Assessment of Community Pharmacists’ Involvement in the Rehabilitation of Drug Abuse Victims in Abuja Municipal Area Council, Abuja, Nigeria

Drug abuse has now become a major public health problem in Nigeria requiring urgent attention. Although drug abuse cut across all age groups, the youths are however the most affected. This study aimed at assessing Community Pharmacists involvement in the rehabilitation of drug abuse victims. The study was carried out in Abuja Municipal Area Council, questionnaires were administered to Community Pharmacists practicing within the Area Council. A total of 176 Community Pharmacists participated in the study, and slightly above a quarter (27.43%) of them had post-graduate degrees. More than three-quarters (79.5%) of the study participants had received training on drug abuse. A total of 89.2% of the study participants had come across persons suspected to be abusing prescription medicines. Almost all (96.6%) of the study participants indicated that they are willing to advise persons suspected to be abusing drugs on the dangers of drug abuse, and 88.1% of the study participants had spoken to clients concerning abuse of prescription medicines. Also, more than three-quarters (80.1%) of the study participants indicated that pharmacists’ role in the prevention of drug abuse is very important. The study has revealed that Community Pharmacists can play an invaluable role in the rehabilitation of drug abuse victims in Nigeria.


Introduction
Drug abuse is a major public health problem across the world [1]. The abuse of drugs, especially among adolescents, is one of the most alarming public health problem in Nigeria and other parts of the world [2]. As a result, several adolescents experience mental health problems, either temporarily or for a long period of time. Some develop psychiatric problems due to maladjustment to school situations and sooner or later drop out of school. A drug has the power to alter the body functions either positively or otherwise depending on individual body composition, the type of drug used, the amount used and whether used singly or in combination with other drugs. The term drug abuse has further been explained as extreme and persistent self-administration of a drug without regard to the medically acceptable patterns [3]. This implies that drug abuse is the use of a drug to the extent that it interferes with the health and social function of an individual. It is therefor important for drug abusers who exhibit symptoms of stress, anxiety, depression, among others to seek medical attention from medical experts and counselors so as to save them from mental illness and other health conditions that are associated with drug abuse [4].
Pharmacists have the unique knowledge, skills, and responsibilities for assuming an important role in substance abuse prevention and enlightenment. Pharmacists are the most accessible health care professionals especially at the community level [5], thereby placing them at the forefront of the war against drug abuse in the society. This implies that, Pharmacists are well-positioned to help prevent and treat substance use disorders and therefore, they should be well equipped to perform these functions.
Drug abuse treatment is aimed at helping individuals with addiction to stop engaging in drug abuse [6]. Treatment can take various forms and last for different length of time [7]. This is because drug addiction is usually a chronic disorder associated with occasional relapses, thereby making a short-term or one-time treatment not being enough. For many, the treatment entails a long-term process of multiple interventions and regular monitoring.
A review of literature revealed that a significant proportion of drug abuse studies that has been undertaken in Nigeria are focused on prevalence of drug abuse. Only few studies seemed to have focused on intervention on drug abuse [8][9][10], no study has however been undertaken to assess Pharmacists' role in the rehabilitation of drug abuse victims. It is against this backdrop that this study aimed at assessing the role of Community Pharmacists, in the rehabilitation of drug abusers in Abuja Municipal Area Council in Federal Capital Territory of Nigeria.

Sample Size
This was calculated using [11]

Data Collection Procedure
A questionnaire was developed to assess the knowledge of Community Pharmacists in Abuja Municipal Area Council (AMAC) about drug abuse rehabilitation and also to explore their views on roles of Community Pharmacists in drug abuse rehabilitation. The questionnaire contained socio-demographic items as well other items relating to various aspects of drug abuse rehabilitation. The items in the questionnaire required the selection of relevant options.
Face and content validation were carried out using an expert panel, there after pretesting of the questionnaire was carried out. The feedback received from the pretesting did not result to any major change. Questionnaires were then administered to 200 Community Pharmacists in AMAC.
Ethical approval was obtained from Federal Capital Territory Health Research Ethics Committee before the commencement of questionnaire administration. Confidentiality was maintained as participants were not requested to include their names on the questionnaire. Informed consent form was included in the questionnaire so as to ensure that participation is voluntary.

Data Analysis
Questionnaires retrieved from the respondents were entered into Microsoft Excel and rechecked for accuracy. The data were then imported into Statistical Package for Social Sciences (SPSS) version 25 for analysis. Descriptive statistics was conducted, and results were presented in tables and graphs.

