الفهرس 
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Abstract
A substance abuse is a mental disorder that affects a person’s brain and behavior, leading to a person’s inability to control the use of substances such as legal or illegal drugs, or alcohol. Substance abuse have a variety of symptoms that range from moderate to severe, and ended with addiction the most severe form. On the other hand, the researchers have found that about half of individuals who experience a substance abuse during experience a co-occurring mental disorder. Co-occurring disorders can include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD), bipolar disorder, personality disorders, and schizophrenia (National Institute of Mental Health, 2021).
The withdrawal symptoms resulting from substance abuse can be uncomfortable and even life-threatening in some cases. Hence, medically assisted detoxification is the process of disengaging a person from a specific psychoactive substance in a safe and effective manner. The choice of which strategy to use for detoxification can depend on many factors, involving clinical judgment, the users’ personal preference and circumstances, lifestyle and expectations, degree of dependence and concomitant health problems (Anderson, 2020).
This study aimed to assess the emotional problems among substance dependent patients undergoing detoxification.
Research question:
What are emotional problems among substance dependent patients undergoing detoxification?
Research design: -
Descriptive design has been utilized in this study.
Research setting:
The study was conducted in the National Center for Addiction affiliated to the Abbasia mental health hospital.
Subjects of the study:
A sample of 92 substance dependent patients who agree to participate in the study and fulfilled the following inclusion criteria:
• Sex: both sexes.
• Age: from18 to 45 years.
• Number of admission: (has a previous admission).
• Period of substance dependence: one year or more.
• Number of drug dependence (one or more than one substance abuse).
Selection of the sample:
Convenient sample was used in the current study.
Tool of data collection:
Data were collected by using the following tool:
II. Structured interviewing questionnaire sheet:
An Arabic questionnaire was developed by the researcher, after reviewing the related literature and consisted of two parts:
The first part consisted of the following:
A. Socio-demographic characteristics of the studied patients (Appendix I): That included age, sex, educational level, marital status, occupation, types of admission, and family history.
B. Clinical data about substance abuse: That included age at the beginning of drug addiction, the current used drugs, rout of administration, duration of drug addiction, the reason for drug addiction, the pattern of usage, the desired effect to resort drug addiction, and the general effect of drug addiction on health, problems associated with drug addiction, previous attempts to give up drug addiction, reason for giving up drug addiction know, and support system during quit substance abuse.
The second part consisted of the following scales:
C. General Health Questionnaire (GHQ-28) (Appendix II): It was developed by (Goldberg, Gater & Sartorius, 1997) and adapted by the researcher including 28 items, grouped into four subscales; a- physical health, b- anxiety and insomnia, c- social dysfunction, and d- severe depression.
Scoring system:-
Each subscale contains seven items and was rated of four-point scale ranging from ”not at all” to ”much more than usual”. These were scored respectively from 0 to 3 so that not at all indicated to (0), less than usual indicated (1), more than usual indicated (2), and much more than usual indicated (3).
The score of each subscale items were summed-up and the total of each subscale divided by the number of the total items, giving a mean score for each subscale. These scores were converted into a percent score. The score higher than 60% considered worth mental health and considered good mental health if it less than 60%.
D. Brief Substance Craving Scale (BSCS) (Appendix III): It was developed by (Somoza, Baker, Himmler, Locastro, Mezinskis & Simon, 1995), and consisted of 16 items which used to assess the studied patients’ craving for three addictive drugs over a 24 hour period. It was also asked about the intensity, frequency, and duration of craving, and overall intensity of cravings during the past 24 hours since the last use of drugs.
Scoring system:-
All the items of intensity, frequency, and duration of cravings were rated on 5 point likert scale. The score of each subscale items were summed-up and the total of each subscale divided by the number of the total items, giving a mean score for each subscale. These scores were converted into a percent score. The score higher than 60% corresponded to higher craving, and the score lower than 60% corresponded to low craving.
The result of the current study can be summarized as the following:
• Regarding the socio-demographic characteristics of the studied patients; more than half of them aged between 30-- to less than 40 years old, with a mean age of (34.48 ± 7.65), more than three quarters of them were males, and about one third of them had intermediate education. Regarding the marital status and occupation, less than half of the studied patients were married, and less than half of them were craftsman. Concerning the admission, less than three quarters of them had voluntary admission.
• Concerning the family history of addiction among substance dependent patients; slightly less than two thirds of them had family history of addiction.
• Regarding the substance dependent patients’ current drug using pattern; less than half of them aged between 30 to less than 40 years old when they started addiction, less than one fourth of them were taking Estrox, and less than half were taking the drugs orally. Moreover, the majority of them started drug addiction more than a year ago.
• More than one third of the substance dependent patients addicted drugs due to peer pressure, more than half of them were taking the drugs regularly every day, slightly less than one third of them were taking the drugs in order to increase their attention, and all of them mentioned that there was a negative effect on their health due to drug addiction.
• Regarding the substance dependent patients’ general health condition; more than half of them feel that their health much worth than usual, less than two fifths of them were feeling headache much more than usual, less than two fifths of them were suffering from tightness or pressure in their head, and else need of energizers more than usual to improve health condition.
• Concerning the presence of anxiety and insomnia among the substance dependent patients; more than half of them much more than usual had difficulty in staying asleep once they are off, fell constantly under strain, found getting everything on top of them, and feeling nervous and strung-up all the time respectively.
• Regarding the presence of social dysfunction among the substance dependent patients; slightly less than half of them more than usual takes long time to do things than before, while less than half of them less than usual feel that they are playing a useful part in things or being able to enjoy their normal day-to-day activities respectively.
• As regards the presence of severe depression among substance dependent patients; more than half of them much more than usual thinks themselves as a worthless person, less than half of them don’t feel that the life isn’t worth living, while more than half of them definitely don’t have any suicidal thoughts.
• Concerning the substance dependent patients’ total mental health score; the majority of them had a worth total mental health score.
• Regarding the substance dependent patients’ total craving score to the addictive drugs; three quarters of them had a high total craving score.
• As for the relation between the substance dependent patients’ total mental health score and their socio-demographic characteristics; there were highly statistically significant differences found between the substance dependent patients’ total mental health score and the all items of their socio-demographic characteristics at (P≤0.001).
• Concerning the substance dependent patients’ total craving score and their socio-demographic characteristics; there were highly statistically significant differences found between the substance dependent patients’ total craving score and the all items of their socio-demographic characteristics at (P≤0.001).
• Regarding the correlation between the substance dependent patients’ total mental health and total craving; there was highly statistically significant positive correlation between the substance dependent patients’ total mental health and total craving at (P≤0.001).
In the light of the present study findings and research question, the following can be concluded: -
The highest percent of substance dependent patients point out that family was the main support for them during quite substance abuse.
The highest percent of substance dependent patients had a worth total mental health score and high total score of craving.
In the light of the present study findings the following recommendations are suggested:-
• Further study should be carried out on the aspect of improving the substance dependent patients’ self-esteem after detoxification.
• Further study should be carried out on the aspect of improving the substance dependent patients’ quality of life after detoxification.
• A psychosocial nursing intervention about positive coping skills to reduce craving belief among substance dependent patients referred to addiction centers.
• A psycho-educational program about social adjustment should be applied for the substance dependent patients based on a treatment protocol during their hospitalization