Profile of female patients seeking in-patient treatment for prescription opioid abuse from a tertiary care drug dependence treatment centre from India

Abstract

Background & objectives:There has been a limited focus on prescription drug abuse among women in the country. Choice of psychoactive substance, reasons for initiation and co-occurring disorders have been found to be different among men and women. The current study was aimed at studying the profile of female patients seeking in-patient treatment for prescription drug use over a period of five years at a tertiary care drug dependence treatment centre in India.Methods:Case records of all female patients admitted with substance use disorder at a national level drug dependence treatment centre in north India across five years (between January 2008 and December 2012) were reviewed retrospectively to study their socio-demographic and clinical profile. The information was gathered using a semi-structured proforma and detailed case records. Abstinence, relapse and retention rates were calculated.Results:Over the five years, 31 female patients were admitted with prescription drug abuse. Of them, 12 (39%) used prescription opioids and 11 (36%) used prescription opioid along with benzodiazepines. Commonest prescription opioid was pentazocine used by 87 per cent of the women. Twenty two (71%) women were introduced to opioid by medical practitioners and commonest reason for introduction was pain (among 48%). Common co-occurring psychiatric diagnoses were depressive disorder (26%), cluster B traits/disorder (19%) and somatoform disorder (13%). Eight women did not complete treatment and left against medical advice. Thirteen women were advised maintenance treatment, and 70 per cent of them were retained for at least six months.Interpretation & conclusions:Our findings revealed a link between mental illness, pain and non-medical use of prescription opioids among women. Majority of these women received opioids as a legitimate prescription form physician. Therefore, these legitimate prescribers should be trained for pain management to facilitate proper treatment of pain and to prevent the subsequent misuse of these medicines. Female patients with frequent pain complaints should be assessed for psychopathology while prescribing opioids.

Profile of Women Seeking Treatment for Substance Use Disorder

“…The present study showed that socio-demographic variables of marital, employment and socio-economic status of women who sought in-patient care, majority of them were housewives, married and low socio-economic background; this finding was similar to results of previous studies (Atul 2017, Kanika 2017, Dayal 2016 , Grover 2015). Most of them come to treatment on their own or brought by family members, , and some of them referred by a psychiatrist.…”

“…In the present study, nearly half of them was not using more than one substance. Common co-morbidity psychiatric illness was depression in this study, similar to previous Indian studies ( Dayal 2016 , Arnaudo et al 2017 , Nebhinani et al 2013 and Ray et al 2004 ). More than half of them did not have any psychiatric co-morbidity condition in the present study.…”

“…This finding was similar to other studies (Malik 2015, Potukuchi and Rao, 2010 ). Whereas studies conducted in North, North West, and Northeast India showed the most common substance abuse was opioids among women who sought treatment for their conditions ( Dayal 2016 , Grover 2015, Atul 2017). The second most common substance use was nicotine, along with primary substance.…”

“…Women were introduced to opioids by medical practitioners and husbands who used the substance for pain relief. Common comorbidity was depressive disorder, anxiety, cluster B personality traits/disorder, and somatoform disorder (Atul 2017, Dayal 2016 , Grover 2015).…”

Interventions in individuals with specific needs

“… 4 Nearly half of the women treatment-seekers in tertiary addiction treatment centres or community clinics in India also report similar psychosocial issues for initiation of substance use. 5 6 7 Treatment seeking and retention are usually poor among women all over the world including India. 5 6 Studies indicate that women face various systemic, structural, social and individual barriers in treatment seeking and retention in treatment for substance abuse.…”