scholarly journals Direct Medical Cost of Treating Substance Use Disorders in Two Tertiary Hospitals in South-West, Nigeria: A Cross-Sectional Study

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Margaret Ilomuanya ◽  
Ogochukwu Amaeze ◽  
Chinenye Umeche ◽  
Ugochukwu Mbata ◽  
Omonike Shonekan ◽  

Introduction. Successful interventions for substance use disorders (SUDs), though obtainable, are not effectively utilized due to the high cost of treatment. The adoption of any given therapy is often impeded by insufficient evidence of the effectiveness of such treatment. Objective. This study aimed to assess the direct medical cost of treating SUD in two tertiary hospitals in South-West, Nigeria. Methods. A descriptive, cross-sectional survey of patients managed for SUD at the two psychiatric hospitals was carried out between January and June 2020. The inclusion criteria were patients with SUD above 18 years of age, registered and managed at the two hospitals. Data were collected from selected patients' case notes using a standardized data collection tool and analyzed using descriptive and inferential statistics. Results. The average costs of treatment for alcohol use disorder, drug use disorder, and drug and alcohol use disorder were ₦146,425.38 ± 57,388.84, ₦135,282.09 ± 53,190.39, and ₦143,877.33 ± 68,662.04, respectively. This translates to $384.82, $355.53, and $378.12, respectively. The highest contributors to SUD treatment cost are inpatient admissions and the cost of medicines; inpatient admissions include accommodation, feeding, and laundry. Conclusion. Considering that over 60% of the Nigerian population lives below the poverty line, the direct cost of SUD treatment is unaffordable to the patients and the health care system, which is grossly underfunded.

2021 ◽  
Vol 12 ◽  
pp. 117955732198969
Badiru Dawud ◽  
Eyerusalem Yeshigeta ◽  
Alemayehu Negash ◽  
Almaz Mamaru ◽  
Liyew Agenagnew ◽  

Background: Substance use disorders are more common among people with mental illness than in the general population. It makes recovery from mental illness more difficult, leads to frequent thoughts of suicide and re-hospitalization. Objective: Aimed to assess the prevalence of substance use disorders and associated factors among adult psychiatric patients in Jimma Town, Southwest, Ethiopia, 2017. Methods: A community-based cross-sectional study was conducted on a total of 300 patients with mental illness using the case tracing method. Participants were interviewed using the alcohol use disorder identification test questionnaire to assess Alcohol Use Disorder (AUD). Fagerstrom test tool for nicotine dependence and structured questionnaires were utilized to assess the socio-demographic characteristics of participants. Data were analyzed using SPSS version 20. The variable that showed association with AUD and nicotine dependence at P < .25 in the bivariate analysis was entered into multivariable logistic regressions to control confounders for both outcome variables independently. The significance of association was determined by P < .05 and strength was described using an adjusted odds ratio at a 95% confidence level. Results: The prevalence of alcohol use disorder and nicotine dependence was 14.3% and 23.3%, respectively. Female gender (AOR 0.15, 95% CI = 0.04-0.57), starting treatment within the first month of the onset of the illness (AOR 0.20, 95% CI = 0.05-0.82) and nicotine dependence(AOR 4.84, 95% CI = 1.85-12.67) associated with AUD. Additionally, being female (AOR 0.04, 95% CI = 0.01-0.25), joblessness (AOR 3.05, 95% CI = 1.30-7.16), absence of relapse of illness (AOR 0.18, 95% CI = 0.065-0.503), no improvement in illness (AOR 5.3, 95% CI = 1.70-16.50), and current khat use (AOR 3.09, 95% CI = 1.21-7.90) were associated with nicotine dependence. Conclusion: This study revealed a high prevalence of substance use disorders among psychiatric patients in the community. Being female, experiencing a shorter duration of illness before initiating treatment, and nicotine-dependence were significantly associated with AUD. On the other hand, female sex and absence of relapse of illness were negatively associated with nicotine dependence whereas, joblessness, less improvement of illness, and khat chewing were positively associated with it. Therefore, services on substance use disorders have to be extended to the community level with wide-scale training for the town’s health care providers, including health extension workers who have direct contact with these individuals. Accordingly, comprehensive and suitable interventions were advised to be provided on factors contributing to substance use disorders in general.

