الفهرس 
Substance use disordersOnly 14 pages are availabe for public view
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Abstract
SUDs has been and continues to be a primary, chronic, progressive, and often fatal health problem (Dunn, 2005).During course of the disorder the person with SUDs loses control over the use of psychoactive substances (SAMHSA, 2005). SUDs are the most common psychiatric disorders and constitute a major public health concern (Kessler et al., 2005). The harm befalling human civilization from an increasing problem of alcohol and other substance misuse cannot be overstated )UNODC, 2009(. The consequences of SUDs can include interpersonal difficulties, interference with work or school, legal problems, and even death (Mueseret al., 2003). Risk factors of SUDs exist in different domains: individual, family, peer, school, local community, macro environment. These domains interact with each other in a complex web of causation. Risk factors can also be situational; for example, features of licensed premises can impact upon levels of violence (Homel et al., 1999). Serious medical problems may develop that affect job performance and occupational roles. Individuals with SUDs are at greater risk of developing chronic health conditions, such as cirrhosis of the liver and autoimmune deficiency disorders. They are also at higher risk for cardiovascular disease, hypertension, cerebro-vascular accidents, diabetes, and depression (NIAAA, 2001). The abuse of alcohol and other drugs increases the risk of death from automobile accidents as well as injuries received from recreational activities (Thompson, 2007). Nursing is a profession of nobility and high esteem, however the demanding and stressful nature of their job, many nurses have fallen into “the traps of substance abuse” (Onuoha et al., 2014). The misuse, abuse and dependency of substances amongst nurses, as a maladaptive pattern of substance use, with adverse consequences, on the physical health, and by extension the work performance of the affected nurse as well as the development of tolerance, withdrawal, and compulsive drug-taking behavior which is consistent with addiction and substance abuse (Naegle, 2012). Access is important risk factors of SUDs for nurses in the workplace are which means that the ready availability of drugs is an occupational hazard, especially when combined with a poorly managed administration of controlled substances in health care facilities (Trinkoff et al., 1999a). Stress is a common risk factor of substance use among nurses. The relationship between work schedule characteristics and substance use was; the more adverse the schedule characteristics, the greater the likelihood of substance abuse. The schedule characteristic most strongly associated with substance use was a combination of shift rotation and long shifts. Shift work and long work hours also lead to fatigue, sleep deprivation, circadian rhythm disruption, and other psycho-physiological consequences (Geiger-Brown & Trinkoff, 2010). Lack of education on the addictive process and its signs and symptoms remains one of the more profound—and overlooked—risk factors for nurses. This lack of education contributes to the negative stereotypes of those with substance use disorders, especially nurses and physicians (Chappel, 1992, Grower& Floyd, 1998). problematic substance use can affect an individual’s cognitive functioning and judgment, as well as her/his ability to make decisions, respond appropriately, and/or handle stress, it is considered a threat to nurses’ professional standards and the provision of safe, competent and ethical nursing care. If left unchecked, problematic substance use can lead to adverse circumstances for clients and nurses (CRNNS, 2008). Denial is a defining feature of addictions and the chemically dependent nurse is often the last to see that she [he] has a life-threatening illness (Hughes & Smith, 1994). Denial may also be compounded by cravings: compelling urges to use a substance that dominates a person’s thoughts and can affect a person’s mood, behavior and actions. Some nurses with an addiction have described these cravings as being all-encompassing, in that the need for the drug directs how they organize their workday - to access drugs and hide their addiction (Lillibridge et al., 2002). Colleagues may also unintentionally contribute to an affected nurse’s denial through their own denial or by enabling. Enabling allows inappropriate and non-productive behavior in another person to go unquestioned; allowing a colleague to avoid confrontation while, in effect, encouraging and perpetuating her/his behavior (NANB, 2003). 417 nurses from 3 major hospitals in Cairo, Egypt recruited into the present study. Each nurse assessed with the Sociodemographic sheet & Alcohol, Smoking and Substance Involvement Screening Test t (ASSIST). Nurses who reported using substance according to (ASSIST) were further and individually assessed by Mini international neuropsychiatry interview (MINI) Regarding the present study, the rate of substance use at least once in the last 3 months were 21.6%, non user at all about 78.4 %. Smoking tobacco was the most substance use. The rate of psychiatric comorbidities among nurses who used substances about 64.4%. The most common comorbid psychiatric disorders noticed among nurses with history of substance use were major depressive disorder and generalized anxiety disorders. Gender, religion, educational level, marital status, specialty, salary income and type of hospitals had a significant relation with using substance among nurses. Gender, Religion, Salary income and type of hospital were independent predictors of substance use.