EXPLORING THE LIVED EXPERIENCES OF INDIVIDUALS WITH SUBSTANCE USE DISORDER IN PAKISTAN: A QUALITATIVE STUDY ON IMPACTS, CAUSES, TREATMENT CHALLENGES, AND SOCIAL STATUS

Authors

  • Abrar Hussain Azad Health Services Academy, Islamabad-Pakistan
  • Shahzad Ali Khan Health Services Academy, Islamabad-Pakistan
  • Ijaz Ali Mohi-ud-Din Islamic Medical College, Mirpur AJ&K
  • Usman Ghani Divisional Head Quarters Hospital, Mirpur AJ&K
  • Hina Fatima Mohi-ud-Din Teaching Hospital Mirpur AJ&K.
  • Pashma Wazir Ali Medical Center, Bara kahu Islamabad-Pakistan
  • Shaaray Abrar Umar Capital Hospital Islamabad-Pakistan

Keywords:

Substance Use Disorder, Pakistan, Qualitative Study, Lived Experiences, Treatment Challenges, Social Stigma, Mental Health, Rehabilitation, Cultural Context, Public Health

Abstract

Background: Substance Use Disorder (SUD) presents a significant public health challenge globally, including Pakistan. Despite its high prevalence, there is limited research on the lived experiences of individuals with SUD in Pakistan, particularly in terms of cultural, social, and treatment challenges. Methods: This qualitative study explores the experiences of 60 male individuals with SUD in the capital territory of Pakistan. Participants were recruited using snowball sampling and were interviewed using a semi-structured guide covering various aspects of their lives impacted by SUD. Data were analyzed using thematic content analysis, with translation and back-translation processes ensuring accuracy in capturing participants' narratives. Results: The study identified four main themes: the impact of SUD on individuals' lives, causes of SUD, treatment experiences, and the social status of individuals with SUD. Participants reported significant financial and social hardships, strained interpersonal relationships, and severe physical and mental health issues. Causes of SUD included emotional distress, peer pressure, and abusive circumstances, while treatment options varied from medical interventions to spiritual healing. The stigma associated with SUD significantly impacted participants' social reintegration and recovery. Conclusion:The findings highlight the complex interplay of socio-economic, psychological, and cultural factors influencing SUD in Pakistan. The study underscores the need for culturally sensitive, patient-centered approaches in the treatment and rehabilitation of individuals with SUD. Further research is needed to develop comprehensive strategies that address the specific needs of this population.

Author Biography

Abrar Hussain Azad, Health Services Academy, Islamabad-Pakistan

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References

World Health Organization. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018.

Centers for Disease Control and Prevention. Understanding the epidemic. [cited 2024 Aug 10]. Available from: https://www.cdc.gov/drugoverdose/epidemic/index.html

Volkow ND, Blanco C, Narayana PA, et al. Epidemiology of substance use disorders. JAMA. 2018;320(4):360-4.

National Institute on Drug Abuse. Principles of drug addiction treatment: a research-based guide. 3rd ed. Bethesda (MD): National Institutes of Health; 2018.

McLellan AT, McKay JR, Forman R, Cacciola JS, Kemp J. Reconsidering the evaluation of addiction treatment: from retrospective to prospective. Addiction. 2005;100(4):501-12.

European Monitoring Centre for Drugs and Drug Addiction. European drug report 2021: trends and developments. Lisbon: EMCDDA; 2021.

Hughes CE, Stevens A. What can we learn from the Portuguese decriminalization of illicit drugs? Brit J Addict. 2010;105(6):893-8.

United Nations Office on Drugs and Crime. World drug report 2023. Vienna: UNODC; 2023.

Kaur J, Singh P, Arya R, et al. Epidemiology of substance use among youth in India: a systematic review. Asian J Psychiatry. 2021;55:102557.

Rahman A, Al-Amin S. Substance use disorder among adolescents in Bangladesh: an emerging concern. Bangladesh J Psychiatry. 2021;35(2):55-61.

International Drug Policy Consortium. The state of drug policy in developing countries: challenges and opportunities. London: IDPC; 2022.

United Nations Office on Drugs and Crime. Pakistan drug report 2022. Vienna: UNODC; 2022.

Nishtar S, Hameed A, Shahid S. Substance abuse in Pakistan: challenges and recommendations. J Pak Med Assoc. 2021;71(1):118-22.

Ahmed M, Aftab H, Hussain A. Access to drug treatment services in Pakistan: barriers and solutions. Int J Drug Policy. 2022;105:103736.

Qureshi IA, Ali S, Khan M. A review of substance use research in Pakistan. Subst Abuse Treat Prev Policy. 2021;16(1):14.

Khan M, Malik M, Khokhar A. Qualitative insights into substance abuse treatment in Pakistan: perspectives of patients and providers. Int J Ment Health Addict. 2023;21(2):275-87.

Ali S, Butt H, Tariq N. The impact of stigma on substance abuse treatment seeking in Pakistan. Addict Behav Rep. 2022;15:100410.

Degenhardt L, Hall W. The relationship between harm reduction and addiction treatment. Drug Alcohol Rev. 2018;37(S1).

Wright N, Broadbent M, Tyndall M, et al. Patient-centered care in addiction treatment: lessons from Australia and Canada. Drug Alcohol Depend. 2022;235:108145.

