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Table of Contents
ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 13-17

Trends and patterns of drug abuse in select population of Punjab in year 2016-201


1 Demonstrator, SINPMS, BFUHS, Badal, Punjab, India
2 Associate Professor, University college of Nursing, BFUHS, Punjab, India
3 Professor and Head, Dept of Psychiatry, GGSMCH, Faridkot, Punjab, India

Date of Web Publication10-Jul-2019

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-1505.262499

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  Abstract 


Background: Psychoactive substance abuse in India continues to be a substantive problem for the individual as well as for the society. However, its consumption trends are liable to change from time to time which seems challenging to traditional treatment interventions. It has negative impact on physical and mental health, interpersonal relationship, financial status and occupation of substance users and their family.Aim: The aim of the study is to assess the recent trends of drug abuse by drug users in Punjab. Methods: Quantitative, descriptive research approach with cross-sectional survey design was used to assess the pattern of drug abuse in 200 conveniently selected drug users visiting tertiary care level hospital of Punjab by using socio-demographic sheet and pattern of substance use sheet. Results: Majority (54.5%) of drug users were using opioids. Mean age of initiation of all drug use was 20 years. More than half (62.5%) of subjects were indulged in drug use due to suggestion of friends. Heroin was reported most expensive drug by users. Majority (86.5%) of subjects were using drugs at agricultural fields, river banks, old buildings and lonely places etc. Maximum (42.5%) of subjects were admitted to de-addiction ward due to financial problems. Conclusion: Study concluded that pattern of drug use changed from natural to synthetic/medical substances. Appropriate interventional strategies need to be used to address with changed drug use pattern during the care of patients.

Keywords: Trends, substance use


How to cite this article:
Kaur A, Maheshwari S K, Sharma A. Trends and patterns of drug abuse in select population of Punjab in year 2016-201. Indian J Psy Nsg 2018;15:13-7

How to cite this URL:
Kaur A, Maheshwari S K, Sharma A. Trends and patterns of drug abuse in select population of Punjab in year 2016-201. Indian J Psy Nsg [serial online] 2018 [cited 2021 Oct 16];15:13-7. Available from: https://www.ijpn.in/text.asp?2018/15/1/13/262499




  Introduction Top


The use or abuse of drugs in one form or the other has lived with the mankind as a part of life for ages. Natural drugs prepared from plants or fruits that grow wild have been abused in Asia since ancient times.[1] According to WHO (2014),1.1 million smokers in the world, about 1/3 under age of 15 years, 21.4% alcohol users, 30% cannabis users, 0.2% heroin users,0.4% opium users and 0.1% other opiates users.[2]

For the last three decades, India has become a transit hub as well as destination for heroin and hashish produced in the ‘Golden Triangle’ and the ‘Golden Crescent’.[3] As per National survey (2006), an estimated 7.5 crore Indians were drug addicts and number is going up significantly. It was estimated that about 6.25 crore alcoholics, 90 lakh cannabis and 2.5 lakh opiates and nearly 10 lakh illicit drug users in the country. A high level of alcohol, cannabis and opioids abuse was reported in North east and Western regions of India.[4]

In a survey of Punjab government (2009), extent of drug abuse was found to be 70% in Punjab Household survey suggested that there was at least one drug user in 65% of families in Maja and Doabaa and 64% families of Malwa. Tarn Taran was most affected rural district and Amritsar was the most affected urban district in Punjab. In border areas, the extent of substance abuse was 70-75% in age group of 15-25 years and up to 40% in the age group of 35-60 years.[5]

There are many reasons for initiation of substance abuse such as easy availability, peer pressure, suggestion of friends, imitation of parents etc. A descriptive study on 50 drug users from 6 villages of Punjab and found that peer pressure or influence, addiction in family history and exposure to drugs were found to be main instigators for youth to indulge in drug abuse. Factors responsible for continuation of drug abuse were mainly withdrawal symptoms and social labeling of addicts. The main consequences of addiction among youth were found to be negative impact on health, loss of social reputation and broken families.[6]

However, the substance abuse is liable to change over time. It depends upon various factors such as availability of substance abuse, cost of substance in community, existing legislations and their implementations, social perception, attitude about use of particular substance, peer pressure and other socio-cultural factors. Therefore pattern of substance use is changing over time.[7] A study on 1730 subjects of rural Punjab reported that 93.18% individuals of the total cases surveyed had used alcohol during the past 12 months. Age at first alcohol use was 15-44 (99.78%) years, whereas 3.77% used alcohol before age of 15years.[8]

Another study showed that the prevalence of substance use was 60.0% for ever users and 34.93% for regular users. Among ever users, alcohol (44.49%) was the most common substance used while tobacco (14.42%) was mostly consumed by regular users. Substance use was more in age group of 17-19 years belonging to nuclear family. Overall 42% were using more than one drug combination.[9] The problematic situation of substance use in Punjab and emergence of new illegal synthetic drugs ignite the mind of researchers to conduct this study.


