Jahangeer Ganaie
Srinagar, Nov 19: Intravenous opioid use has surged among young population in Kashmir during Covid-19 with many patients having relapsed due to non-adherence to medications during the two years of pandemic, a study conducted by a Post Graduate Resident Department of Psychiatry (IMHANS) GMC Srinagar along with three other doctors has revealed.
The study conducted to find the various sociodemographic variables of substance use disorder among patients and to study the change in the pattern of substance use disorder has showed that percentage of intravenous opioid use has increased tremendously and that major chunk of patients also relapsed due to non-adherence to medications during Covid-19 when most of the drug de addiction centres were closed.
“The COVID-19 pandemic and the various SOP measures have adversely affected substance use patterns adversely. Disruptions in health services and various treatment plans of people who consume substances were seen in many parts of the world,” one among the doctors who conducted the study.
He said that the lockdown and restrictions during the pandemic could not affect drug trafficking.
The curbs implemented to contain the Covid, according to the doctor, triggered social isolation, frustration, boredom, stress and panic among people
“To counter these emotions many people indulged into and relapsed back and started taking drugs again. This negative coping has led to immense increase in substance use in various populations,” he said.
The doctor said that study reflects that people belonging to the age group 21-30 years are mostly using substances, specifically opioids and the percentage of people affected was significantly higher in this study (64.5%) as compared to the study conducted earlier (50.5%).
“This finding would reflect the frustration and free time this age group experienced due to the confinement in homes and closure of various recreational facilities as this group in the most active and outgoing age group) In the study, rural and urban population constituted 68.60% and 31.40% respectively. “This is because our hospital is a government hospital which is preferred by the rural population as compared to the affluent urban population who mostly visit private facilities due to the stigma associated with substance use disorder),” he added.
“The closure of various educational institutions and change in the delivery of education services such as online classes led to build up of tension and anxiety in young students besides that the lack of technical knowledge and excessive screen time spent in view of online classes has fuelled up the anxiety and stress among students. Likewise, people belonging to the economic sector, especially the self-employed, faced huge economic setbacks due to closure of various business establishments and start ups and it is seen that people with substance use disorder develop increased severity when faced with unemployment or financial crisis,” the doctor said.
Heroin was the most commonly used opioid (94.12%) compared to pharmaceutical opioids (5.88%). In contrast to a study conducted earlier, in which heroin was 84.33% and pharmaceutical opioids was 24.33%, he said.
He explained it by saying the resilience of the opioid market to various pandemic measures but pharmaceutical opioids were restricted.
In the study, the most common route of administration of drugs was intravenous 79.42% in contrast to studies conducted earlier where percentage of intravenous users is 7.91% and 51.53%) and it reflects that the shortage of resources to procure the substance leading to a switch from oral/chasing to intravenous route as the amount required for the same effect is quite low when opioids are used intravenously, he added.
“The percentage of patients having positive serology was also greater. This could be explained by increase seen in reusing of needles due to lack to procure fresh needles and also increasing frequency of injecting in people with substance using behaviour and the percentage of patients who had sought treatment in the past was about 38.31% in comparison to only 13% and 11% of patients as per studies conducted earlier and this finding would be due to increased relapse during the pandemic as the various treatment facilities were shut down,” he added.
The IMHANS de-addiction center where the study was conducted was the only centre in the valley that continued providing services both IPD and OPD to substance users during COVID times.
The need to continue services was felt by the IMHANS department because drug addiction was a parallel epidemic in Kashmir with more mortality and morbidity rate compared to Covid.
