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Addiction is a psychiatric disorder (Part 1)

Dr Boima

HEALTH ISSUES

 

We all have a certain behavior that we by all means try to conceal from the rest of the world. Perhaps something a bit unusual, more than just a habit or not socially acceptable. 

You might be having an addiction. Most of us know that addiction is a serious problem but the questions we tend to always ask ourselves are; ‘’how do I know it’s an addiction?’, ‘how is it different from experimentation, misbehaving or bad habits?’, ‘is there any help out there and how successful is the treatment?’’. This article will try to resolve the mystery and controversy surrounding addiction and hopefully help you make informed decisions about what to do when faced with what looks like an addiction.

According to the definition given by American Society of Addiction Medicine (ASAM), ‘addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with ones behaviors and interpersonal relationships, and a dysfunctional emotional response. 

Like other chronic illnesses, addiction often involves cycles of relapse and remission. Without proper diagnosis and medical management, addiction becomes progressive and can result in disability or premature death.

Addictive disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the latest version of the American Psychiatric Association's (APA) classification and diagnostic tool.

Substance Addiction

This includes substances that are taken into the body, both legal and illegal. The DSM-5 recognizes substance related disorders resulting from the use of ten separate classes of drugs:

Alcohol , Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives, Hypnotics, Anxiolytics, Stimulants (including amphetamine-type substances, cocaine, and other stimulants), tobacco, and other or unknown substances. 

Substance use disorders span a wide variety of problems arising from substance use, and cover eleven different criteria:

Taking the substance in larger amounts or for longer than the you meant to

Wanting to cut down or stop using the substance but not managing to

Spending a lot of time getting, using, or recovering from use of the substance

Cravings and urges to use the substance

Not managing to do what you should at work, home or school, because of substance use

Continuing to use, even when it causes problems in relationships

Giving up important social, occupational or recreational activities because of substance use

Using substances again and again, even when it puts the you in danger

Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance

Needing more of the substance to get the effect you want (tolerance)

Development of withdrawal symptoms, which can be relieved by taking more of the substance

Behavioral addictions
Two examples of behavioral addictions are discussed below.

Gambling – Various surveys have determined that around two million people in the U.S are addicted to gambling, and for as many as 20 million citizens the habit seriously interferes with work and social life. DSM – 5 defines gambling addiction as; Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

Needs to gamble with increasing amounts of money in order to achieve the desired excitement

Is restless or irritable when attempting to cut down or stop gambling

Has made repeated unsuccessful efforts to control, cut back, or stop gambling

Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble)

Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed)

After losing money gambling, often returns another day to get even (“chasing” one’s losses)

Lies to conceal the extent of involvement with gambling

Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling

Relies on others to provide money to relieve desperate financial situations caused by gambling

The gambling behavior is not better explained by a manic episode

Sex addiction – the DSM- 5 proposed diagnostic criteria for hypersexual disorder is as follows;

Over a period of 6 months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following;

Time consumed by sexual fantasies, urges or behaviors repetitively interfering with other important (non-sexual) goals, activities and obligations

Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g. boredom, anxiety, irritability, depression)

Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events

Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors

Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.

For questions or comments email agboima@yahoo.com

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WeekendLife

YAMAS 2020 Go Virtual

14th September 2020
YAMAS 2020

After announcing the postponement in March, the 6th edition of Yarona FM Music Awards (YAMAS) have bounced back and will be held virtually via Now Channel on DSTV Channel 290 and on the Yarona FM Facebook page on September 26 at 20h00.

This is one of the first virtual music awards to be held in Botswana.The 2020 edition of the YAMAS was originally slated to be held at the University of Botswana (UB) Campus Indoor Sport Centre early this year, but plans for an indoor ceremony were thrown for a loop by the coronavirus pandemic.

“There will be no public attendance at this year’s event, it will be produced for broadcast on TV and digital platforms. The event will take place in an extended reality studio which will comprise of the hosts only. The show must go on and we still have to award artist for their splendid job” said Yarona FM Station Manager Kelly Ramputswa.

Furthermore, Ramputswa stated that nothing much has changed apart from the awards ceremony going virtual, the voting lines for nominees remain the same. The voting lines opened on Tuesday 8th September and will close on 23rd September at midnight.Yarona FM has partnered with the Ministry of Youth Empowerment, Sport and Culture Development (MYSC) and First National Bank Botswana (FNBB) who contributed money to ensure that winners go home with cash prizes ranging from P10 000 and P15 000.