  Materials And Method Top


Quantitative, descriptive cross sectional survey design was used to collect data from 200 conveniently selected drug users who were admitted to de-addiction ward or visiting de-addiction OPD of a tertiary care level medical college hospital, Faridkot during November 2015 to 2016. Relapse cases were excluded from the study. Following two tools were used in the study which are as follows:-

Socio-demographic data sheet: It is self developed questionnaire which is used in this study to measure socio demographic profile of the subjects. Items included are age, gender, residence, religion, type of family, educational status, marital status, occupational status, any type of substance or alcohol use by primary care giver.

Tool : Pattern of drug use questionnaire: It is self developed questionnaire which is used in this study to measure drug use profile of the subjects. Items included are type of drug used, age at onset, duration, reason for starting drug use, source of availability of drug, drug frequency, location of taking drug, need to increase amount of existing use of drug and money spent.

The reliability of the tool by test-retest reliability (0.87 ). Pilot study was conducted on twenty subjects and the study was found to be feasible.

After obtaining the permission from significant authorities and subjects, data was obtained from subjects only after obtaining their informed consent. Appropriate descriptive and inferential statistics was used to analyze data. p value <0.05 was considered as level of significance.


  Results Top


Socio demographic characteristics of subjects

Mean age of subjects were 31.51±9.7. All (100%) of subjects were male. Majority (83.5%) of subjects were belonging to rural area,majority (85%) of subjects were Sikh. More than half (57%) of subjects were living in nuclear families, whereas Maximum (38%) of subjects were educated upto secondary, whereas 10.5% of subjects were illiterate. Nearly two third (65%) of subjects were married, one third (35%) of subjects were farmers. More than half (59.5%) of subject’s primary care givers were also using substance.


  Drug use trends Top


As given in [Table 1] that shows distribution of subjects as per their type of drug use. Slightly more than half (54.5%) of subjects were using opioids [among opioids slightly more than half (51%) subjects were using heroin, whereas 2.5% were using opium (Poast) and 1% were using morphine] and 1% was using cannabis.
Table 1: Frequency distribution of subjects according to type of drug use n=200

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As given in [Table 2] that the distribution of subjects according to amount of drug use, age of initiation and total duration of substance use. The mean age of initiation of all types of drug use was 20 years, only heroin was having late age of initiation i.e. 24 years.Heroinwasusingwithl argedose i .e.1.30gm/day.
Table 2: Distribution of subjects according to amount of drug use, age of initiation and total duration of substance use. n=200

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Asgivenin [Table 3] that distribution of subjects according to reason of their drug use.Morethanhalf(62.5%)ofsubjectswereindulged in drug use due to suggestion of friends, 59.5% due to peer pressure. 39% due to curiosity or experimental, 31% due to recreation, 18.5% due to easy availability, 16% due to increase physical performance, 11.1% due to release of tensions and worries, 10% due to substitute for other drugs, 8.5% were due to imitation offather, 2% were due to sleep induction, 1.5% i mitation of siblings, 1.5% due to traditional view, 1.5% due to family problems and only 1% were due to marital disharmony(divorce, forcemarriage).
Table 3: Distribution of subjects according to reasons for starting drug use n=200

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Asdepicted in [Figure 1] that the distribution of subjects according to theirlocationofdruguse. Majority(86.5%)ofsubjectswereusing substance at other places like agricultural fields, river banks, old buildingsandl onelyplacesetc.
Figure 1: Distribution of subjects according to their place used for taking substance

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As given in [Table 4] that the subjects who were using heroin, spending large amount of money on drug use.
Table 4: Distribution of subjects according to money expenditure n=200

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A person may have more than one reason to continue drug use

As given in[Table 5] tha treveals distribution of subjects according to reasons ofcontinuing drug use. More than halfsubjects continue substanceusetoavoidwithdrawalsymptoms.
Table 5: Distribution of subjects according to reasons to continue drug use n=200

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  Discussion Top


In present study all subjects were male. Prevalence of substanceusewashighinruralarea(83.5%)ascomparetourban area(16.5%)andthosewhoweremarried(65%).Morethanhalfof subjects (59.5%) had primary care giver who were using substance. These findings are supported by Gupta VK et al[1] in

Punjab, who reported that all substance users were males and 65%weremarried.Incontrast, Tiwari SCetal[10]that prevalence of substance use among males was 30.22% and 4.09% in females in Lucknow. Another study by Carl DC et al[11] found that prevalence of substance use in California was 31.8% among males and 21.4% were females, in Texas 27.3% were males and 21.4% were females and in New Mexico 13.6% males and 7.1% females.

