Heroin addiction among young people : a new development in Sri Lanka

Sections

ABSTRACT
Introduction
Method and results of the study
Patterns of heroin abuse
Socio-demographic characteristics
Heroin-related disability
Comparison of data
Conclusion

Details

Author: N. MENDIS
Pages: 25 to 29
Creation Date: 1985/01/01

Heroin addiction among young people : a new development in Sri Lanka

N. MENDIS Chief, University Psychiatry Unit, General Hospital, Colombo, Sri Lanka

ABSTRACT

Heroin addiction is a recent phenomenon in Sri Lanka. The records of the University Psychiatry Unit of the General Hospital at Colombo show that in 1982 the first two Sri Lankans were hospitalized in the Unit for heroin addiction ; the number increased to 92 in 1983. This article summarizes the results of a study of 100 heroin addicts who were treated in the Psychiatry Unit from January 1983 to March 1984. Most addicts inhaled heroin, and the average amount consumed was 340 mg per day. The majority of them had used heroin for a period of less than one year, while 9 per cent had used it for more than two years.

All the addicts in the study were males. Only 6 per cent were older than 34 years; 5 per cent were unemployed at the time they started using heroin ; 67 per cent were single ; and 93 per cent had left school before the tenth grade. Two ethnic groups - Moors and Burghers - were relatively over-represented compared with the proportion of these groups in the national population. The majority of the employed addicts (70 per cent) reported that heroin addiction had interfered with their ability to work.

Introduction

As in other countries of southern Asia, heroin addiction is a relatively new phenomenon in Sri Lanka, although addiction has been prevalent in South-East Asian countries since the 1970s [ 1] - [ 4] . Evidence shows that heroin addiction has rapidly increased in Sri Lanka over the last few years. The considerable increase in hospital admissions for the treatment of heroin addicts supports this evidence. The increase in heroin addiction has been accompanied by increases in the number of heroin seizures and in the amount seized. While heroin addiction has been extensively studied in the Western countries [ 5] , [ 6] and South-East Asia [ 1] , [ 3] , there is a paucity of relevant information for the southern Asian countries. For this reason, recent clinical research on patterns and the socio-demographic characteristics of heroin addiction in Sri Lanka is summarized in this article.

Method and results of the study

Heroin addicts admitted for detoxification to the University Psychiatry Unit of the General Hospital at Colombo who had used heroin continuously over a period of one month preceding hospitalization and who showed physical and psychological dependence were included in the study. All Subjects in the study were administered a questionnaire by a psychiatrist to obtain information on patterns of heroin abuse and on the sociodemographic characteristics of addicts.

From 1971 to 1981 only four heroin addicts, all foreigners, were admitted to the University Psychiatry Unit. The first two heroin addicts from Sri Lanka were hospitalized in the Unit in 1982, and the number increased to 92 in 1983. The study covered l()() addicts treated in this Unit from January 1983 to March 1984.

Patterns of heroin abuse

Two thirds of the addicts used heroin for less than one year, 24 per cent for between one and two years and 9 per cent of the addicts for more than two years; 78 percent of the addicts used the drug continuously while the rest had heroin-free periods lasting from a few days to two months. The distribution of addicts by the amount of heroin used in milligrams per day, was:

Amount of heroin (mg)

Percentage of total users

Less than 125
33
126 - 250
32
251 - 500
23
501 - 750
4
751 - 1,000
8

The addicts needed an average of 50 to 100 Sri Lanka rupees per day to maintain the habit. The average daily income of the addicts was often less than this amount. Many addicts obtained the required money from their families or by selling personal and family belongings.

Most of the addicts (87 per cent) inhaled the heroin vapour, known as "chasing the dragon's tail while l 1 per cent smoked it in cigarettes and 2 percent either sniffed or injected it. All addicts consumed brown heroin with a purity of approximately 50 per cent.

The majority of the addicts commenced drug abuse with cannabis (67 per cent). Heroin was the first drug used by 18 per cent of the addicts, while 12 per cent commenced with alcohol and 3 per cent with opium.

A small number of addicts (8 per cent) used heroin in combination with lysergic acid diethylamide, cocaine, benzodiazepines or amphetamines.

Socio-demographic characteristics

All the addicts were males ; 81 per cent were between 20 and 34 years old, 12 per cent were in the 15 to 19 year-old age group, and one was younger than 14. Only 6 per cent of the addicts were older than 34 years. The average age at which the subjects began using drugs was 16 years, while the average age at the time of initial heroin use was 20. Most of the addicts (70 per cent) came from the slum areas of Colombo, which are characterized by crowded housing conditions, high rates of crime and other antisocial activities.

