|Year : 2015 | Volume
| Issue : 4 | Page : 259-263
Pattern and reasons for substance use among long-distance commercial drivers in a Nigerian city
Christopher Izehinosen Okpataku
Lecturer/Consultant Psychiatrist, Department of Psychiatry, Bingham University/Bingham University Teaching Hospital, Jos, Nigeria
|Date of Web Publication||17-Nov-2015|
Christopher Izehinosen Okpataku
Senior Registrar, Department of Psychiatry, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Objective: To determine the pattern and reasons for psychoactive substance use by long-distance commercial vehicle drivers in a Nigerian city. Materials and Methods: All licensed long-distance commercial vehicle drivers who travel a distance of at least 500 km from the city metropolis were recruited. Each fourth consecutive driver who was to load his vehicle for the day was interviewed at the 10 long-distance motor parks. They responded to a sociodemographic and semi-structured pro forma requesting the type of drug used and the reason and pattern of use. The data obtained were analyzed by means of descriptive statistics using the statistical package for social sciences (SPSS) version 16. Results: All the respondents were males with a mean age of 43.4 years. There was no statistically significant difference between the mean age of substance users and nonusers (t = 0.491, P = 0.853). The reasons given for drug use were to keep awake while driving, for pleasure, as part of the culture, peer influence, as a substitute for food and for no obvious reason. The pattern of use tended to be related to the reason given for the use. Conclusion: The reason for drug use in long-distance drivers could be used to modify the pattern of use to minimize the risk associated with drugged driving.
Keywords: Driver, Nigeria, pattern, psychoactive, reason, use
|How to cite this article:|
Okpataku CI. Pattern and reasons for substance use among long-distance commercial drivers in a Nigerian city. Indian J Public Health 2015;59:259-63
|How to cite this URL:|
Okpataku CI. Pattern and reasons for substance use among long-distance commercial drivers in a Nigerian city. Indian J Public Health [serial online] 2015 [cited 2019 May 19];59:259-63. Available from: http://www.ijph.in/text.asp?2015/59/4/259/169649
| Introduction|| |
The use of psychoactive substances by vehicle drivers is a common occurrence globally. ,,, This practice involves the use of virtually all substances known today. Concerns are growing over the incidence of road traffic accidents in drivers who drive under the influence of these substances, especially alcohol and Cannabis as reported by some studies. , Although road crashes may have multiple interacting causal factors, some accident culpability and responsibility analysis had demonstrated that serum levels of substances correlates positively with road traffic accidents. ,
Substance use could be a regular activity in a driver who then takes the substance while driving as is observed in day-to-day vehicle drivers , or it could be a routine behavior related to the occupation of driving.  The latter pattern of drugged driving is commonly practiced in Nigeria and other parts of the world. , However, most of these studies were based on reports from drivers who were involved in intracity taxi and short-distance services.
In developing countries including Nigeria, transportation is still largely by road. Young and middle-aged men take to long-distance driving as a means of earning a living. This job demands that a driver remains awake for long periods of time, sometimes at night while driving due to which drivers may take substances to remain awake, as popularly expected. However, the reason given by intracity drivers had been reported by some studies. Reasons for the use of alcohol included "to cope with frustration," "to boost morale," "for more energy",  and " for relaxation, increased confidence on the road and to socialize."  None of these had any report of drug use to prevent sleep as commonly expected. The reasons for substance use may actually influence the pattern of use. A study in south western Nigeria documented that 90.8% of their intracity drivers who claimed to use alcohol to get pleasure took the substance mostly after work.  The pattern and reasons for substance use by long-distance drivers, which is a common means of transportation in Nigeria, is not clearly known. Globally, there is relative dearth of information on the reasons and pattern of substance use by drivers. There is a good prospect that when the reasons for substance use are provided by drivers, they can be educated and instructed to modify the pattern of use to minimize the risks associated with substance use while driving. To the best knowledge of the author, there has not been any study that had documented the pattern of substance use as it relates to the reasons among long-distance drivers. The objective of this study therefore, was to determine the reasons and pattern of substance use by long-distance vehicle drivers in a Nigerian city.
