Abstract:

Background: Substance abuse is the term that used to refer to the harmful or hazardous use of psychoactive substance, including alcohol and illicit drugs. Studies have shown that substance use is more common among people with severe mental illness than in general population, with nearly half of people with severe mental illness use substances at some point during their lives. Numerous studies have been done in other countries, showing a high rate of substance use among psychiatric patients. Little published work, however, has been done in Tanzania specifically to investigate prevalence of substance abuse among psychiatric patients. In Tanzania the most frequently used substances are alcohol, tobacco and cannabis, while heroin and cocaine are least used with young adults aged 18 to 25 having a higher prevalence of alcohol or drug use than any other age group.

Methods and Material: Classified sampling was used where patient’s files were picked at the interval of every 16th file and filled the questionnaire.

Results: This study had revealed that substance abuse is a significant burden especially in the mental health institutions. The prevalence of substance abuse in patients admitted at Mirembe Hospital in 2011 being 51(39.2%). Of 130 study sample, 59(45.4%) were not recorded if they were drug abuser or not. So this means that the burden of substance abuse may bigger than the apparently known. 51(39.2%) patients had history substance abuse, 20 (15.4%) did not have history of substance abuse and 59(45.4%) there were no documentation as to whether they ever used substances. Most patients experienced various psychological side effects, but of significance with the history of substance abuse are auditory hallucinations and suicide ideation and attempt. Given the P value above. In terms of frequencies of the above side effects in all patients in the study, 51 (39.2%) had auditory hallucinations, 35 (26.9%) were delusional, 6(4.6%) were worried and fearful, 11(8.5%) were depressed, 8(6.2%) had history of suicide ideation or attempt and 1(0.8%) had cravings. There were no records of any physiological side effect in the study files. In term of frequencies in the whole study population, 66(50.8%) were violent, 2 (1.5%) had marital problems, 2 (1.5%) had criminal history, 1 (0.8%) got into MTA. Only violence is a statistically significant social side effect of substance abuse.

Conclusion: In this study it has been found that substance abuse is a major problem especially in mental institutions. The substance abuse has been linked with psychological effects like auditory hallucination and suicidal ideation and attempt, also linked to violence.