Pattern of Psychoactive Substance Use Among Long Distance Commercial Drivers in Calabar, Nigeria
Total Page:16
File Type:pdf, Size:1020Kb
International Neuropsychiatric Disease Journal 8(3): 1-9, 2016; Article no.INDJ.29676 ISSN: 2321-7235, NLM ID: 101632319 SCIENCEDOMAIN international www.sciencedomain.org Pattern of Psychoactive Substance Use among Long Distance Commercial Drivers in Calabar, Nigeria Chidi J. Okafor 1, Owoidoho Udofia 1 and Theophilus Onyuku 2* 1Department of Psychiatry, University of Calabar, Nigeria. 2Department of Clinical Services, Federal Psychiatric Hospital, Calabar, Nigeria. Authors’ contributions This work was carried out in collaboration among the three authors. Author TO designed the study and wrote the protocol. Author OU preformed the statistical analysis. Author CJO managed the literature search and wrote the first draft of the manuscript with assistance from authors OU and TO. All the authors read and approved the final manuscript. Article Information DOI: 10.9734/INDJ/2016/29676 Editor(s): (1) Pasquale Striano, Pediatric Neurology and Muscular Diseases Unit, University of Genoa, G. Gaslini Institute, Genova, Italy. Reviewers: (1) Md. Sahab Uddin, Southeast University, Bangladesh. (2) Patricia Martínez Lanz, Universidad Anáhuac México Norte, México. Complete Peer review History: http://www.sciencedomain.org/review-history/17176 Received 23 rd September 2016 Accepted 15 th November 2016 Original Research Article Published 8th December 2016 ABSTRACT Background: The abuse of psychoactive substances has become a global menace that threatens the entire society because of its dire consequences. It has been observed that driving a vehicle under the influence of psychoactive substances is a growing cause of fatal road traffic accidents. In Nigeria, road transportation is a major means of movement of persons and goods, and long distance commercial drivers play a crucial role in this regards. These drivers sometimes use psychoactive substances to remain energetic and alert. Aims: To examine the pattern of psychoactive substance use among long distance commercial drivers in Calabar with the view of obtaining information that may be useful for social monitoring and planning preventive strategies. Methodology: A two-stage cross-sectional survey which lasted for three weeks, involving one hundred randomly selected (using table of random number) long distance commercial drivers drawn from the seven major motor parks in Calabar. These drivers had CAGE-AID and Socio- demographic questionnaires administered on them at the first stage of the study. Those that scored 1 and above on the CAGE-AID questionnaire were further interviewed using the computerized _____________________________________________________________________________________________________ *Corresponding author: E-mail: [email protected]; Okafor et al.; INDJ, 8(3): 1-9, 2016; Article no.INDJ.29676 version of drug and alcohol module of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) in order to generate psychiatric diagnoses. Results: The mean age of the respondents was 36.43 (SD 8.01). The most commonly used substance was alcohol (by 82% of the respondents) while the least commonly used was cocaine (used by 5% of the respondents). Some of the respondents use combination of substances. The most commonly used combination was alcohol/tobacco (used by 66%). Forty-three respondents (43%) reported using “combine” which is a mixture of cannabis leaves and seeds in local gin. Hired drivers were significantly more likely (than owner drivers) to use cannabis ( P=.04), alcohol (P=.02), tobacco ( P=.01) and “combine” ( P=.04). The study recorded road traffic accident rate of 19% with some occurring under the influence of psychoactive substances. Following the SCAN interview, Thirty two (76.2%) out of the 42 respondents that scored 1 or above on the CAGE-AID questionnaire had psychiatric diagnoses. The commonest of these diagnoses were alcohol and cannabis related disorders. Conclusion: There is a wide spread use of psychoactive substances by long distance commercial drivers and this is associated with road traffic accidents as well as diagnosable psychiatric disorders. This calls for urgent interventions by relevant agencies of government. Keywords: Long distance commercial drivers; psychoactive substance use; road traffic accidents; drug abuse. 