Ajit Avasthi1, Debasish Basu2, B N Subodh3, Pramod Kumar Gupta4, B S Sidhu5, P D Gargi6, Arvind Sharma7, Abhishek Ghosh8, Poonam Rani9. 1. Department of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: drajitavasthi@yahoo.co.in. 2. Drug De-addiction & Treatment Centre (DDTC), Department of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: db_sm2002@yahoo.com. 3. Department of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: drsubodhbn2002@gmail.com. 4. Department of Biostatistics, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: guptapkg@gmail.com. 5. Department of Psychiatry, Government Medical College, Patiala, India. Electronic address: drbssidhumd@yahoo.com. 6. Department of Psychiatry, Government Medical College, Amritsar, India. Electronic address: gargpdass@gmail.com. 7. Department of Psychiatry, Guru Gobind Singh Medical College (GGSMC), Baba Farid University of Heath Sciences, Faridkot, India. Electronic address: arvindsharma7557@gmail.com. 8. Drug De-addiction & Treatment Centre (DDTC), Department of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. Electronic address: ghoshabhishek12@gmail.com. 9. Department of Radiotherapy and Oncology, Government Medical College & Hospital, Sector 32, Chandigarh, India. Electronic address: poonambajaj.pu@gmail.com.
Abstract
BACKGROUND: Despite its political sensitivity, little scientifically valid evidence on the prevalence, pattern and treatment need of substance use in the northern border state of Punjab, India is available till date. METHODOLOGY: The 'universe' for the survey was the entire house-dwelling population of Punjab, of both genders, aged 11-60 years. Stratified multistage sampling technique was used. Following a pilot study, data were collected by trained research workers by face-to-face interview using pre-tested survey instruments. RESULTS: From 6398 households, 13,925 respondents were interviewed. Prevalence of lifetime and current (12 month) dependence on any substance were 15.8% (95% confidence interval [CI] 15.1-16.4%) and 14.7% (95% CI 14.1-15.3%) respectively. Of the specific substances, current dependence was the highest on alcohol (10.9%; 95% CI 10.3-11.4%), followed by tobacco (8.1%; 95% CI 7.7-8.6%). Regarding opioids, lifetime use was 1.9% (95% CI 1.6-2.1%) and current dependence 0.8% (95%CI 0.7-1.0%). Use of and dependence on natural opioids was the highest. After projecting these figures to the entire source population of the state, number of currently dependent alcohol, tobacco and opioid users were 2.2, 1.6, and 0.17 million, respectively. Overall, substance use was predominant in men and significantly more common in rural areas. Majority (81%) of the tobacco users, and 51% each of alcohol and opioid users needed intervention. However, merely one in six subjects sought any professional help. CONCLUSION: Punjab has a substantive problem related to substance use. Though alcohol and tobacco are by far the major substances of use and dependence, the large number of opioid users also raises concern. Treatment services need scaling-up.
BACKGROUND: Despite its political sensitivity, little scientifically valid evidence on the prevalence, pattern and treatment need of substance use in the northern border state of Punjab, India is available till date. METHODOLOGY: The 'universe' for the survey was the entire house-dwelling population of Punjab, of both genders, aged 11-60 years. Stratified multistage sampling technique was used. Following a pilot study, data were collected by trained research workers by face-to-face interview using pre-tested survey instruments. RESULTS: From 6398 households, 13,925 respondents were interviewed. Prevalence of lifetime and current (12 month) dependence on any substance were 15.8% (95% confidence interval [CI] 15.1-16.4%) and 14.7% (95% CI 14.1-15.3%) respectively. Of the specific substances, current dependence was the highest on alcohol (10.9%; 95% CI 10.3-11.4%), followed by tobacco (8.1%; 95% CI 7.7-8.6%). Regarding opioids, lifetime use was 1.9% (95% CI 1.6-2.1%) and current dependence 0.8% (95%CI 0.7-1.0%). Use of and dependence on natural opioids was the highest. After projecting these figures to the entire source population of the state, number of currently dependent alcohol, tobacco and opioid users were 2.2, 1.6, and 0.17 million, respectively. Overall, substance use was predominant in men and significantly more common in rural areas. Majority (81%) of the tobacco users, and 51% each of alcohol and opioid users needed intervention. However, merely one in six subjects sought any professional help. CONCLUSION: Punjab has a substantive problem related to substance use. Though alcohol and tobacco are by far the major substances of use and dependence, the large number of opioid users also raises concern. Treatment services need scaling-up.