Demographic Mapping of Multiple Psychoactive Substance Abusers in a Federal Neuropsychiatric Hospital in Nigeria

Abstract

Background: Adopting strategies to curb the menace of substance abuse in any given locality would require clear and detailed population based understanding of the patterns of abuse so as to guide comprehensive preventive and control measures. Objectives: The objectives of the study are to survey the various substances abused and their patterns of abuses through the demographic characteristics of abusers. Methods: The prospective study surveys the pattern of abuse of several psychoactive substances that have caused hospitalization and/or hospital visits. The demographic characteristics of patients and how they relate to the pattern of abuses were demonstrated. Results: The distribution for most agents rises between the second and the third decades of life before declining. Agents like cannabis, tramadol, rohypnol, diazepam, benzhexol, codeine, suck and die were abused in the proportion of 68(54.4%), 75(55.6%), 9(64.3%), 33(58.9%), 24 (66.7%), 10 (66.7%) and 13(61.9%) respectively by those in their third decades of life. The age dependent declines in the proportion of abusers of agents like cannabis, tramadol, rohypnol, diazepam, benzhexol, codeine, suck and die after 30 years were significantly correlated (P<0.05). The occupational distribution showed that the quartet of nicotine, tramadol, cannabis and diazepam were abused across all occupational lines but alcohol was the main substance abused by civil servants. Both stimulants and depressants are co-abused by students, farmers, and artisans. Out of 551 cumulative substances abused, the educational distribution are primary 42(7.6%), secondary 179(32.5%), tertiary 123(22.3%), informal education 179(32.5%), adult education 4(0.7%) and uneducated 24(4.4%). The influence of education on the pattern of abuse was only demonstrated with nicotine and alcohol which recorded a progressive increase as one moves from primary to tertiary levels of education. However, abusers with secondary level of education recorded the highest cases with nitrazepam, diazepam, benzehexol, and caffeine while alcohol, rohypnol and codeine are higher in abusers with tertiary level of education compared to abusers with other educational levels. The distributions for single, married and the divorced are 396(71.9%), 148 (26.9%) and 7(1.3%) respectively. The odds values of single to married for the abusers of cannabis, tramadol, rohypnol, nitrazepam, diazepam and benzehexol are 3.4, 3.0, 6.0, 3.0, 4.6, and 2.6 respectively. Conclusion: Substance abuse affects all age strata but the critical ages of abusers are those in their third and fourth decades of life. The distribution cut across diverse occupational background and for many individuals, the distribution pattern of substance abuse and the occupation appeared to be well correlated whereas educational association played marginal role in some few instances.