**1. Introduction**

The World Health Organisation (WHO) reported that there are 2 billion alcohol users and 185 million drug users worldwide in the general population [1]. Around the world, almost all people use one or more substances that affect their Central Nervous System (CNS), relieving physical and mental anguish or producing euphoria [2]. This is in spite of the fact that globally, there are approximately 250,000 deaths per year due to illicit drug use, and 2.25 million are caused by alcohol use [3]. Substances from all over the world currently flood South Africa (SA) [4]. The high prevalence of Substance Use Disorders (SUD) in SA makes it one of the top 10 substance-abusing countries globally [5]. This is a serious problem that needs to be attended to as soon

as possible. The prevalence of substance use among forensic Mental Health Care Users (MHCUs) in Kenya is 74.8% [6]. Among the admitted Norwegian MHCUs, the prevalence of SUD is as high as 50% [7]. These statistics show that the high rates of SUDs among the MHCUs are well documented in literature [7]. From these statistics, it could be possible that most of the countries' SUD is above 50%. This is a problem that needs further research. These high statistics are a serious concern and there are no studies or book chapters found on the nurses' coping strategies when caring for MHCUs diagnosed with SUDs. These are the reasons that prompted us to write this chapter. This chapter might add important literature in the field of psychiatry and mental health nursing science. The chapter might also be relevant for other mental health care practitioners, researchers, educators and policymakers who are also concerned about the nurses who are caring for MHCs who are diagnosed with SUDs.

On the other hand, some of the authors refer to Nigeria as a substance culture [6]. For instance, the Nigerians use substances such as coffee or tea for waking up in the morning, they take soft drinks or smoke cigarettes for staying alert throughout the day, they take alcohol as a way of relaxation, and they take paracetamol for pain [6]. This shows that there are some Nigerians who are taking substances every day or 365 days a year. According to the authors of this chapter, there is a possibility that more countries can also be regarded as "*substance cultures*" particularly SA because literature indicates that it is one of the top 10 substance abusing countries globally [5]. Interestingly, SUD does not discriminate among its victims, it affects women, men and people of all races and ethnicities [8]. However, SUD is among the most prevalent mental disorders. This includes Alcohol Use Disorder (AUDs) [3]. The following information is the DSM-5 criteria for SUDs [2]:

Problematic pattern of use that impairs functioning. Two or more symptoms within a one-year period:

a.Failure to meet obligations.


k.Craving to use the substance is strong.

From the above information, it is clear that SUD is a serious problem for the users, their families and nurses. As a result, we strongly recommend that something must be done as a matter of urgency. SUDs among MHCUs can be diagnosed with comprehensive
