Pattern and prevalence of substance use and dependence in two districts of Union Territory of Jammu & Kashmir

Abstract

Background: Kashmir has been at the centre of conflict between India and Pakistan after partition of erstwhile British India in 1947. While research suggests that conflict exposure may result in increased substance use, the prevalence of substance use disorders has remained an under-searched area in Kashmir. Method: We employed respondent-driven sampling (RDS) for recruiting substance users from two districts of Kashmir. Estimation of substance dependence was done using benchmarkmultiplier method. Results: Prevalence of any substance dependence was estimated to be 1.95% while as for any opioids, it was 1.80%. Heroin was the most common opioid with last year use by 84.33% respondents. Current prevalence of injection drug use was 0.95% and heroin was the most common opioid among Injection Drug User (IDU), being used by 91.12% IDUs followed by Pentazocine (5.92%). Conclusion: Our results indicate that RDS was a feasible and acceptable sampling method for recruiting 'difficult to reach 'participants like illicit substance users including IDUs. Our results further demonstrate that opioids are highly prevalent in Kashmir and heroin injection is not uncommon. All these findings call for attention from policy makers as opioids are one of the important contributors to mortality and morbidity related to substances.

Psychiatric comorbidities and concurrent substance use among people who inject drugs: a single-centre hospital-based study

“…More than half of our participants had never been married, and the majority lived with nuclear family. The sociodemographic profiles of our participants were similar to those of participants in previous studies conducted by Yasir et al 21 , Andreecia et al 25 , and Trouiller P et al 7 . Similar findings were reported by Nizam Ud Din et al in their study on substance users 26 .…”

“…Our study also included participants < 18 years of age, which could partly explain the lower age distribution and never married status of most participants. Equal representation of subjects from nuclear and joint families was reported by Yasir et al 21 , while in our study, 79.9% had nuclear families. This can be explained by the difference in the settings (community vs. hospital-based) in which the studies were conducted.…”

“…In this study, all the participants were injecting heroin. Yasir Hassan et al 21 and Trouiller P et al 7 also reported 91.12% and 100% heroin users among PWID, respectively. However, Armstrong et al 27 found buprenorphine to be the major injectable in 77% and heroin in 18% of the participants.…”

“…However, these findings differed from those of the study conducted by Andreecia M et al 25 , in which the most commonly abused substance (barring tobacco products) with opioids was cannabis followed by alcohol. The results from the study by Yasir et al 21 reported lifetime use of cannabis, alcohol, and sedatives-hypnotics in 50.33%, 21.33%, and 18.33% of participants, respectively. This difference in the prevalence of use of these substances between our study and the study by Yasir et al could be because the current study was based exclusively on opioid injectors.…”

“…Various sociocultural and geographical factors play an essential role in the onset, maintenance, and treatment of substance use disorders 20 . According to recent research on substance use in Jammu and Kashmir, the prevalence of substance use is 1.95% 21 , with a total number of 25,000 PWID in the entire state 2 , 21 . While the relationship between various drugs and psychiatric comorbidities has been studied in various parts of the world, few studies on injection drug abuse and comorbid psychiatric disorders in Kashmir have been conducted 5 , 7 , 22 – 24 .…”