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Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months. Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies.
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Anxiety and depression were interlinked with the severity of liver diseases. Patients should know the true severity ofthe disease and patient counseling helps them. This was a cross-sectional study carried out on 100 patients sufferingfrom chronic liver disease. Child Turcotte Pugh score was used to calculate the severity of the disease. HospitalAnxiety and Depression Scale was used to calculate the anxiety and depression of patients. Non-parametric tests areused to find out the association. The level of significance was p < 0.05. The mean age group of patients was 47.29± 13.17 years. The three most presenting clinical signs and symptoms according to their occurrence was abdominalpain (74%), edema (58%), and ascites (51%). The median Child Turcotte Pugh score was 9 corresponds to class B.We observed highly significant association (p < 0.01) between total bilirubin (p < 0.0001), albumin (p < 0.0001),and the severity and prognosis of the disease. We observed a higher percentage of patients with borderline abnormalanxiety (61%) and depression (51%) in our study. High-risk patients were made aware of the severity of the diseaseand consequences thereafter, provided with patient counseling along with a list of deaddiction centers. Integrating apsychologist can benefit patients struggling with deaddiction of alcohol.
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Background: Quality of life (QOL) is individuals' perceptions of their position in life. QOL of alcohol dependent patients is an area that has received relatively less attention compared to other alcohol related problems.Methods: A deaddiction centre based cross sectional study was done on 370 individuals using a predesigned questionnaire during the period of 2012-2013. The data was analyzed using SPSS version 17. Spearman抯 rank correlation test was used to find association between the study variables.Results: The mean age of the study subjects was 38.08�46 years. The mean duration of drinking was 12.62�47 years. The overall score of the QOL and the perceived health in alcohol dependent patients was 3.19�89 and 3.01�98 respectively. The mean of the transformed scores of physical, psychological, social and environmental domains are 69.12�.82, 57.84�.81, 58.52�.05, 68.62�.23 respectively. Statistical analysis of age with physical, environmental and social domains showed a significant negative correlation; literacy status with QOL, perceived health, physical, psychological, social and environmental domains showed a significant positive correlation; socio economic status with QOL and psychological domain showed a significant positive correlation; duration of drinking with QOL, perceived health, physical and psychological domain showed a significant negative correlation.Conclusions: Harm from alcohol use is a major public health problem. Reducing the level of social and health harms from alcohol requires preparation and planning.
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Problem: Areca nut (AN) chewing is common among Southeast Asian population. Use of AN products (with or without tobacco) have a multifaceted effect on physical health, especially on cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. AN is a known group 1 carcinogen and carries addictive potential. Varying degrees of AN-related substance use disorder (SUD) have been reported among AN chewers. There is a lacuna in awareness of the health risk of AN use, prevention, and cessation programs among AN users, particularly in those who have developed SUD. Existing Lacunae: The dynamic interaction of factors that promote AN use and later the risk of developing SUD at individual and community level has not been studied in depth. Understanding of the bio-psycho-socio-economic-cultural factors is necessary to identify the factors that prelude, promote, and reinforce AN usage. For managing AN-related conditions, including the several systemic disorders, there is a knowledge lacunae, among health care providers with respect to the pathophysiology of AN-related health issues, SUD, and nonavailability of structured, evidence-based cessation protocols. Solutions/Recommendations: This manuscript presents a model-map to study the dynamics of AN use and the impact of AN on health and health care system at individual as well as community level. The model proposed can help the health policymakers to create evidence-based awareness and cessation protocols for AN.
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Background: Substance abuse has emerged as a global phenomenon and prevalent throughout the world in all the cultures. Abuse of alcoholic beverages and tobacco are endemic in many societies, whilst the abuse of other psychoactive substances is growing concern in India. It has major impact on physical, psychological, social and environmental aspect of life.Methods: A cross sectional study was carried out amongst 100 persons attended at Mind Care de-addiction centre, Ahmedabad during the period of 1st January to 28th February 2018 with the help of pretested semi structured questionnaire.Results: Majority of the substance abusers were males (98%) and within the age group of 31 to 45 years (46%). Out of total abusers 28% were graduate and 47% doing skilled work. Majority of study participants were married (47%), belong to joint families (92%) and belongs to socio economic class I and II (50%). Most commonly used drug was alcohol (64%), followed by tobacco (20%), cannabis (12%) and opium (4%). Majority of users started to use it for social reasons (33%) and stress (26%). They got it for the first time from friends in 62% cases and 36% got by themselves. Health related changes were experienced in more than 50% of cases. Out of them, 84% feel improvement after visiting the centre.Conclusions: Drug use pattern is ever changing and has emerged as a global burden as it causes serious public health problems. There is a felt need for the assessment of the evolving trends of substance abuse. And suitable interventions for primary prevention should be considered.
