Prevalence and Determinants of Substance Abuse Among Slum Dwellers in Islamabad- Pakistan

Abstract

Background: The slums are illegal settlements and are always left out in health surveys. However, studies around the world show that substance or drug abuse is higher among slum dwellers and may have different patterns and determinants which need to be studied in order to frame targeted programs and policies. The present study was aimed at estimating the magnitude as well as determinants of substance/drug abuse among slum dwellers in Islamabad, the capital city of Pakistan.

Methodology: This community-based cross-sectional study was conducted among the residents of slums/nomadic settlements of Islamabad. A total of 207 statistically calculated sample size comprised of adults from both genders aged 15 years and above, consenting to participate from the randomly selected 9 clusters in Islamabad was needed for the study. From each cluster, 23 households, and from each household one individual was randomly selected for estimating the prevalence. All those who were abusing substances were counted as cases and others as controls for case-control analysis. A structured questionnaire was used to gather information on demographics, trends, types of substances abused, risk factors for getting engaged in substance abuse, whether they had tried to quit at any stage and what difficulties they faced when trying to quit. Results were entered and analyzed using Epi-info version 7.2.

Results: A total of 204 participants were enrolled in this study. Among these 68 (33%) were substance or drug abusers. For the case-control study, substance/drug users were considered as cases 68 and rest as controls. Bivariate analysis of the risk factors indicated that easy of availability of drugs in slum areas (OR: 20.3, p= 0.000); exposure to tobacco smoking (OR: 8.8, p= 0.000); and being a working child (OR: 6.0, p= 0.000) were the strong predictors of high substance abuse. Education (OR: 0.2, p= 0.000) and living with own parents during childhood (OR: 0.7 p= 0.2) had protective effects against substance abuse.

Conclusion and Implications for Translation: The study concludes that the following were the determinants of substance/drug abuse among the slum dwellers in the study: easy availability due to unregulated sales of drugs, high rate of tobacco consumption, poverty, low level of literacy, and being a working-child. Specific policies and plans focused on law enforcement for curbing the illegal drug sales and reduction of child labor along with the provision of education should be devised and implemented to help these neglected communities and modify the determinants.

Key words: • Substance abuse • Drug abuse • Slum dwellers • Case-control • Islamabad • Pakistan

© 2019 Faiza 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 work is properly cited.