Assessing Factors Contributing To Opioid Abuse Among Nurses Working In A Tertiary Refferal Hospital, Nairobi, Kenya

ABSTRACT

Addiction among health providers is a significant but undocumented cause of death globally. The non-talked about behavior is increasing day by day. In Kenya, drug and substance abuse is an increasing public health problem. The medical professionals are particularly at increased risk of abusing drugs at their disposal meant for prescription and non-prescription purposes. Such drugs for example are the opioids, sedatives, tranquilizers, alcohol, caffeine, nicotine, and cannabis among others. Opioids are drugs controlled by dangerous drugs act; they are normally administered on prescription only. The problem of opioid abuse in Kenyatta national hospital had been noted to be on a rising trend. This was particularly among nurses who administered these drugs and were also the major custodians. Kenyatta hospital is the apex of referral system in Kenya situated within Nairobi city capital, hence increasing risk of accessibility to drugs from within the capital. The main objective was to assess the contributing factors of opioid abuse among nurses working in Kenyatta National Hospital. The specific objectives were: to determine the prevalence of opioid abuse among nurses, to identify the major medical opioid abused by nurses, to establish the behavior of opioid nurse abusers, and to explore the measures taken to nurses identified with opioid abuse. This was a descriptive cross-sectional design. A sample size of 343 nurses was desired from a population of 1,664 calculated using Fishers et al (1998) formula. Female nurses were 1,374(82.6%) while males were 290(17.4%).Multistage sampling technique was used to get the distribution of study participants based on gender and department of work. Simple random sampling was used to select 284 female nurses and 59 male nurses. Data was collected through self-administered questionnaires, closed for quantative data and open for qualitative data. The responses were assigned numerical values according to data type. Continuous data was analyzed and summarized as frequencies and proportions. Categorical data was also analyzed and displayed by use of frequencies and proportions. Results of this study revealed that opioid abuse among nurses is an emerging public health threat with a prevalence of 14 nurses been abusers in every 100 nurses. The factors contributing to this trend was mostly due to Peer pressure,46.5% closely followed by family problems 46.2% availability of substance 43.6% and coping with stressful hospital conditions 43%. Apart from opioids, the study also revealed that abuse of other substances is also high. Alcoholic beverages been the most used by 52.3% of the respondents, this was followed by sedatives or sleeping pills 17.1%, Opioids 14.0%, tobacco products 11.3%, cannabis 10.0%, amphetamines 4.3%, inhalants 2.3% and finally hallucinogens 2.1%. The recommendations of the study were to explore further on extent of abuse among other clinicians, and for the hospital to support the existing employee drug addiction assistance programme. The study concludes that nurses are increasingly abusing opioids. It is recommended that medical staff who self report as opioid abusers should be treated with positive consideration and non punitive measures of rehabilitating them should be initiated.