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Aim: To assess the opinion of patients towards the tobacco cessation program that were enrolled / attending various tobacco de-addiction centers in Hyderabad. Material and Methods: Data were collected from a sample of 128 tobacco users through a well-designed questionnaire which includes information on demographic data, duration and frequency of tobacco use, type of tobacco use etc. Results: Sixty-eight percent of the participants recommended this program to those who wants to quit tobacco use. Fifty-four percent of the participants were satisfied with the tobacco cessation program. Conclusions: Majority of the patients were satisfied with the counseling given to them in the de-addiction center. Periodic counseling is needed for the tobacco users to cease the habit.
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Background: Although the history of substance abuse is as old as mankind itself, recently it has become a global problem that is influenced by social, economic, political, and psychosocial factors. The objective of the study was to study the socio-demographic profile of patients attending at de-addiction center. Methods: The present cross sectional study was conducted at de-addiction center of GMERS Medical College, Dharpur-Patan, North Gujarat, India during December 2014 to July 2015. After obtaining approval from Institutional ethical committee and taking written and verbal consent of patients, total 206 patients were interviewed using predesigned, pretested and semi structured proforma. Data thus collected were analysed using SPSS 17 (trial version). Results: Out of total 206 substance abusers, 138 (67%) patients were between the age group of 25 to 45 years.69% of the total abusers belonged to socio economic class 4 and 5. 14.6% substance abusers were illiterate 66.9% of the substance abusers were skilled and semi-skilled workers. Out of total 206 substance abusers, 102 (49.5%) patients had family history of substance abuse. 40.8% of the substance abusers had initiated substance abuse in adolescent age group while 45.6% of the substance abusers had initiated substance abuse between 20 to 30 years age group. Mean age of substance initiation in our study was 22±6 years. The mean duration of substance use was 18.1 years. Friends of substance abusers (peer pressure) were responsible for starting of substance abuse in majority of the substance abusers (81.6%). Out of total 206 substance abusers, 128 (62.1%) patients were addicted to alcohol. Conclusions: This study shows that youth is falling in vicious trap of drug abuse at early age. Awareness programs and camps need to be conducted at community level to address this major public health problem of substance use.
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Background: In India, the traditional drugs like opium, charas, bhang and ganja were used by sections of the society partly as leisure time activity and partly as part of the religious ceremony. Therefore, their consumptions did not invite much negative sanction from the society. The addictive potential of a drug varies from substance to substance, and from individual to individual. Dose, frequency, pharmacokinetics of a particular substance, route of administration, and time are critical factors for developing a drug addiction. Aims & Objective: (1) To identify the socio-demographic characteristics of the substance abusers; (2) To identify the substances commonly used other than tobacco; (3) To identify the effects of positive family history on starting the substance. Material and Methods: Interview based Cross-Sectional study was conducted among Substance abusers who were attending De-addiction centres “Naya Jivan Vyasan Mukti Kendra, Ahmedabad” Results: Substance abuse was commonly seen in the age group of 25-45 years (66.3%) and also in class IV and V (69.0%). Only males were found to get treatment in de-addiction centre for various addiction and 80.6% of them were married. 58.3% Substance abusers (58.3%) were living in nuclear families. Substance abuse was higher (75.8%) in less educated people (secondary or below). Age of initiation of substance was below 30 years of age (86.1%). Mean age for starting substance was 23.96 + 6.96 years. Commonly abused substances for which patients were coming to de-addiction centre were Alcohol (62.1%), Cannabis (13.6%), Brown sugar (13.6%), Alprazolam (2.9%), Cough syrup (1.9%), White Ink (2.9%). Friends were mostly responsible for initiating the substance abuse (81.6%). Headache (12.6%), vertigo (11.7%) and insomnia (11.7%) were most common presenting symptoms seen in substance abusers. Conclusion: The mean age of initiation of substance abuse was early twenties. Alcohol addiction was significantly associated with the positive family history of alcohol intake (p value <0.0001). Commonly abused substances for patients which were coming were Alcohol (62.1%), Cannabis (13.6%) etc.
