6771337 Drug Addiction Main

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THE THESIS ON

HOSPITAL MANAGEMENT DEVELOPING

COUNTRIES

Knowledge of Drug Addiction of first year MBBS

Students of selected Medical College in Dhaka

Submitted in the fulfillment of the requirement for the award of the

Degree in

MPH Program

To

ATISH DIPANKER UNIVRSITY OF SCIENCE

AND TECHNOLOGY

By

Dr. Sufia Khanam

MPH (HM) COURSE Batch# 7th

ID No: UND00922


AND TECHNOLOGY

DHAKA, BANGLADESH

1



I

STUDENTS DECLARETION

I do hereby declare that the MPH dissertation entitled “ Knowledge of Drug

Addiction of First year MBBS students of selected Medical College in Dhaka”


Degree in

MPH Program

To


AND TECHNOLOGY

Is my original work and not submitted for award of any other fellowship or

Similar title of prizes.

Place: Bangladesh Dr. Sufia Khanam

Date: MPH (HM) COURSE Batch# 7th

ID No: UND00922

2



II

CERTIFCATE OF THE RESEARCH GUIDE

This is to certify that the thesis entitled




Degree in

MPH Program

To


AND TECHNOLOGY

Is a record Bonafide Research Work Carried out by

By

Dr. Sufia Khanam

ID No: UND00922

Under my supervision & guidance and that no part of this project report has been

submitted for the award of any other degree / diploma / fellowship or similar

title or prizes and that the work has not been published in any scientific or population magazines.

Research GuideSignature:

Name: Dr. Masuma Akter

Assistant professor

University of new Castle, USA(Affiliated center, Bangladesh)

3



III

CERTIFCATE OF APPROVAL

This thesis work of Dr. Sufia khanam titled



Is approved and accepted in quality an form

Board of Examiners: Signature:

Chairman:

Full Name:

Member:

Full Name:

Member:

Full Name:

Research guide:

Signature:

Name: Dr. Masuma Akter

Assistant professor

University of new Castle, USAAffiliated center, Bangladesh


AND TECHNOLOGY

4



IV

Dedicated:

My deepest regards to the departed soul of my beloved

Mother and Father.

5



V

ACKNOWLEDGEMENT

All thanks to almighty Allah, the merciful, the beneficent and the

compassionate for giving me the opportunity and providing me with enough

energy to carry out and complete this Thesis.

I acknowledge my sincere profound gratitude to Prof. Dr. Shamsun

Nahar and the chairman of the Thesis selection committee and other

members of the committee for their kind approval of the topic of my Thesis.

I extend most sincere appreciation and own special of debt gratitude to

my guide Dr. Masuma Akter for her valuable suggestion, active guidance,

sincere supervision and cooperation throughout in the preparation and

completion of the Thesis. I would like avail this opportunity to pay my

sincere tribute and appreciation to Prof. Md. Hafiz for his endless effort and

constant help, valuable suggestion and for his incessant mental support

provided to me throughout the work. I am also grateful to my Colleagues for

their kind Co-operation and encouragement. Individual effort alone is not

enough to conduct a research work. So, I am thankful to all concerned

personnel who helped me in completion of this study.

Dr. Sufia Khanam

6



VI

Contents

1. Acknowledgements VI

2. Contents VII

3. List of Tables with Results IX

4. List of graphs and diagram with Results X

CHAPTER-I

1. Justification of Field Practice 02

2. Abstract 03

3. Introduction 05

4. Historical Background 06

5. Literature Review 07

6. Incidence 087. Prevalence 16

8. Gender differences in Prevalence of Drug Abuse 18

9. Objective 23

10. General Objective 24

11. Specific Objectives 24

12. Key Variables 2513. Operational definition 26

14. Limitation of the Study 27

VII

CHAPTER-II: Methodology

2.1 Type of study 29

2.2 Place of study 29

2.3 Study period 29

2.4 Study population 29

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2.5 Sample size and sampling technique 29

2.6 Selection and development of research instrument 29

2.7 Procedure of data collection 29

2.8 Data analysis and report writing 29

CHAPTER-III:

3.1 Tables 31-44

3.2 Diagrams 31-44

CHAPTER-IV: Discussion 46

CHAPTER-V:

5.1 Recommendation 495.2 Conclusion 50

5.3 Bibliography 51

5.4 Questionnaire 54

VIII

LIST OF TABLES

Page

1. Distribution of respondents by their age 32

2. Distribution respondent by their knowledge regarding

high-risk people.

34

3. Knowledge about age group of addicted people. 364. Economic status of addicted people. 37

5. Causes of addiction. 39

6. Drugs commonly used in addiction. 40

7. Common sources of drug.

8. Effect of drug addiction. 41

8



9. Knowledge about authorities responsible for control

of addiction.

42

10. Knowledge of appropriate agencies for management

of addicts.

43

11. Sources of information about drug addiction. 44

IX

LIST OF GRAPHS & DIAGRAMS

1 Histogram of distribution of age of respondent. 33

2 Bar diagram of high-risk people. 34

3 Pie chart/diagram of economic status of addicted

people.

38

9



X

Chapter-I

10



Justification of Field Practices

The current field practice is indispensable part of the course curriculum

of community medicine in “Master Degree”. It provides the opportunity for

practical application of our knowledge, which we learned theoretically. We

learn how to conduct small-scale survey at the community level. The topic

selected for the study is a vital issue of today. Drug addiction is a major global public health problem affecting usually the youth. Now drug addiction

is a common psychosocial problem in our country also. Thus the purpose of

this study is to assess the knowledge about socioeconomic, demographic

characteristics and the factors influence drug addicted people & its after

effect.