| Materials and Methods|| |
This was a descriptive cross-sectional survey of all licensed long-distance commercial vehicle drivers in Kaduna, Kaduna State, conducted over a 4-month period (February 2012 to June 2012). Kaduna is the capital city of the third most populous state in Nigeria, with a population of 6 million.  Road transportation is the major means of human and goods movement within and outside the Kaduna metropolis to other states and across the border. The study was conducted in motor parks, which were designated for long-distance journeys. Ethical clearance for the study was obtained from the Health Research Ethics Committee of the Ahmadu Bello University Teaching Hospital and Kaduna State Ministry of Health. In addition, a written informed consent of the respondents was sought before the interview. Permission was requested from the National Union of Road Transport Workers (NURTW), Kaduna, Kaduna State to conduct the study.
The sample size required was calculated using the formula for calculating a sample size in cross- sectional studies when the population is less than 10,000. 
n = The desired sample size.
n = Z 2 pq/d 2 , where:
z= The standard normal deviate, set at 1.96 to the 95% confidence level.
P= The proportion in the target population estimated to have a particular characteristic, in this case 0.40. This was based on the prevalence of psychoactive substance use in a similar study. 
q = 1-p.
d = Degree of precision desired, set at 0.05.
An estimated minimum sample of 270 was therefore, obtained. However, 274 drivers were recruited to give better power.
Each consecutive fourth driver in the various long-distance motor parks was interviewed until the sample size was attained. They responded to a sociodemographic and a semi-structured pro forma, which sought information on the type of drug used, reasons for their use, and preferred time of use. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.
| Results|| |
The respondents were all males. The mean age of substance and nonsubstance users were 43.57 ± 10.22 years and 42.86 ± 10.24, respectively, with no statistically significant difference between them (t = 0.491, P = .853). Substances were used in combination and the types were as shown in [Table 1].
The common reasons given for the use of the various substances varied with the type of substance. Notably for the most common substances used, the reasons were: For caffeinated substances, kolanut, and tobacco - "to keep awake while driving;" for alcohol - "pleasure;" while for the anxiolytics and solvents - "other reasons". For all types of substances used, the respondents also pointed to "other reasons" (which included responses like "it is part of my culture to use the drug," "peer influence," "as substitute for food," and "no obvious reason" [Figure 1].
The respondents used the substances in three major patterns: Just before and while driving, after driving activity, and at any time (before, while and after driving) with no predominantly regular pattern. The pattern of use tends to be related to the reasons for the drug use [Figure 2].
| Discussion|| |
This study found variation in the pattern of psychoactive substance use in terms of periodicity. Although most respondents readily admitted to using the drugs after driving, a higher percentage of drivers used these drugs before and while driving. Respondents who used alcohol reported that they took this drug mostly after driving. This is fairly compatible with the major reason given for alcohol use, which the respondents reported as "for pleasure and relaxation". Abiona et al. had a similar report although this was among intracity commercial drivers in Southwest Nigeria.  Users of kolanuts and nonspecified substances, which were mainly caffeine-containing substances such as energy drinks, took these drugs mostly before and while driving. This was also understandable in the context of the reasons for use, which the respondents cited as "to keep awake while driving." The reasons given for the use of these drugs were related to their current driving experience and not necessarily the reason for the drug use at onset. Caffeine-containing substances are often taken as food and with beverage.
