WAEC Health Education & JAMB Biology — Drug Abuse Topics

The Four Terms Examiners Test

• Drug use — taking a drug for its intended medical purpose, at the correct dose, as prescribed or recommended.
• Drug misuse — taking a drug for a purpose other than intended, or in a way not recommended (e.g. taking someone else's prescription, or using more than the prescribed dose).
• Drug abuse — the deliberate, repeated use of a drug for its psychological or physical effects rather than for a medical reason, despite the harm it causes.
• Drug dependence — a state in which the body and/or mind has adapted to a drug, so that stopping it causes withdrawal symptoms. Dependence can be physical, psychological, or both.

Drug Tolerance & Withdrawal

Tolerance is when the body needs increasingly larger doses of a drug to achieve the same effect, because it has adapted to the substance. Withdrawal is the set of physical and psychological symptoms — which can include anxiety, tremors, sweating, and in severe cases seizures — that occur when a dependent person stops or reduces use.

Why the Distinction Matters

Understanding these terms is not just an exam requirement — it is the foundation of every other topic in this module. A person can misuse a drug once without becoming dependent; dependence develops through repeated abuse over time. Recognising the early stage (misuse) is what makes prevention possible before dependence sets in.

The Five Routes

• Oral — swallowed by mouth (tablets, capsules, syrups such as codeine cough syrup). The slowest route, as the drug must pass through the digestive system first.
• Injection — introduced directly into the bloodstream, muscle, or under the skin using a needle. The fastest route, and the highest-risk for infections such as HIV and Hepatitis when needles are shared.
• Inhalation — breathed in through the nose or mouth as smoke, vapour, or fumes (e.g. smoking, sniffing glue or petrol). Reaches the brain almost as fast as injection because the lungs absorb it directly into the bloodstream.
• Topical — applied to and absorbed through the skin (creams, patches). Some skin-lightening creams misuse this route to deliver steroids and other drugs.
• Anal (rectal) — inserted into the rectum, used for some medical suppositories but also a route of abuse for certain drugs, bypassing the stomach.

Speed of Absorption — Fastest to Slowest

Injection (into a vein) → Inhalation → Anal → Oral → Topical. The faster a drug reaches the brain, the more intense the effect — and generally, the higher the risk of abuse and dependence.

Cannabis (Marijuana)

Nigeria's most seized illicit drug — accounting for over 60% of all NDLEA seizures in Southeast Nigeria. Classified as a hallucinogen/depressant with stimulant effects at some doses.

Tramadol (Abused)

A prescription painkiller widely misused as a stimulant. "Super Tramadol" (225mg) is the fastest-rising drug of abuse among Nigerian youth aged 15–35 — NDLEA recorded a 300% increase in seizures between 2019 and 2023.

Crystal Meth (Mkpuru Mmiri)

A synthetic stimulant that NDLEA recorded a 200%+ increase in seizures of, in Southeast Nigeria between 2019 and 2023 — with Imo State identified as a primary distribution hub. Known locally by the street name "Mkpuru Mmiri."

Codeine / Lean

An opioid cough-suppressant. Before NAFDAC's 2018 ban on open sale, an estimated 3 million bottles of codeine-based cough syrup were consumed daily in Nigeria — the majority purchased without prescription.

Alcohol & Tobacco — the Legal Drugs

An estimated 13% of Nigerian adults meet the criteria for Alcohol Use Disorder. Tobacco kills approximately 28,000 Nigerians annually from smoking-related disease — more than all illicit drug deaths combined. Both are legal, both are drugs, and both appear in WAEC's syllabus alongside illicit substances.

Want the full picture on any of these? ALTDAP's Drug Information library has complete, evidence-based profiles on all nine substances covered on this platform.

Reasons People Drink

• Peer pressure and the desire to fit in socially
• Stress relief and escape from personal problems
• Cultural and social acceptance at ceremonies and gatherings
• Availability and affordability of local spirits (e.g. ogogoro, kai kai)
• Curiosity, especially among adolescents

Effects of Alcoholism

• Physical — liver damage (cirrhosis), high blood pressure, weakened immune system, birth defects if consumed during pregnancy.
• Psychological — depression, impaired judgement, dependence, memory problems.
• Social — domestic violence, road traffic accidents, absenteeism from school or work, family breakdown, poverty.

Methods of Controlling Drinking

1. 1Public health education on the risks of alcohol abuse.
2. 2Legal restriction of the sale of alcohol to minors, and enforcement of existing age limits.
3. 3Taxation and pricing policy to reduce affordability of harmful local spirits.
4. 4Counselling and rehabilitation services for people already dependent.
5. 5Strong family and community support systems that reduce the stress factors that lead to drinking.

Reasons People Smoke

• Peer influence, especially in adolescence
• Advertising and media portrayal (historically a major driver, now heavily restricted)
• Stress relief and the perceived calming effect of nicotine
• Nicotine dependence, once smoking has already started
• Imitation of parents, older siblings, or role models who smoke

Health Effects of Smoking

Lung cancer and other respiratory diseases, heart disease, reduced lung capacity, harm to people nearby through secondhand smoke, and complications during pregnancy for smokers who are expectant mothers.

Methods of Controlling Smoking

1. 1Health warnings on cigarette packaging and restrictions on tobacco advertising.
2. 2Banning smoking in public places to protect non-smokers from secondhand smoke.
3. 3Taxation of tobacco products to reduce affordability, especially among young people.
4. 4School-based health education programmes that reach students before they start.
5. 5Nicotine replacement therapy and counselling support for people trying to quit.

What Is Self-Medication?

Self-medication is the use of drugs to treat self-diagnosed symptoms, without consulting a qualified health professional. In Nigeria, it is extremely common — driven by the cost of healthcare, the ease of buying prescription-only drugs over the counter, and limited access to clinics in rural areas.

Risks of Self-Medication

• Wrong diagnosis — treating the wrong illness because symptoms were self-interpreted, not professionally assessed.
• Incorrect dosage — taking too much or too little, reducing effectiveness or causing harm.
• Drug interactions — combining drugs that react dangerously with each other.
• Masking serious illness — relieving a symptom while an underlying condition goes untreated and worsens.
• Path to dependence — repeated self-medication with drugs like codeine or tramadol is one of the most common routes into drug abuse in Nigeria.

What Is Rehabilitation?

Rehabilitation is the structured process of helping a dependent person stop drug use and rebuild a healthy, functional life. It typically involves detoxification (safely managing withdrawal), counselling, and long-term support to prevent relapse.

Stages of Rehabilitation

1. 1Detoxification — safely clearing the drug from the body under medical supervision.
2. 2Counselling & therapy — addressing the psychological causes of dependence.
3. 3Rehabilitation programme — structured daily routine, skills-building, and peer support.
4. 4Aftercare & relapse prevention — ongoing support once the person returns to normal life.

Methods of Preventing Drug Abuse

• Public health education in schools and communities
• Strict regulation and enforcement against the illegal drug trade
• Access to counselling and mental health support before dependence develops
• Strong family involvement and positive role models
• Providing young people with genuine alternatives — skills, opportunities, and purpose