11



ABSTRACT

This descriptive type of cross sectional study with one step

stratification was conducted among the students of Z. H. Sikder Women’s

Medical College, Dhaka to assess their knowledge and practice regarding

drug addiction in Bangladesh.

Most of the respondent (57%) told the highest incidence of drug

addiction occurs among students and 18% & 14% told that it occurs among

professional blood donors & drivers respectively. About 60.75% that highest

incidence occurs among 20-30 yrs age gr. of people & below 20 years also

important risk age group (35.5%) and incidence very less about 30 yrs of age.

According to respondent higher socioeconomic group (44.3%) are suffering

more from addiction & also poor class (34.1%) suffering from average

incidence where as middle class (17%) escaping more. Significant no. of

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respondent mentioned frustration (54.43%) is the main cause of drug

addiction along with it unemployment (25.31%) 2nd cause. About 50.63% of

respondent told that Phensidyl is the commonly used drug & Heroine,

Pethidine, Alcohol comes next (25.31%, 11.39, 8.86%) respectively. And

according to their knowledge common source of drug is 39.24% and very

close to this source underground agents (37.97%) also another couse &

13.92% told from Pharmacy. Most of the respondent told 37.97% as effect of

drug addiction has antisocial activities & others have different types of

physical problem (31.64%) & others have psychological problem (24.05%).

Death (1.26%) also is an important consequence. Highest number of respondent told that responsible authorities to prevent drug addiction in

Ministry of Health & Family Welfare is 25.3%, Directorate Narcotics Control

(22.7%) & Drug administration (20.2%) & other Civil Society (11.3%) &

Ministry of Home Affairs (10.1%) have some responsibility. Regarding

respondent their knowledge about appropriate agencies for management of

addiction is specialized hospital (55.69%) & then parents are responsibleauthority (31.64%) & Social Welfare department can play an important role

(10.12%). Highest no. of respondents told that television (34.17%) acts as a

source of information about drug addiction & next from friends (26.58%) &

also from parents (16.45%) & knowledge from books (13.92%) & radio also

play a part (7.59%) as source of information.

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INTRODUCTION

Drug addiction has become a major social problem in Bangladesh. In a

developing country lives Bangladesh incidence of drug addiction increasing

day by day. It was a problem of developed country beforehand, but now it is

one of the important social problem of country trapped by this addiction it

will affects the future of our country. It is spreading like mushroom &

invading the every level of our nation like home, educational institution &

affecting individuals of all classes. In creasing number of drug addiction not

only decrease the economical development of a country but also directly

related to increased incidence of crime, unexpected violence and corruption.

Easy availability of drugs is a major cause of prevalence of drug addiction.

Peer pressure is generally considered to be an important factor in the

initiation of taking drugs. ESCAP (Economic and Social Commission of Asia

and the Pacific) showed that in 1989 there were 10,000 heroin addicts in

Bangladesh. But the no. of addicts are increasing day by day. Alam’s studies

that the no of addicts had increased tenfolds within last few years. They

14



estimated (1989) that there were 250,000 addicts present in Bangladesh Due

to improved and easy transport facility, drugs are being available easily

around the world. The general people are not aware of the factors of drug

addiction. Thus the purpose of this study is to find out the knowledge

regarding factors influencing drug addiction & to assess the

sociodemographic characteristics of addicts.

HISTORICAL BACKGROUND

Drugs were used by primitive people in religious rituals to combat or

naturalize various taboos. Throughout the ages significant number of

substances were used to treats disease but only a few of these substances had

only direct influences on the symptom of disease. The American Indians

extracted drugs like medicine from desserts plants, to enable them to

communicate with their dead ancestors. Continued study and refinement of

this product give medical science a great variety of drugs and medicines

unfortunately many of these substance have dangerous and damaging effects

on the body used indiscriminately. As there is increased use of such drugs by

the medical professionals there is growing tendencies for the people in

general to used drugs without prescription or medical purpose.

Medical use of drugs has always existed in Bangladesh as in elsewhere but

the present form of drug dependence among the youth of the country was

little known to people before 1960.The abuse of Heroine was first detected in

Dhaka in 1984.In the economically deprived communities cannabis,

15



depressants and opiates were found to be the agent of choice & among more

affluent young person cannabis, LSD and depressants were used extensively.

In 1994 the Bangladesh Govt. banned the consumption of opium and

closed the opium vendering in the country. Bangladesh experienced a

dramatic change in this field during last decade. An early identification of

cause of drug addiction might be helpful in developing a program for

reduction and prevention of the problem in the country.

LITERATURE REVIEW

This paper Review the literature in an area, which has received little attention

of drugs researchers spontaneous remission. The paper reviews all the

research studies that have looked at the phenomena of the “natural” recoveryfrom heroin addiction natural in the sense that some addicts manage to stop

using heroin and not become re-addicted without the help of treatment

intervention. Some areas for future research are also suggested.

Conventional wisdom among clinicians and researchers in the field of drug

abuse and addiction is that heroin addicts seldom, if ever, overcome addictionwithout treatment. Occasionally researchers have speculated that there may

be something akin to spontaneous remission among addicts, but until recently

it was though that the numbers and percentages of such recoveries were very

small (5-15%) and insignificant. New evidence suggests that the rate of

natural recovery may be much higher than expected. Furthermore, new

16



studies suggest that addicts who do not go to treatment recover at

approximately the same rates as those who do go to treatment.

