A survey of patients with substance use disorders at government treatment facilities in The Bahamas / Estudio de pacientes con trastornos por uso de sustancias en centros gubernamentales de tratamiento en Las Bahamas

OBJECTIVE: To determine the sociodemographic information and characteristics of patients aged 18-60 years diagnosed with substance use disorders presenting to the three government treatment facilities. To determine the prevalence rates of alcohol, cannabis, cocaine and poly-substance use disorders in patients presenting to government treatment facilities. METHODS: The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition, text revision (DSM-IV-TR) Axis 1 disorders was the first instrument used to screen for drug abuse or dependence. Additional questionnaires included a sociodemographic questionnaire and the Survey of Addicted Patients in Treatment Centre Standardized Questionnaire. RESULTS: The number of participants interviewed in the study was 120 people; 89.2% were males and 10.8% were females. The mean age of all participants with substance use disorders was 36.22 (10.74) years and they were predominantly male (8 to 1). Males were mostly single, unemployed or casually employed, of middle school education and were residents of New Providence. Alcohol, cannabis and cocaine were the common drugs that were misused. Of cocaine users, 52 (82.5%) met the DSM-IV-TR criteria for dependence and of cannabis users, 20 (18.9%) met the DSM-IV-TR criteria for abuse. CONCLUSIONS: There is a need to conduct community surveys on school children, other adult populations eg in the wider community and on other island populations to determine the population rates of substance use disorders. Once the needs have been identified through research for the different islands and target groups, informed decisions can be made as to the allocation of financial and human resources.

OBJETIVO: Determinar la información sociodemográfica y las características de los pacientes en edades de 18-60 años diagnosticadas con trastornos por uso de sustancia, que acuden a los tres centros gubernamentales de tratamiento de la drogadicción. Determinar la tasa de prevalencia de los trastornos por uso de alcohol, cannabis, cocaína y polisustancias en los pacientes que acuden a los centros de tratamiento del gobierno. MÉTODOS: La Entrevista clínica estructurada para el diagnóstico y el Manual estadístico de trastornos mentales, cuarta edición, texto revisado (DSM-IV-TR), trastornos del eje 1, fue el primer instrumento utilizado para detectar el abuso o dependencia de drogas. Los cuestionarios adicionales incluyen un cuestionario sociodemográfico así como la llamada Encuesta de pacientes adictos en el cuestionario estandarizado de los centros de tratamiento. RESULTADOS: El número de participantes entrevistados en el estudio fue de 120 personas; 89.2% eran varones y 10,8% eran hembras. La edad promedio de todos los participantes con trastornos por uso de sustancias fue 36.22 (10,74) años y eran predominantemente masculinos (8 a 1). Los varones eran en su mayoría solteros, desempleados, o trabajadores eventuales, de nivel educacional medio, y residentes de Nueva Providencia. Alcohol, cannabis y cocaína fueron las comúnmente las sustancias del uso adictivo. De los consumidores de cocaína, 52 (82,5%) correspondían a los criterios del DSM-IV-TR con respecto a la dependencia, y de los consumidores de cannabis, 20 (18,9%) correspondían a los criterios de DSM-IV-TR en relación con el abuso de sustancias. CONCLUSIONES: Es necesario llevar a cabo encuestas comunitarias con niños en edad escolar, otras poblaciones adultas - por ejemplo en la comunidad en general y en otras poblaciones de la isla - para determinar las tasas poblacionales de trastornos por uso de sustancias. Una vez que las necesidades hayan sido identificadas mediante investigación de las diferentes islas y los grupos seleccionados como objetivos, pueden tomarse decisiones informadas en cuanto a la asignación de las finanzas y recursos humanos.

The practice of polypharmacy involving herbal and prescription medicines in the treatment of diabetes mellitus, hypertension and gastrointestinal disorders in Jamaica

The interference in the metabolism of a drug by another drug, food or other foreign chemical is commonly observed and often leads to clinically significant adverse drug reactions. In Jamaica, there is an extensive use of natural products as medicines, although there is little information on whether natural medicines are used along with prescription medicines, which might increase the likelihood of drug adversities. This current pilot survey was initiated to gain information on the prevalence of such polypharmacy practices. Two concurrent surveys were carried out in Kingston (an urban parish) and Clarendon (a rural parish) in 743 patients above age 14 years with diabetes mellitus, hypertension and gastrointestinal disorders of persons who visited health centres and pharmacies. Patrons visiting these places at various times of the day were informed of the nature of the questionnaire and willing participants with the above disease conditions and who were on prescription medicines were included in the survey. The results indicated that 80 of the respondents reported combining natural products in their treatment along with prescription medicines, with only 13 of those patients informing their physicians of such practices. Such polypharmacy practices were independent of the type of disease among both males and females and was statistically most prevalent (p < 0.001) in the 47-57-year age group. There was a significant association (p < 0.001) between such treatment practices and place of residence with 92 of the rural community engaging in polypharmacy but 70 of the urban did likewise. Therefore, being aware of the prevalence of multiple therapy practices would be especially useful when designing a pharmaco-vigilance system