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

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.

Socioeconomic and Environmental Factors Associated With Increased Alcohol Purchase and Consumption in 38 Countries During the Covid-19 Pandemic

AimsTo explore changes in alcohol purchase and consumption during the first few months of the Covid-19 pandemic, and assess associations between increased alcohol purchase/use and socioeconomic and environmental factors.DesignSecondary data from a cross-sectional online survey conducted from 17 April to 25 June 2020.SettingThirty-eight countries from all continents of the world.ParticipantsA total of 37,206 adults (mean age:36.7, SD:14.8, 77% female) reporting alcohol purchasing and drinking habit before and during the pandemic.MeasurementsChanges in alcohol stock-up and frequency of alcohol use during the pandemic and increased alcohol stock-up and use were stratified by gender, age, education, household structure, working status, income loss, psychological distress, and country based on alcohol consumption per capita. The associations between increased alcohol stock-up/use and living with children, working from home, income loss and distress were examined using multivariate logistic regression, controlling for demographic factors.FindingsThe majority of respondents reported no change in their alcohol purchasing and drinking habits during the early pandemic period. Increased drinking was reported by 20.2% of respondents, while 17.6% reported decreased alcohol use. More than half (53.3%) of respondents experienced psychological distress, with one in five (20.7%) having severe distress. Female gender, being aged under 50, higher educational attainment, living with children, working from home, and psychological distress were all independently associated with increased alcohol drinking during lockdown. Limitations of the study were the non-representative sample, the data collection early in the pandemic, and the non-standard measurement of alcohol consumption.ConclusionIncreased psychological distress among people during the early pandemic period, resulted in increased alcohol consumption, especially among women with children working from home during lockdown.