INCIDENCE

The first evidence to suggest natural recovery came from Charles

Winick’s famous “maturing out” study publish in 1962.Winick traced

the official records of addicts in files of the Federal Bureau of Narcotics

and found that age was associated with such traces. As addicts

approached ages 35-40 years they tended to drop out of the files, which

suggested to Winick that some life cycle processes were involved. He

postulated that addicts gave up their addiction just as some adolescents

matured out of juvenile delinquency.

There are, however, problems with Winick’s study; he did not know

exactly what happened to persons who were no longer in the file and

assumed that they had given up their addiction. A 1973 report of George

Villant’s longitudinal study of 100New York addicts (originally

17



admitted to Lexington Hospital and followed for 20 years) questions

Winick’s assumption of recovery. Vaillant found that “ …more than half

of the actively addicted men of [his] study [were] able to go for five

years more without being reported to the Federal Bureau of Narcotics

and Dangerous Drugs, ”and that “Over 25% of active addicts went for

five years without being reported to the New York Narcotics Register.”

(Vaillant, 1973) These data suggest that Winick’s assumption of

recovery may not be completely justified.

The next study to suggest natural recovery was conducted in 1964 and

1965 and published in 1966. Robert scharse working in the East Los

Angeles halfway house asked known addicts in the program to identify

and locate friends who had used heroin with them but had since given it

up. Scharse identified 71 ex-users by this means and interviewed 40 of

them in a dual interview situation (both the addict and the ex-user). He

found that at least 9 of the 40 interviewed reported that they had

experienced physical dependence from heroin and had recovered with

out going to treatment. (Scharse, 1966)

Social survey data amplified the exploratory studies of Scharse and

Winick in 1967. Lee robins working out of Washington University in

St. Louis published the results of a social survey of a sample of black

males born during 1930-1934 in St. Louis and who attended schools in

that city. This was the first study of drug use of a non-treatment sample

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(called “normal” by Robins) and she found that 10% ( 22 ) of the 235

men interviewed had been addicted to heroin while 4% (9) had been to

Lexington and Ft.Worth Hospitals for drug treatment (at that time there

were few other treatments available). Of the 22 persons reporting heroin

addiction only 16% (4) reported heroin rule during the previous year

(1964-1965); 2 of them4 had been to treatments (or 22% of the 13) and

the remaining (15% of the 13) had not been treated. Put another

way,78% of the treated and 85% of the untreated addicts reported no

heroin use for the previous year. (Robins, 1967) these findings were so

unusual and so much at odds with the accepted knowledge of addiction

at the time that many persons were cautiously skeptical.

The skepticism subsided somewhat in 1973 when robins published her

milestone study of returned Vietnam veterans. Startled by reports of

widespread heroin use in Vietnam during the war, the federal agencies

(more specifically the special Action Office for Drug Abuse prevention)

commissioned a study of returned veterans in 1972 to learn more about

their drug use in Vietnam and also since returning. A Sample of 898 it

was found that nearly one in two had used narcotics in Vietnam (45%)

and one in five (20%) had been addicted to heroin. After returning only

10% reported using narcotics between the time of their return and the

interview and only 1% had been re-addicted. At the time of the

interview only 2%(8% of those addicted in Vietnam) reported to have

been currently using narcotics and 1% were detected to have used

opiates through urine analyses.

19



Research findings concerning the differences between treated and

untreated addicts were not as expected. Veterans who did not get

treatment for their addiction did just as well upon return as those

treated. More specifically the study found that:

37% of the treated and 49% of the untreated veterans who were

dependent and detected (DEROS urine samples) narcotics users(186)

were drug positive at the interview.

48% of the treated and 24% of the untreated veterans who were

dependent but not detected narcotic users (76) were drug positive

and;13% of the treated and 16% of the untreated persons who claimed

never to have been dependent in Vietnam (12)were drug positive.

Still another large scale survey also lends support to the findings of the

two Robin’s studies. In 1976 john O’Donnell and researchers from the

Universities of Kentucky and California (at Berkeley) published

preliminary results form a survey of 2,510 males taken in 1974 and

1975.(O’donnell,Voss,Clayton,Slatin and Room,1976).From a sample

of all the males in the United states born between 1944-1954 and

Known to draft boards, O’Donnell and his associates found that 6% of

the sample had used heroin and 2% were considered heavy users (using

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100 times or more). Only 20 of the heroin users reported going to

treatment; this number constituted 13% of all the heroin users. Half the

heavy heroin users had been to treatment. Comparing those who had

been to treatment with those who had not the authors found major

differences in current heroin use (use during 1974 and 1975):

…..65 percent of the men who had been treated for heroin use were

currently using it, in contact with 27 percent of the men who had never

been treated for use of heroin. These data suggest that users who enter

treatment comparise those least likely to succeed in terminating the use

of heroin. (O’Donnell, Voss, Clayton, Slatin and room, 1976)

Unfortunately, O’Donnell did not organize his data on the current use of

treated and untreated users into addicts or non addicts, heavy or light

users; as a result, we can not tell from his presentation the extent of the

prior heroin use of the non-treated sub-sample. It could be that the

majority of the non-treated users were light or experimental users rather

than heavy users or addicts. We expect that the authors will clarify this

confusion in future analyses.