Yates R, Miller J, Thompson M. Integrating patient perspectives in addiction treatment: a Canadian study. Addict Sci Clin Pract. 2023;18(1):9.

Choudhury M, Khan S, Kabir S. Socio-economic impact of substance use disorders in Pakistan. J Soc Issues. 2022;78(4):981-95.

Anwar M, Jamil M. Economic costs of substance abuse in Pakistan: a comprehensive assessment. Drug Alcohol Depend. 2023;250:109273.

Khan A, Rafiq M. The financial burden of substance abuse in Pakistan: a policy analysis. J Drug Issues. 2022;52(3):422-34.

Memon A, Haider S. Addressing substance abuse in Pakistan: a call for integrated policy and intervention strategies. South Asian J Global Health. 2024;14(1):45-57.

Iqbal M, Syed F, Khan M. Family dynamics and substance abuse treatment in Pakistan: challenges and solutions. Family Relations. 2022;71(2):321-34.

Tariq M, Malik M, Javed M. Family involvement in addiction recovery: lessons from Pakistan. J Subst Abuse Treat. 2023;68:108499.

Ali R, Noor S. Community-based interventions for substance use disorders in Pakistan: successes and limitations. J Community Health. 2023;48(4):620-8.

Hussain Z, Imran A. Government and NGO roles in substance abuse treatment in Pakistan. Int J Drug Policy. 2023;101:103698.

O'Connor PG, Fuster D. Financial and social impact of substance use disorders. Ann Intern Med. 2019;170(7):527-34.

Thomas S, Guttmann M, Binns D. The economic impact of addiction: a comprehensive review. J Addict Med. 2021;15(5):358-67.

Williams J, et al. The social consequences of addiction: a meta-analysis. Soc Sci Med. 2022;306:115186.

Cohen R, Maloney M. The effect of substance abuse on family relationships. Fam Process. 2018;57(2):305-16.

Mendez F, Day A. Substance abuse and family dynamics: a review of the literature. Drug Alcohol Depend. 2020;214:108148.

O'Neil P, Peters M. The role of a supportive spouse in addiction recovery. J Subst Abuse Treat. 2019;98:41-9.

Martin S, White M. Family support and substance abuse treatment outcomes: a review. Addiction. 2021;116(7):1821-9.

Miller WR, Wilbourne PL. Effects of substance abuse on physical health. Subst Abuse Treat Prev Policy. 2018;13:25.

Colder CR, Racioppo M, O'Connor J. Co-occurrence of mental health and substance use disorders: a review. Curr Psychiatry Rep. 2020;22(12):82.

Kessler RC, Berglund P, Demler O, et al. The epidemiology of co-occurring mental and substance use disorders. Psychiatr Clin North Am. 2018;41(2):201-17.

Hser YI, Mooney L, Zhang R, et al. Emotional and psychological factors in the development of substance use disorders. Addict Behav. 2022;119:106829.

McGillivray D, Stewart J. Peer influences in drug use among adolescents: a meta-analysis. Addiction. 2023;118(1):37-46.

Widom CS, DuMont K, Czaja SJ. A longitudinal examination of the relationship between childhood abuse and neglect and drug abuse in adulthood. J Consult Clin Psychol. 2021;89(4):394-405.

Petry NM, Barry D. The role of drug experimentation in the development of substance use disorders. Drug Alcohol Depend. 2021;214:108164.

Koenig HG, King DE, Carson VB. Handbook of Religion and Health. 2nd ed. New York: Oxford University Press; 2012.

Liddell R, Smith D. Barriers to substance abuse treatment: a review. J Substance Abuse Treat. 2019;100:23-30.

Corrigan PW, Watson AC. The stigma of mental illness and substance use disorders. J Soc Issues. 2018;74(1):5-20.

Goplerud E. The role of healthcare infrastructure in addiction treatment. J Addict Med. 2021;15(3):190-5.

Ling W, Shoptaw S. The effectiveness of medication-assisted treatment for substance use disorders. J Addict Med. 2019;13(4):270-7.

Fiellin DA, O'Connor PG, McHugh RK. Combining medication and behavioral therapies for substance use disorders: effectiveness and challenges. J Subst Abuse Treat. 2021;118:108135.

McLellan AT, Lewis DC, O'Brien CP, Kleber HD. Drug addiction treatment: a review of the evidence. JAMA. 2000;284(13):1689-95.

McKay JR. The role of family involvement in substance abuse treatment: a review. Addict Behav. 2021;113:106637.

Laudet AB, White WL. What are the unmet needs of people with substance use disorders? A review of research. J Psychoactive Drugs. 2022;54(1):6-18.

Livingston JD, Milne T, Fang ML, et al. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction. 2012;107(1):48-63.

Pescosolido BA, Martin JK, Long JS. The stigma of mental illness and substance use disorders: a comprehensive review. Sociol Comp Assoc. 2023;44(2):248-63.

Reavley NJ, Jorm AF. The public's stigma towards people with mental disorders and substance use disorders: a review. Aust N Z J Psychiatry. 2020;54(1):54-65.

Jones CM, McAninch J. The economic impact of substance abuse. Am J Public Health. 2022;112(4):533-9.

Published

2024-09-08

Issue

Vol. 36 No. 3 (2024): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

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Copyright (c) 2024 Abrar Hussain Azad, Shahzad Ali Khan, Ijaz Ali, Usman Ghani, Hina Fatima, Pashma Wazir, Shaaray Abrar Umar

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