الفهرس 
THE SCOPE OF DRUG DEPENDENCE PROBLEMOnly 14 pages are availabe for public view
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Abstract
S
ubstance use disorders are more highly stigmatized than other health conditions (Schomerus et al., 2011). There is no physical or psychiatric condition more associated with social disapproval and discrimination than alcohol and/or other drug dependence (Corrigan et al., 2006). Negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients (Boekel et al., 2013).
Several studies suggested a positive relationship between public stigma and intravenous drug use as well as self-stigma and perceived stigma and intravenous drug use risk behaviors among individuals who use drugs. Moreover, researchers reported preliminary findings indicating a complex relationship between public stigma and kind of substance used. Data seems to suggest that alcohol/drug use is more stigmatized than other mental health conditions but results regarding differences in public stigma between alcohol and other drug use (i.e. cocaine) are mixed (Kuleszaet al., 2014).
Several instruments exist for use with a mentally ill population measuring experiences with enacted stigma, perceived stigma, and internalized stigma however; the experiences of stigma in substance using populations are not as well researched. New measures of stigma specific to substance misuse are needed if research on this area is going to progress (Link et al., 2004).
The purpose of our study was to measure and compare stigma variables (familiarity, perceived dangerousness, fear, and desired social distance) towards those with substance use problems among medical students and psychiatric professionals. Participants asked to fill out the sociodemograhic sheet and 4 iterations of a single questionnaire each designed to fit a specific addiction (alcohol, hashish, heroin and tramadol dependence). Each questionnaire had scales to measure the four variables in model: familiarity, perceived dangerousness, fear, and desired social distance. Medical students who participated in the study were in lectures or in clinical round .Psychiatric professionals were in their place of work. The questionnaires were distributed to the participant and took 30-45 minutes for completing.
Results
The study sample consisted of 208 (44.5%) male, 259 (55.5%) female. Their mean age was 25 ± 6.1. Their residence is 234 (50.1%) in rural area, 233(49.9%) in urban area. Their work place is 351 (75.2%) in medical school, 33 (7.1%) in Menoufeya University Hospital, 25(5.4%) in Menoufeya Educational Hospital, 58 (12.4%) in Shebeen EL-Koum Hospital for Mental Health and Addiction Treatment Center. 367(80.5%) are single, 81 (17.3%) are married, 7 (1.5%) are divorced and 3(0.6%) are widowed.
There were 161 (45.9%) male, 190 (54.1%) female among medical students group. Their mean age was 22.6 ± 0.5. Their residence is 177(50.4%) in rural area, 174 (49.6%) in urban area. Their workplace is 351 in medical school (100%). 342(97.4%) are single, 9 (2.6%) are married.
There were 26(40%) male, 39 (60%) female among nurses group. Their mean age was 29.9 ± 7.9. Their residence is 32(49.2%) in rural area, 33 (50.8%) in urban area. Their workplace is 8 (12.3%) in Menoufeya University Hospital, 10 (15.4%) in Menoufeya Educational Hospital, 47(72.3%) in Shebeen EL-Koum Hospital for Mental Health and Addiction Treatment Center. 15(23.1%) are single, 45(69.2%) are married, 3(4.6%) are divorced and 2 (3.1%) are widowed.
There were 21 (41.2%) male, 30 (58.8%) female among doctors group. Their mean age was 35.4 ± 9.4. Their residence is 25 (49%) in rural area, 26 (51%) in urban area. Their work place is 25 (49%) in Menoufeya University Hospital, 15 (29.4%) in Menoufeya Educational Hospital, 11(21.6%) in Shebeen EL-Koum Hospital for Mental Health and Addiction Treatment Center. 19 (37.3%) are single, 27(52.9%) are married, 4 (7.8%) are divorced and 1 (2%) are widowed.
It was found that 410 of the participants were previously exposed to addiction patients (87.8%).The mean duration of experience was 1.8 years ± 4.7.
There was a statistically highly significant difference (P < 0.01) with doctors group showing the highest percent of exposure to addicts (100%), their mean duration of experience was 0.7 years ± 0.6.
In our study there was a positive correlation between familiarity and age and a negative correlation between age and perception of dangerousness, perception of fear and social distance which means there was a negative correlation between age and stigma. This means that as the person gets older, the stigma towards substance use disorders patients decreases. However, in our sample, getting older is associated with increased exposure to patients with these disorders, which might explain these changes in stigma.
In our study the stigma was higher among females towards all type of psychoactive substances except for tramadol.
In our study the stigma was higher with single participants. Among doctors participants the stigma was higher for alcohol in single participants and the stigma was higher for marijuana in divorced participants. Among nurses group the stigma was lower in married participants for tramadol. Among medical students the stigma was higher in married participants for alcohol and marijuana.
In our study the stigma was higher in medical students for all examined psychoactive substances.
In our study the stigma was lower in doctors and nurses working in Shebeen EL-Koum Hospital for Mental Health and Addiction Treatment Center for almost all the examined psychoactive substances.
In our study the results showed a negative correlation between years of experience and stigma.
In our study marijuana showed the highest familiarity (lower stigma) among different psychoactive substances and heroin showed the highest perception of fear and social distance (higher stigma) among different psychoactive substances.