Still other sources of data that suggest natural recovery are two large-

scale treatment evaluation studies that employed control groups. These

studies are the Marcos systems, Inc., evaluation of the New york City

addiction services agency (A.S.A) Programs and the Burt Associates

study of the effectiveness of the National Treatment Association

21



(N.T.A) of Washington, D. C. prior to these two studies, evaluations of

drug treatment did not to the best of our knowledge incorporate control

groups against which the treatment groups could be compared.

Consequently, there has been no base to compare the relative outcomes

of treatment groups and little information about the remission of drug

users who do not partake in long-treatment programs.

The first evaluation conducted by Macro Systems, Inc., a profit research

firm, followed up a sample of 462 persons who had been to a variety of

A.S.A. treatment programs (during the last 6 months of 1971). One-

third of the sample (156) were persons who had stayed in treatment less

than 10 days (and had not undergone any subsequent treatment); this

group was designated as the control group. (Macro System, 1975) Three

years after entry in treatment the evaluation findings showed that

narcotics use by the control group was no greater than it was for those

who had been to treatment. Using an index of narcotics use as a basis of

comparison they found that the controls had a score of 0.29 while those

in treatment from 10-90 days had 0.21 and those persons who had been

in longer than 90 days had a score of 0.20. The differences between the

three scores were not statistically significant. The authors summarized:

These findings have an iconoclastic tenor insofar as they challenge

widely held orthodoxies and substantives implications upon the future

course and direction of drug treatment efforts. The findings, however,

are not consistent with theories related to the natural history of

22



addiction, the healing effect of time, and the inner psychological

motivation of drug users. (Macro Systems, Inc., 1975)

These assertions must be tempered, however, in light of some

methodological problems with the study. Macro systems had a low

interview completion rate-they initially claimed to have had completed

interviews with 74% of the sample but a subsequent report indicated a

much lower completion rate of only 61%. (Burt Associates, 1977) Ile

researchers had considerable difficulty in locating and interviewing

Puerto Ricans in the sample, particularly those living in the South

Bronx, and as a result Puerto Ricans were underrepresented in the

interviewed group and this may biased the findings.

Burt Associates in their evaluation of the National Treatment

Association programs used a similar design in that they also employed a

control group. They successfully located and interviewed 81% of an

initial sample of 360 persons who had previously been to treatment one

to three years earlier. One-third of those interviewed were persons who

had stayed in treatment. One in five (29%) of the total samples were

considered “fully recovered ” at the follow-up interview, while

37%were considers ‘partially recovered’. Full recovery was defined by

the study as persons who two months before the follow-up interview:

1. Used no illicit drugs (except marijuana),

2. Had not been arrested or incarcerated and

3. Who were employed, in school, or job training or a housewife?

23



Partial recovery was more complexly defined but usually included one

negative response to the arrest and employment criteria or some daily

illicit drug use.

When the treatment sample was compared with the comparison sample,

no significant differences were found between the two. The comparison

sample defined as the non-treatment group did just as well in terms of

the definitions of recovery as did the treated group. Furthermore, time

in treatment had no particular association with outcome; people who

stayed in treatment one day did just as well as those who stayed a year.

Two years, or five years. (burt Associates, 1977)

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PREVALENCE OF DRUG ABUSE

Numerous biological, psychological, and sociocultural factors appear to

be involved in alcohol addiction. An offspring of one parent with

alcohol-related disorder is seven to eight times more likely to become

an alcoholic than is a peer without such a parent. Biological factors may

include genetic or biochemical abnormalities, nutritional deficiencies,

endocrine imbalances, and allergic responses.

Psychological factors may include the urge to drink alcohol to reduce

anxiety or symptoms of mental illness; the desire to avoid responsibility

in familial, social, and work relationships; and the need to bolster self-

esteem.

Sociocultural factors include the availability of alcoholic beverages,

group or peer pressure, an excessively stressful lifestyle, and social

attitudes that approve of frequent drinking.

25



More than 15% of American adults have a problem with alcohol use,

and about 5% to 10% of male and 3% to 5% of female drinkers are

alcohol dependent, accounting for about 12.5 million people. Alcohol-

related disorder cuts across all social and economic groups, involves

both sexes, and occurs at all stages of the life cycle, beginning as early

as elementary school.

The following statistics relate to the prevalence of Drug abuse:

■ 19.5 million people over the age of 12 use illegal drugs in the US

(Mayo Clinic)

■ 19,000 deaths from drug addiction in the US (Mayo Clinic)

The term ‘prevalence’ of Drug abuse usually refers to the estimated

population of people who are managing Drug abuse at any given time.

The term ‘incidence’ of Drug abuse refers to the annual diagnosis rate,

or the number of new cases of Drug abuse diagnosed each year. Hence,

these two statistics types can differ: a short-lived disease like flu can

26

PREVELANCE STATISTICS FOR DRUG ABUSE:

ABOUT PREVALENCE AND INCIDENCE STATISTICS:



have high annual incidence but low prevalence, but a life-long disease

like diabetes has a low annual incidence but high prevalence.

GENDER DIFFERENCES IN PREVALENCE OF DRUG ABUSE

TRACED TO OPPORTUNITIES TO USE

Males are more likely than females to abuse drugs. According to the

1999 National Household Survey on Drug (NHSDA) – an annual

Substance Abuse and Mental health Services Administration survey of

more than respondents-8.1 percent of males and 4.5 percent of females

older than age 12 had used illicit drugs month, and this ratio has

remained fairly constant throughout the 29-year history of the survey.