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Background: The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge. Objective: To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre. Methods: A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed. Results: The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11–20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%). Conclusion: A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.
Subject(s)
Substance-Related Disorders , Heroin Dependence , Social Problems , IndiaABSTRACT
Background & Objectives : A combination of buprenorphinenaloxone (Addnok-N) tablets has been recently introduced in India as treatment for Opioid dependence. This study was undertaken to evaluate the possible adverse consequences following use of the buprenorphinenaloxone tablets through post marketing surveillance. Methods : National Drug Dependence Treatment Centre (NDDTC), AIIMS, India, monitored all patients receiving buprenorphine-naloxone combination tablets from the centre over a period of two and half years. Evaluation included subjective and objective side effect checklist, physical examination, and laboratory investigation. Results : Data was obtained from 1132 observations among 158 patients. Commonly reported medication effects, like muscle aches (44.0%), sleepiness (44.0%), relief from pain (41.3%), etc; are expected in opioid substitution treatment. Laboratory investigations were mostly normal except for liver enzyme abnormalities (52.2% of cases). Eight adverse events were reported in the study. No dangerous event or mortality was reported during the study.
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Aim: Associations have been reported between aggression and psychoactive substance use. This study aimed to assess the prevalence and nature of aggressive incidents and to examine the factors associated with aggression in patients in a drug de-addiction unit. Method: Forms of aggression and their severity were assessed based on questions of Overt Aggression Scale (OAS). Data were collected from inpatients about the nature of their aggressive incident during a 12-month period. The characteristics of those patients involved in aggressive incidents were compared with those of others who had not been aggressive. Results: Fifty out of 83 patients admitted during this period were involved in some form of aggressive behaviour. Pattern of aggressive behaviour exhibited by patients were in the form of verbal aggression 60.24% (N=50); Object aggression 28.9% (N=24); Aggression toward other 32.53% (N=27) and Aggression toward self 2.41% (N=2). There were high correlations of one form of aggression in presence of other forms. Most common diagnosis was alcohol dependence. On the whole aggression was found to be higher in the alcohol withdrawal with delirium group. While all other forms of violence showed increase with past histories, statistical significance was there only in aggression towards others (p=0.043). Aggressive behaviours generally reported less in voluntarily admitted patients. Comparison of aggressive behaviour in relation to family type, locality, religion, family history of violence did not yield any significant variation. Conclusion: Like weather forecasting, predictions of future violence will not always be correct. However, in order to prevent aggressive incidents, present study revealed that particular attention and increase support required in patients living in the nuclear family, unwilling for admission, past history of aggressive incidents and diagnoses of alcohol withdrawal. Verbal aggression could be considered as strong predictor for other type of assault.
Subject(s)
Aggression/etiology , Aggression/psychology , Aggression/statistics & numerical data , Alcoholism/rehabilitation , Alcoholism/psychology , Humans , Substance-Related Disorders/psychology , Substance Abuse Treatment CentersABSTRACT
Background & objectives: Cannabis is one of the most commonly abused drugs worldwide. There is a distinct clinical correlation between cannabis abuse and mental disorders. However, it is essential to establish cannabis intake in the abusers in order to establish causality between cannabis and psychiatric illness. The limitations of current detection methods using commercial cassettes prompted us to standardize the method of extraction and detection of cannabinoids in the urine samples of cannabis abusers attending a de-addiction centre in south India. Methods: In this study, diagnostic tests on 102 male patients suspected with cannabis abuse were done. Liquid-liquid extraction of cannabinoids from urine was done and screened by Duquenois-Levine, fast blue B salt and p-dimethylaminobenzaldehyde (p-DMAB) tests. All the results were confirmed by high performance thin layer chromatography (HPTLC). Samples were considered positive for cannabis based on the positive indication in colour test and by detection of 11-nor-Δ9 tetrahydrocannabinol-9-carboxylic acid (THC-COOH) on HPTLC. Results: Based on the colour tests and HPTLC, cannabis abuse was detected in 64 of 102 patients tested. HPTLC method was found to be sensitive for detection and possible quantitation of THC-COOH. Interpretation & conclusion: We report the standardization and utility of cannabinoid extraction, screening and detection by HPTLC in the urine samples of cannabis abusers. The HPTLC method was found to be high throughput, sensitive, reproducible and cost-effective compared to commercial kits.