“We recognize the hardship that has befallen the creative industry due to the COVID-19 pandemic. Botswana’s creative sector remains resilient and Yarona FM, as a crucial player remains committed to contributing meaningfully to develop the sector.

The partnership to bring the YAMAS at this time, with cash winnings for musicians and other creatives involved in the show is demonstration that we are all in this together,” said the Yarona FM Station Manager.The effort of gifting artists with money is a big boost since most of them did not manage to source income from live performances due to COVID- 19 protocols that led to suspension of many events.

The 6th edition of the YAMAS will be hosted by Yarona FM presenters Loungo Andre Pitse and Kedi Molosiwa. There will be performances from artists such as ATI, Mophato Dance Theater, Girly and FME DJs.

 

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WeekendLife

Promoters demand re-opening of their sector

14th September 2020
Franco

The entertainment industry remains the hardest hit by the Covid-19 pandemic and some creatives cannot take the strain anymore.

Other sectors seem to be gradually re-opening and learning to live with the pandemic, the creative industry on the other hand is still closed with no hope for it opening any time soon. Government has seemingly turned a blind eye to the drowning industry.

Meanwhile other countries are coming up with strategic plans on how best their entertainment industries can be re-opened and how people can live with the pandemic without putting each other at risk. Promoters Association gathered to air out their concerns and lament on how much the government has side-lined them.

Government is still delaying to pay subsidies to the creatives. The Ministry of Youth currently claims to have paid a total sum of P19 404 180 to 340 youth businesses and 9090 creatives. The ministry further stated that they have 15 640 who were assessed and vetted and 12 391 were approved.

A further P 4 054 820 is yet to be paid during the ongoing payment process. However, the Botswana Entertainment Promoters Association (BEPA), are demanding that the ministry provides them proof of payment for those who were credited, instead of releasing statistics.

“We have contributed to the best of our ability even though other promoters were not paid. As for now that P7500 is not as important because people have life problems and commitments and they got tired of waiting for the money. We tried were we could as BEPA with MYSC,” said Gilbert Seagile, President of BEPA.

Some promoters however found themselves drowning during the pandemic with no life raft as life issues pile up without any source of income. “We had cases of depression. They came to our offices. We had cases were other promoters almost committed suicide due to lack of income,’’ said Seagile.

Promoters Association wishes to work on their own without relying on the government. They had however crafted a project dubbed ‘Project Tselapedi’, wherein they seek P20 million to fund annual events. The funds are to be disbursed pending on how much each project is worth. This in an effort to help the ministry and to relief problems.

“We believe the project can be financed because even today we do not know when the sector will be opened. We have solutions but we are never called when decisions are made. We are three months away from December without hosting any event. They keep postponing meetings every week. Our industry is dying and it is dying in their hands,” said Promoter Exotic.
“All sectors were met, the transport sector has been fully opened yet they are not adhering to Covid-19 protocols.

Which means we can also host events whilst adhering to covid-19 protocols. The creative industry contribute highly to the GDP. We are not happy and we are going to do everything. We are being colonized by the liquor Act. These two are different. This issue puts us at a disadvantage. The liquor Act has nothing to do with us,” said Seagile.

Former President of BEPA, Zenzel Hirschfield, has sternly lashed out at the government for side-lining promoters and denying them the one thing that buttered their bread.“We are tired of going to the offices without anything coming forth. We also have the expertise to sit down and advice. The reason why they are doing what they are doing is because they are feeling the heat like us. We are not going to remain silent.

We will not listen and sit down. We will continue to speak. And we need to speak to the relevant people which is our President. We are dying of hunger. We don’t trade with alcohol we trade with the arts,” she lamented.

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WeekendLife

Is Polygamy Ideal?

14th September 2020
Polygamy

POLYGAMIST: South African businessman Musa Mseleku and his four wives.

No one can be blamed for thinking that women have been failed in this country. The 2020 World Population Reviews has placed Botswana as the second out of 10 countries after neighbouring South Africa with the highest rape cases in the world.

According to World Population Review, Botswana has 92.9 percent incidents per 100,000 people. The statistics are spine chilling and would prompt any country to act fast and put measures in place to reduce the numbers and keep save the most vulnerable; women and children.

In view of this ignominy, policy-makers would respond by putting in necessary legislations to address the crisis. However, it turns out such a belief is only presumptions. Even female MPs have not proved indifferent to the pleas of those who are at the receiving end, a disappointing gesture on their part.

