Available online on 15.03.2023 at http://jddtonline.info

Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

Copyright  © 2023 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited

Open Access  Full Text Article                                                                                                                                                                          Research Article 

Exploration of drug addiction prevalence among young generation of Pabna district, Bangladesh

Ashish Kumar Sarker^*, Fazlay Rabby Raju, Mst. Prianka Sultana, Mohammad Mostafa Mohsin Milon, Sumiya Akter

Department of Pharmacy, Pabna University of Science and Technology, Pabna-6600, Bangladesh

INTRODUCTION:

Drug addiction is a chronic, relapsing disorder in which compulsive drug-seeking and drug-taking behavior persists despite serious negative consequences ¹.   At present, drug addiction is a burning issue for the health of young citizens worldwide. Youngsters are the valuable asset for the future world as they will dictates the future of the society as well as world. Therefore, ensuring proper health of the young peoples should be given highest priority. Drug addiction affects every parts of our daily life such as personal, financial, social, familial, as well as professional. It affects both the drug user and society at large, from health risks of the user to increased early pregnancies, car accidents, financial cost, and productivity cost ². Primarily, addicted drugs provide relief from physical, psychological and emotional problems by producing temporary euphoric effects. But in the long run, more damaging problems are produced by continuous uses of drugs. 

Various social factors such as social disorganization, family factors, genetic factors, emotional problems, peer pressures, and mental health problems influences drug addiction. The weakness in the family performance, problems, conflicts and family struggles are other causes of drug addiction ³ Kendler et al. found that parental divorce or high genetic susceptibility were the main causes of addiction in the high risk patients ⁴. Apart from this; young generations use drugs just for curiosity, to experiment the drugs, influences by friends, for improving euphoria and happiness. 

Drug addiction impacts the social functioning of individuals and creates a burden for society as well. These contribute to medical or psychiatric conditions, disability, and death as a result of accidents or diseases caused or worsened by drug use, all of which affect society. The costs associated with social problems are staggering, creating an economic burden for the family as well as the governments ⁵. Drug addiction has reached widespread levels across the globe with approximately 247 million drug users worldwide. Excluding alcohol and tobacco, the top ten drugs used across the world were: cannabis, MDMA, amphetamines, cocaine, magic mushrooms, LSD, nitrous oxide, prescribed & non-prescribed opioid medication, ketamine and poppers ⁶. The spread of multiple drug use has aggravated the overall problem, personal and social days function, impairment of health, crime and other violent behavior ⁷. As a result, it is now growing challenge in Bangladesh, where most of the drug users are being young people, between the ages of 18 and 30 years. Many  epidemiological  surveys   carried out  in the Bangladesh shows that the country is  going to be transformed into a potential user of drugs with   the  rapid  increase   in  the  number   of  addicts ⁸.

So, preventive method must be taken immediately to overcome this problem. There is no way to escape this issue, it is very important to analyze it and improve awareness of the general citizens about it. Our present study was mainly directed to evaluate the awareness and knowledge of young generation of Bangladesh about drug addiction. It also designed to discover the factors inducing drug addiction, drugs preferred by the young people, age of first drug used and source of money to buy drugs. In addition, it also aim to uncover the damaging impacts of drug addiction to the society, various complications associated with drug addiction, response of the addicted person towards treatment and finally find out the effective measures to tackle this problem.

MATERIALS AND METHODS:

This survey based study was descriptive, qualitative and cross-sectional in nature conducted in Pabna district, which is located at the northern part of Bangladesh. The duration of our research was over six month, started from September 2019 to February 2020. 

Sample Selection: The information of this survey was collected from the young people belongs to different region (Thana or Upazilla) of Pabna district, Bangladesh.  Both male and female aged from 12 to 35 years were randomly selected. 

Research Instrument: The study accomplished the field test with the participant which was carried out by developing a questionnaire. The questionnaire was developed by reviewing literature about circumstances and consequences of drug addiction considering Bangladeshi perspective. 

Data Collection Technique and Procedure: Data collector collected data through face to face interview process in this study. The language of the questionnaire was English which was translated to Bengali language by the data collectors to the participants while collecting data. 

Data Analysis: After collecting information, the data were analyzed by using statistical analysis. Descriptive statistics, graphical representation and various charts like column, pie, line and bar were applied to the collected data using Microsoft Excel 2007 software.

