Impact of Traumatic Events on Substance Use among Internally Displaced People in Selected Flood and War Impacted Areas in Rivers State

Abstract

Background: Different individuals react differently to emotionally traumatic events just as there are varying degrees of coping mechanisms. One of the common maladaptive coping mechanisms of victims of internal displacement is increased predisposition to substance use. Aim: This study determined the relationship between stressful life events and substance use among victims of flood and wars in selected parts of Rivers State. Methods: A cross-sectional study was conducted in 4 different flood and war impacted areas where 357 respondents were investigated. Ethical procedures were followed including consent from participants. Respondents of between the ages 10-75 years were included in the study and their socio-demographic characteristics determined. The Impact of Event Scale –Revised (IES-R) was used to assess posttraumatic symptomatology of the flood victims, while the CAGE and a semi-structured questionnaire were used to assess alcohol and other psychoactive substances. Rapid urine drug toxicology was done for the respondents. Data was analysed using the SPSS version 20. p≤0.05 was considered statistically significant. Results: Two hundred and eighty (79.6%) respondents had IES-R score of 22 and above while 65.3% (n=233) scored 33 and above. Prevalence of substance use was 34.4% (n=123) from self-report and 41.7% (n=149) from urine toxicology. Of the 149 respondents, 138 was among those who scored IES-R 22 and above while 11 was among those who scored below 22 (p=0.001). Alcohol was the most consumed drug with 22.65 (n=81), followed by cannabis with 18.8% (n=67), tramadol 16.5% (n=59), codeine 15.7% (n=56), Nicotine 14.8% (n=53), kolanut and khatchewing 6.4% (n=23), and benzodiazepam 12.8% (n=64). Polysubstance use was 34.17% (n=122). Three respondents use drug intravenously. Substance use significantly correlated with IES-R scores (p=0.002). Conclusion: Stressful and traumatic events may increase vulnerability to substance use, therefore Internally Displaced People (IDP) may require substance use disorder services and psychological care.