1. INTRODUCTION accidents has taken an alarming dimension. It is worrisome to note that even though there are It is universally acknowledged that drugs are of fewer automobiles and miles of roads in tremendous benefits to man, but their developing countries, the number of motor inappropriate use may produce incalculable harm vehicle fatalities per 10,000 vehicles in Nigeria, not only to the individual but to the society at Ethiopia and Kenya far exceeds that of the large. Currently, drug abuse has become a United States and United Kindom by at least six global menace that threatens the entire society times [8]. because of its dire consequences. Recently, the World Health Organization (WHO) estimated that Nigeria is a large country with massive landmass about 5.4% of global burden of disease comes and very mobile people. Movement of goods and from the use of psychoactive substance [1]. services in the country are mainly via the road Much of the attributable burden of psychoactive transport system. Reports show that there has substance use includes a range of health and been an increase in the number of motor vehicle social problems, not least of which are injuries fatalities recorded on Nigerian roads [9]. from vehicular accidents. It has been observed Although poor road network, driver inexperience that driving under the influence of psychoactive and mixture of road users (four and two wheeled substances is a growing cause of road traffic vehicles, non motorized transport and accidents both in the developed and developing pedestrians) are among the factors responsible nations [2,3,4,5,6]. for the increased rate of accidents on Nigerian roads, recent finding has shown that vehicle Logan and colleague reported in their study that drivers under the influence of psychoactive psychoactive substance was a factor in 52% of substance are more likely to be involved in fatal road fatalities recorded in the United State [2]. road accidents [7]. They identified alcohol as the most implicated factor accounting for over half the cases. The Long distance commercial drivers play a crucial trend of road traffic accidents following role in the movement of goods and services in psychoactive substance use by drivers has led Nigeria. It is reported that some long distance some developed countries to introduce laws commercial drivers use performance enhancing banning driving under the influence of certain drug in their bid to stay awake/vigilant, check illegal drugs. The enactment of such laws was fatigue and enhance their ability to drive for long based on the knowledge that psychoactive hours [10]. There is need for more studies on substances can affect driving skills and increase psychoactive substance use among the long the risk of road traffic accidents [7]. distance commercial drivers. In countries, the association between Although previous studies [11,12,13] conducted psychoactive substance use and road traffic among drivers in Nigeria reported association 2 Okafor et al.; INDJ, 8(3): 1-9, 2016; Article no.INDJ.29676 between drug/alcohol use and road traffic will spend at least five hours before getting to his accident, it is not clear which classes of destination. The sample size consists of 100 long drugs/alcoholic beverages are commonly distance commercial drivers that were randomly implicated in the road accidents. Besides, selected from the seven major motor parks in previous studies did not examine the Calabar. characteristics/categories of the drivers involved i.e whether or not they were intercity, intra-city or 2.2.1 Sampling long distance drivers. The present study investigated the pattern of psychoactive The sample size required for the study was substance use among long distance commercial calculated using the formular drivers with a view of obtaining information that 2 might be useful for social monitoring and n = Z Pq planning of preventive strategies. D2 2. METHODOLOGY Where n = minimum sample size; Z =1.96 (2SD) at 95% confidence interval; P = probability that a This study was a two-staged cross-sectional driver will use a drug (0.5) at 95% confidence descriptive survey. interval; q = 1-P; D = precision expected at 95% confidence interval (0.1). 2.1 Study Location Thus The study was conducted in Calabar, the capital 2 2 city of Cross-river state in Nigeria. The state is n = [(1.96) (0.5) (1-0.5)] / (0.1) = 96 renowned for the production of cocoa, rubber, timber and local gin. Calabar has a functional This minimum sample size was rounded up to seaport, airport and an export free zone. It is 100. bounded on the north by Odukpani local government area, on the west by Calabar river Considering that the number of long distance with the great Qua river on the south and east. commercial drivers in each motor park varied, a The city is tourism destination in the West African quota (using proportional sampling methods) was sub-region where business, relaxation and used to determine the number of subjects to be pleasure are guaranteed. Calabar has seven recruited from each of the seven motor parks. major motor parks namely Etim-edem, Cross- lines, Calculus, Young shall grow, Eta-agbor, For each motor park – Gbogobiri and Flour-mill parks. Although there are some minor and road-side parks, long (Number of long distance driver in the motor