This definition of drug abuse was given by Dr. R.M. Gakunju during a workshop at the St. Stephen's Cathedral, Jogoo road Nairobi. The one day event was jointly organised by the Office of the National Coordinator, National Agency for the Campaign Against Drug Abuse (NACADA) and the Diocesan Clergy of St Stephen's Cathedral and targeted the entire church clergy, lay leaders, Mothers Union, men's' association and other opinion leaders.

"When God created man, created a very balanced person," he noted as he went on to explain the meaning of several terms which are common when talking about addiction.

Tolerance was developed after repeated administration of a given dose of a substance produces a decreasing effect so that more of it then needed to produce the same effect. As for physical dependence, this occurred after repeated administration of the substance develops physiological processes that lead to change in the body so more needed to maintain these new levels in the body

Dr. Gakunju also explained the addiction behavioural pattern of drug use, is charecterised by overwhelming involvement with the the use of the drug. This in other words was what was termed compulsive use which was coupled with relapse of which there was a high tendency after withdrawal. These then were the terms which were most commonly used when talking about the addiction cycle.

"Why then did people use alcohol and tobacco?" Reasons were various but some of them he listed as

• poverty
• too much money
• boredom
• curiosity
• stress in the home
• family discomfort
• false ideas or perceptions, e.g. they give you more strength
• cultural reasons
• or the media which he emphasized plays a significant role. "60% of the time that children were away from school, they spent watching T.V

Dr. Gakunju noted that alcohol had been used since time immemorial noting that he grew up in Eastlands side of Nairobi and "I don't think there is anything I have not tried," but he did not proceed with use. "And I thank God because many of my friends were lost" to drugs.

The active ingredient in alcohol was ethanol, which Gakunju wryly noted "can be used as a disinfectant, medicine" amongst other uses also as beverage alcohol.

"You start as a social drinker. But the problem is that alcohol causes physiological changes to all parts of the body starting with the brain, which is the control center of the whole body. The brain then atrophy's and the brain is one of the organs of the human body which when the cells die don't rejuvenate"

The heart also underwent major changes. Cells died and one got elevated blood pressure. Turning to the liver, this organ was the most affected by alcohol consumption of any amount. Diseases one could get ranged from fatty liver and the loss of enzymes which were used to process food resulting in bad digestion. It also depresses the appetite as alcohol though high in calories had no nutrients

The kidneys also underwent changes which could not be reversed and could even lead to kidney failure. There was also the danger of high risk behaviours due to altered perception. "You walk into a bar and have two beers and a woman 50 years of age starts to look 20. Time slows down that's why you find people want to stay in the bar longer and longer."

But the effects on the body did not end there. Organic changes in the lungs also occur causing certain kinds of of cancers. Decreased sexual libidos "and I am sure you have seen women in Kenya demonstrating that their men have become useless" not able to perform sexually.

On miraa (khat) Gakunju noted that miraa doesn't bring about physiological changes but pseudo ephenedrines released into the brain creates alertness, though after some time this leads to a state of depression.

In Kenya miraa was originally chewed by one community but now the drug was used by nearly all communities. Miraa which is classified as an amphetamine and was chewed when fresh, because that was when the active ingredient was most effective and one could get hallucinations after chewing. Fatigue was also not felt as a result of chewing miraa but here too, there was the loss of libido. This was in spite of the fact that production of sperm was increased. "So many men even found themselves using pads, as the sperm was so much, it just dripped from the penis. Homes have been affected because of this condition known as spermatorhea".

Other side effects of miraa chewing were moth ulcers which were quite common among consumers and "in this age of HIV/AIDS any form of ulcers were dangerous. Add to this list inflammation of the esophagus or gullet and stomach leading to certain forms of cancer. Pseudo ephedrines also raised the individuals metabolism and lead to psychological dependence such that the person could chew miraa the whole day with only a bottle of soda. There were several further consequences of chewing miraa. These were one does:

• not want to work
• not want to think of their family's
• spend a lot of their money on miraa
• become withdrawn from peer groups

Dr. Gakunju also sensitised the audience on the dangers of inhalants of which he said the main ones abused in Kenya are

• glue
• gasoline
• kerosene
• paint thinners
• aerosols
• dry cleaning substances

Further compounding the problem as far as inhalants go is the fact that they are cheap and readily available as well as not needing to be an adult to purchase. As a result of this the hardest hit were the street families, yet these substances are lethal as they destroy brain tissue directly

Some of these kids you have seen with running eyes and dripping noses which they can't control. He warned that inhalants also had a very high level of addiction.

Dr. Gakunju concluded with the disturbing observation that though miraa might not be as highly used as alcohol, it's use among the youth was was rising. At the same time "people think miraa is an aphrodisiac yet in fact the opposite was true."