Reasearch by Dr. James Anthony, a NIDA –supported scientist at the

Johns Hopkins University School of Hygiene and public health in

Baltimore, shows that these gender differences in drug abuse are not

related to gender differences in Instead, they have their foundation in

the very first stage of drug involvement-the opportunity to use drugs

given the opportunity to use, males and females are equally likely to use

drugs.

27



59.00%

43.90%

28.70%

18.30% 18.60%

10.00%7.80%

3.20%0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Marijuana Coc aine Halluc inogens Heroin

Boys

Girls

Having opportunity to use Drugs

39.20%

28.70%

14.50%

8.50% 11.80%

5.90%

1.40%0.80%0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

Marijuana Cocanine Hallucinogens heroin

Boys

Girls

Actual Drug use

Fig: According to the National Household Survey on drug Abuse, boys

are more likely to abuse drugs than girls. The Graph above shows theestimated percentage of boys and girls using each drug and the

percentage having the opportunity to use each drug

Dr. Anthony and his colleagues analyzed NHSDA data for 1993 to look

for information that might explain the gender difference in rates of drug28



abuse. “Males are more likely than females to have an opportunity to

use drugs ”, Male-Female difference with respect to trying a drug once

an opportunity to do so has been experienced says.

The findings are findings are consistent for marijuana, cocaine

hallucinogens, and heroin, Dr. Anthony says. The proportion of

opportunities to use marijuana was 59 percent of males compared with

43.9 percent of females; to use cocaine 28.7 percent of males and 18.3

percent of females; to use hallucinogens, 18.6 percent of males and 10

percent of female and to use heroin, 7.8 percent of males and 3.2

percent of females.

Once presented with an opportunity ti use drugs,44.2 percent of males

and 42 percent of females began using marijuana within 1 year;37.7

percent of males and 33.2 percent of females began using cocaine;

50.5% of males and 50 percent of females began using hallucinogens;

and 14.6 percent of males and 22.1 percent began using heroin.

29



44.20%42.00%37.70%

33.20%

50.50%50.00%

14.60%

22.10%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Mariguana Cocaine Hallucinogens Heroin

Boys Girls

Drug Use Within 1 Year of First Opportunity

66.80%65.50%

50.60%46.30%

66.10%61.70%

17.70%

25.60%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Marijuana Cocaine Hallucinogens Heroin

Boys Gir ls

Eventual Drug Use

Fig: This graph shows the percentage of drug use within year of the first opportunityto use drugs and the percentage of boys and girls to eventually use drugs, given the

opportunity.

30



Dr. Anthony found that females were likely to get their first

opportunity to use cocaine at an earlier age than were males (age 19 for

females, 20 for males) but that there were no difference among males

and females in age first opportunity to use marijuana, heroin, or

hallucinogens.

One benefit of improved understanding of the link between opportunity

and eventual use is that counselors or physicians may be able to learn

about young patients’ drug use by asking about their opportunities to

use drugs. “Young people may feel free to answer a question about the

opportunity to use drugs rather than a question actual drug use, because

the opportunity is less likely to be illegal or particularly sensitive”.

31



OBJECTIVES

32



GENERAL OBJECTIVE

To assess the knowledge of the 1styr. MBBS students regarding drug

addiction in Bangladesh.

SPECIFIC OBJECTIVES:

1. To assess knowledge about drug addiction in Bangladesh regarding-

Socioeconomic group of drug addicted people

Age group of drug addicted people

Cause of drug addiction/factors influencing drug addicted

Preventive measure

Complications/effects due to drug addicted

2. To know the sources of information

3. To know their advices regarding prevention of drug addicted

4. To evaluate the prevalence of substance abuse dependence and/or

alcohol abuse dependence among subjects with bipolar І versus

bipolar І І disorder in a voluntary registry.

5. Using the structured clinical interview for DSM- ІV Axis І

disorders, to validate the diagnosis of this registry.

33



RESEARCH QUESTIONS:

1. What are the factors influencing drug addiction

2. Who are the persons subject to addiction?

KEY VARIABLES:

A. Regarding socioeconomic status of respondent-

1. Age

2. Religion

B. Regarding knowledge of respondent about drug addiction-

1. Categories of people addicted to drugs.

2. Age group of addicted people

3. Age group of addicted people

4. Cause(s) of addiction

5. Commonly used drugs for addiction

6. Common sources of drugs

7. Effects of drug addiction

8. Authorities responsible for prevention of addiction

9. Appropriate agencies for the managements of addiction

10. Sources of Information of drug addiction.

34



OPERATIONAL DEFINATION:

1. Respondent: The 1st year MBBS students of Z. H Sikder Women’s

Medical College & Hospital (Pvt.) Ltd.

2. Knowledge: Response about drug addiction assessed by direct

questionnaire.

DRUGS:

The word drug is defined as “any substance that, when take into the

living organism, may modify one or more of its functions” (WHO)

DRUG ADDICTION:

Drug addiction is defined as a state of periodic on chronic intoxication

detrimental to the individual and society produced by the respected intake of

habit-forming drugs.

35



LIMITATION OF THE STUDY:

1. Due to time constraints we had to limit our study in only one

college.

2. Enough literatures could not be reviewed due to lack of resource

& time.

3. Lack of facility hampered speedy outcome of our study.

36



Chapter- II

METHODOLOGY:

37



METHODOLOGY:

1. Type of study: It was descriptive type of cross sectional study with

one step stratification.

2. Place of study: Z. H. Sikder Women’s Medical College & Hospital

(Pvt.) Ltd.

