Substance use patterns are notorious for their ability to change over time. Both licit and illicit substance use cause serious public health problems and evidence for the same is now available in our country. National level prevalence has been calculated for many substances of abuse, but regional variations are quite evident. Rapid assessment surveys have facilitated the understanding of changing patterns of use. Substance use among women and children are increasing causes of concern. Preliminary neurobiological research has focused on identifying individuals at high risk for alcohol dependence. Clinical research in the area has focused primarily on alcohol and substance related comorbidity. There is disappointingly little research on pharmacological and psychosocial interventions. Course and outcome studies emphasize the need for better follow-up in this group. While lack of a comprehensive policy has been repeatedly highlighted and various suggestions made to address the range of problems caused by substance use, much remains to be done on the ground to prevent and address these problems. It is anticipated that substance related research publications in the Indian Journal of Psychiatry will increase following the journal having acquired an 'indexed' status.

Substance use and addiction research in India

Acute exercise ameliorates craving and inhibitory deficits in methamphetamine: An ERP study

A sample of 4,691 subjects aged 14 years and above were interviewed on a schedule based on WHO Questionnaire to collect information about prevalence & pattern of alcohol and substance abuse The study revealed a prevalence rate of 19 78%. 42.41% of users were in the age group of 25-34 years while 44.1 % were literate (up to matric). 45.04% among labourers were alcohol users. In terms of age of onset, 94.83% respondents had their first drink between the ages of 15-25 years. Most common type of alcohol consumed was country liquor by 69.07%. Majority (63.44%) of alcohol users said that they usually drink with some companion, only in the evening and night. 50.03% had arguments with family or friends after taking alcohol while 13.57% alcohol abusers confessed that they had neglected their family and work due to alcohol. In family history of 23.16% alcohol users, father was abusing alcohol. 26.61% alcohol users cited to be sociable as reason for their drinking. 16.81% users were smokers also while 6.89% had the habit of taking Pan Masala/Zarda. 2.04% of alcohol users were taking soolfa also along with alcohol while the frequency of opium and cannabis abuse was 1.51 and 1.18% respectively.

Prevalence and pattern of alcohol and substance abuse in urban areas of rohtak city.

The National Academy of Clinical Biochemistry

Codependency is a complex and debatable concept, which has been used over the years by mental health professionals to inform their practices. Researchers have attempted to identify the main problems associated with codependency; however, their evidence is still inconclusive. This is the first time that interpretative phenomenological analysis (IPA) has been used to explore the lived experience of codependency from the perspective of self-identified codependents. Eight participants recruited from local support groups for codependency in the UK, offered in-depth information about their subjective experiences, and embedded in their lifeworld. Data was gathered through interviews and a visual method. The shared experience of codependency was portrayed by the participants as a complex but tangible multidimensional psychosocial problem in their lives. It incorporated three interlinked experiences: a lack of clear sense of self, an enduring pattern of extreme, emotional, relational, and occupational imbalance, and an attribution of current problems in terms of parental abandonment and control in childhood.

/pdf/the-lived-experience-of-codependency-an-interpretative-ao75eexfki.pdf

The Lived Experience of Codependency: an Interpretative Phenomenological Analysis

This study examines the relationship between social support, coping resources and codependence in the wives of individuals with drug and alcohol dependence. Thirty male individuals each with drug and alcohol dependence were assessed for severity of addiction by Addiction Severity Index (ASI). Their wives were administered Social Support Scale (SSS). Coping Resources Inventory (CRI) and Codependence Assessment Questionnaire (CAQ). Of the sixty patients, forty nine were found to be codependent. On ASI, the codependent group had more impairment in the financial and the legal domains of the husbands whereas non codependent group had more impairment in the psychological domain. Codependent wives had lower coping resources and social support. On multivariate analysis, three variables were found to be significant predictors of the development of codependence in the wives. These were (i) husbands'duration of drug or alcohol abuse, (ii) total CRI score and (Hi) husbands' ASI employment score.

Social support, coping resources and codependence in spouses of individuals with alcohol and drug dependence.

Craving is considered to play an important role in the persistence of drug use and relapse of drug use. Very few studies have looked into the subjective experience of this phenomena. This study attempts to study craving comprehensively as described by the subjects. In the present study 30 patients of heroin dependence syndrome were assessed (using a semi-structured questionnaire) for the subjective experience of craving and its various dimensions. All subjects reported having experienced craving. Majority of subjects (90%) described craving as a strong desire to use the substance. About 77% reported that intensity of craving could vary while others described it as a strong urge. Majority (83.3%) reported that only heroin or other opiates could satisfy the craving they experienced for heroin. During craving, thoughts of using the drug by all means would preoccupy their mind. Withdrawal symptoms (70.0%), increased respiration (56.7%) and palpitation (53.3%) were the common physical symptoms and anger (83.3%), tension (63.3%), anxiety (50.0%) were the common emotions experienced during craving. Craving was described as difficult to control and resulted in consumption of heroin on an average of 76.7% occasions. All subjects reported multiple cues that induced craving. Frequency of craving decreased with increase in length of period of abstinence. After being abstinent for 3 months, 90% subjects did not experience craving or experienced it once in a day. Socio-cultural factors do not appear to have prominent influence on subjective experience of craving.

The enigma of craving.

Self-report validity of recent drug use among heroin abusers depends on many factors including the population being studied and the setting in which the study is carried out. This study was conducted by the treating physicians to assess the self-report validity of recent heroin use by heroin dependent patients in the outdoor setting using 'thin layer chromatography' (TLC) and two highly sensitive methods of urinalysis viz. 'gas liquid chromatography' (GLC) and 'high performance liquid chromatography' (HPLC). Out of seventy-six heroin dependent patients who entered the study, 64 provided urine sample on the same day. Patients' self-report about recent opiate use was found to have a moderate agreement with urinalysis report. However, it is important to validate it with urinalysis during the treatment process because a substantial proportion of patients fails to report recent opiate use. It is recommended that all drug dependence treatment centres should be equipped with a sensitive urinalysis facility. Otherwise, the outcome of the treatment process should be considered with caution.

Validity of self-report of recent opiate use in treatment setting.

Aim: The aim of the study is to examine the agreement between self‐reports of drug use pattern and urinalysis data of 112 male intravenous drug users seeking treatment at National Drug Dependence Treatment Centre of All India Institute of Medical Sciences, New Delhi, India.Design: All the male intravenous drug users (n = 112) seeking treatment during the study period were included in the study. Addiction Severity Index Questionnaire was administered, and the agreement between self‐reports of drug use and urine analysis of drugs using gas liquid chromatography was compared.Findings: The data showed that although the primary drug of use was heroin in all the subjects a significant number of them were currently using a combination of buprenorphine, diazepam and pheniramine. The agreement of self‐report and urine analysis varied across the type of drug used. Acceptable agreement was seen with buprenorphine, diazepam, pheniramine and promethazine. The reports of patients on heroin and morphine showed poor agre...

Can you trust self‐reports among injectable drug users in clinical setting?

Ninety two patients of alcohol dependence were studied for liver function at a specialised drug dependence treatment centre. Biochemical laboratory evidence of liver dysfunction was found in a very large number of patients, including the patients who had no clinical signs or symptoms. The findings from this retrospective study are discussed in the context of the earlier studies from other settings in India.

Profile of liver dysfunction in alchohol dependence.

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