RESULTS AND DISCUSSION:

Drug addiction is a major public health problem that impacts society on multiple levels. In recent years, drug addiction has significantly increased in the whole world, especially in the South Asian countries like Bangladesh. In this country, this agent of human devastation has spread its tentacles to every nook and corner. The scope of the problem is broad and requires innovative and multifaceted programs for preventing, reducing and stopping substance use amongst young generation. This research is primarily focused on the young generations of Pabna district who may or may not be drug addicted. This is an initial study where Pabna district was targeted and the data accumulated from respondents were analyzed. 

Proportion of drug addicted participants:

From the survey result it is shown that more than half of the participants (exactly 53%) were drug addicted and rest of the respondents was not drug addicted.

Impacts of poverty on drug addiction:

Our study was designed to justify the impacts of poverty or financial status or average monthly income of family on drug addiction among the young participants. Although buying capability is directly proportional to higher monthly income, we found in our study that substance abuse is more prevalent among families living in poverty whose monthly income is below 15000 taka (about 40.45%) (Figure 1) which may basically due to the types of drugs available in this part of Bangladesh and their cost. 

It also could be due to depression and socio-economic condition. Most of them shared drugs with friends to reduce their expense. Usually day laborers have low incomes, so that they are depressed as a family member and they take drugs to get rid of depression and tension. An opposite study revealed that, someone who makes less than $20,000 annually is about one-third less likely to recover from a cocaine addiction than someone who makes over $70,000 ^{9, 10}. A person addicted to cocaine or heroin can spend over $10,000 a year to support the habit ¹¹. We explored that, poverty has some direct as well as indirect impacts on drug addiction. Being poor is a curse in this region, where everyone is judge by their financial status. Money is the prime and sole predictor of happiness, power and well-being in this society.  As consequences, everyone is trying to be rich by any means, which may be by following legal or illegal ways. But it is obvious that, it’s impossible to be rich by everyone. Those who failed to be rich, they suffer from depression, anxiety and so on, as a result they seek help from drugs to get rid of this depression and subsequently become drug addicted. 

Figure 1: Impacts of financial status of family on drug addiction

Influence of sports/ others voluntary activities on drug addiction:

Participation in sports and other physical activities can have many benefits for individuals. Sports are one of good source of healthy life and behavior. Our study aim was to reveal the influence of sports or voluntary activities on drug addiction. In this study, we found a result that we have expected; young generation who had involvement with sports/others voluntary activities are less prone to drug addiction (about 38%) than the young generation who had not involvement with sports/ others activities (about 62%) (Table 1).

Table 1: Relationship between involvement with sports/ others and drug addiction

Participation in organized sports offers the chance for youth to enhance their physical and social skills. It also helps the young generation to be focused with his career goal and helps them to avoid drugs assistance to be succeed in life.

                                        Types of drugs primarily used by the addicted participants:

In the present study, we found that, nicotine or nicotine users was highest (about 95.08%) among the drug addicted participants (Figure 2). The second most used drug among the addicted people was alcohol (63.93%) and the third one was Marijuana/ Hashish/Bhang (44.26%). Apart from these, among the addicted respondents 44.62% tried out tobacco, 16.39% tried out sedatives, 24.59% tried out amphetamines, and 4.92% tried out both heroin and solvents/glue. Surprisingly, LSD and cocaine were not tried by any addicted participants. 

According to Alam et al., the rate of nicotine or nicotine users were found about 95.08%, almost near to our findings ¹². It proved that, the popularity of these substances among young generation is higher in this region. The major cause behind this is the availability of nicotine almost everywhere in Bangladesh and lowest price. Others factors may be the popularity of nicotine and minimum social obstacles to cigarette smoking. From Rahman FN et al. study, we found that the highest rate of addicted young in Dhaka city was with barbiturates (56.14%). Others prominent addicted drug in Dhaka were amphetamine (49.12%), marijuana (36.84%), alcohol (29.82%) and others like heroin, pethidine were very low amount ¹³.

Figure 2: Types of drugs the addicted participants primarily used

Source of money for purchasing addicted drugs:

In this study, we observed that, self-income (41%) and parents (42%) were the major source of money to buy addicted drugs (Figure 3). So, it could be estimated that, money that is earned by the addicts or addicts’ family was being wasted mostly through addiction. Moreover, youngster got money to purchase drugs from friends or relatives (5%) and youth group/club (12%), but a less considerable proportion. Easy availability of money to buy the drugs has definite relationship with drug addiction. 

