW.
Despite doctors ruling out her fears, Bianca still carries the guilt of her daughter's death. The 20-year-old and her husband are some of the 3,000 active injecting drug users in Malindi.
She says she was introduced to the habit by her ex-boyfriend, who used to lace her cigarettes with heroin secretly.
By the time she realized what was happening, she was already hooked.
What is drug and substance abuse?
The World Health Organization (WHO) describes substance abuse as the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.
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It says that illicit drug use has adverse health and social consequences because it puts a heavy financial burden on users, their families and society.
"The government has forgotten us. We are left homeless, sick at home, or sick in the streets, so we have no choice but to support each other," Yassir Abdallah, a recovering addict in Malindi, told DW.
Cannabis: Open to cultural interpretation
Opponents demonize it while supporters praise it as a universal remedy: for decades, myths and tales have surrounded cannabis like no other plant.
Image: Mukhtar Khan/AP Photo/picture alliance
Mythical plant
This is the hemp plant of legend. Intoxicating cannabis can be obtained from certain varieties, so its cultivation is strictly regulated in Germany. Unlike 200 years ago, hemp plants in the country are completely out of the public eye, paving the way for myths generated from the camps of supporters and opponents alike.
Image: Christian Charisius/dpa/picture alliance
French troops brought home hashish
The use of hemp as an intoxicant has a comparatively recent history in Europe. French soldiers, who took home hashish made from the resin of female cannabis plants from Napoleon's Egyptian campaign in 1798, played a key role in spreading it. While Napoleon banned hashish in Egypt, it became popular in Paris.
Image: Christian Böhmer/dpa/picture alliance
Prescribed for menstrual cramps
Since the 1990s, the UK has been discussing the legalization of cannabis. There was a rumor at the time that Queen Victoria was prescribed cannabis for menstrual cramps. The only evidence: in 1890, her personal physician John Russel Reynolds noted in a medical journal the "great value" of cannabis in treating an array of conditions.
Image: dpa
Parchment or hemp?
Urban legend has it that the American Declaration of Independence was written on paper made from hemp. That's not quite true: the document, vacuum-sealed and behind thick panes of glass at the National Archives in Washington, DC, was written on parchment paper. The first two drafts, on the other hand, were probably written on hemp paper.
Image: Rauchwetter/dpa/picture alliance
Reefer Madness
"Reefer Madness," originally financed by a church group under the title "Tell Your Childen," was a 1936 US propaganda movie that depicted young people as immediately addicted, violent and crazy after consuming cannabis. With its almost comical exaggerations and misconceptions, the film is a historical testimony to the fear-mongering of that era.
Image: Richard Vogel/AP Images/picture alliance
Racist undertones
Back then, Harry Anslinger, the racist head of the US Drug Enforcement Administration, had been fighting for prohibition since the 1930s. Allegedly, Mexicans and African Americans in particular consumed cannabis, but Anslinger wasn't concerned about their health. Weed makes Black people think they're as good as white people, he once said. For over 30 years, he set the tone of US drug policies.
Image: Mary Evans Picture Library/picture alliance
Religious devotion
Other cultures are perhaps more open about the intoxicating effects of cannabis. Sacred texts about the Hindu deity Shiva state that he renounced all life's pleasures — except cannabis. Contrary to often repeated claims, cannabis use can very well be addictive.
Image: Mukhtar Khan/AP Photo/picture alliance
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The UN estimates that by 2030, the number of drug users in Africa will have increased by 40%.
Across the continent, drug addicts often face discrimination and a lack of support, making it difficult for them to regain their lives even if they stop using.
"Such persons need treatment and critical attention," said Richard Opare, a former addict who is now a drug addiction management professional in Ghana's capital, Accra.
"When they walk into the [rehabilitation] centers, many of the drug addicts are not ready," he said.
He explained that there was a screening system to determine which drug(s) an addict had used. Afterwards, therapists conducted an assessment to ascertain the severity of the problem. He said that drug addicts were given medical attention through the detox stage to ensure that they got better.
Sharing needles when injecting drugs is linked to contracting HIV and HepatitisImage: diego.cervo/Panthermedia/IMAGO
Heroin and cocaine on the beach
Best known for its white sandy beaches and Italian tourists, Malindi is home to one of the biggest group of heroin addicts in Kenya.
Like most coastal towns in the East African country, it is used by international traffickers as a transit point for drugs transported from Afghanistan to the West.
According to the UN drugs agency (UNODC), the most often used illicit drug on the continent is currently cannabis. The second most frequently used class of drugs are amphetamine-type stimulants (ATS), which include "ecstasy" and methamphetamine.
However, more and more drug users are beginning to inject substances, though the practice is deemed particularly risky as sharing contaminated needles and syringes can transmit viruses such as HIV and Hepatitis B, and C.
