Preferences for Treatment Setting by Substance Users in India

Abstract

Background:Drug and alcohol use is a growing public health concern for India. Treatment services delivery for substance use disorders is available through three sectors viz. Government (GO) centres under Ministry of Health and FW, Non-Government (NGO) under Ministry of Social Justice and Empowerment and the private sector. Information on ttreatment utilisation and preferences of treatment settings by substance users are not available for India.Methods:A performa was filled up prospectively for each consecutive new patient seeking treatment for drug/alcohol use (excluding tobacco) at De-addiction centres funded by MOH&FW; NGOs under MoSJE and private psychiatrists between 15th July to 15th October, 2011. All data available for 182 drug using persons from private, 1228 persons from 35 NGOs and 1700 persons from GO organizations were entered into SPSS-21.0, data quality checks performed and analysed.Results:There was a variance in the population profile in the three sectors providing treatment delivery for substance users in India. Treatment seeking for illicit drugs (heroin, opiates and cannabis) was higher in GO sector; injection drug use was higher in NGO sector while alcohol was higher in private sector.Conclusions:Strengthening linkages between GO and NGO sector is important for an improved coverage and quality of treatment services in the country. The Andersen's Behavioural Model as theoretical background to clarify some issues in analyzing with larger datasets is warranted.

Alcohol consumption in India: A rising burden and a fractured response

“…While preventing alcohol use in the population is crucial, it is also vital to provide appropriate health services to individuals with risky or harmful alcohol use to reduce the overall burden. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke [61], the ‘Drug De‐addiction Programme’ [62] and a ‘Scheme for Prevention of Alcoholism and Substance (Drugs) Abuse’ [48]—all programs of the Government of India—are implemented throughout the country. These programs provide a range of services, including identifying individuals with alcohol use/harmful use and offering counselling, referral, treatment and rehabilitation.…”

“…Alcohol has also been part of the NCD risk factor surveys, which are implemented at infrequent intervals in different states, providing information on prevalence, harm, type, frequency and quantity of alcohol consumed [152]. The ‘Drug Abuse Monitoring System’ tracks the pattern of alcohol use and profile of treatment seekers at government de‐addiction centres [62]. These examples by their very nature provide limited information on various aspects of alcohol use in the country.…”

“…Health services for alcohol use disorder are predominantly confined to large institutions and de-addiction centres in India [63], as screening and brief interventions are still not a part of the primary health-care system [58]. In addition, the quality of services available in de-addiction centres has been found to be sub-optimal, with limited availability of resources, limited or no information about the functioning of such centres in the private sector [62], along with high levels of stigma for those using the services.…”

Research on opioid substitution therapy in India: A brief, narrative review

“…[ 1 ] It is estimated that currently, India has about 4 million people who use opioids and around 1 million people who are opioid dependent. [ 3 ] A recent study reported that around 232,000 people were opioid dependent in Punjab alone. [ 4 ] Thus, there is undoubtedly a sizable burden of opioid dependence in many parts of India.…”

Substance Use, Mental Health, HIV Testing, and Sexual Risk Behavior Among Men Who Have Sex With Men in the State of Maharashtra, India

“…Because the country is between the golden crescent (Iran, Afghanistan, and Pakistan) and the golden triangle (Myanmar, Thailand, Laos, and Vietnam), areas where much of the region’s opium is grown, northern India has increased access to heroin and other opioids. The result is a well-documented opioid epidemic to which researchers, government agencies, and nongovernmental organizations have been coordinating a response (Balhara, Gupta, & Lal, 2016; Basu, Gaur, Das, & Mattoo, 2011; Basu, Jhirwal, & Mattoo, 2005; Dayal, Balhara, & Mishra, 2016; De, Mattoo, & Basu, 2003; Dhawan, Chopra, & Ray, 2016; Dhawan, Pattanayak, Chopra, Tikoo, & Kumar, 2016; Government of India, Ministry of Home Affairs, & Narcotics Control Bureau, 2016; Joseph & Badyal, 2016; M. S. Kumar & Sharma, 2008; Singh et al, 2011; Vaswani & Desai, 2004).…”