Dominic Hodgkin ◽  
Hilary S. Connery

Drug and alcohol use disorders, also called substance use disorders (SUD), are among the major health problems facing many countries, contributing a substantial burden in terms of mortality, morbidity, and economic impact. A considerable body of research is dedicated to reducing the social and individual burden of SUD. One major focus of research has been the effectiveness of treatment for SUD, with studies examining both medication and behavioral treatments using randomized, controlled clinical trials. For opioid use disorder, there is a strong evidence base for medication treatment, particularly using agonist therapies (i.e., methadone and buprenorphine), but mixed evidence regarding the use of psychosocial interventions. For alcohol use disorder, there is evidence of modest effectiveness for two medications (acamprosate and naltrexone) and for various psychosocial treatments, especially for less severe alcohol use disorder syndromes. An important area for future research is how to make treatment more appealing to clients, given that client reluctance is an important contributor to the low utilization of effective treatments. A second major focus of research has been the availability of medication treatments, building on existing theories of how innovations diffuse, and on the field of dissemination and implementation research. In the United States, this research identifies serious gaps in both the availability of SUD treatment programs and the availability of effective treatment within those programs. Key barriers include lack of on-site medical staff at many SUD treatment programs; restrictive policies of private insurers, states, and federal authorities; and widespread skepticism toward medication treatment among counseling staff and some administrators. Emerging research is promising for providing medication treatment in settings other than SUD treatment programs, such as community mental health centers, prisons, emergency departments, and homeless shelters. There is still considerable room to make SUD treatment approaches more effective, more available, and—most importantly—more acceptable to clients.

Michael Burgard ◽  
Robert Kohn

Substance use disorders in older adults remains lower than in younger adults; however, the prevalence is rising in the elderly population. In the United States, the lifetime prevalence of an alcohol use disorder among persons age 65 and older is 16.1%. Studies of Veteran’s Administration nursing home residents have found that 29% to 49% of those admitted have a lifetime diagnosis of alcohol use disorder. A sizable proportion of the elderly acknowledge driving under the influence. In 2013, 1.5% of the elderly had used illicit drugs. The number requiring treatment for substance abuse is expected to double by 2020. The populations with the fastest increase in opiate mortality are those age 55 and older, including those 65 and older. This chapter presents the epidemiology of substance use among older adults and discusses issues related to elders’ substance use, including use in nursing homes, impaired driving and arrests, use of non-prescription medications, screening for substance use, and treatment.

2019 ◽  
Vol 15 (3) ◽  
pp. 159-171 ◽  
Marco Cavicchioli ◽  
Francesca Prudenziati ◽  
Mariagrazia Movalli ◽  
Pietro Ramella ◽  
Cesare Maffei

2018 ◽  
Vol 2 ◽  
pp. 247054701775263 ◽  
Terril L. Verplaetse ◽  
Kelly E. Moore ◽  
Brian P. Pittman ◽  
Walter Roberts ◽  
Lindsay M. Oberleitner ◽  

Background Stress contributes to the development and maintenance of substance use disorders, with some research suggesting that the impact of stress on substance use disorders is greater in women. However, this has yet to be evaluated in a national dataset, across major substances of abuse. Methods Using data from the newly available U.S. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 3; n = 36,309), we evaluated relationships among past year stressful life events (0 or 1 vs. 2+ events, range 0–16) and gender, and their association with transitions (new vs. absent cases; ongoing vs. remitted cases) in Diagnostic and Statistical Manual of Mental Disorders Fifth Edition alcohol use disorder, tobacco use disorder, cannabis use disorder, and nonmedical prescription opioid use disorder diagnoses. Results Having two or more stressful life events in the past year increased the odds of having a new alcohol use disorder, tobacco use disorder, cannabis use disorder, and opioid use disorder (OR = 3.14, 2.15, 5.52, and 3.06, respectively) or ongoing alcohol use disorder, tobacco use disorder, and cannabis use disorder (OR = 2.39, 2.62, and 2.95, respectively) compared to zero or one stressful life event. A stress by gender interaction for new vs. absent alcohol use disorder demonstrated that having two or more stressful life events was associated with increased odds of new alcohol use disorder in men (OR = 2.51) and even greater odds of new alcohol use disorder in women (OR = 3.94). Conclusions Results highlight that stress is a robust factor in both men and women with new or ongoing substance use disorders, and that effective treatments for substance use should consider the role of stress in addiction etiology and maintenance. There was little evidence for gender differences in the role of stress on transitions in substance use disorders, except for the onset of alcohol use disorders. Given that rates of alcohol use disorders are increasing in women, the impact of stress needs to be considered.