In West Africa, Guinea-Bissau is also an important hub for drug trafficking — especially for cocaine. It began its transformation into a narco-state in 2005, when former president Joao Bernardo "Nino" Vieira — who had ruled the country with an iron fist from 1980 to 1999 — was reelected after returning from six years of exile in Portugal.
"The drug lords feel right at home in Guinea-Bissau, like they are in paradise," Calvario Ahukharie, the former head of Interpol in Guinea-Bissau, told DW.
COVID and substance abuse
Experts say that the COVID-19 pandemic, unemployment, the high cost of living and a lack of prospects have created "a perfect storm" for substance abuse on the entire continent.
"When schools closed [during the lockdown], the number of young drug users shot up," said Alphonse Maina, a volunteer with the Omari Project, a community-based rehabilitation center in Malindi.
"In Malindi, if you are not taking heroin, you are taking khat, smoking marijuana or cigarettes."
He and other experts say that people should treat drug abuse as a medical condition, not a crime. They say that it's critical to combat stigma and provide those who request it with free rehabilitation and medical care.
"If you're arrested with a small portion of heroin or cocaine for personal use, you go in for 15 years," Wamala Twaibu of the Uganda Harm Reduction Network said. His initiative has been criticized for offering legal support to those arrested for injecting drugs such as heroin.
"The law is not fair. And what is happening is that law enforcement is using the law to extort. To get money from these communities, already disadvantaged communities."
At the moment, the only support for Asia Bianca is her husband — who is himself an addict.
Eunice Wanjiru, Antonio Cascais and Michael Oti contributed to this article
Edited by Keith Walker
On the front line of the opioid epidemic in the US
Cheryl, a 71-year-old woman from Phoenix, has adopted her 3-year-old great-grandniece Jessie, who was an addict before she was even born, suffering from drug withdrawal symptoms at birth. Eline van Nes reports.
Image: Reuters/B. Snyder
Going out for the day
While Jessie sits in her car seat, Cheryl takes out the baby stroller to be able to push Jessie around through the shopping mall. Cheryl doesn't take Jessie to the mall often because it's tiring to go on these trips. She prefers staying at home, or they go to the nearby playground. They often visit Jessie's biological sister who lives two doors down.
Image: DW/E. Van Nes
Catching her breath
Raising a 3-year-old as a 71-year-old is a lot to ask for. The number of grandparents taking care of their grandchildren in the US because their parents are addicted to drugs, specifically opioids, is increasing. According to recent studies, around 12 percent of children in Arizona live with relatives, almost 9 percent of those live with their grandparents.
Image: DW/E. Van Nes
Sitting on a bunch of admin
On July 9, the Supporting Grandparents Raising Grandchildren Act was signed into law. It's designed for grandparents who need information and assistance on issues in dealing with legal custody, available social services, and mental health counseling. One problem, however, is that relatives who take care of a child don't get the same amount of financial support that foster care families do.
Image: DW/E. Van Nes
A little joy goes a long way
Jessie was apprehensive about riding the merry-go-round for the first time. When Cheryl was buying the tickets, the vendor asked about Jessie. Cheryl said that Jessie was her own daughter. She thinks Jessie's biological mother is still alive, but doesn't know where she is or if she's in rehab. "The last time she was seen was in the fall of last year. Rumor has it that she was in Mesa."
Image: DW/E. Van Nes
Finding a way to make it work
Cheryl knows that because of her age she probably won't be around when Jessie grows up. She has some physical problems and Jessie does wear her out, but she doesn't see a problem there. She believes it's important Jessie is around family and not in the care of strangers. Her son will take care of Jessie after Cheryl's gone.
Image: DW/E. Van Nes
Sunday school
Every Sunday, Cheryl and Jessie go to a Presbyterian church. Jessie is too young to attend the sermon so she goes to Sunday school. After the sermon, Cheryl and Jessie join other families for snacks in a large auditorium. The church has always been supportive of Cheryl. She has lost three husbands and a son due to a drug overdose. Cheryl believes taking care of Jessie is her last calling.
Image: DW/E. Van Nes
Pushing Mommy around
Cheryl has permanent damage to her back and also suffers from arthritis in her hands and sciatica in both legs. She wears a back brace to help relieve the pain. To be able to cope with the pain, she takes painkillers and other medicines. She can't do without — especially with a young toddler pushing her around.
Image: DW/E. Van Nes
It's my party
It's Jessie's third birthday. Only a few guests have been invited, so that it doesn't get too busy for Jessie. Jessie's mother had two other children: Jessie's older sister, who's in the care of Cheryl's brother and his wife. But they couldn't handle more than that. Jessie's little brother has been adopted by a foster family.
Image: DW/E. Van Nes
Taking it easy
Just before Jessie's mother went into labor, she had another hit of methamphetamine. After Jessie was born she was crying and screaming and twitching — typical withdrawal signs. Since then, Jessie has had to cope with a raft of health problems as a result of the drug abuse during pregnancy. Doctors are still monitoring her to see if there is any permanent damage.
