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Translate this page into:. In Pakistan, slums are illegal settlements that are always left out in health surveys. However, studies around the world show that substance or drug abuse is higher among slum dwellers and may have different patterns and determinants which need to be studied in order to frame targeted programs and policies. A population of individuals was calculated as the appropriate sample size. Both female and male participants aged 15 years and above, from 9 randomly selected slum clusters in Islamabad provided their consent to participate in the study. From each cluster, 23 households were selected, and from each household one individual was randomly selected for estimating the prevalence of substance abuse. All those who were abusing substances were counted as cases and others as controls for case-control analysis. A structured questionnaire was used to gather information on demographics, trends, types of substances abused, risk factors for getting engaged in substance abuse, whether they had tried to quit at any stage, and what difficulties they faced when trying to quit. Results were entered and analyzed using Epi-info version 7. A total of participants were enrolled in this study. Among these, 68 Bivariate analysis of the risk factors indicated that easy access to drugs in slum areas OR: Education OR: 0. Specific policies and plans focusing on law enforcement for curbing the illegal drug sales and reduction of child labor, along with the provision of education, should be devised and implemented to help these neglected communities and modify the identified determinants. Substance abuse in Pakistan is one of the major causes of concern that affects almost all segments of society. Substance abuse not only has devastating effects on the physical and psychological wellbeing of people, but also has adverse effects on the economic growth of the country. Particularly, heroin abuse is spreading at a high rate, especially among those between the ages of 15 and 39 years. Cannabis usage appears to be most prevalent in people aged 30 to 34, whereas heroin use appears to be most prevalent in people aged 35 to According to a study by Khalily 2 on developing a coordinated response to drug abuse in Pakistan, the average age of initiation of drug use is 18 years and drugs are more prevalent among the lower and lower- middle classes of society in some areas of the country. The increasing point of concern is the high prevalence of non-medical use of prescription drugs nationwide, particularly among women. Among addicts, women have a higher prevalence of drug use when compared to men in Pakistan. A high proportion of women that have confirmed their drug use, revealed that they have resorted to misusing opioid-based painkillers, and to a lesser extent tranquilizers and sedatives, which are readily available in pharmacies. The situation is of concern due to the high prevalence of Hepatitis B and C, which is associated to injection drug use. The number of people injecting drugs is estimated to be 4. Pakistan is situated in the northwestern part of the south Asian subcontinent, comprising a total land area of , square kilometers. The share of Pakistan's urban population was Rapid urbanization has generated some public health issues due to limited urban infrastructure and housing facilities in the country. People from lower socioeconomic classes are unable to build appropriate shelters in large cities, leading to the building of squatter housing settlements known as slums. Though the living conditions, health facilities, and health services are not optimal for even the general population, they are far superior compared to those in the slums, due to access to better housing, employment opportunities, and health services. As the settlements are illegal and temporary, they are unable to become a focus for the facilitation of infrastructure, health and education facilities, and law regulation and enforcement. The growing number of slum areas in Pakistan is a major issue exacerbated by the occurrence of floods, growing urbanization, the unplanned growth of cities, and the concentration of employment opportunities within urban settlements. Pakistan's slums have many similarities compared to other low- and middle-income countries LMICs , such as overcrowding, lack of housing, inadequate hygiene, extremely poor sanitation, precarious economic situation, low education levels and limited to no access to healthcare. Also, there is no healthcare delivery system focused on these underserved populations. Literature shows that the slums are at the worst of conditions, especially concerning their healthcare. Slums are missed in health and other global surveys of Pakistan. However, studies around the world show that substance abuse is relatively high among slum dwellers, which may have different patterns that need to be studied so that information can be used to target programs and policies. Adults from both sexes and aged 15 years old and above, were enrolled from selected clusters, and consented to participate in the study. Mentally unstable individuals, and those that could not comprehend the questions asked, were excluded from the study. The survey was planned in a two-staged cluster sampling manner, to ensure adequate coverage. According to the latest list from Islamabad's Federal Capital of Pakistan Capital Development Authority CDA , almost 18 settlements were present, with an estimated population of 80, people. Assuming a design effect of 2. From each cluster, and in a randomized manner, a total of 23 households were selected. Subsequently, one individual from each household was randomly selected for estimating the prevalence of substance abuse. Substance abusers were considered case subjects, while non-substance abusers were deemed as control subjects. The questionnaire was administered by a team of trained data collectors who use to have a prior meeting with the community head for permission to carry out the survey. Informed written consent was obtained in Urdu national language from the respondents. There were a majority of uneducated members in the population, thus a community member accompanied the researchers while taking consent, who would explain the research study objectives and requirements to the respondents. Participants were assured of the confidentiality of the information by not using personal identifiers. They were also given the choice to leave the study at any point if they wanted to. A total of participants were enrolled in the study. The majority of of participants were male, constituting a total of participants The mean age of the respondents was The age wise distribution showed the highest prevalence of substance abuse in ages years followed by ages years. Drug use is less prevalent in