3. Study Period: September 2007.

4. Study Population: First year MBBS students of Z. H. Sikder

Women’s Medical College & Hospital (Pvt.) Ltd.

5. Sample size & Sampling technique: 100 students were selected

purposively.

6. Selection and development of research instrument: Keeping in

view of the objective the questionnaire was prepared and pre-tested. It

was modified and finalized. The questionnaire has both open & close

ended.

7. Procedure of data collection: Seventy nine students of our college

were divided into 2 groups each comprising of 40 students

approximately. Respondents also were divided into two groups and

collected data by face to face interview from two groups of students.

The interview session was conducted during college hours.

38



8. Data complication and processing: After collection of raw data, we

stoned out and prepared a master table manually, keeping in view the

objectives and variables.

9. Data analysis and report writing: Data were processed with the

help of SPSS program.

39



Chapter - III

TABLES AND GRAPHS:

40



TABLES AND GRAPHS:

Field survey of the knowledge of fist year MBBS student of

Z.H.S.W.N.C, about drug addiction in Bangladesh:

Table No. 1 (Q: 2)

Distribution of age of the respondent:

Age (yrs)

X

Number fx % X-X (X-X)2

18 9 162 11.39 -1.44 2.07

19 32 608 40.50 -0.44 0.19

20 32 640 40.50 0.56 0.31

21 6 126 7.59 1.56 2.43

Total 79

(n)

1536 99.98 =

100%

5

41



Fig-1 : Histogram of Distribution of age of the respondent:

Age (years) of respondent

A = 18 years B = 19 years

C = 20 years D = 21 years

Table-1:

Distribution of age of the respondents (Table-1 shows that

mean (x) = 19.44 years, SD = 0.25 out of total 79 students 81F% were in the

age group between 19.20 years. All of them were young adults and 11.39%

were in lowest age group like 18years and 7.59% were in highest age 21

years. Average age was 19.44 years with standard deviation 0.25.

42

11.39%

40.50% 40.50%

7.50%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

1

A

B

C

D



Table No.-2:

Knowledge of the respondent regarding drug addiction people &

group:

Drug addict groups No. %

Student 45 56.96

Businessmen 3 3.79

Drivers 11 19.92

Professional Blood Donors 14 17.72

Sex workers 5 6.32

Others 1 1.26

Total 79 99.97=

100%

Fig-2: Bar diagram of the knowledge of the

respondent regarding drug addict people:

43

59.69%

3.79%

13.92%17.72%

6.32%1.26%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

A B C D E F



Drug Addict Groups

A Student

B Businessmen

C Drivers

D Professional Blood Donors

E Sex workersF Others

Table-2:

Distribution of the knowledge of the respondent regarding

drug addicted people/group.

Table-2 shows that highest incidence of drug addiction occurs among

student (57%) approximately next to them are professional blood donors

(18%) (Approximately) & then among drivers (14%) (Approximately)&

lowest among businessman which is 3%.

Table No.-3:

44



Age group of addicted people:

AGE (yrs) No %

<20 28 35.44

20-30 48 60.75

30-40 3 3.79

>40 - -

Total 79 99.98

=100%

Table-3:

Distribution of knowledge of respondent about age group of

addicted people Table-3 shows that highest incidence of addiction occurs

between 20-30 yrs (60.75%) on age and next to it 35.5% addiction occurs

below 20 years of age and very less incidence occur above 30 years (3.79) &

no incidence above 40 years of age.

45



Table No.-4:

Socio-economic status of addicted people:

Economic Status No %

Poor class 27 34.1

Middle class 17 21.5

Upper class 35 44.3

Total 79 99.98=100%

Chart No.-3:

46



Pie diagram shows socio-economic status of addicted people:

Table-4:

Knowledge about socio-economic status of addicted people.

Table-4 shows that drug addiction occurs more among upper socioeconomic

group (44.3%) and lowest among middle class (17%) and average among

poor class (34.1%)

Table No.-5:

47

34.10%

21.50%

44.30%Poor Class

Middle Class

Upper Class



Causes of addiction:

Causes No %

Unemployment 20 25.31

Frustration 43 54.53

Influence from peer groups 4 5.06

Easy availability of drugs 5 6.32

Disharmony in family life 6 7.59

Chance use 1 1.26

Other - -

Not known - -

Total 79 99.97 =100%

Table-5:

It shows that frustration is the no.1 course of drug addiction

(54.43%), than unemployment (25.31%) is another important cause of drug

addiction. Among the other causes disharmony in family life, easy

availability of drugs, influence from peer group come chronologically 7.59%,

6.32% & 5.06%.

Table No.-7:

48



Common sources of dugs for addiction:

Source No %

Friends 31 39.24

Pharmacy 11 13.92

Hospital/Clinics - -

Markets 7 8.86

Underground agents 30 37.97

Total 79 99.99 =100%

Table-7:

Knowledge of common sources of drugs for addiction.

It has been shown that common sources of drugs are from friends (39.24%).

Underground agents are also a good source of drug (37.97%). Drugs are also

freely available from pharmacy (13.92%)

49



Table No.-8:

Effects of drug addiction:

Effects No %

Physical Problems 25 31.64

Become psyche 19 24.05

Commit anti social activities 30 37.97

Death 1 1.26

Unemployment 4 5.06

Total 79 99.99 =100%

Table-8:

Knowledge of effects of drug addiction. It shows that regarding

effects of drug addiction antisocial activities are highest (37.97%) than comes

physical problems (31.04%) & then come psychological problem (24.05%).

