Qualitative study of the drivers and lived experiences of controlled prescription drug use among mental health patients at Butabika National Mental Referral Hospital

Abstract

Background: Abuse of controlled prescription drugs (CPDs) is rampant among patients with mental disorders in Uganda. Abuse of CPDs can have far reaching impact on individuals, families and communities. Therefore, the drivers, routes and impact of CPD abuse among these patients ought to be understood. Objectives: To assess the drivers, routes of administration, health effects, and socio-economic impact CPD abuse among patients with mental disorders at Butabika National Mental Referral Hospital. Methods: A phenomenological qualitative study of 15 CPD abusers in Butabika Hospital was conducted. In-depth interviews (IDIs) were used to collect data in the months of July and August 2019. Background characteristics of the study participants were collected before the IDIs. Proportions were then used to analyze the categorical data. The Qualitative data was transcribed, coded and analyzed to determine the dominant themes. Results: Among study participants, 60% were males, 40% were between 26-33 years, and 53% were employed. And pethidine abuse was most dominant (47.1%). 47.1% of study participants abuse CPDs by self-injection, pain was the greatest driver for CPD abuse, and 60% were bachelor holders. The participants reported that they felt pain free, relieved, and good at the start of using the drugs. However, they also revealed that they went through distress and tormenting process during addiction. Drug abuse also caused negative stigmatization, family issues, job loss, school drop outs. Conclusion: Pain is the dominant driver of CPD abuse while self-injection with pethidine is the dominant form of CPD abuse among patients with mental disorders at Butabika Hospital. Devastation of CPD abuse among patients with mental disorders extends from beyond health and economic distress to social stigmatization and family distress. Recommendations: Regulation and control of access to CPDs in Uganda should be strengthened to prevent over-the-counter exposure to the drugs and subsequent dependence.