Examination of childhood trauma and self-esteem of individuals WHO applied to the probation office due to substance use

Substance abuse is the use of an illegal substance or the misuse of a legal substance in a harmful way. Substance abuse has been increasing worldwide. Serious additional problems are seen as a result of social, economic and medical effects of substance use. In order to prevent the consequences of substance abuse, legal regulations have been established in our country as well as in the world. Instead of arresting and imprisoning people with substance abuse, the practice of probation system, which is an alternative method of punishment, is preferred. With this system, it is aimed to help individuals to keep addiction under control, provide appropriate treatment and follow-up. 73 individuals who were referred to Adıyaman Training and Research Hospital Psychiatry Outpatient Clinic between 01.09.2019 and 01.01.2020 due to the "Treatment and Probation" decision were included in the study. Hospital records indicated that they had substance abuse, and they confirmed having had a history of substance abuse during the examinations of the participants in the outpatient clinic. On the other hand, we randomly selected a control group of 73 individuals, who did not have a history of substance use and known psychiatric diseases, with similar age, marital status, and gender characteristics of the patient group. The study was conducted prospectively. 146 individuals who were informed to participate, and whose written and verbal consent was obtained, were included. We aim to examine the sociodemographic and substance abuse data of both groups, childhood trauma (CT), self-esteem level and accompanying psychiatric disease data in individuals with substance abuse, and to compare these data. A Structured Clinical Interview for DSM-5-Disorders - Clinician Version (SCID-5/CV) was applied to the participants with substance use. Thus, it was planned to determine possible psychiatric diagnoses in individuals. It was aimed to examine the relationship between childhood traumas and substance use by applying the Childhood Trauma Scale to all individuals. The Rosenberg Self-Esteem Scale was applied to the participants and the self-esteem levels of individuals with substance abuse were evaluated. It was observed that all of the cases (n = 146) were male. The mean age of the participants was 28.88 ± 5.70 in the probation group and it was 27.59 ± 7.55 in the control group. There was no significant difference between the groups (p = 0.247). The majority of the participants, 101 cases (69.2%) were observed to be in their young adulthood between the ages 18 and 30. It was noted that 67.1% (n = 49) of the probation group were primary school graduates or less, and 86.3% (n = 63) of the control group were high school graduates or above. In the probation group, it was determined that 53.4% (n = 39) of the individuals used a single type of substance use, and 46.6% (n = 34) had multiple substance use. It was observed that cannabis was the most (n = 54; 74.0%) used substance in these cases. The mean age of first use of the substance was found to be 18.40 ± 5.14 years. It was understood that substance use was most frequently started the ages of between 16 and 20 (n = 39.7%). It was determined that individuals with substance abuse committed crimes more frequently, with a higher rate of crime history and substance abuse in their family. It was found that the participants in the probation group had a significantly lower self-esteem and a high rate of exposure of CT. Based on all the cases that are examined in this study, it was concluded that as the level of self-esteem decreased, exposure of CT was higher. In our study, it was found that the education level of the probation group was significantly lower than the control group. In order to reduce substance use, individuals should be educated starting from the primary education period. It was evaluated that multiple substance abuse made the treatment process difficult due to the individuals with multiple substance abuse having started at an earlier age, having a longer history of substance abuse, having higher rates of substance treatment and alcohol use. It was noteworthy that the rate of CT was high (72.6%) among substance users. This was attributed to the tendency of individuals who were victims of CT to abuse substances in order to eliminate the loss of self-confidence and normalize the symptoms of depression after abuse. Self-esteem level was observed to be an important factor in starting and continuing substance abuse. In effective fight against substance abuse, it was thought that sociocultural programs should be implemented and accessibility of these programs should be expanded in order to increase the self-esteem levels of individuals. In the study, it was observed that as the level of self-esteem decreased, the rate of exposure of CT was significantly higher. In light of this, we encourage that studies should be conducted to educate families about the concept of childhood trauma and its possible future consequences. Among individuals with substance abuse; A higher rate of comorbid psychiatric disorders was found in those with CT. In addition, it was observed that as the level of self-esteem decreased, the possibility of comorbid psychiatric disorders increased. A positive relationship was found between childhood traumatic experiences, low self-esteem, and adult psychiatric disorders. Finally, it was concluded that childhood traumatic experiences and self-esteem levels should be evaluated routinely in individuals with substance abuse.