With regard to ethnic groups, Moors and Burghers comprised 29 and 7 per cent of addicts, a high proportion in view of the fact that they represent 7 and 0.3 per cent of the total population. There were 53 per cent Sinhalese and 11 per cent Tamil addicts; those population groups represent 74 and 18 per cent, respectively, of the national population.

Approximately two thirds of the addicts were single. The majority came from families with more than five children. In respect of education, 43 per cent of the addicts had left school before completing the eighth grade and 48 per cent had left before the tenth grade. Questions on employment revealed that 41 per cent of the addicts were employed as skilled workers or as labourers, cooks, sales assistants, drivers and mechanics ; the second largest occupational group (35 per cent) were self-employed, mainly engaged in trade or tourism ; 5 per cent were unemployed. The other subjects had various occupational backgrounds.

Heroin-related disability

Of the employed addicts, 30 per cent had experienced a severe impairment of their ability to cope with their occupations by the time they consulted the psychiatric service. They had either lost their jobs or functioned at a very low level of effectiveness and attributed this impairment to a loss of interest, lack of motivation and sluggishness owing to heroin abuse. Various degrees of impairment were reported by 40 per cent of the addicts, while 30 per cent of the subjects claimed that heroin addiction did not interfere with their work. Loss of weight, appetite and libido as well as marital problems were commonly associated with heroin addiction. Only 5 per cent of the addicts had been charged with drug-related offences, while 14 per cent had a past criminal record.

Comparison of data

The age, occupational status, educational level and marital status of heroin addicts are comparable to those reported elsewhere [ 5] - [ 8] . However, in Sri Lanka the abuse of psychoactive substances is rare among females, and the absence of female addicts is not found in other countries.

Two minority ethnic groups were seen to be relatively over-represented among the addicts ; similar observations were made by Deva in Malaysia [ 9] and Teo in Singapore [ 7] . The Moors have traditionally been involved in the trade and the consumption of opium ; this may account for the high proportion of Moors addicted to heroin. Burghers are known to have been largely involved in tourism and the entertainment business in Sri Lanka, and their contacts with tourists may have contributed to their overrepresentation.

The majority of the subjects came from large families with more than five children, and less than half the parents of the dependent subjects were living together. Similar findings were reported by Deva in Malaysia [ 9] . Heroin addicts had a lower occupational level than their fathers. The age at which the subjects started experimenting with drugs and the time interval between this and the time at which heroin abuse commenced agrees with reports from other countries [ 6] , [ 9] .

The average consumption of heroin was 340 mg per day for addicts in Sri Lanka, compared with an average consumption of 240 mg per day by addicts in Western countries [ 5] . *

Conclusion

As in other neighbouring countries, heroin addiction in Sri Lanka is a recent phenomenon, and the extent of the problem is still not known. The estimates vary from 2,000 to 10,000 addicts. At present heroin seems to be freely available in most major urban centres and tourist areas in the country. The availability of heroin at a very low price in neighbouring countries, the growth of the tourist industry, and the rapid changes in the socio-economic conditions of the people may be contributing to the spread of heroin abuse in Sri Lanka. The only form of treatment available in Sri Lanka for heroin addicts is detoxification, which is usually undertaken in the existing psychiatric units.

A certain persentage of heroin is wasted during the inhalation of vapour, which should be considered in comparing the average daily consumption rates of heroin.

References

01

l. C. P. Spencer and V. Navaratnam, Drug Abuse in East Asia (Kuala Lumpur, Oxford University Press, 1981).

02

S. Saxena and D. Mohan, "Rapid increase of heroin dependence in Delhi - some initial observations", Indian Journal of Psychiatry, vol. 26, No. l (1984), pp. 41 -45.

03

P. A. Abarro, "An overview of d rug abuse and country responses in the Colombo Plan Region", presented at the Tenth Biennial Summer School on Alcohol, Drugs and Chemical Dependency, 26 - 28 June l983 , New Zealand.

04

N. Mendis, "Heroin problems in Sri Lanka - a preliminary communication", Journal of the Ceylon College of Physicians, vol. l6, l983, pp. 37 - 42.

05

T. Bewley, "Study of l00 consecutive inpatients", British Medical Journal, vol. l, l968, pp. 727 - 730.

06

A. Kosviner and others, "Heroin use in a provincial town", Lancet, vol. l, l968, p. ll89.

07

S. H . Teo and others, "Heroin abuse in Singapore - a profile and characteristic study", Singapore Medical Journal, vol. l9, No. 2 (l978), pp. 65 - 70.

08

M. Deva, "Opiate dependence among Sikks in Malaysia", Proceedings of the XIV Singapore-Malaysia Congress of Medicine (Singapore, Academy of Medicine of Singapore, l979), pp. 228 - 232.

09

M. Deva, "Some characteristics of male opiate dependents in Malaysia", presented at the Fifth Asian Regional Symposium on Psychotropic Medication, Singapore, 20 - 22 July 1984.