The controversy over the number of drug addicts in Punjab looks set to continue after a new study by the Chandigarh-based PGIMER has estimated that the number of people addicted to opioids in the state could be anywhere between 1.7 lakh and 2.7 lakh. The PGIMER study is called “Epidemiology of Substance Use and Dependence in the state of Punjab” and is based on two surveys, which have projected two vastly different estimates of the number of drug addicts.
The study was funded by Department of Health Research, Government of India, under the supervision of Indian Council of Medical Research. The respondents were in the age group of 11 to 60 years. An investigator said most of the respondents interviewed in the study were in the age group of 20 to 40 years.
A study by All India Institute of Medical Sciences (AIIMS) last year had noted that 2.32 lakh addicts in Punjab were hooked to opioids. One survey method used in the new study, the “Household Survey” for Punjab, used the “multi-stage stratified random sampling” procedure. Under this, PGIMER researchers studied 6,398 households and interviewed 13,295 respondents across 22 districts of Punjab and concluded that an estimated population of 1.7 lakh were currently addicted to opioids.
“Opioid use is likely to have been underestimated in this household survey because of design issues,” the study, however, says. In another survey, called Rapid Assessment Survey, based on respondent-driven sampling and where only addicts were interviewed, the PGIMER experts noted that Punjab has “a huge opioid dependent population of estimated 2.7 lakh people”.
In Rapid Assessment Survey, 6,600 respondents were interviewed, 300 from each of the 22 districts and using benchmark multiplier method, PGIMER investigators concluded that as per this survey 2.7 lakh people were hooked to opioids in Punjab. Principal investigator Dr Ajit Avasthi, who is a professor in psychiatry department of PGI, while giving a presentation before the media in PGIMER Chandigarh, said that no one can determine exact number of drug addicts in a study. He said the number of addicts hooked to opioids in Punjab was anything between 1.7 lakh and 2.7 lakh.
The data for Household Survey was collected between November 2015 and April 2016, at a time when erstwhile SAD-BJP government was patting its back for “checking the menace of drugs in a massive and prolonged statewide crackdown”. The data for Rapid Assessment Survey was collected between June 2016 to January 2017.
“Consistent efforts need to be made to check the menace of drugs,” said Dr Avasthi. The Household Survey noted that approximately 1 in 6 persons in Punjab were dependent on any substance. “Contrary to expectation, substance use and dependence were more common in rural than urban areas,” it pointed out.
The survey said single most common substance of use and dependence in Punjab was alcohol, followed by tobacco. “There were more than 22 lakh alcohol dependent persons and nearly 16 lakh tobacco dependent persons in Punjab currently. These are huge figures,” it said. Estimates projected that dependence of alcohol was 11 per cent , of tobacco 8 per cent, of opioids 0.8 per cent and of cannabinoids and other drugs at 0.2 per cent and 0.17 per cent, respectively.
Rapid Assessment Survey noted that opioid dependent subjects were “typically young aged male” and natural opioids (opium and poppy husk) were most common type of opioids used, with almost 1 in 2 users using natural opioids. It said injection opioid was the second most common form of opioids in dependent users with approximately 1 in 4 using injection opioids. It said heroin was the “commonest type” (61.6 percent) in use of injection opioids. It also noted that out of 78,000 estimated injection opioid users, one-third were abusing buprenorphine (32.5 per cent).
It said only 2.1 per cent of opioid dependent population reported criminal convictions. Also bringing into focus the social, medical and other problems related to substance use, the study noted that most common reason for initiation of substance use was fun (69.9 per cent) followed by peer pressure (43.9 per cent). It said on an average an addict spent Rs 300 a day on drugs. It said common source of drug were drug dealer (77.6 per cent) and pharmacy/outlet (59 per cent).