Screening for alcohol use and associated level of harm in a Primary Health Care Facility in Nigeria

Abstract

Background : Psychoactive substance use presents both economic and psychological burden to the society at  large with far reaching consequences. The prevalence and pattern of substance use have been studied extensively in many  settings; however, studies carried out in primary care centres which are usually the first contact of patients with health care  givers are few. The level of risk for adverse effects of these psychoactive substances and treatment needs of such patients are usually not assessed. We assessed the prevalence and pattern of alcohol use and associated level of risk among patients attending a primary care centre in Nigeria.
Methods: This was a cross sectional study. Three hundred and twenty five patients were recruited using systematic random  sampling at the waiting room of the primary health care centre, Okeilewo, Abeokuta. Psychoactive substance use, level of risk and treatment needs were assessed using the WHO ASSIST.
Results: Lifetime and 3-month prevalence rates of alcohol use were 51.7% and 17.9% respectively. Those who exhibited  moderate and high risk for adverse effects of alcohol use were 2.8% and 0.9% respectively. All respondents who were at moderate and high health risk resulting from alcohol use (n=12) were weekly alcohol users and none of them had ever received treatment for their alcohol use. Men were significantly more likely to be weekly alcohol users in the past 3 months OR = 3.0, 95% CI (1.41- 6.20). Respondents who were of Yoruba ethnicity were significantly less likely to be weekly alcohol users in past 3  months, OR = 0.3, 95% CI (0.09-0.92) compared to other tribes.
Conclusion: In view of high prevalence of alcohol use among patients in primary care with its associated health risk, there is a need for screening and brief intervention for problem drinking in primary care in Nigeria.

Key Words: Alcohol Use, Health Risks, Access to Treatment, Primary Care