Most of the addicted young people expressed that, they starts to use drugs as an occasional user, and that primary use is a voluntary and manageable decision. But as time passes and drug abuse continues in more desperate ways that contribute to obsessive and even uncontainable drug use. In such a case, purchasing capability as well as source of money to buy addicted drugs is one of the primary factors that influence drug addiction.

Figure 3: Source of money for buying addicted drugs

Causes of drug addiction:

A plethora of factors may contribute to drug addiction. But whatever their reason for starting, once addiction sets in, and the disease usually spirals more and more out of their control ¹⁴. In this study, family problems were the most prevalent cause of drug addiction which was about 43.93% and the second most prevalent cause was failures in life (Figure 4).  Influence of friends, economic crisis, depression, failure in love was also among the causes. 

From Iran study a total of 525 addicts, failures in life and escape from problems were the major causes of drug addiction. There was a significant difference between male and female addicted persons in most of the drug addiction causes (P < 0.05) ¹⁵. To compare all study it is seen that problems of family, depression, influence of friends and failures in life are the main causes of drug addiction. Youth should be concerned about life and society and family should be cared and responsible to youth.

Figure 4: Causes of drug addiction among drug addicted people

Starting age of taking drugs:

It is reasonable that lower the age of using first drug by the addicts, higher the tendency to use more and more drugs. The reason behind this might be the time margin they get in their lives to get their desired drugs to quench the longing their addiction. Most of the young participants of Pabna (about 44%) used their first illicit drugs at the age range of 15 to 17 years. Unfortunately, a significant proportion of addicted respondents (exactly 10%) received their first addicted drugs at the age of 11 years or less. However, 26% and 20% of the addicted sample population used their first addicted drugs at the age of above 18 years and between 12 to 14 years respectively (Figure 5). One of the alarming issues is that, a fraction of addicted respondents used their first addicted drugs at the age of 11 years or less. This result revealed that, our children are not safe from this deadly poison.

In a similar study, age of first use (ranging from 13.2 years for alcohol to 15.1 years for cocaine) was significantly younger for nicotine, alcohol, and cannabis than for “harder” drugs like cocaine and heroin, and adolescents increased their use of almost every substance (except inhalants) with increasing age ¹⁶. 

Figure 5: Starting age of first drug used by addicted young participants

Proportion of addicted respondents faced complications from drug addiction:

Among the all drug addicted participants in our study, 91% confirmed the presence of complications with drug addiction, which indicates that the major portions of addicted peoples experienced some complications in their whole addicted life. A less proportions (9%) of addicted young generation did not experienced any complications with drug addiction. 

Specified complications experienced by the addicted respondents:

Drug addiction affects individual's physical and mental health. In our study, it was observed that, most of the addicted participants experienced different types of complications from drug addiction in their whole drug addicted life. Short-term administration of heroin or morphine produces euphoria, sedation, and a feeling of tranquility but repeated administration rapidly produces tolerance and intense physical dependence. Overdose can cause lethal respiratory depression ^{17, 18}. 

Among the addicted people anxiety and depression was found most prevalent (32%) complications of drug addiction (Figure 6). On the contrary, other complications comprise the least portion (about 2%) in our study. Moreover, 26% of the addicted respondents suffered from both aggressiveness and sleep disorders. Furthermore, 18% and 22% of the addicted participants affected by forgetfulness and dependence to drugs respectively. Drug addiction can cause temporary euphoria. But it can also cause various complications such as anxiety, hallucinations, paranoia, depression and uncontrolled behavior. Every drug is different, but generally, drugs interfere with nervous system’s basic functions. It can also affect muscles and can cause respiratory and cardiovascular systems to malfunction or fail. Some abused substances, such as glue or butane, can cause immediate death. In addition to these mental, behavioral, and health related effects, drugs also have social consequences ¹⁹.

Figure 6: Percentage of specified drug complications

Proportion of addicted young takes treatment for drug addiction: 

Drug treatment is intended to help addicted individuals to stop compulsive drug seeking and use. This study showed that, a massive proportion of people did not undergo any treatment for their addiction (89%). Only a small percentage of people (11%) did their treatment for addiction. But in most of the cases, they received short term treatment. The reason behind this may be insufficient knowledge about treatment and unavailability of treatment facilities in this region. Alarmingly, among the respondents who took treatment, some respondents are tried drugs again after taken treatment. Some of the respondents expressed that; the part of the society was neglecting them after taken treatment. A similar study performed by Azizul et al where all most all of the drug users did not take any treatment in order to get rid of drug addiction (79%), and less than one third of the drug users took treatment for get rid of drug addiction (21%) ²⁰. 