Demography
A total of 176 Community Pharmacists within AMAC participated in the study, thereby giving a response rate of 88%, more than half (58.5%) of the study participants were married, slightly above a quarter of the study participants had post graduate degree (27.43%). Further details about socio-demographic characteristics are presented in table 1 below.

Knowledge of Community Pharmacists on Drug Abuse
More than three-quarter (79.5%) of the study participants have received training on drug abuse, almost all (92.0%) the participants consider using medications without prescription or recommendation as abuse. Further details about knowledge of on drug abuse are presented in table 2 below.

Attitude of Community Pharmacists towards Drug Abuse Rehabilitation
Almost all (96.6%) the study participants indicated that they are willing to advice suspected drug abusers about the risk involved in drug abuse, Close to half (48.3%) of the study participants indicated that suspected drug abusers should be referred to a physician, and 88.1% of the study participants indicated that they have spoken to client about abuse of prescription medicines. Further details are presented in table 3 below.

Prescription Medicines Control
Only about a quarter (24.4%) of the study participants indicated that prescription medicines circulation is strongly controlled. Further details are presented in figure 1 below

Discussion
In this study, more than three-quarter of the study participants had received training on drug abuse, suggesting that the participants may have the basic training required for the rehabilitation of drug abuse victims. Also, a strong majority of the study participants had come across suspected drug abusers. This is an indication that Community Pharmacists should be fully involved in the rehabilitation of drug abuse victims. Community Pharmacists are the most accessible healthcare professionals [5], and their involvement in the rehabilitation of drug abuse victims will help reduce the menace of drug abuse in the society.
Almost all the study participants had indicated that they are willing to advise suspected drug abusers about the dangers involved in drug abuse. This is an indication that Community Pharmacists are readily available to contribute their quota in reducing the menace of drug abuse in the society. Community Pharmacists as the most accessible healthcare providers can play critical role in the reduction of drug abuse in the society if they are fully integrated into the management of drug abuse victims in the society. Although, almost half of the study participants had indicated that all suspected drug abuse victims must be referred to a physician, this do not however stop the role that Community Pharmacists can play in curbing the menace of drug abuse in the society. Pharmacists role has continued to evolve over the years [12,13]. In the past, the role of Pharmacists in hospital and community settings seems to have focused primarily on dispensing and supply of medication, while interaction with other healthcare professionals was somewhat limited [14]. However, with the emergence of clinical pharmacy and pharmaceutical care, pharmacy practice is now patient oriented with addition of more responsibilities [15].
Pharmacists ensure rational use of medicines, promote healthy leaving, and improve clinical outcomes by actively engaging in direct patient care and collaborating with other healthcare professionals [14]. With this expanding scope of practice, pharmacists are being recognized as key components in providing healthcare services for people in the community. Community Pharmacists can therefore work in collaboration with physicians in hospitals within the community they practice, and such collaborations will help strengthen the war against drug abuse in the society. There is therefore need for a policy framework that will support the collaboration of community pharmacies and hospitals in the fight against drug abuse within the local community level. While there is need for physicians input on the rehabilitation of drug abuse victims, easy identification of drug abuse in community pharmacy will go a long way in curbing the menace of drug abuse.
While majority of the study participants have had interaction with their patients about prescription medicines abuse, almost all the study participants were willing to provide counselling to clients about prescription abuse suggesting that majority of the study participants have positive attitude towards prevention and reduction of drug abuse in the society.
The role of Pharmacists in prevention of drug abuse cannot be overemphasise, three-quarter of the study participants had indicated that the role of Pharmacists in prevention of prescription medicines abuse is very important. This is attributed to the fact that Pharmacists are the custodians of medicines [16], and as such they are required to ensure rational use of medicine at every point in time.
On the area of prescription medicines control, only about a third of the study participants indicated that prescription medicines circulation is adequately controlled suggesting that drug abusers have easy access to prescription medicines. This also collaborate previous findings that reported poor regulation and monitoring of pharmaceutical products in Nigeria [17].

Conclusion
This study has given an insight into role of Community Pharmacists in rehabilitation of drug abuse victims. This study has shown that majority of the Community Pharmacists had positive attitude towards reducing drug abuse in the society and they are willing to participate in managing drug abuse victims. There is therefore need for the inclusion of Community Pharmacists in the management of drug abuse victims in the society.
The study has also revealed that Community Pharmacists often come across drug abuse victims in the community setting, as such their involvement in rehabilitation of drug abuse victims will go a long way in reducing the menace of drug abuse in the society.