Death also occurs 1.26% which is a fatal effect.

Table No.-9:

50



Knowledge about authorities, responsible for the prevention of

addiction:

Authorities No %

Directorate Narcotics control 18 22.7

Drug Administration 16 20.2

Ministry of Home affaire 8 10.1

Ministry of health & family welfare 20 25.3

Civil society 9 11.3

Others 8 10.1

Not known 1 1.2

Total 79 =100%

Table-9:

Knowledge about authorities responsible to prevent drug

addiction Table shows that knowledge regarding responsible authorities for

prevention of addiction are ministry of health & family welfare is 25.3% then

Directorate Narcotics Control (22.7%) then Drug Administration 20.2%.

Responsibilities of Civil Society (11.3%) also important & then come

Ministry of Home affairs (10.1%). Only one respondent don’t know about the

concerning authorities responsible authorities, responsible for prevention of

drug addiction.

Table No.-10:

51



Knowledge of appropriate agencies/authority for management of

addicts:

Agencies No %

General Hospitals 1 1.26

Specialized Hospitals 1 1.26

Parents 25 31.64

Social welfare department 8 10.12

Others 8 10.1

Total 79 99.97

=100%

Table-10:

Distribution of respondent by knowledge of appropriate

agencies for management of addicts.It shows that specialized hospital (55.69%) is the no. 1 choice for appropriate

management of addicts. Then come the parents (31.64%) are appropriate

authority for management of addicts. Social welfare department (10.12%)

occupy the next position and general hospital (1.26%) become lease selected

authority for management of addicts.

Table No.-11:

52



Sources of information about drug addiction:

Sources No. %

Parents 13 16.58

Friends 21 26.58

Books 11 13.92

Radio 6 7.59

TV 27 34.17

Others 1 1.26

Total 79 99.97

=100%

Table-11:

Knowledge about source of information about drug addiction.

Table-11 shows that knowledge about sources of information regarding drug

addiction is highest from television (34.17%). So mass media plays an

important role. Next from friends (26.58%) & then from parents (16.45%) &

knowledge from books (13.92%) & from radio (7.39%). A reasonable

percentage got information about drug addiction from parents & friends.

53



Chapter- IV

DISCUSSION

54



This study was conducted on the first year MBBS students of Z. H.

Sikder Women’s Medical College & Hospital (Pvt.) Ltd. to assess knowledge

regarding sociodemographic characteristic of drug addiction & sources of

information about addiction & after effects.

All the study population were young adult female first year MBBS

students of Z. H. Sikder Women’s Medical College & Hospital (Pvt.) Ltd. &

have average value of 19.44 yrs with standard deviation 0.25 (Table-1 & Fig-

1). Thy have knowledge about drug addicted people or group (Table-2 & Fig-

2) that highest incidence occurs within student. Along with it professional

blood donors and drivers are also addicted in a remarkable percentage.Among the businessman the incidence are less. According to respondent the

20-30 year age group people affected more by drug addiction and very less

incidence occurs about 30 years (3.9%) & no incidence occurs above 40

years (Table-3). Out of 79 respondents from (Table-4 & Fig-3) 44.3% told

that drug addiction occurs among upper socioeconomic class where as lowest

incidence (17%) occurs between middle class and an average incidenceoccurs among poor class (34.1%). Out of all respondents (54.43%) told that

frustration is the no. 1 cause of drug addiction & next to this unemployment

is another important cause of drug addiction (25.31%) (Table No-5). Other

cause of drug addiction like disharmony in life easy available of drugs,

Influence from peer groups come (7.59%), 6.32%, 5.06% respectively.

Regarding knowledge of commonly used drugs from addiction is phensidyl(50.63%) which is very easily available & next to this is Heroin (25.31%),

Pethidine (11.39%) & alcohol (8.86%) comes next respectively. Only one

student don’t know about the commonly used drug from addiction.

Regarding sources of drug addiction (Table No.7) 39.24F% of students

told that common source of drugs are from friends, underground agents are

55



also a good source of drugs supply (37.97%) and 13.92% told about easy

availability of drugs from pharmacy and 8.88% told that another sources of

drug is market. Out of 79 respondents from (table 8) highest percentage

(37.97%) told that antisocial activities are alarming effect of drug addiction.

Among other effects of drug addiction physical problem (31.64%) &

psychological problem (24.05%) also have great important and 1.26% told

that death is also a very fatal effect. Out of all students (Table-9) regarding

knowledge about responsible authorities to prevent addiction (25.3%) told

that Ministry of Health & Family7 welfare is the responsible authority. Next

to this 22.7% and 20.2% told that Directorate of Narcotics Control and Drugadministration (20.2%) are the responsible authority respectively. Civil

Society and Ministry of Home affairs (11.3% & 10.1%) are also concerning

authorities to prevent drug addiction. Maximum number of student (From

Table-10) told that (55.69%) appropriate management of drug addicts can be

done by specialized Hospital. Next to ti (31.64% told that appropriate

management can done by parents. Among other social welfare department(10.12%) also can play important role for management of drug addicts and

according to their opinion General hospital (1.26%) are least important

authority to manage drug addicts. From Table 11 out of all students every

body have knowledge about source of information about drug addiction

maximum from Television (34.17%) from friends (26.58%), from parents

(16.45%), from books (13.92%) & rest (7.59%) from Radio.

