BEHIND THE BURDEN: A QUALITATIVE STUDY ON CAREGIVING FOR SUBSTANCE USE DISORDER IN PAKISTAN
DOI:
https://doi.org/10.55519/JAMC-S4-14248Keywords:
Substance Use Disorder, Caregiving, Mental Health, Stigma, Financial Burden, Qualitative Research, PakistanAbstract
Background: Substance Use Disorder (SUD) poses severe challenges for both individuals with addiction and their caregivers. Caregivers in Pakistan experience psychological distress together with economic hardship and social discrimination which healthcare systems fail to recognize and address. Through this research both practical and emotional aspects of caregiving life of people who care for addicts (PWSUD) in Pakistan were studied. Methods: This qualitative study recruited 50 informal caregivers (male: 38, female: 12) through snowball sampling. The research team gathered information through advanced interviews that examined caregivers' experiences with caregiving roles while investigating treatment option awareness and obstacles to medical assistance. Research participants participated interviews conducted in Urdu followed by transcription and translation and data analysis through Braun and Clarke’s thematic analysis methodology. Results: Stigma and social rejection enhanced emotional distress among caregivers who experienced symptoms of anxiety depression and helplessness. Thematic analysis identified three primary themes: The research uncovered three main themes which encompass socio-economic challenges such as social isolation and lack of educational resources beside economic struggles together with survival skill deficits. Financial instability arose for caregivers because of continuous care responsibilities which restricted their access to professional treatments for their family members. Caregivers suffered from mental health problems because social stigma surrounding addiction both kept them isolated and prevented them from getting external support. Conclusion: The individuals who care for people with substance use disorders in Pakistan experience heavy emotional and social burdens together with financial stress while receiving almost no support. Accessible mental health services together with financial support programmes and stigma reduction interventions represent essential elements in supporting caregiver health and enhancing treatment results for individuals with Substance Use Disorder (PWSUD).
References
1- Ali F, Baig W, Saad M, Tabassum S, Aslam MS, Zahra F, Choudhary AK. Depression in the primary caregivers of patients with substance use disorder. Pak J Med Health Sci. 2022;16(5):913. doi:10.53350/pjmhs22165913.
2- United Nations Office on Drugs and Crime. The social and economic impact of drug use on families. 2013.
3- Sharma A, Sharma A, Gupta S, Thapar S. Study of family burden in substance dependence: a tertiary care hospital-based study. Indian J Psychiatry. 2019 Mar-Apr;61(2):131-8. doi:10.4103/psychiatry.IndianJPsychiatry_123_15. PMID: 30992606; PMCID: PMC6425802.
4- Abbas S, Iqbal S, Sher A, Waseem A. Stigma and substance use disorder in Pakistan: A comparison over drug-taking duration. J Pak Psychiatr Soc. 2022;19(1):12-17.
5- Grover S, Avasthi A, Singh A, Dan A, Neogi R, Kaur D, et al. Stigma experienced by caregivers of patients with severe mental disorders: a nationwide multicentric study. Int J Soc Psychiatry. 2017 Aug;63(5):407-17. doi:10.1177/0020764017709484. Epub 2017 May 24. PMID: 28537123.
6- Medina S, Van Deelen A, Tomaszewski R, Hager K, Chen N, Palombi L. Relentless stigma: a qualitative analysis of a substance use recovery needs assessment. Subst Abuse. 2022 May 30;16:11782218221097396. doi:10.1177/11782218221097396. PMID: 35664045; PMCID: PMC9160899.
7- Imtaiz N, Hussain S, Karar S, Khan S, Alimudin M, Kamran M, et al. Depression and its associated factors: a study on caregivers of psychiatric patients. Pak Armed Forces Med J. 2021;71(6):1933-6. doi:10.51253/pafmj.v6i6.2971.
8- Memon JA, Nasir M, Nayab D, Siddique O, Kishwar S. Economic burden of tobacco use in Pakistan. Tob Control. 2024 Jun 4;33(Suppl 2):s101-7. doi:10.1136/tc-2022-057726. PMID: 36521854.
9- Maina G, Ogenchuk M, Phaneuf T, et al. "I can’t live like that": the experience of caregiver stress of caring for a relative with substance use disorder. Subst Abuse Treat Prev Policy. 2021;16:11. doi:10.1186/s13011-021-00344-3.
10- Timko C, Lor MC, Rossi F, Peake A, Cucciare MA. Caregivers of people with substance use or mental health disorders in the US. Subst Abus. 2022 Dec;43(1):1268-76. doi:10.1080/08897077.2022.2074605. PMID: 35849747
11- .Azad AH, Khan SA, Ali I, et al. Experience of psychologists in the delivery of cognitive behaviour therapy in a non-western culture for treatment of substance abuse: a qualitative study. Int J Ment Health Syst. 2022;16:55. doi:10.1186/s13033-022-00566-3
12- .Shyangwa PM, Tripathi BM, Lal R. Family burden in opioid dependence syndrome in tertiary care centre. JNMA J Nepal Med Assoc. 2008;47:113-9.
