Help Seeking Patterns in Patients with Substance Use Disorders in Ain Shams University Psychiatry Hospital

Abstract

Despite increased attention to drug demand reduction in recent years, drug use continues to take a heavy toll. Data from literature indicates that Substance use and dependence causes a significant burden to individuals and societies throughout the world. The World Health Report 2002 indicated that 8.9% of the total burden of disease comes from the use of psychoactive substances (WHO, 2004). Actually annual reports of World Health Organization in 2005 revealed that there are about 200 million addicted people in the world. Epidemiological data on drug abuse (including alcohol and prescribed medicines such as benzodiazepines) in the Arab countries are still very scarce. Hardly any official reports can be obtained from most Arab countries where drug abuse is prohibited by legal and religious systems. In Egypt, with a population around 80 million (mainly Muslim) inhabitants, drug addiction is considered one of the serious problems that worry both the people and the government. It affects young people within their productive years and may lead to many problems such as social maladaptation, decreased work productivity and job loss. Although epidemiological data on drug misuse in Egypt are scarce, health professionals report a multitude of reasons for such concern, including an increase in the rate of addicts seeking psychiatric treatment, increases in drug-related health problems (mainly overdose toxicity; and an alarming drop in age at initiation of drug use, with a consequent rise in adolescent addicts. The present scene in Egypt is characterised by an unprecedented shift towards ‘demand reduction’ at the primary prevention level, hand in hand with efforts to provide services at both secondary and tertiary health care levels. Supply control mechanisms are duly and seriously implemented Soueif (1994) reports different reasons for the different user categories. For secondary school students the main reason for drug use was as entertainment on happy social occasions, and the substance mostly used was hashish. Sedatives and hypnotics were the next most frequently used substances; these substances were used in situations of physical exhaustion and fatigue, and to cope with psychosocial problems or difficult working conditions, as well as at times of studying and examinations. Although millions of adults meet criteria for substance use disorder, only a fraction receives treatment. This may be due to individuals with substance use disorder not perceiving a need for treatment. Perceiving a need for treatment may be described as one of the steps in the well-known model that describes the stages of change for addiction, the five step transtheoretical model of intentional behavior change (DiClemente, Schlundt, & Gemmell, 2004; Prochaska & DiClemente, 1984). Identification of the need across different ages, races, sex and other environmental variables became an area of research for many years. The increased number of addicts is not opposed by an equal effort to increase awareness of the available services provided to them in their community. Patterns of seeking help and sources of advice and referral to specialized and professional help are not clear and quiet related to the cultural and demographical environment, something that had never been properly investigated in the Egyptian community. To our knowledge, only few studies are available about the help seeking pattern and perceived need for treatment among substance users in the Egyptian population and there are only scarce data on the source of referral to the available addiction treatment services.