Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 26;11(3):e037602.
doi: 10.1136/bmjopen-2020-037602.

Predictors of controlled prescription drug non-medical and lifetime use among patients accessing public mental health services in Uganda: a cross-sectional study

Pakoyo Fadhiru Kamba  1 , John Mulangwa  2 , Peter Kageni  2 , Sulah Balikuna  2 , Allan Kengo  3 , Brian Byamah Mutamba  4 , Nelson Sewankambo  5 , Richard Odoi Adome  2 , Pauline Byakika-Kibwika  5
Affiliations

Predictors of controlled prescription drug non-medical and lifetime use among patients accessing public mental health services in Uganda: a cross-sectional study

Pakoyo Fadhiru Kamba et al. BMJ Open. .

Abstract

Objectives: We determined the prevalence of controlled prescription drug (CPD) non-medical and lifetime use and their predictors among patients at three public psychiatric clinics in Uganda to identify missed care opportunities, enhanced screening priorities, and drug control needs.

Methods: A cross-sectional survey of 1275 patients was performed from November to December 2018. Interviewer-administered semi-structured questionnaires, desk review guide and urine drug assays were employed. Questionnaire recorded CPD non-medical and illicit drug use history from patients' files, CPD lifetime use and risk factors. Desk review guide recorded recently prescribed drugs in patients' files to corroborate with urine assays. Predictors were analysed by multivariate logistic regression.

Results: From desk review, 145 (11.4%) patients had history of CPD non-medical use and 36 (2.8%) had used illicit drugs. Of 988 patients who provided urine, 166 (16.8%) self-medicated CPDs, particularly benzodiazepines while 12 (1.2%) used illicit drugs. Of those with drug-positive urine, 123 (69.1%) had no documented history of CPD non-medical and illicit drug use. Being an inpatient (OR=10.90, p<0.001) was independently associated with CPD non-medical use. Additionally, being an inpatient (OR=8.29, p<0.001) and tobacco consumption (OR=1.85, p=0.041) were associated with CPD non-medical and illicit drug use combined. Among participants, 119 (9.3%) reported CPD lifetime use, and this was independently associated with education level (OR=2.71, p<0.001) and history of treatment for substance abuse (OR=2.08, p=0.018).

Conclusions: CPD non-medical use is common among Uganda's psychiatric patients, and more prevalent than illicit drug use. Rapid diagnostic assays may be needed in psychiatric care in resource limited settings. It is necessary to assess how CPD non-medical use impacts mental care outcomes and patient safety. High risk groups like inpatients and tobacco consumers should be prioritised in psychiatric screening.

Keywords: clinical pharmacology; clinical physiology; forensic medicine; mental health; psychiatry; substance misuse.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Similar articles

See all similar articles

Cited by

References

    1. Katzung BG. Basic and clinical pharmacology. 10th edn. New York: McGraw-Hill, 2007.
    1. Hulme S, Bright D, Nielsen S. The source and diversion of pharmaceutical drugs for non-medical use: a systematic review and meta-analysis. Drug Alcohol Depend 2018;186:242–56. 10.1016/j.drugalcdep.2018.02.010 - DOI - PubMed
    1. Novak SP, Håkansson A, Martinez-Raga J, et al. . Nonmedical use of prescription drugs in the European Union. BMC Psychiatry 2016;16:274. 10.1186/s12888-016-0909-3 - DOI - PMC - PubMed
    1. United Nations . Single convention on narcotic drugs, 1961, as amended by the 1972 protocol amending the single convention on narcotic drugs, 1961. New York, 1961.
    1. United Nations . Convention on psychotropic substances 1971. New York, 1971.

Publication types