Profile of Problems Associated with Psychoactive Substance Use Among Long Distance Commercial Automobile Drivers in Ibadan

Introduction: Automobile drivers are vulnerable to psychoactive substanceuse often to their detriment in terms of the health hazards of these substances and also to the detriment of commuters in terms of their safety. The objectives of the study were to identify pattern of psychoactive substance use among long distance commercial drivers in general and also with respect to their status (hired or owner) and also to identify the profile of health and social problems associated with substance use disorders among them. Method: Four hundred and twenty two commercial drivers selected through a multi stage stratified sampling technique from four motor parks in Ibadan were interviewed using the alcohol and drug section of the CIDI. The CIDI auto program was used to generate psychiatric diagnosis. The CIDI auto is a computer program which could concurrently generate both ICD 10 and DSM IIIR diagnoses using various indices which include physical and social health problems. Focus group discussion and direct observation were also conducted in each of the study parks. Results: Their median age was 39 years, 76.8% were married, 5.0% had no formal education. Alcohol was the most prevalent currently used substance, 324 (76.8%). The most prevalent current single ICD 10 diagnosis was harmful use of alcohol, 61 (14.5%), while the most prevalent current multiple ICD 10 diagnoses were harmful use of alcohol/harmful use of cannabinnoids, 33 (7.8%). In all, 124 (29.4%) respondents had single ICD 10 diagnosis, while 46 (10.9%) hadmultiple ICD 10 diagnoses. Current ICD 10 diagnosis was significantly most reported among young drivers, p < 0.01, drivers with low educational level, p < 0.01 and also among hired drivers, p < 0.001. Each ICD 10 versus DSM diagnosis showed good to excellent agreement (k) = 0.68 – 1.0. Predictors of any ICD 10 diagnosis were: age range 25 – 34 years, OR = 5.7, 95% CI (1.3 – 11.5) p < 0.01, being single, OR = 8.8, 95% CI (2.5 – 21.9), p = 0.00, hired drivers, OR = 6.2, 95% CI (2.4 – 13.4) p = 0.00, drivers whose route was outside the country, OR = 3.7, 95% CI (1.2 – 7.9),p = 0.01. Road accidents were the most common problems reported inthis study, 112 (26.8%) and were commonest among those with alcohol related disorders. Risk factors for road accidents were: age range 25 – 34years, OR = 7.4, 95% CI (2.3 – 21.5) p = 0.00, hired drivers, OR = 7.6, 95% CI (2.7 – 25.4) p = 0.00, harmful use of alcohol, OR = 2.6, 95% CI (1.4 – 11.9), p=0.03, dependence syndrome alcohol, OR = 2.7, 95% CI (1.3 – 13.2), p = 0.02, harmful use alcohol/harmful use cannabinoids, 0R= 8.8, 95% CI (2.5 – 31.9), p = 0.00, harmful use alcohol/dependence syndrome cannabinoids, 0R= 5.5, 95% CI (1.5 – 20.5), p = 0.00.Conclusion: Psychoactive substance use was common among long distance automobile drivers with consequent social and physical health consequences. The government should randomly screen commercial drivers plying the roads for drug use and increase the frequency of educational programs to improve their knowledge about its harmful effects in order to ensure commuters’ safety.Key Words: Psychoactive Substances, Automobile Driving, ICD 10/DSM IIIR