Mental Health, Environmental, and Socioeconomic Geographic Factors of Severe Drug Addiction: Analysis of Rehabilitation Center Data in Indonesia

Abstract

Background: A growing number of recent literatures have attempted to document the factors related to drug use in different contexts, but limited studies analyzed the factors related to patient’s severity level. Objective: We aimed to examine the correlates of behavioral, environmental, socioeconomic, geographic factors, and severe drug addiction. Methods: We used a sample of 6790 people who use drugs (PWUD) from rehabilitation centers during 2019 to 2020 in Indonesia. Data were obtained from Drugs Rehabilitation Information System (SIRENA) by the Indonesian National Narcotics Agency (BNN) during 2019 to 2020. SIRENA used the adapted version of WHO’s Addiction Severity Index (ASI), which assesses patient’s addiction severity level and relevant factors. A composite of the ASI factors is classified as “poor” or “serious” if its score is 4 or higher. The data was analyzed using logistic regression model to estimate correlations of severe drug addiction. Results: We found a high prevalence (65.08%) of our sample reported having severe drug addiction, which needed intervention and support. Poor psychiatric condition (OR = 4.02, CI: 2.97-5.44), serious work-related issue (OR = 2.10, 1.75-2.51), poor medical condition (OR = 2.01, 1.32-3.06), and serious family and social problems (OR = 2.56, 2.15-3.05) were significantly associated with severe drug addiction. Male users had higher odds of severe drug addiction (OR = 1.81, 1.55-2.20), compared to female counterparts. Patients in urban areas had higher odds of severe drug addiction (OR = 1.19, 1.1-1.3) than those in rural. Those in less developed regions (eg, Sumatera, Kalimantan, and Sulawesi) had higher odds of severe drug addiction (OR = 2.33, 1.9-2.9), compared to those in the most developed region (eg, Java and Bali). Conclusion: This evidence can help policymakers in refining the harm reduction policies in Indonesia and other countries with similar settings.

Validity of severity of dependence scale-Indonesia in patients with drug and alcohol dependence

“…According to the research, data, and information center, National Narcotics Board of The Republic of Indonesia, the prevalence of narcotics use in the year 2021 is 1.95%, an increase from 1.80% in 2019 especially in those between 15-24 and 50-64 years of age and a total of 43,320 are currently rehabilitated [12]. As of the year 2021, the most widely abused substance in Indonesia is methamphetamine, also known as sabu, followed by marijuana [12]. In Indonesia, the death penalty is enforced upon those involved in the distribution of 1 kilogram or more of narcotic plants or 5 grams of its processed form [13].…”

“…In 2021, 82% of the total death penalty cases in Indonesia were narcotics-related [14]. Screening or early detection of narcotics usage is done by random urine testing which has successfully detected 1,022 positive cases in 2021 [12].…”