These gender differences of subjects in substance use in India and western country may due to different social norms. There might be substance use by females but it is under reported due to social stigma, shyness and male dominance etc. Although substance use is present in females but it is quite low as compare to males in Western countries also. Disinhibiting and thrill seeking behavior traits may be responsible for substance use more in male s than in females.

The present study revealed that pattern of substance use has been changed from natural drugs to synthetic drugs. Itwas found in current study that 54.5% of subjects were using opioids [heroin(51%), poast (2.5%) and morphine(1%)], 45.5% cigarettes, 38.5% tobacco, 35.5% tramadol, 34.5% alcohol and only1%wasusingcannabis.Thepresentstudywassupportedby a study conducted by Singh SJ et al[12] and found that the pattern of substance use changed. Opium use has decreased, the use of poppy husk and OTC drugs like dextroproxyphene, diphenoxylate, codeine has been increased. Although it is old findings, but have importance to interpret findings. Similarly, study conducted by Basu Detal[13]revealed that the proportion of subjects using natural opioids decreased over the three decades with a concomitant emergence and/or increase of newer and prescription opioids such as buprenorphine, codeine and dextropropoxyphene. The pattern of drug use is liable to change. Waxingandwaning of substanceuse trends are supplier driven more than they are symptomatic of consumer demands.

The present study demonstrated that 59.5% subjects were indulged in drug use due to peer pressure and 62.5% subjects were used substance due to suggestion of friends. The present finding is supported by Farrel DA and Kamila S[14], who concluded that peer pressure and peer drug use was significantly related to the reported frequency of drug use. Borrari B and Cary K[15] did extensive review literature about peer influences and drug use and found that interpersonal process strongly influence college studentdrinking. At woliLet al[16] reported in that 75.1% were introduced by a friend while 23.5% were introduced by a relative other than a member of the nuclear family. Addiction is like a dormant seed, waiting there, even for decades for something to bring to life. The substance comes and the addiction begins to blossom. Here, peer pressure act as water to germinate this dormant seed and help them to blossom.


  Conclusion Top


The present study revealed that trends of drugs use is liable to change. Peer pressure can be a factor for initiation of substance use. Therefore, information related to substance use must be included in the curriculum of adolescents to curb the menace of substance use atan early stage.The present studywas delimited to single setting. Similar study can be conducted on l arge sample with multiple settings. Study recommend that policy makers should keep study findings in mind while making policies for drug usersandi nterventionsfortheirde-addictionclients.

Conflict Of Interest :

None.

Acknowledgement :

Authors would like to thank all participants of the study.



 
  References Top

1.
Gupta Kumar Vikram, Kaur Paramjeet, Singh Gurmeet, Kaur Amanpreet, Sidhu B.S. Profile of patients admitted in the de-addictioncenters i nthestateofPunjab.ISSN(0)[internet].2013[cited 2015 April 16];1(2):53-62.Availalblefrom:www.ijrhs.com.  Back to cited text no. 1
    
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Dube S, ChaudharyA, Mahajan R, PurohitR, Chaudhary S, Saluja N, etal.PrevalenceandpatternofalcoholabuseinaruralareaofPunjab. JofEvolutionofMedandDentSci.2015;4(19):3293-3302.  Back to cited text no. 10
    
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Qadri S, Goel RKD, Singh J, Ahluwalia S, Pathak R, Bashir H. Prevalenceandpatternofsubstanceabuseamongschoolchildrenin NorthernIndia:Arapidassessment study.IntJMedSci PublicHealth. 2013;2(2):273-282.  Back to cited text no. 11
    
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Tiwari SC, Kumar P, Tripathi R. Pattern and frequency of substance abuse in urban population of Lucknow. Indian J Psychiatry.2008; 17(1):33-38  Back to cited text no. 12
    
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Basu D, Aggarwal M, Das PP, Mattoo SK, Kulhara P, Varma VK.Changing pattern of substance abuse in patients attendinga de-addiction centre i nnorth India (1978-2008). Indian J Med Res, 2012; 135:830-836.  Back to cited text no. 15
    
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Farrel DA, White SK. Peer influences and drug use among urban adolescent: Family structured and parent-adolesecnt relationship as protective factors. Journal of consulting and clinical psychology. 1998;16(2):248-58.  Back to cited text no. 16
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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Abstract
Introduction
Materials And Method
Results
Drug use trends
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