Recently, Member of Parliament for Mahalapye East, Yandani Boko tabled a motion in parliament on urgent basis in which he requested President Mokgweetsi Masisi to set-up a Commission of Inquiry on GBV and other sexual offenses.The motion was infamously opposed by Anna Mokgethi, the minister responsible for gender affairs, disputing its urgency.

Incidentally, not long ago, Mokgethi went on record and sought help from President Masisi, seeking protection from her husband, citing that she fears for her life.Despite refusing to support the motion when it was tabled later, Mokgethi has been taking part in campaigns against GBV on social media.

If that was not enough, this week another female MP took it to another level. Beauty Manake, a Specially Elected MP is of the firm belief that polygamy can be a solution to GBV. It begs the question; how does having many wives solve GBV? If anything it may very well lead to a spike in the number of cases.

These remarks have left many women very much disenchanted on the idea, arguing that they are misrepresented and disappointed that the remarks were made by another woman.WeekendLife has taken it to the relevant people to find whether polygamy is really what we need to curb Gender Based Violence.

“Such a law disadvantages women as they are seldom involved in the decision to invite another women into their marriage. It is of course, highly discriminatory and should not be entertained. It will not work especially given the many social ills that lead to Gender Based Violence. Many domestic disputes are centered around adultery.

Legalising polygamy would lead to a conflict in homes and of laws in which an aggrieved spouse can sue for adultery, but the law in question would allow men to court other women during marriage,” Precious Gondwe, President of Pan African Game Changers and the founding Partner of Precious & Partner Law Firm.

“How will the rights of the first wife be protected? People are already killing each other as they cannot handle sharing their spouse. Couples fight about the presence of a third party in their marriage. Therefore officialising something that is not right, won’t make it morally right. It will only continue to repress women further and breakdown the family.

Once the family is broken then the very essence of society will be broken.””Legalising such a social ill would not make it morally correct. What does that mean to us as Batswana with the high rate of HIV and other social ills? This does not cure any of the social ills related to GBV. It is retrogressive in nature would be a proponent of GBV.

Surely in 2020 that is unacceptable. You cannot solve this by bringing in another predicament. As a woman and a Batswana, I am deeply concerned as to why that issue should be raised. We are adding more injury to the wound. I vehemently disagree with what the minister raised. We can’t legalize a problem!”

Polygamy in an era faced with Covid-19 and the repercussions of it is tantamount to economic suicide. Women no longer submit to men as easily, they understand the importance of independence and building legacies and protecting their wellbeing and that of their children. They understand that their lives are not centred around a man.

Social Activist Gaontebale Omphemetse Mmolai strongly believes polygamy will only regress women.“I am against polygamy because looking at the things we normally complain about, be it finances, children’s welfare, family relations and all, I believe that if we legalise polygamy in Botswana it will be a way of advocating for an increase in women’s problems.

Men will be given more power to oppress and abuse women in all different ways,” she said.“So imagine if you are stuck in that kind of a relationship or a marriage. Then both of you are being abused and the situation is worsened. So legalizing polygamy is a way of making an excuse for men. It will never be an alternative to solve GBV issues in our country. I am against the idea.”

The church however believes that in as much as there was polygamy in the Bible, God was clear that a man shall leave his family to be joined to his wife and not wives. They are of the belief that, there is no room for polygamy in the body of Christ and hence people should be inspired by the truth of God regarding marriage.

“The fact that there was polygamy in the bible does not mean that God approved of the practice. When we come under the new dispensation, we are under the New Testament. In 1Timothy 3 v 2 & 12, Titus 1 v 16, which explains that good leadership comes with a man having only one wife. In this portion of scripture, it was referred to church leaders and pastors,” Boago Ramogapi, Royal Assembly Ministries Pastor highlighted to WeekendLife.

“The reason why it was so, it was because they were the example of the Godly life. So that what we see in them becomes an example of what we are supposed to have in our personal lives. A man with one wife meant the congregation of the society must also follow an example of being joined to one wife. We are of the belief that one man one wife.”

As GBV persists, he has admitted that it has even entered church doors and that they are affected as much. Many people within church indoors are victims of rape and violence. “When it comes to GBV and polygamy being used to curb GBV I don’t think it will work. We just need behavioural change. The stance is that we need to permeate all the spheres so that men can rise to the occasion. And much more importantly I wish to see more men standing against it,” he said.

“We need to rise up to the occasion because GBV have also permeated church walls, because church members are sometimes abused sexually in the church. We need to reach out to men, we have done well with the girl child. It is now time to empower the boy child.”

 

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