View of society to drug addicted people:

The perception of a society has great influence on drug addiction and addicted people. Considering this in this survey, we explore the view of local residents as well as society to drug addiction and addicted peoples. As expected, the view of society (both drug addicted and non-drug addicted) was very negative (about 55%) towards drug addicted people and there was no person who was positive to drug addicted people (Figure 7). 

Moreover, 36% of the participants felt negative to the drug addiction as well addicted individuals. Interestingly, about 9% of the respondents had no specific response or headache on drug addiction. It indicated that, inhabitants of the society feel that drug addiction is devastating to the society. Similar study was found from American study that compared 1999 and 2006 data from the General Social Survey (GSS) that hold significantly more negative attitudes toward persons with drug addiction than toward those with mental illness ²¹.

Figure 7: View of society to drug addicted people

Effects of drug addiction on the society:

Drug addiction is not a problem of addicts only but it also affects their families, communities and society as a whole ²². Advancement of the community will be hampered by this destructive threat. There is a conclusive link present between crime and drug addictions. Sources at the DNC intelligence wing also said that around 10,000 cases are filed and 9,000 people are arrested every year in connection with drug-related violence and crimes ²³. This study also explored that, highest proportion (86.40%) of participants thought that the main detrimental effect of drug addiction was that it increases crime in the society. Additionally, 56% respondents thought that it might increase financial problem as addicted people worked less with physically weakness. Some of participants (about 49.60%) expressed that, drug addiction may lower manpower (Table 2). 

Table 2: Effects of drug addiction on the society

Potential preventive measures to tackle drug addiction:

Some preventive actions are immediately needed to save the society as well as country from this deadly threat. In our study we found that, highest percentage (about 71%) of participants expressed that, counseling on drug addiction can be the best way to prevent drug addiction (Figure 8). On the other hand, lowest 44.8% of the participants expressed that free education could be effective measures of addiction. Moreover, 61.6%, 52.8%, 66.4%, 47.2% and 53.6% of the total respondents suggested that free education on drug addiction, rehabilitation, strengthening penalty, repelling unemployment and increasing cost of drugs respectively could be beneficial to prevent drug addiction. 

This study also provides the information that, government as well as society is less active to take proper steps to prevent this rising and emerging problem. Support from family and friends, professional help from doctors, and will power of the patient during inpatient or outpatient drug addiction treatment may help to end dependence on drugs ²³. Giving proper time and support from the family and society to the young generation could be better preventive measure to drug addiction. At the same time, availability of these addicted drugs and its using facilities should be decreased. But the main issues are on the implementation of these laws in reality. It’s the government responsibility to implement this law in an effective way so that it can reduce drug addiction frequency in young generation. Finally, government, family and society should act like a team and come forward to take some preventative steps such as counseling, free education on drug abuse, strengthening penalty, repelling unemployment, rehabilitation etc. 

Figure 8: Potential preventive measures to tackle drug addiction

CONCLUSION:

Drug addiction is a multidimensional problem, so it should be viewed from multidimensional perspective and proper address should be given ^[24]. Bangladesh is geographically located in the vital point between the 'golden triangle' (Myanmar, Thailand and Laos) and the 'golden crescent' (Pakistan, Afghanistan and Iran). Having easy land, sea, and air access of Bangladesh is becoming a major transit route for illicit drugs. It is obvious that the drug addicts are involved in various anti-social activities and their deviant behavior causes many problems in society. During this research, it has been found that young people abuse drugs due to complex social and peer groups influence, frustration, depression, curiosity, sub-cultural and psychological environment that induce the youths to take drugs. At the same time, youths were eager to get rid of drugs. But unfortunately, they can hardly find any way out. Nationwide concerted action needed to reduce the illicit demand for drugs. Law enforcement, mass media, medical practitioners, NGOs, local communities, affected families, international agencies – all possible stakeholders have to be incorporated while making up the strategies. Elaborate national plan is needed to motivate young generation for involvement in study and productive activities. Effective drug policy and drug legislation have to be incorporated along with incorporation of drug addiction damages in syllabus. 

ACKNOWLEDGEMENT:

This study was supported by Pabna University of Science and Technology, Pabna-6600, Bangladesh. 

CONFLICT OF INTEREST: None

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