It is important to recognize that kolanut consumption is a widespread practice in Nigeria , and it is usual to find middle-aged and elderly people with kolanut in their pockets. After eating kola as it is popularly called, one can go without food and sleep for longer time. However, it has been documented that the use of kolanuts "postpones" sleep transiently only to make the user fall asleep at another time when he is not expecting to, thereby increasing the risk of road traffic accident.  Hence, drivers who use this substance need to be aware of this effect. Respondents in this study reported using cannabis, opioids, and anxiolytics before, while, and after driving. This nonspecific pattern may reflect the primary role of these drugs outside the driving occupation. Drivers may have been using these groups of substances for their other extraneous effects not related to driving. Opioids and anxiolytics for instance are more likely to depress the central nervous system and keeps the user asleep - effects that are "opposite" to what commercial drivers would desire while on their job. , They used tobacco mostly before and while driving, which is consistent with the major reason for tobacco use that is cited as "to keep awake while driving." Respondents using alcohol were found to have been taking the drug essentially before and after the commencement of long-distance driving. This could be accounted for by the value placed on alcohol as a means of achieving pleasure and recreation as reported by the respondents as well as relaxation from the stress of day-to-day job. This finding was also reported in Southwest Nigeria. 
It was notable that there were drivers who took substances all the time for reasons such as "under peer influence," and "as part of my culture," and others for no obvious reason. This is crucial for the understanding that drug use in drivers may not necessarily be directly related to the driving occupation, as is often expected or believed; other factors or circumstances are codeterminants of this behavior and should guide the direction for drug intervention for this group of vehicle drivers.
From this study, there are indications that rather than the insistence on total abstinence from drugs and alcohol use by vehicle drivers as an only strategy in most control programs and law enforcement agencies around the world today that largely appears unrealistic and unsuccessful, attention should be redirected at harm reduction. The aim of restriction of substance use in drivers is mainly to prevent the risk of injury and death of the driver and his/her passengers as well as the effect of the drugs on his/her health. This may be more successfully achieved by harm reduction strategies. Harm reduction can be viewed as the prevention of adverse consequences of illicit drug use without necessarily reducing their consumption,  and the goal is to reduce adverse consequences, not eliminate the use of illicit drugs.  The strategies vary depending on who uses the drug, what drug is being used, and the type of harm envisaged to occur.  A strategy of legal restriction combined with instructive guidance to drivers on the "moderate use" of "licit" substance at a time when it poses minimum risk holds more potential, especially in settings where complete cessation of use is not practicable. In its application, the reasons drivers had given for the use of substances may be placed in the context of the reasons given for substance use in regulating drugged driving. For instance, a moderate consumer of alcohol may use alcohol after the day's job rather than before or while driving since he/she takes alcohol for pleasure and relaxation. A change in the pattern of drug use is the essence of the strategy. In addition, measures such as encouraging a better sleep habit and adjustment of travel schedule and hours of driving may minimize fatigue and sleepiness and ultimately reduce the desire for drugged driving.
| Conclusion|| |
The reasons for the use of psychoactive substances by vehicle drivers have been shown in this study to be related to the pattern of use. The pattern of use of these substances during driving which significantly determines the negative consequences such as road traffic crashes can be modified. As most strategies for controlling substance use in drivers in Nigeria are based on the enforcement of total abstinence, which has been quite difficult to implement, it is suggested by this study that a combination of total restriction and harm reduction strategies be cautiously applied. Since this study was conducted among long-distance commercial vehicle drivers who are arguably at the greatest risk for drugged driving, the reasons and pattern of drug use among this unique group of drivers have provided an insight to some motivations for drug use, which may hold true for other drivers globally.
Financial support and sponsorship
This work was financed from the author's personal funds.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Girotto E, Mesas AE, de Andrade SM, Birolim MM. Psychoactive substance use by truckdrivers: A systematic review. Occup Environ Med 2014;71:71-6.
Labat L, Fontaine B, Delzenne C, Doublet A, Marek MC, Tellier D, et al
. Prevalence of psychoactive substances in truck drivers in the Nord-Pas-de-Calais region (France). Forensic Sci Int 2008;174:90-4.
Bates MN, Blakely TA. Role of cannabis in motor vehicle crashes. Epidemiol Rev 1999;21:222-32.
Drummer OH, Gerostamoulus J, Batziris H, Chu M, Caplehorn J, Robertson MD, et al
. The involvement of drugs in drivers of motor vehicles killed in Australia road traffic crashes. Accid Anal Prev 2004;36:239-48.
