Knowledge and views on drug abuse of primary health care workers in Nigeria

Psychoactive substance abuse among inmates of a Nigerian prison population

The objectives of the study were: (1) to assess the prevalence rate of psychoactive substance use and dependence among inmates of a Nigerian prison population within the past month; (2) to highlight how aware these prisoners were, of the various drugs of abuse; (3) to compare the findings with those of reports from abroad, and general Nigerian population samples. In mid-1995, 395 subjects (97.5% males, mean age 30.5 years) were interviewed, with a questionnaire that contained DSM-III-R criteria for dependence. About two-thirds were those on remand or awaiting trial, and the majority (70%) were accused of theft and armed robbery. Compared with Nigerian general population samples, the cohort had much higher prevalence rates of awareness and life-time use of psychoactive substances. Cannabis was the only drug regularly abused in the past month, by 26 (6.6%) subjects (all males); out of whom 11 (42.3%) satisfied DSM-III-R criteria for dependence. Use of intravenous drugs was not evident. This pattern differed markedly from the situation in industrialised countries. Cannabis abuse was significantly associated with those in prison for less than six months and on a charge of theft/armed robbery.

Problems and Prospects of Implementing Harm Reduction for HIV and Injecting Drug Use in High Risk Sub-Saharan African Countries

The use and misuse of a broad spectrum of psychoactive substances, including heroin and cocaine, is of growing concern in many African countries. Approximately one-third of global HIV and AIDS cases are reported from Africa, but injecting drug use has not yet been documented as a causative factor. The drug supply control strategy has recorded only limited success in Africa, and the currently adopted demand reduction programs are beset with many problems. In this paper we review possible constraining and facilitating factors in the adoption of harm reduction approaches in high risk sub-Saharan African countries. We conclude that appropriate needs assessments are urgently required to establish the extent of problem drug use and of injecting. This exercise may identify clinical and psychosocial problems that could benefit from an intervention approach based on a combination of the principles of harm reduction and demand reduction.

Alcohol-related problems in primary care patients in Nigeria

A total of 440 (50.1%) drinking patients were found in a study of 878 primary care patients in Nigeria, of whom 126 (28.6%) of drinking patients were observed to have alcohol-related problems. Those with alcohol-related problems were significantly more likely to be males, middle-aged and to belong to higher occupational groups. In addition, they were also more likely to be separated, divorced or widowed, made more frequent visits to health care facilities and were more likely to have associated mental morbidity. The primary health care (PHC) workers did not recognize these problem drinkers in their care. The need to improve the ability of PHC workers to detect and manage primary care patients with alcohol-related problems in developing countries through the use of reliable and valid short alcohol screening instruments (e.g. CAGE, AUDIT) and brief intervention techniques is emphasized. It is also suggested that, on a long-term basis, the training curricula for medical and paramedical primary care personnel in third world countries should include more hours on alcohol education.

A review of the incidence of nonprescription psychoactive substance use/misuse in Nigeria

The past 15 years of published literature on the use/misuse of non-prescription psychoactive substances in Nigeria was reviewed. It was found that alcohol, tobacco products, cannabis, and stimulants are more frequently used than other substances. More males than females, more single than married persons, and more urban than rural residents use the substances. As a result of insufficient information, it could not be established who uses the substances more among different age, religious, social class, educational, and occupational categories. The incidence of substance misuse could not be established precisely because most of the authors did not clearly distinguish substance use from substance misuse. However, a low incidence of chemical dependency was established. Improved research methodology was suggested as a way of obtaining better results in the future.