MHM Magazine

34 | MENTALHEALTHMATTERS | Issue 4 | 2021 MHM posed by the pandemic. For some smoking cigarettes was the default option as they came off harder drugs. The risk of relapse was a problem during the ban on the sale of cigarettes. Many resorted to smoking illicit cigarettes or consuming dangerous home brews. Those who could afford it paid exorbitant prices for contraband liquor. The pandemic unearthed conspiracy theories, a range of WhatsApp epidemiology experts, ignorant vaccine naysayers, and a flood of thieves who plundered the fiscus with inflated PPE and other tenders. There’s also been the recent resignation of the Minister of Health against a background of alleged corruption. The lockdown has affected people differently, and the poor and vulnerable suffered more. Many are stuck in inhospitable conditions. Not everybody has DSTV, Netflix, books, a pool and a garden. A privileged few have mobile devices and data to make virtual contact with their psychologists and psychiatrists or hold Skype or Zoom parties with family and friends. GLOOM These are uncertain times for many. People have lost jobs or not been paid; the future is unknown. Widespread economic hardship and food insecurity looms. The state has failed to deliver adequate and appropriate financial assistance to those in need. The psychological impact of the pandemic has drawn much attention. A meta-analysis in the Lancet showed that 28% suffered some form of ‘trauma related mental health related disorder.’ They presented with irritability, depression, and post-traumatic stress symptoms. The associated risks were avoidance behaviour, alcohol abuse, absenteeism, and loss of productivity. HOPE As we meander through the throes of a third wave difficult times lie ahead. The pandemic has left indelible scars. It’s important that mental health professionals equip patients with tools to cope in this different world. Treatment must be holistic – a combination of medication, if warranted, and psychosocial treatments. Meditation, mindfulness, exercise, hobbies, a proper diet, and good sleep hygiene should be promoted. Patients should be encouraged to remain productive and utilise the host of online resources that exist. Medication is used at various phases in the treatment of addiction – detoxification, initiation of abstinence, relapse prevention, and withdrawal. Medication is also used to treat substance-induced conditions like psychosis, agitation and depression. There are specific drugs for the treatment of some substances of abuse. These include, amongst others, disulfiram and acamprosate for alcohol, bupropion and varenicline for nicotine, and methadone and buprenorphine for the treatment of opioid use disorder. Many of these drugs are not easily available to the majority of the population because of cost considerations. The search for accessible, affordable medication for the treatment of addiction continues. The pandemic has caused us to pause and reflect. It has taught us how fragile our existence is and forced us to prioritise and refocus. We have learnt to appreciate one another and our environment. If this helps create tolerance, understanding, respect and a culture of human rights something positive would have emerged from the gloom of the last 18 months. References available upon request