13- Ali F, Baig W, Saad M, Tabassum S, Aslam MS, Zahra F, Choudhary AK. Depression in the primary caregivers of patients with substance use disorder. Pak J Med Health Sci. 2022;16(5):913. doi:10.53350/pjmhs22165913.
14- El Hayek S, Foad W, De Filippis R, Ghosh A, Koukach N, Pant SB, et al. Stigma toward substance use disorders: a multinational perspective and call for action. Front Psychiatry. 2024;15:1295818. doi:10.3389/fpsyt.2024.1295818.
15- Mikulić M, Ćavar I, Jurišić D, Jelinčić I, Degmečić D. Burden and psychological distress in caregivers of persons with addictions. Challenges. 2023;14(2):24. doi:10.3390/challe14020024.
16- Aragão AT, Milagres E, Figlie NB. [Quality of life and hopelessness of relatives of addicted]. Psico-USF. 2009;14(1):117-23. Portuguese.
17- Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, et al. Caregiver burden among caregivers of patients with mental illness: a systematic review and meta-analysis. Healthcare (Basel). 2022 Nov 30;10(12):2423. doi:10.3390/healthcare10122423. PMID: 36553947; PMCID: PMC9777672.
18- Irfan B, Irfan O, Ansari A, Qidwai W, Nanji K. Impact of caregiving on various aspects of the lives of caregivers. Cureus. 2017 May 2;9:e1213. doi:10.7759/cureus.1213.
19- Jatoi H, Majeed S. Psychological distress, coping styles and emotional well-being among caregivers of patients with schizophrenia. J Pak Psychiatr Soc [Internet]. 2022 Oct 31 [cited 2025 Jan 22];19(02):22-6. Available from: https://www.jpps.pk/index.php/journal/article/view/143
20- Shamsaei F, Cheraghi F, Bashirian S. Burden on family caregivers caring for patients with schizophrenia. Iran J Psychiatry. 2015 Sep;10(4):239-45. PMID: 27006669; PMCID: PMC4801494.
21- Murfield J, Moyle W, O'Donovan A, Ware RS. The role of self-compassion, dispositional mindfulness, and emotion regulation in the psychological health of family carers of older adults. Clin Gerontol. 2024 Jan-Dec;47(2):316-28. doi:10.1080/07317115.2020.1846650. Epub 2020 Dec 2. PMID: 33263503.
22- Wu MS, Hamblin R, Nadeau J, Simmons J, Smith A, Wilson M, et al. Quality of life and burden in caregivers of youth with obsessive-compulsive disorder presenting for intensive treatment. Compr Psychiatry. 2018 Jan;80:46-56. doi:10.1016/j.comppsych.2017.08.005. Epub 2017 Aug 30. PMID: 29031217; PMCID: PMC5858930
23- Gelaye H, Andualem A. Quality of life and associated factors among family caregivers of individuals with psychiatric illness at DRH, South Wollo, Ethiopia, 2020. Sci Rep. 2022 Nov 3;12(1):18550. doi:10.1038/s41598-022-22015-4. PMID: 36329187; PMCID: PMC9633784.
24- Masood S, Us Sahar N. An exploratory research on the role of family in youth's drug addiction. Health Psychol Behav Med. 2014 Jan 1;2(1):820-32. doi:10.1080/21642850.2014.939088. Epub 2014 Aug 20. PMID: 25750821; PMCID: PMC4346037.
25- Yang LH, Wong LY, Grivel MM, Hasin DS. Stigma and substance use disorders: an international phenomenon. Curr Opin Psychiatry. 2017 Sep;30(5):378-88. doi:10.1097/YCO.0000000000000351. PMID: 28700360; PMCID: PMC5854406.
26- Ali F, Baig W, Saad M, Tabassum S, Aslam MS, Zahra F, et al. Depression in the primary caregivers of patients with substance use disorder. PJMHS. 2022 May;16(05):913-5. doi:10.53350/pjmhs22165913.
27- Settley C. The physical and psychological wellbeing of caregivers of individuals suffering from substance addiction. Arch Psychiatr Nurs. 2020 Jun;34(3):107-9. doi:10.1016/j.apnu.2020.03.007. Epub 2020 Mar 12. PMID: 32513458.
28- Ali F, Baig W, Saad M, Tabassum S, Aslam MS, Zahra F, et al. Depression in the primary caregivers of patients with substance use disorder. PJMHS. 2022 May;16(05):913-5. doi:10.53350/pjmhs22165913.
29- Bakker EM, Witkamp FE, Luu KLN, van Dongen SI, Raijmakers NJH, van Roij J, et al. Caregiver activation of relatives of patients with advanced cancer. Eur J Cancer Care (Engl). 2022 Nov;31(6):e13656. doi:10.1111/ecc.13656. Epub 2022 Jul 16. PMID: 35841207; PMCID: PMC9788340.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Abrar Hussain Azad, Irum Gilani, Ijaz Ali, Usman Ghani, Laraib Fatima Malik, Afifa Shabbir, Shaaray Abrar Umar, Pashma Wazir
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