Patrick Bach ◽  
Anne Koopmann ◽  
Falk Kiefer

Abstract Aims The appetite regulating hormone leptin, which is mainly secreted from adipose tissue, is an important regulator of food intake and modulator of reward-driven behavior. Leptin exerts its biological actions via binding to the leptin receptor, which is expressed in the hypothalamus, but also in the hippocampus, the amygdala and the substantia nigra. In the ventral tegmental area (VTA), leptin attenuates the firing rate of dopaminergic neurons that project to the Nucleus accumbens (NAc), which serves as relay to other brain areas of the “addiction network”, such as the prefrontal cortex. This suggests that leptin plays a role in the processing of rewards in the context of substance use disorders such as alcohol use disorder, especially through attenuation of dopaminergic activity in the mesolimbic reward system. This supports the plausibility of leptin’s potential effects in alcohol use disorder. Methods We searched MEDLINE from 1990 to February 2020. All abstracts were screened for relevance and we only included publications reporting original data with a full text available in English language. Studies that did not report leptin-data, reviews or case reports/series were not included. Results We identified a total of N=293 studies of whom a total of N=55 preclinical and clinical studies met the specified criteria. N=40 studies investigated the effects of alcohol on leptin plasma levels, N=9 studies investigated the effects of leptin on alcohol craving and N=6 studies investigated the effects of leptin on relapse and alcohol consumption. Conclusions In this review of preclinical and clinical data, we assess the role of leptin in alcohol use and the development and maintenance of an alcohol use disorder, alcohol craving and relapse. Integrating the existing preclinical and clinical data on leptin may reveal new and innovative targets for the treatment of substance use disorders in the future.

2016 ◽  
Vol 80 ◽  
pp. 52-58 ◽  
Angelina Isabella Mellentin ◽  
Maria Brink ◽  
Lene Andersen ◽  
Annette Erlangsen ◽  
Elsebeth Stenager ◽  

2021 ◽  
Vol 21 (1) ◽  
Lars Lien ◽  
Ingeborg Bolstad ◽  
Jørgen G. Bramness

Abstract Background Smoking is still prevalent among people with substance use disorders. The objective of this study was to investigate the prevalence of smoking among patients in treatment for substance use disorders and to analyze the effect of smoking both at baseline and follow-up on drop-out, mental health and quality of life. Methods One hundred and twenty-eight inpatients (26% female), mainly with alcohol use disorder, staying at three different rehabilitation clinics in Eastern Norway, were interviewed at admission, and at 6 weeks and 6 months follow-up. The interview contained mental health-related problems, trauma, questions on alcohol and other substances and quality of life. Non-parametric tests were used to test group differences and unadjusted and adjusted linear regression to test the associations between smoking and the main outcome variables, while logistic regression was used to test the association between smoking and drop-out. Results At admission, 75% were daily smokers. Compared to non-smokers at baseline, the smokers had higher drop-out rates (37% vs. 13%), more mental distress, and lower quality of life from baseline up to 6 months follow-up. Those quitting smoking while admitted improved in mental distress and quality of life at the same rate as non-smokers. Alcohol-related factors did not differ between smokers and non-smokers. Conclusions Smoking was associated with mental distress, quality of life and treatment drop-out among patients in primary alcohol use disorder treatment. The results indicate that smoking cessation should be recommended as an integral part of alcohol use treatment both before and during inpatient treatment to reduce drop-out.

2019 ◽  
Vol 64 (11) ◽  
pp. 761-769
Joshua Palay ◽  
Tamara L. Taillieu ◽  
Tracie O. Afifi ◽  
Sarah Turner ◽  
James M. Bolton ◽  

Objective: There is limited information to guide health-care service providers and policy makers on the burden of mental disorders and addictions across the Canadian provinces. This study compares interprovincial prevalence of major depressive disorder (MDD), bipolar disorder, generalized anxiety disorder (GAD), alcohol use disorder, substance use disorders, and suicidality. Method: Data were extracted from the 2012 Canadian Community Health Survey—Mental Health ( n = 25,113), a representative sample of Canadians over the age of 15 years across all provinces. Cross tabulations and logistic regression were used to determine the prevalence and odds of the above disorders for each province. Adjustments for provincial sociodemographic factors were performed. Results: The past-year prevalence of all measured mental disorders and suicidality, excluding GAD, demonstrated significant interprovincial differences. Manitoba exhibited the highest prevalence of any mental disorder (13.6%), reflecting high prevalence of MDD and alcohol use disorder compared to the other provinces (7.0% and 3.8%, respectively). Nova Scotia exhibited the highest prevalence of substance use disorders (2.9%). Quebec and Prince Edward Island exhibited the lowest prevalence of any mental disorder (8.5% and 7.7%, respectively). Manitoba also exhibited the highest prevalence of suicidal ideation (5.1%); however, British Columbia and Ontario exhibited the highest prevalence of suicidal planning (1.4% and 1.3%, respectively), and Ontario alone exhibited the highest prevalence of suicide attempts (0.7%). Conclusions: Significant interprovincial differences were found in the past-year prevalence of mental disorders and suicidality in Canada. More research is necessary to explore these differences and how they impact the need for mental health services.

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