Factors Associated with Number of Drugs Abused among PatientsAdmitted to Tanka Tanka Psychiatric Hospital, The Gambia

Abstract

Background: Psychoactive substance abuse remains a pressing public health challenge worldwide with a significant impact on physical, social and psychological well-being. The burden of drug abuse has grown considerably, affecting millions of people and contributing to morbidity, mortality and disability. In SubSaharan Africa, high rates of substance use have been reported among persons presenting for psychiatric evaluation in mental health facilities. Most of the studies have not examined the factors associated with number of drugs being abused. There is rarity of studies in this subject matter at the psychiatric facility in the Gambia. This study was undertaken to examine the factors associated with the number of drugs being abused among patients admitted to Tanka Tanka Psychiatric Hospital in the Gambia.

Aim: The study aimed at exploring the factors associated with number of drugs abused among patients admitted to Tanka Tanka Psychiatric Hospital, The Gambia.

Methodology: The study employed a descriptive cross-sectional design to elicit information on drug abuse among in-patients at Tanka Tanka Psychiatric Hospital. After Ethical approval from HREC of EFSTH, 116 patients who consented and satisfied the inclusions criteria were recruited to complete Questionnaire containing sections on Socio-demographic, Drug Abuse and Clinical Profile. Data were analyzed using Stata MP 17. Descriptive statistics were used to summarize the sociodemographic characteristics of the participants. Continuous variables such as age were reported as means and standard deviations, while categorical variables were presented as frequencies and percentages. Association between sociodemographic characteristics and the number of drugs abused was examined using bivariate non-parametric tests (Mann-Whitney U across two groups) while Kruskal-Wallis H test was used to compare median across more than 2 groups. For the multivariate analysis, a Poisson regression model was fitted to identify independent factors associated with the number of drugs abused. A p-value < 0.05 was considered statistically significant.

Results: Out of the 116 patients that participated in the study, 69.8% were males. The mean (SD) age of the patients was 35(10.7) years, 36.2% were unemployed while 52.6% were single. Most of the patients (70.7%) initiated drug use within 15-19 years of age. Lifetime prevalence of any drug use was 100% with all participants reporting at least use of 2 different psychoactive substances. Substance use was predominantly a male affair with proportion of male users over twice greater than for females. Males reported a higher median drug abuse (Median = 3.0, IQR = 3.00) compared to females (Median = 2.0, IQR = 1.00) at a significant level (Z = 4.76, p< 0.001). The median number of drugs abused was higher among respondents aged </= 39years. Retired individuals had a high median drug abused (median=3.5, IQR=3.00) with individuals having single marital status reporting the highest median number of drugs abused
(median=3.0, IQR= 3.00). Among educational group, those with junior secondary education reported the highest drug abused (median=4.0, IQR=3.00) while individuals with no formal education had the lowest (median=1.0, IQR=1.00).

Conclusion: This study demonstrates a high prevalence of poly-drug use among psychiatric inpatients in The Gambia, with male gender being a significant independent predictor. These findings call for urgent policy and clinical responses, including routine substance use screening, development of addiction services, and early preventive interventions, particularly targeting adolescents and young adults. Further longitudinal and mixed-methods research is needed to better understand the pathways to multiple drug use and develop tailored intervention strategies for the Gambian context.