Robbe H. Marijuana's impairing effects on driving are moderate when taken alone but severe when combined with alcohol. Hum Psychopharmacol Clin Exp 1998;13:70-8.
Ramaekers JG, Berghaus G, van Laar M, Drummer OH. Dose related risk of motor vehicle crashes after cannabis use. Drug Alcohol Depend 2004;73:109-19.
Robertson MD, Drummer OH. Responsibility analysis: A methodology to study the effects of drugs in driving. Accid Anal Prev 1994;26:243-7.
Lowenstein SR, Koziol-McLain J. Drugs and traffic crash responsibility: A Study of injured motorists in colorado. J Trauma 2001;50:313-20.
Horwood LJ, David MF. Drink driving and traffic accidents in young people. Accid Anal Prev 2000;32:805-14.
Neutel I. Benzodiazepine-related traffic accidents in young and elderly drivers. Hum Psychopharmacol Clin Exp 1998; 13:115-23.
Abiona TC, Aloba OO, Fatoye FO. Pattern of alcohol consumption among commercial road transport workers in a semi- urban community in south western Nigeria. East Afr Med J 2006;83:494-9.
Bello S, Fatiregun A, Ndifon WO, Oyo-Ita A, Ikpeme B. Social determinants of alcohol use among drivers in Calabar. Niger Med J 2011;52:244-9.
National Population Commission: Nigerian National Population Census; 2006. p. 9.
Araoye MO. Research Methodology with Statistics for Health and Social Sciences. Ilorin: Nathadex Publisher; 2003. p. 117-20.
Lasebikan VO, Baiyewu O. Profile of problems associated with psychoactive substance us among long distance commercial automobile drivers in Ibadan. Nig J Psychiatry 2009;7:9-13.
Asogwa EU, Anikwe JC, Mokwunye FC. Kola production and utilization for economic development. Afr Sci 2006;7:217-22.
Asogwa SE. Letters to the editor. AJPH 1978;68:113-4.
Costigan G, Crofts N, Reid G. Manual for reducing drug related harm in Asia. Melbourne, Victoria, Australia: The Centre for Harm Reduction; 2003, p. 35.
Hilton BA, Thomson R, Moore-Dempsey L, Jansen RG. Harm reduction theories and strategies for control of human immunodeficiency virus: A review of the literature. J Adv Nurs 2000;33:357-70.
Addy D, Ritter A. Clinical treatment guidelines for alcohol and drug clinicians. No 4: Reducing harm for clients who continue to use drugs. Fitzroy, Victoria, Australia: Turning Point Alcohol and Drug Centre. 2000. p. 38.
[Figure 1], [Figure 2]
|This article has been cited by|
||Patterns of Harmful Alcohol Consumption among Truck Drivers: Implications for Occupational Health and Work Safety from a Systematic Review and Meta-Analysis
| ||Nicola Bragazzi,Guglielmo Dini,Alessandra Toletone,Alborz Rahmani,Alfredo Montecucco,Emanuela Massa,Alessia Manca,Ottavia Guglielmi,Sergio Garbarino,Nicoletta Debarbieri,Paolo Durando |
| ||International Journal of Environmental Research and Public Health. 2018; 15(6): 1121 |
|[Pubmed] | [DOI]|
||Rationale and Implications of Psychoactive Substances Use Among Commercial Road Transport Workers in Lokoja, Nigeria
| ||Ajibade David,Adefolaju Toyin |
| ||Mediterranean Journal of Social Sciences. 2017; 8(5-1): 143 |
|[Pubmed] | [DOI]|
||A Concept Analysis of Substance Misuse to Inform Contemporary Terminology
| ||Khadejah F. Mahmoud,Deborah Finnell,Christine L. Savage,Kathryn R. Puskar,Ann M. Mitchell |
| ||Archives of Psychiatric Nursing. 2017; |
|[Pubmed] | [DOI]|