Epidemiology of Substance Abuse in Bangladesh: A Narrative Review
Received Date: Jul 13, 2018 / Accepted Date: Jul 16, 2018 / Published Date: Aug 10, 2018
Background: Substance abuse is an important public health and social problem in Bangladesh. The menace of substance has been increasing day by day in the country.
Objectives: This review was aimed to look into the epidemiology of substance abuse in Bangladesh based on recent literatures.
Methods: Search was done in PubMed, PubMed Central, Google Scholar, and Bangla JOL with searching keywords till March 2018. After considering inclusion and exclusion criteria total 15 articles were selected for review.
Results: From the pooled data the review revealed majority of the respondents were less than 30 years of age, 94.17% were male, 62.90% were unmarried, 94.17% from urban background, and 19.66% were businessman. Peer pressure was found as the commonest risk factors (54.69%) followed by anger or impulse issues (41.87%) and availability of drugs (41.17%) were considerable risk factors. Heroin was found as a first choice of drug followed by yaba and cannabis.
Conclusion: This review revealed early adulthood was more risky years, males are mostly affected by drugs, peer pressure was most significant influencing risk factor and heroin is the mostly expected drug in Bangladesh.
Keywords: Substance abuse; Bangladesh; Drug abuse; Epidemiology; Heroin; Yaba; Demography
Substance abuse is recognized as an important public health and social problem in Bangladesh [1,2]. The incidence of drug abuse has been increasing day by day in a developing country like Bangladesh . Drug addiction hampers the mental well-being of an individual as well as it causes lots of physical complications . In terms of geographical location Bangladesh is situated in the central point of the world's biggest growing narcotics zone: the 'golden crescent' (Afghanistan, Pakistan, and Iran) and the 'golden triangle' (Myanmar, Laos, and Thailand). So, the country has become a major transit point for drug dealers . They are routing their shipments through this country to the markets of other parts of the world including Europe, Africa and America. Besides this, India, which is an important producer of opium and other substances located around Bangladesh. Though there was no available exact estimation of substance abusers in Bangladesh, on the basis of different and statistics, it can be estimated that the number may be more than 6 million and these people spend over 70 million BDT every day on illegal narcotics . The major illicit drugs available in Bangladesh are opium derivatives (heroin, pethidine), cannabis (marijuana, ganja, chorosh, bhang, hashish), stimulants (yaba, cocaine), sleeping pills, cough syrup (phensidyl, dexpotent etc.) and few others [1,4]. The problem is increasing day by day and threatening the nation. Males are being affected by drugs more than the females  and early adulthood is the vulnerable age for abusing drugs. Preferable drugs are heroin, yaba, cannabis, followed by few others. However, it is under studied in the country. No nation-wide prevalence study has been published yet. There is dearth of epidemiological research on drug abuse. We aimed to look into the epidemiology of drug use in Bangladesh based on the existing literature.
For selecting article search was done in electronic data bases (PubMed, PubMed Central, Google Scholar & Bangla JOL) with searching key words till March 2018. Initial screening was done by analyzing the titles, then abstract was reviewed and finally full articles were downloaded and studied. After exclusion of duplication, screening, finally selection was done on basis of inclusion and exclusion criteria and finally 15 articles were selected for review.
Substance abuse in Bangladesh, drugs in Bangladesh, drug abuse in Bangladesh, yaba in Bangladesh, addiction in Bangladesh, cannabis in Bangladesh, substance use disorder in Bangladesh, substance related disorder in Bangladesh, prevalence of substance use/related disorder in Bangladesh, demography of substance users in Bangladesh
1. Full downloadable original articles in pdf form
2. Articles regarding substance abuse in Bangladesh
3. English language.
1. Review articles
2. Articles of single substances
3. Article of suicide outside the Bangladesh demography.
Variables: Age, sex, occupation, status, residence, marital status, choice of drug, route of drug, identifiable risk factors, reason for relapse, and sources of money, were considered as the variables of the study.
Permission: As the data includes only online available previously published information, no formal ethical clearance was needed.
Data analysis: All selected articles were scrutinized for the variables and data were pooled to create a single source. Percentages were calculated based on summation of the total samples of the mentioned article and summation of corresponding variable frequencies. There were multiple responses and different pattern of variables in different articles. So total number of sample and total frequencies were mentioned in every variables separately.
The mean age of the respondents was 28.10 years with ranges from 10-50 years. Majority of the respondents were less than 30 years of age. About 94% of the respondents were male, 63% were unmarried, 94% from urban background, 33% were unemployed and 51% were from joint family (Table 1). Peer pressure was found as the most influencing risk factors. About 55% of the respondents take substance due to peer pressure, 41% were influenced by availability of drugs, 34% took drug to get pleasure, and 27% started for their curiosity (Table 2). Heroin was the choice of drug in this review. About 67% of respondents considered heroin as their choice of drug, 44% considered yaba, and 39% considered cannabis as drugs of choice (Table 2). For abusing drugs 65.49% of the respondents arranged money from criminal activities, 64.28% from family and 33.80% from own income. Majority of the respondents (63.45%) took drug orally, 57.39% took through inhalation, and only about 9% in injectable form (Table 3). But, a substantial portion of respondents took drug in multiple routs. Moreover, abusing more than one substance is an important concern (Table 4).
