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Role of the family in drug abuse. SK Kartikeyan, RM Chaturvedi, VR BhaleraoDepartment of Preventive and Social Medicine, K.E.M. Hospital, Parel, Bombay.
Correspondence Address: Source of Support: None, Conflict of Interest: None PMID: 0001512731
A simple random survey of 9863 population out of the total 70,000 population is one slum pocket of Bombay revealed drug dependence in 104 persons. Out of 104, 83.65% smoked 'brown sugar' 10.68% used cannabis and 5.77% opium. Most of the addicts (95.2%) belonged to large families. Family history of alcoholism and drug abuse was present in 41.35%. Parental deprivation was additional contributing factor in 30.7%. Keywords: Child of Impaired Parents, psychology,Developing Countries, Human, India, Psychotropic Drugs, Risk Factors, Social Environment, Substance-Related Disorders, psychology,Urban Population,
The use of major psychotropic drugs has been socially accepted during festivals in India, but restricted to adults[1]. Since the early 1980's, the Indian youth have been introduced to more potent synthetic psychotropic drugs and addiction to these drugs has spread like an epidemic among the affluent and the urban poor. An estimated 80,000 to 100,000 'brown sugar; addicts lived in Bombay in 1985 alone[2] ('Brown Sugar' is an impure form of heroin). The host and the environment are integral factors in the genesis of drug abuse. A study was, therefore, carried out to investigate the family background of the drug addicts from an Urban slum.
For the purpose of this study, an addict or drug user was defined as one, who compulsively used psychotropic drugs for 6 months or more. This study did not consider other patterns of drug use described as 'experimental' or 'casual' and recreational' [3]. Tobacco and alcohol were not considered in this study because their use is socially accepted and legal. This study was conducted in an urban slum in the Western suburbs of Greater Bombay where a health centre delivers comprehensive health care since 1977. This slum area has a population of about 70,000 and is divided into plots, which are serially numbered. A simple random survey was taken from all the geographical areas of the locality by picking up the plot numbers by the lottery system and surveying the entire population in these plots. The socio-demographic profile of the sample (viz. age, sex, religion, literacy, income and occupation) was compared with that of the total slum population. Among the surveyed population, all were questioned on use of drugs (mentioned by their local names), and only those persons, who admitted to using psychotropic drugs compulsively for 6 months or more, were further interviewed by means of a proforma. The answers given by the drug addicts were independently verified by questioning other family members, usually the spouse or parent(s) of the drug user. Data were analysed by using chi-square test.
Out of a sample size of 9,863, only 104 persons admitted to having used dependence drugs (mentioned by their local names) compulsively for 6 months or more. These 104 addicts were interviewed. Out of them 83.65% smoked 'brown sugar' while the rest used traditional drugs like opium (5.77%) and cannabis (10.68%) The interviews revealed that 95.2% of the drug addicts came from families with 5 or more members. The chi square test showed the significance of the difference with the sample [Table - 1]. Only 24.03% of the compulsive drug users lived within their income. The other respondents said they had borrowed money from family members or incurred debt and had pawned their belongings to support their habit. Twenty-one interviewees admittedly lived beyond their income but refused to reveal the source of extra money for supporting their habit [Table - 2] Out of total, 41.35% of the respondents had a family history of drug abuse or of alcoholism [Table - 3]. This was usually corroborated independently by other family members. 30.7% has been separated from their fathers during their childhood. The family attitude towards drug taking behaviour was found to be sympathetic in 51.93% of cases [Table - 4]. 11.54% revealed that their problem was kept a secret from their family members since they stayed away from them. The paternal education status did not differ significantly from that of the sample, but literacy among the mothers of drug addicts was significantly lower when compared with that of the sample. [Table - 5].
A glance at [Table - 1] reveals that a predominant number of drug addicts belonged to large families with 5 or more members. It is possible that each child received less parental attention, when there were many children in the family. Moreover, the breakdown of the traditional joint family system in urban areas has resulted in lack of supervision of the growing child by relatives and grandparents. The probability of vagrancy, delinquency and association with antisocial elements in the locality increased when family control on the children is lax. Child rearing is a painstaking task and every adolescent requires parental guidance. That 37 our of 104 interviewees [Table - 2] are supported financially by their families and relatives, shows that addicts were tolerated in their families, Hughes et al[3] have reported that the crime rate is much lower in Asian countries, even though the abuse of drugs 'IS equally widespread as in the West. This may because of strong family ties in Asian societies, This study also revealed that the presence of an alcoholic or a psychotropic drug user in the family sets a bad example to growing children in that family. 41.35% of the addicts had a family history of alcoholism or psychotropic drug use. Nearly one third of the drug addicts were separated from their (30.7%) fathers during their childhood and adolescence due to reasons such as paternal jobs, marital discord between parents or paternal death. Robins et al[4] had reported that the risk of heroin abuse among urban black American males was 17%, if the father was absent and only 5%, if he was present. The family attitude towards drug taking behaviour was found to be sympathetic in majority of the cases. Similar findings were reported by Veeraraghavan[5], who conducted a study on University students in 13 Indian cities. Her study revealed a sympathetic attitude in 62% of the drug user's families, while 20% of the families were indifferent. Suwanwela and Poshyachinda[6] reported from Thailand that strong family ties and cultural attitudes alleviated the psychosicial and financial stress associated with drug addiction. In most Indian families, the father is the sole bread earner who is usually away from home. Thus it is the mother who influences her off-spring during the formative years of childhood and adolescence. An illiterate mother is less likely to know the whereabouts or the doings of her adolescent off-springs especially, if she has younger children to care for. This study has its limitations, because only those who used drugs compulsively for 6 months or more were interviewed. Thus study did not consider other patterns of drugs use described as 'experimental' or 'casual' and `recreational'[7]. Though the respondents were assured of the utmost secrecy, it is possible that they may not have been forthright in their answers. Paucity of community based studies on drug abuse, especially in urban slums made comparisons difficult.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]
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