An Observational Study of Treatment Seeking Users of Natural Opiates from India

Abstract

All subjects were male with a mean age of 44.6 (±11.0) years. Majority (97%) used poppy husk daily orally. Curiosity/experimentation (63%) was the most common reason for starting opiate use. The past month rates of tobacco, alcohol, cannabis, and sedative-hypnotics use was 58%, 33%, 3%, and 12%, respectively. Only 4% injected any opioid. Inability to afford opiates (72%) was the most common reason for seeking treatment. Rates of medical, familial, social, psychological, and legal complications were low, while the WHOQOL-BREF scores fell between 40 and 50 across various domains. Conclusions/Importance: Natural opiate users may constitute distinct subgroup of opioid users with fewer/no complications despite long duration of uninterrupted use. These findings would be important in planning management strategies for people dependent on natural opiates.

Buprenorphine/naloxone maintenance for “poppy husk” dependence: A retrospective study

“…Our results showed the mean age of onset and duration of dependence to be 27.5 and 18.25 years, respectively. Statistics comparable to our findings, ie, mean age of onset of 28.1 years and median duration of dependence of 18 years, were reported by Parmar et al (), who included 98 poppy husk users across various age groups. A case series by Parmar et al (), specifically focussed on elderly (>60 years) persons, report the mean age of onset and duration of dependence as 30.8 and 33.1 years, respectively.…”

“…There are a limited number of studies that have described the substance use‐related characteristics of “poppy husk” users. Parmar and colleagues, in their two reports (Parmar et al, ; Parmar, Patil, & Sarkar, ), found that a majority of natural opiate users consumed “poppy husk” and described their characteristics. Our results showed the mean age of onset and duration of dependence to be 27.5 and 18.25 years, respectively.…”

“…Among the two of them, consistent trends of a 2.5‐fold rise in use of poppy husk and decline in the use of raw opium by half have been reported (Basu et al, ; Sachdev, Yakhmi, & Sharma, ). Among treatment‐seeking natural opiate users, the proportions of those dependent on poppy husk have been reported to be up to 97%, in recent studies (Parmar et al, ).…”

“…While opium is used in several ways—smoked, injected, swallowed, or drunk—poppy husk, on the other hand, is only orally consumed, either as a dry grounded powder or as a concentrate by dissolving in boiled water or by drinking soaked'n strained water solution. Although introduction of heroin to the Indian market in the 1980s has affected the prevalence rates of natural opiates' use, they still remain to be the predominant products used among opioid dependents in India (Ambekar et al, ; Parmar, Patil, Sarkar, & Rao, ; Ray, ). Among the two of them, consistent trends of a 2.5‐fold rise in use of poppy husk and decline in the use of raw opium by half have been reported (Basu et al, ; Sachdev, Yakhmi, & Sharma, ).…”

“…Overall, research on abuse of natural opiates is deemed limited (Parmar et al, ). More importantly, it is much more meager with respect to characteristics of subjects dependent on “poppy husk,” who form a significant proportion of patients with substance use disorders, in many parts across northern, central, and western India.…”