Travel and substance abuse
Travel on its own does not cause substance abuse, but it can provide an opportunity to misuse substances. The excitement of travelling and the associated stress can lead to unsafe use of alcohol or drugs. Substance abuse is the excessive use of psychoactive drugs, such as alcohol, pain medications, or illegal drugs leading to physical, social, or emotional harm.
Several factors can predispose you to substance misuse and they can be further highlighted during travels especially when isolated. These factors include existing substance use disorders, moving to a new environment, easy accessibility to substances, changing schools, poor behavior, poor academic performances, peer pressure, social isolation, parent that abuse substances. Other life stressors like divorce, loneliness, loss of a job, the chronic illness also play a significant role. People with prior history of substance abuse are more susceptible to misusing drugs or alcohol while travelling, though it can also happen for people who have no prior history of substance dependence or misuse.
How to know when you are misusing psychoactive substances
When you need more of the substances to feel high, when you hide or lie about how much you are taking, planning your day around the use of substances, taking the risk to get the substance, spending less time on previously enjoyed activities, not paying attention to yourself and hygiene continual use even after the negative consequences of taking it. Presence of withdrawal symptoms like anxiety, sweating, shakiness, tiredness, anger, confusion when substance wears off.
Most people use psychoactive substances due to the benefit they derive from them, either getting pleasure or avoiding pain. However, it can cause harm both in the short and long term.
Long term use of alcohol has been linked to liver cirrhosis, cigarette smoking with chronic lung diseases, opioids with HIV, hepatitis B, and C. Short term consequences are not less weighty as these are the common scenarios seen in travelers. Using mood-altering substances can put you in unwanted or dangerous situations. It increases risk-taking behavior which can lead to unsafe choices such as violence or risky sexual practices. Loss of control, disorientation, psychiatric disassociation, psychosis, or the effects of withdrawal (such as anxiety, agitation, hallucinations, delusion, delirium tremens, seizures, and hyperactivity) can also occur. In an unfamiliar environment, these could result in a medical emergency or arrest.
If you are going to seek a prohibited substance abroad, be aware that the purchase and use of some psychoactive drugs is illegal in the majority of countries and can lead to criminal charges, fines, imprisonment, or the death penalty (i.e. Singapore, Iran, and Saudi Arabia).
In addition, the quality of the product may be different than you may be used to back home. Consuming a drug of unknown quality may lead to unwanted physical or mental effects or cause you to overdose. Make sure you know the risks of accidental overdose, where to get clean injecting equipment, and always practice safe sex. Getting treatment in a foreign country for substance misuse in a foreign country might pose a huge challenge. Lack of familiar support networks, language barriers, and cultural perceptions toward substance use can make it difficult to seek appropriate medical attention.
Recognize that substance misuse is not good for your well-being. Be determined to work with your physician to overcome it. Seek appropriate help to manage the disorder before you travel. Management of substance misuse can last several months to years. It may include addiction counselling psychotherapy, peer support, and medication. Carry your physician along as you plan your trip. Limit exposure to triggers; avoidance of peers or environment that encourage drug misuse. Get adequate support from professionals and loved ones when going through difficult times, instead of taking solace in drugs and alcohol. Recognize the warning signs of substance abuse and/or dependence and know how to get help abroad. Treatment for substance abuse usually involves hospitalization to stabilize symptoms of intoxication or withdrawal, with possible evacuation. Keep in mind that travel health insurance policies do not cover medical expenses related to the misuse of alcohol or the use of illegal drugs. If you require medical attention for substance abuse, visit your doctor once you return home to continue treatment.
Helping a family member or friend
If you are travelling with someone who you suspect is experiencing an overdose or withdrawal, seek medical attention immediately. Remove self-harming objects such as knives, toxic chemicals, alcohol, and other psychoactive substances. Contact the person’s embassy or consulate for emergency assistance. Note that travellers may require legal assistance if they are found to be in possession of illegal substances.
I have substance dependence
You can travel safely if you are actively controlling and treating your substance addiction. Know how unfamiliar environments, language barriers, and difficulty understanding social mores can increase stress levels and trigger the need to use drugs. Recognizing warning signs that may lead to substance use can help you seek support or medical care in a timely manner. Keep in mind that countries restrict the use or import of substances that alleviate withdrawal symptoms, such as methadone or Ibuprenorphine. Check International Narcotics Control Board website: https://www.incb.org/incb/en/travellers/index.html for country restrictions (note that some country information may be missing or incomplete). You can also check your destination’s embassy, consulate, and ministry of health websites for further information.
Adeniyi Bukola, Consultant Family Physician and Travel Medicine Physician
Q –Life Family Clinic
qlifeadvisory@outlook.com.