Substance abuse and dependence among patients attending an emergency hospital in eastern Nile delta, Egypt

Background: Substance abuse and dependence are frequently encountered in emergency hospitals. The aims of this study were to estimate the prevalence of drug abuse and dependence among patients attending Emergency Hospitals and to describe the sociodemographic, clinical and psychiatric features of these patients .Secondary aims were to evaluate the type of medical care given to these patients and to assess the predictors of substance abuse and dependence Methods: All 1,526 patients attending the Mansoura emergency hospital during the month of April 2012 were included in this study. Alcohol and illicit drug use were assessed using a questionnaire filled in by the patients and their relatives followed by an interview based on the Arabic version of Mini international neuropsychiatric interview (MINI) for the diagnosis of comorbid psychiatric disorders. Results: After exclusion of 155 cases, 1,317 patients were included: 108 (8%) with substance abuse and 47(3.5%) with substance dependence .Cannabis was the most common drug abused for 3.6% of patients followed by tramadol and polysubstance in1.8%, 1.7% of patients respectively, whereas, tramadol ranked the first in the dependence group in 1.2% of patients followed by the cannabi and stimulants in 1% and 0.5% of patients respectively). Multivariate regression analysis showed that being of younger age (< 30 years) (Odds ratio OR=1.74), male and single with unsatisfactory income (OR= 3.71, 1.59 and 2.66 respectively) and diagnosed with psychiatric illness OR=2.08) positively predict the abuse status included. Those with status of drug dependence had features similar to the status of abuse patients except regarding reason for hospital referral and the presence of psychiatric illness. Conclusion: About one in ten of the attendants presented with either substance abuse or dependence .This should be considered during history taking and clinical examination of patients referred to an emergency hospital particularly in male gender, single, younger age group with unsatisfactory income.