older age groups. Figure 1. Drug abuse was reported by Bivariate analysis of the risk factors indicated that easy availability of drugs in slum areas OR: It was further determined that education OR The study found a high prevalence of substance abuse This is much higher when compared to the estimated country report in There are numerous factors influencing the engagement in substance abuse such as the influence of friends or peer pressure, social and family stresses, or someone else in the family using drugs. However, belonging to a broken family, living on your own, or living as a working child, were suggestive of being strong predictors of substance abuse. This was supported by a prior study, which described factors such as problems with parental or marital relations, a relationship breakup, the desire to escape stressful life events, or feelings of failure, as being contributors to substance abuse. Another important finding of the present study was that easy access to drugs was one of the strongest predictors of substance abuse within slums. Illegal and unregulated communities seem to be the hub of illicit activities and drugs, and where these are easily accessible, thus increasing the exposure to the population. The study was a non-funded activity, therefore the lack of resources was a major limitation to going beyond a specified geographical location, namely Islamabad. Although the key characteristics of the slum areas remain the same, a study with limited geographical representation is a limitation and our results lack the element of generalizability for the slum areas of the entire Pakistan. However, this pilot study provided some insight to the gravity of the situation and warrants further large-scale interventional studies to adress the modifiable determinants of substance abuse. The prevalence of substance abuse among Islamabad residents was alarming. The determinants of substance abuse included unregulated and illegal drug sales, high rate of tobacco consumption, poverty, illiteracy, social and family issues, and being a working child. Though these determinants are inherent to slum settlements, they are largely modifiable. It is recommended that the menace of substance abuse among such vulnerable populations require strategic interventions such as enacting laws for curbing the illegal drug and tobacco sales and their accessibility, regulating child labor practices, and the provision of health and behavior change education. All authors hereby declare that they have no conflict of interest that may have affected the results obtained in the study. Informed written consent was obtained from respondents in Urdu national language. They were also given a choice to leave the study at any point if they wanted to. As this was a non-funded activity supported by Pakistan Health Research Council; the logistics and human resource was graciously provided for this research study and we extend our gratitude for this support to PHRC and its personnel. The publication of this article was fully supported by the Global Health and Education Projects, Inc. The information, contents, and conclusions are those of the authors and should not be construed as the official position or policy of nor should any endorsements be inferred by ESGP or GHEP. Buy Reprints PDF. Abstract Background: In Pakistan, slums are illegal settlements that are always left out in health surveys. Results: A total of participants were enrolled in this study. Show Related Articles from PubMed. Introduction Substance abuse in Pakistan is one of the major causes of concern that affects almost all segments of society. Results Sociodemographic characteristics A total of participants were enrolled in the study. Figure 1: Prevalance of drug abuse among different age groups in slum dwellers of Islamabad. Export to PPT. Table 1: Demographic information of the study participants. Table 2: Distribution of risk factors among cases and controls. Table 3: Risk factors analysis of substance abuse among slums in Islamabad References Aslam N. Horrendous situation of substance abuse in Pakistan: a bird's eye view on socio-demographics. J Alcohol Drug Depend. Khalily MT. Developing a coordinated response to drug abuse in Pakistan. J Interprof Care. United Nations Office on Drugs and Crime. Drug Use in Pakistan Government of Pakistan. Ministry of Narcotics Control. Published accessed October 13 \[Google Scholar\]. Demographic profile and etiological factors of starting drugs among patients with drug addiction. J Coll Physicians Surg Pak. Pakistan Demographic and Health Survey Pakistan Bureau of Statistics. Pakistan Tehsil Wise for Web Census Pakistan Bureau of Statistics ; Published accessed October 13 Pakistan Demographic and Health Profile Socio-economic status of transferred and non-transferred urban slums: a case study from Faisalabad. Pakistan Institute of Development Economics. Britannica, The Editors of Encyclopedia. Exploration of socio-economic problems of the inhabitants of slum areas and their impact on vicinity residents: a case study of Arifwala Pakistan. Sci Int. Lahore \[Google Scholar\]. Kamruzzaman M , Hakim MA. Child criminalization at slum areas in Dhaka City. American Journal of Psychology and Cognitive Science. Sharma M , Chaudhary M. A study of drugs and substance abuse among adolescents of slum dwellers. Int J Indian Psychol. Slum health: diseases of neglected populations. Co-occurrence of behavioral risk factors of common non-communicable diseases among urban slum dwellers in Nairobi, Kenya. Glob Health Action. Epi Info \[Computer Software\]. Version 7. Substance abuse amongst the street-children in Guwahati City, Assam. Ann Med Health Sci Res. An epidemiological study on substance abuse among college students of north India. Substance abuse among adolescents in urban slums of Sambalpur. Indian J Community Med. Drug abuse in slum population. Indian J Psychiatry. Tobacco smoking and its association with illicit drug use among young men aged years living in urban slums of Bangladesh. PLoS One. Prevalence and causes of substance abuse among undergraduate medical college students. Ind Med Gaz. Fulltext Views PDF downloads Showing results from PubMed. Share Post Share. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Do not sell my personal information. Cookie Settings Accept. Cookie Consent. Close Privacy Overview This website uses cookies to improve your experience while you navigate through the website. 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Islamabad buying Heroin
Prevalence and Determinants of Substance Abuse Among Slum Dwellers in Islamabad- Pakistan
Islamabad buying Heroin
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Prevalence and Determinants of Substance Abuse Among Slum Dwellers in Islamabad- Pakistan
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