Background information: The unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious public health challenge across the globe, with the use of psychoactive substances among drivers implicated in every three out of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State. Methods A descriptive cross-sectional design was used for the study. A total of 400 commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique. The data was analyzed with IBM SPSS, and the level of significance was set at 0.05. Results The mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever used a psychoactive substance was 74.3%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about pyschoactive substance abuse. Among the factors found to be significantly associated with substance use among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p < 0.001) and poor perception (p < 0.001). However, this study found religion (p = 0.031; OR = 5.469; CI = 1.170 to 25.555), knowledge (p < 0.001; OR = 4.21; CI = 2.201 to 8.287) and perception (p < 0.001; OR = 9.828; CI = 15.572 to 65.052) as determinants of substance use abuse. Conclusion Religion, along with poor knowledge and poor perception, were the major determinants of substance abuse among commercial bus drivers. Targeting commercial bus drivers for educational interventions as well as using religious leaders as conveyor belts may therefore reduce the use of psychoactive substances among them.
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