56



Chapter- V

CONCLUSION

57



The students of medical college are the active participants in health

system of a country. So if they have proper knowledge about drug addiction

then they can propagate this knowledge to the general people of Bangladesh.

They can also motivate patients in ward and in surrounding general public

through health education about drug addiction. And every person must award

about the bed effect of drug addiction on individual and also as a burden on

the country.

58



RECOMMENDATION

In view of the study finding following recommendation are made:

1. Drug addiction, its bad effects & preventive measures should be

included in school curriculum.

2. Agencies concerned from dealing with drugs addicts should accelerate

their campaign through mass media that is widespread publicity to

develop a sense of awareness among people about the consequence of

drugs through all mass media.

3. To give special attention to the high-risk group of drug addicts (age

group).

4. Law enforcing agencies should be strict in respective entry of all

banned drug identification and stopping of underground market, drug

traffickers should be seriously dealt with.

5. Community participation should be ensured to find out the drug addicts

for treatment and rehabilitation and in preventing the spread of drug

addiction problems.

59



BIBLIOGRAPHY

Dr. Hossain Jahangir: Study on Possible factors leading to drug

addiction as stated by drug addicts attending central drug addiction cure

center Tejgaon, Dhaka.

Park JE. Park K: Alcoholism and dreg dependence Park’s Text book of

Preventive and social medical 17th edition Jabalpur, India 2003: 600, 483.

Armour, David J. et. al 1976 Alcoholism and Treatment Santa Monica: Rand

Corporation, Report# 1739-NIAA.

Bess, Barbara, et.al. 1972 Factors in successful narcotics renunciation. American

journal of Psychiatry. 28(7).

Brill, Leon 1972 The De-Addiction process. Springfield, III. : Charles Thomas.

Brunswick, Ann F. 1978 Black Youth and Drug Use Behavior. Mimeographed. New

York: Columbia University School of Public Health.

Burt Associates. 1977 drug Treatment in New York City and Washington, D.C.:

Follow-up Studies. N.I.D.A. Monograph.

Greaven, David B. and Kathleen A Graeven Treated and untreated addicts: factors

associated with participation in treatment and cessation of heroin use. Mimeographed,

n.d.

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Harding, Wayne M., Zinberg, Norman E., Stelmack, Shirely M., and Barry, Michael

1979 “Formerly Addicted-New- Controlled Opiate Users” Mimeographed, 1078 to be

published in The International Journal of the Addictions 14(7), 1979.

Knupfer, Genevieve 1972 ex-problem drinkers. In Life History Research in

Psychopathology. Edited by Merrill Kopp, Lee N. Robins and Max Pollack.

Minneapolis: University of Minneapolis Press.

Macro Systems, Inc. 1975 Three year follow-up-study of clients enrolled in treatment

programs in New York City. Phase III Final Report.

O’Donnell, Lee N. and Murphy, George T. 1967 Drug use in a normal population of

young Negro men. American Journal of Public Health. 57(9), 1967.

Robins, Lee N. and 1973 The Vietnam drug User Returns. Washington D.C.: US.

Government Printing Office.

Robins, Lee N., Hezer, John E. and Davis, Darlene H. 1975 Narcotic use in Southeast

Asia and afterward. Archiver of General Psychiatry. 23.

Rutledge, Carolyn, et.al. 1073 A socio-epidemiological study of alcoholism in East

Baton Rouge Paris. Baton Rouge, Louisiana: Alcohol and drug Abuse Section,

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Scharse, Robert 1966 Cassation Patterns among neophyte heroin users. The

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61



Smart, Reginald 1975-Spontaneous recovery in alcoholics: a review and analysis

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62



QUESTIONNAIRE

1. Name of the respondents (Student)

2. Age:

3. Religion: Islam/Hindu/Buddhist/Christian/

Other

4. What is the occupation of your father?

Service/Farmer/Businessman/Working abroad/others.

5. Who are the people usually become addicted to drug?

Student/Businessman/Drivers/Professional blood donor/Sex

workers/Other.

6. At that age people become more addicted?

Below-20yrs/20-30yrs/30-40 yrs/after 40 yrs

7. Which socio economic group of people more addicted?

Poor class/Middle class/upper class

8. What are the backgrounds causes that lead to addiction?

Unemployment/Frustration/Influence from peer group/easy availability

of drug/ disharmony in family life/chance use/others/ not known.

9. What drugs are commonly used for addiction?

Phansedyl/Pethidine/Morphine/Heroine/

Sedative/hypnotic/alcohol/not known

10. What are the common sources of the drugs?

Friends/Pharmacy/Hospital-clinic/Market/ Underground agents.

11. What are the affects of drug addiction?

63



Physical problem/become psychic/comits antisocial

activities/death/unemployment.

12. Do you think that problem is deteriorating?

Yes/No

13. If yes, put forward your suggestion for prevention of addiction?

Banning sales of addicting drugs without valid prescription

Dissemination of information about harmful effects of drug

Social support for the distressed and unemployed people

Proper enforcement of existing drug act

14. Please name the authorities responsible for controlling drug addiction?

Directorate Narcotics control/Drug administration/Ministry of

Home/Ministry of Health & Family welfare/Civil society/Others

(specify)

15. Who are responsible for management of the addicts?

General hospital/Specialized hospital/Parents

Social welfare department/Other (specify)

16. What are the sources of your knowledge about drug addiction?

Parents/Frinds/Books/Raido/TV/ Other (specify)

17. Did you get any advice from your guadians regarding avoidance of

drug?

Yes/No.

Documents

6771337 Drug Addiction Main