Substance Use Disorders in Rheumatic Patients

Background: The current research assessed the prevalence of substance use among patients with rheumatic diseases who were admitted in different rheumatic wards at Shiraz general hospitals. Methods: In a cross-sectional survey using a structured interview and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) criteria for substance dependence, 160 inpatients with rheumatic diseases selected randomly from general hospitals in Shiraz city. Results: A percentage of 39.4% (52.5% of men and 26.3% of women) reported the use of substance(s) once or more in their lives. The majority (37.5%) used tobacco. None used cocaine or LSD. A percentage of 32.5% (43.8% of men and 21.3% of women) were current substance users. The majority (31.3%) were nicotine users, and 6.9% were opium users. The reported reasons for initial use of substance(s), in order of frequencies, were Enjoyment, Modeling (Imitation) and Release of tension, and also for current users were, Habit, Enjoyment, Release of tension, Depression and Need. Conclusions: Substance use was found to be higher among men than women. This is in contrast with findings in the West, which indicate that lifetime substance use does not vary significantly by gender. In Iranian culture, people especially women dislike to smoke tobacco or opium, or take other illegal drugs and this positive idea is probable explanation of the difference. There was no report of cocaine or LSD use. Cultural attitudes toward substance use were found to affect the type and amount of use. These findings can be considered when planning preventive programs.