Chapter 19: Assessment of co-occurring substance related disorders and mental illness among psychoactive substance users by Gloria S. Karuri, Gray G. Ejikeme & Andrew Zamani


Substance related disorders and mental illness are ailments that have been with man since the days of old. The use of psychoactive substances dates back to the primitive age when man experimented with herbs and roots for survival, both as food and medicament. While the harmless ones were chosen for food, those with psychoactive properties were kept for social and ritual purposes. Their addictive properties served as motivational factors that encouraged and sustained their use in large quantities across societies. The presence of mental health problems and psychoactive substance use can result in the user abusing the substancels) as a means of coping with prolonged stress, which is perceived as being relatively permanent or as a way of seeking relief and/or distraction from other emotional distress (Ross, Glaser & Germanson, 1988; Fiegier, Farmer, Rae, Locke, Keith,
Judd &Godwin, 1990).
Nigerians‘ understanding of the dangers of psychoactive substance use/abuse revealed that most users and significant others are either ignorant or careless. Many surveys in Nigeria among secondary school students reveal and supports the view that availability and use of these substances by adolescents is on the increase (NDLEA 1992, 1993, 1999; Obot, Karuri & Ibanga, 2003). A detailed retrospective analysis of the case records of all psychiatric patients admitted to 13 centres in Northern Nigeria and 15 in the South in 1989 revealed that in the north the relative frequency at which abuse of drugs was recorded was 77% for cannabis; 19.9% for alcohol; 2.4% tor heroin‘, 1.1 % tor cocaine; 0.26% tor pethidine; 3.5% for amphetamine and 8.7% for a mixture of ill- defined psycho – stimulants. In the southern centres, the figures were 60.6% for cannabis; 15.6% for alcohol; 40.3% for heroin; 23.7% for cocaine (Ohaeri & Odejide, 1993). Most patients were young males from low socio – economic background.