Substance Use Disorders among Patients With Sickle Cell Disease, A Case Series and Literature Review

AbstractIntroductionThe commonest complication of sickle cell disease (SCD) is vaso-occlusive crises resulting in recurrent pain episodes. The stress of adult roles and responsibilities increases this risk as well as the use of substances to relieve pain and reduce stress. This increases their chances of developing substance use disorders. This study aimed at reawakening clinicians to the increasing problem of drug abuse among SCD patients.Methods.This case series and literature review employed a qualitative and quantitative study design involving 8 SCD patients attending a mental health clinic. Diagnoses of Substance use disorders and mental disorders was based on ICD 11 diagnostic criteria. Qualitative data analysis was triangulated with quantitative data analyzed using SPSS version 25 for continuous and categorical variables.Results: Mean age of participants was 34.57(SD± 5.79). Types of substances used included: pentazocine, amphetamine, ketamine, and cannabis. Pentazocine was the commonest, followed by cannabis. Reasons for substance use include pain, cravings, withdrawal symptoms, insomnia, loss of appetite, and for relaxation. Three (37.5%) of the patients inject selves. Complications reported included, dirty wounds, ulcers, abscesses, ugly scars/swellings and priapism. At least 62.5 % of the clients had co-morbid substance use disorder (SUD) and mental illness e.g. depression, anxiety, insomnia, suicidal ideation and aggressive tendencies. Conclusion: Substance use disorders is common among SCD patients, often unrecognized and frequently co-morbid with mental disorders emphasizing the importance of a holistic and multidisciplinary approach in the management of adults with sickle cell disease.