Substance use among outdoor treatment-seeking patients with mental illness: A case–control study from a tertiary care hospital of northern India

Srivastava, Mona; Jain, Shobhit; Patel, Ashok Kumar

doi:10.4103/jehp.jehp_97_17

Cited by 4 publications

(1 citation statement)

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“…[ 16 17 ] In the past decade, few studies in India compared substance use patterns in rural and urban patients; and those which did, found variable results. [ 7 9 18 19 ] Even fewer studies compare psychiatric co morbidity in such patients viewing locality as a viewpoint. [ 6 20 ] Considering scant research and public health importance, this study aimed to compare the presenting pattern (sociodemographic and drug-related variables), reasons for substance use, and psychiatric comorbidities (prevalence, type, and severity) among rural and urban substance-dependent patients in the hope to provide insights into area-specific factors needed for drug policy.…”

Section: Introductionmentioning

confidence: 99%

Presenting Pattern and Psychiatric Comorbidities in Rural versus Urban Substance Dependent Patients: A Hospital-Based Cross-Sectional Study

Bansal,

Saini,

Bansal

et al. 2023

Indian Journal of Community Medicine

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Background: “Locality” is a significant factor in substance initiation, maintenance, and relapse. The pattern of substance dependence among rural and urban populations varies across studies and is scarcely studied, warranting further research. To compare presenting patterns (sociodemographic and drug-related variables), reasons for substance use, and psychiatric comorbidities (prevalence, type, and severity) between rural and urban substance-dependent groups. Materials and Methods: This study was a cross-sectional analytical study in a government de-addiction center, including rural and urban patient groups aged 18–65. International Classification of Diseases, Tenth Revision (ICD-10) criteria, and severity of dependence scale were used for diagnosing substance dependence. After detoxification, psychiatric comorbidity was assessed using brief psychiatric rating scale, Young’s mania rating scale, and patient health questionnaire – somatic, anxiety, and depression symptoms scale. Post-analysis was performed to assess socioeconomic variables and access to de-addiction services. Results: The final sample was 500 (250 rural and 250 urban). The post-analysis sample size was 386 (211 rural and 175 urban). The mean age was 38.2 ± 12.4 years, mostly males (n = 495, 99%). Substance frequency was opioids (92%)> benzodiazepines (24.8%) > alcohol (22%) > cannabis (1.6%) for rural and opioids (91.2%) > alcohol (29.6%) > benzodiazepines (14.8%) > cannabis (2%) for urban patients. More than half of patients had comorbid nicotine dependence. Rural patients were more benzodiazepine dependent (P = 0.007), and urban were more opioid + alcohol dependent (P = 0.001). Rural patients had higher age (P = 0.012), less education (P < 0.001), positive family history of substance (P = 0.028), daily wagers, and farmers (P < 0.001) than urban patients who were younger, students (P = 0.002), businessmen and government employed (P < 0.001). Urban patients expended more on drugs (P < 0.001), had higher treatment attempts (P = 0.008), and had better availability and accessibility of de-addiction services (P < 0.001). More rural users initiated substances to “enhance performance,” whereas urban ones initiated for “stress relief/novelty” (P < 0.001). For treatment seeking, “External pressure” was a more common reason in urban patients (P < 0.001), who also had more psychiatric comorbidities (P = 0.026). Conclusion: Significant pattern differences exist between rural and urban substance dependents, warranting emphasis on locality-specific factors for appropriate intervention.

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Section: Introductionmentioning

confidence: 99%

Presenting Pattern and Psychiatric Comorbidities in Rural versus Urban Substance Dependent Patients: A Hospital-Based Cross-Sectional Study

Bansal,

Saini,

Bansal

et al. 2023

Indian Journal of Community Medicine

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Substance Use and Anxiety Disorders: A Scoping Review

Goldfield,

Zhang,

George

2024

Curr Addict Rep

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A Review of Historical Context and Current Research on Cannabis Use in India

Karki

Rangaswamy

2022

Indian Journal of Psychological Medicine

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Background: The cultivation and use of cannabis is historically rooted in the Indian subcontinent and this rich heritage of cannabis use dates back to at least two thousand years. Cannabis remains an illicit substance in India despite its changing status globally with many countries legalizing cannabis use in recent years. Scientific research on cannabis use in India has also been sparse. Method: Extensive search of online databases resulted in the identification of 29 original research studies pertaining to one of three areas of cannabis research; a) prevalence of cannabis use b) psychological correlates of cannabis use, c) cannabis use in substance use treatment settings. Findings: We found that most Indian studies used very basic quantitative research designs and had poor scientific rigor. Samples were small, region specific and included only males. Data analyses were limited to descriptive methods. The criteria for cannabis use in most of the reviewed studies were not rigorous and prone to biases. Conclusion & Implications: With changing attitudes and loosening of restrictions on cannabis use, the prevalence of new users is rising dramatically particularly in the college going population. This presents a strong need for research on motivations and attitudes to cannabis use and how those can influence patterns of use, and also the short- and long-term effects of use. More studies with stronger research designs (both cross sectional and longitudinal) are required for the study of cannabis use and this knowledge will be critical for managing the growing substance epidemic, generating public health solutions as well as formulating effective policy frameworks.

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Substance use among outdoor treatment-seeking patients with mental illness: A case–control study from a tertiary care hospital of northern India

Cited by 4 publications

References 34 publications

Presenting Pattern and Psychiatric Comorbidities in Rural versus Urban Substance Dependent Patients: A Hospital-Based Cross-Sectional Study

Presenting Pattern and Psychiatric Comorbidities in Rural versus Urban Substance Dependent Patients: A Hospital-Based Cross-Sectional Study

Substance Use and Anxiety Disorders: A Scoping Review

A Review of Historical Context and Current Research on Cannabis Use in India

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