Prevalence and factors associated with controlled drug misuse among health workers in Ibanda District, Uganda: a cross-sectional study.

Abstract

Background: Objective: To determine the prevalence of, and factors associated with, controlled drug misuse among health workers at two health facilities within Ibanda District.  Methods: A hospital-based cross-sectional study was conducted among health workers at two health facilities in Ibanda District. A census sampling approach was employed, in which all 144 eligible health workers were invited to participate; 115 consented, yielding a response rate of 79.9%. Data were collected using a structured, self-administered questionnaire and analyzed in SPSS version 27.0. Descriptive statistics were used to summarize the characteristics of the respondents and the prevalence of misuse. Chi-square tests examined bivariate associations, and variables with p<0.20 were entered into a binary logistic regression model with multiple explanatory variables. Statistical significance was set at p<0.05.  Results: The prevalence of controlled drug misuse was 46.96% (54/115). Among those reporting misuse, pain management (59.26%), sleep aid (29.63%), and stress relief (11.11%) were the most cited reasons, while tramadol (42.6%) and opioids (40.7%) were the most commonly misused substances. At the bivariate level, years of work experience, weak supervision, infrequent stocktaking, easy access to controlled drugs, excessive workload, inadequate staffing, extra shifts, pressure to maintain a professional image, anxiety, use of sedatives or alcohol to aid sleep, and emotional exhaustion were significantly associated with misuse (p<0.05). After adjustment for confounders, emotional exhaustion remained the sole independent predictor of controlled drug misuse (AOR=15.40; 95% CI: 1.75-135.53; p=0.014).  Conclusion: Controlled drug misuse is widely reported among health workers involved in the study facilities. Emotional exhaustion emerged as the strongest independent correlate, drawing attention to the effects of workplace pressure, stress, and burnout in contributing to misuse behaviours.  Recommendation There should be strengthening of controlled drug management systems and instituting staff mental health and wellness programs to help reduce controlled drug misuse among healthcare workers.