Help-seeking by substance dependants presenting to healthcare professionals in the Free State Province

Abstract

INTRODUCTION: Current data regarding treatment needs in South Africa for substance dependence are based on admissions to specialised treatment centres. The data therefore do not include patients presenting to independent healthcare workers and state hospitals. AIM: The aim of this study was to investigate help-seeking behaviour for substance dependence disorders from the perspective of healthcare professionals at various levels of the referral chain in the Free State Province. DESIGN: A descriptive study was performed. SETTING: Treatment environments in the Free State Province accessible to substance-dependent persons served as the study setting. PARTICIPANTS: General practitioners, private psychiatrists, prescribing healthcare professionals at state hospitals and treatment centres, and non-prescribing therapists responsible for the management of substance-dependent persons, were considered for participation. MEASUREMENTS: A questionnaire was used to determine the level of help-seeking experienced by the participants regarding various classes of psycho-active substances. FINDINGS: The presentation of alcohol, cannabis, opioid, benzodiazepine, ecstasy, cocaine and inhalant dependency at general practitioners, private psychiatrists, treatment centres and non-prescribing therapists was compared. Different patterns of help-seeking for substance dependence from the various professional groups were detected. Regarding alcohol dependence, 40.3% of private general medical practitioners reported being confronted with alcohol dependence at least once per month, compared with 100% of treatment centre representatives and private psychiatrists, 70.6% of state hospitals and 53.8% of non-prescribers. State hospitals reported the highest frequency for contact with cases of cannabis dependence, compared with the other professional groups, while psychiatrists reported the highest contact with cases involving benzodiazepine, cocaine and ecstasy. Therapists reported a higher level of contact with inhalant dependence, while this group virtually never presented at general practitioners and private psychiatrists. CONCLUSION: Help-seeking data can be used in conjunction with other data, such as treatment demand data, to inform and adapt policies and practice. Variations in the manifestation of help-seeking behaviour at various groups may be important pointers to conditions that influence help-seeking, and should therefore be investigated further.