|Year||Author||City||Location||Sample Size||Type of study||Investigated issue|
|2014||Zaman et al. ||Dhaka||CTC||300||Cross-Sectional||Psychosocial illness in detoxification center|
|2013||Maehira et al. ||Dhaka||Private Hospital||260||Prospective cohort||Factors associated with relapse in detoxification–rehabilitation programme|
|2010||Roy et al. ||Dhaka||BSMMU and CTC||500||Case Control||Personality Traits of Substance Users|
|2013||Hossain et al. ||Dhaka||CTC||1076||Cross-Sectional||Sex-habit and STIs among drug abusers in Detoxification|
|2013||Riya et al. ||Dhaka||CTC||150||Cross-Sectional||Pattern of Drug Abuse in Addiction Rehabilitation Centers|
|2015||Islam et al. ||Mymensingh||Private Hospital||38||Cross-Sectional||Social Impact of Drug Addiction|
|2015||Khan ||Munshiganj||Community||182||Cross-Sectional||Debunking the Drug Abuse-Crime in Urban Youths|
|2017||Hasam and Mushahid ||Sylhet||Private Hospital||99||Cross-Sectional-multi center||Causes of Drug Addiction in Urban Life|
|2014||Islam et al. ||Across Bangladesh||Universities, public institutions||100||Descriptive||Impact of Drug abuse|
|2017||Mohit et al. ||Dhaka||Private Hospital||306||Descriptive||Prevalence and Patterns of Substance Abuse among Male Patients|
|2017||Roy and Mian ||Sylhet||Private Hospital||155||Descriptive||Socio-Demographic and Clinical Profile of Substance Abusers|
|2017||Soron et al. ||Dhaka||NIMH and CTC||101||Descriptive||Social and Family Determinants of Substance Abuse|
|2016||Maruf et al. ||Dhaka||Private Hospital||105||Descriptive||Pattern of Substance Use in De-addiction Clinic|
|2018||Hossain et al. ||Dhaka||CTC||120||Descriptive||Oral and Dental Diseases and Oral Hygiene Practices among Illicit Drug Abusers|
|2017||Ahad et al. ||Sylhet||Private Hospital||42||Descriptive||Socioeconomic Status of Young Drug Addicts|
Table 1: List of articles.
|Demographic Variable||Frequency||Percentage||Total sample|
|Type of family|
Table 2: Distribution of demographic variables of the respondents.
|Failure in love||56||11.61||482|
|Death of loved ones||4||1.30||306|
|Choice of drugs|
|Reason to relapse|
|Drug craving, withdrawal symptoms||6||9.37||64|
|To enhance sexual power||2||3.12||64|
|Extra marital affair||8||2.61||306|
Table 3: Distribution of Risk factors, drugs choice, reasons for relapse, among the respondents.
|Variable Routes of drug||Frequency||Percentage||Total sample|
|Drug abuse in lifetime|
Table 4: Distribution of routes and number of drugs among the respondents.
In this paper, epidemiology of substance addiction in Bangladesh was reviewed. About 94% of the respondents were male that signifies the gender representation of substance use in Bangladesh. Repeated studies in Bangladesh revealed that males are being addicted more than the females [4-14]. This review found unmarried (62.90%) respondents were more likely to take substances than married and others those are supported by other studies [3,10]. However, Maehira et al., found most of the respondents (59%) were divorced/separated/widower/ widow . Most of the respondents (94.17%) were urban background which was found in multiple studies [3,8,12-14]. The situation can be explained by the sample distribution and place of the studies. Most of the studies were conducted in clinical settings in urban areas. As a result, such urban rural distribution was found. Study revealed almost similar distribution in regards to the educational achievements, interestingly more respondents were prevalent in graduate class (Table 2). Unemployment and businessmen were more prone for substance abuse which was found in multiple studies [2,8,10,11,13,14]. Unemployment may act as both cause or effect of substance abuse. However, none of the studies studied the relationship of unemployment and substance abuse. In other ways, Islam and Hossain, found students were more take substance than unemployment and businessman . Peer pressure contributed highest as a risk factor followed by anger or impulse, availability and getting pleasure which was supported by multiple original studies [1,3,11,14,15]. Heroin as a most choice able drug of majority of the respondents followed by yaba and cannabis those are repeatedly found in other study [1,3,4,6-9,11,12,14,15]. In current scenario of the country yaba might be the most abused drug and future studies would reveal that.
The review revealed the recent epidemiology of substance abuse in Bangladesh. To the authors best knowledge this is the first study to explore the substance abuse in the country. Early adulthood, is risky part of life, abusers are mostly male, peer pressure is the most significant influencing risk factor and Heroin is the mostly expected drug. However, further systematic reviews would help to generalize the findings.
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Citation: Kamal M, Huq N, Mali B, Akter H, Arafat SMY (2018) Epidemiology of Substance Abuse in Bangladesh: A Narrative Review. J Ment Disord Treat 4: 165. DOI: 10.4172/2471-271X.1000165
Copyright: © 2018 Kamal M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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