Qualitative And Quantitative Investigation On Drug Abuse In Rural Hunan

Part1Drug abuse in rural Hunan:a preliminary investigationOBJECTIVE:To compare characteristics and illicit drug abuse patterns among drug abusers in rural and urban areas of Hunan Province, China.METHODS:Data collected by public security bureau on newly registered drug abusers between2005and2008in5urban and5rural areas (N=1639) were extracted anonymously and analyzed. All newly registered drug users in urban (n=812) and rural (n=827) areas of Hunan Province were included.RESULTS:Drug users from the rural areas were younger (31(6.6) vs.34(8.0) years, p<0.001), with a higher proportion of males (86%vs.82%, p<0.05), or married (34%vs.27%, p<0.01). Rural drug users reported an earlier onset of drug use (27(5.9) vs.30(7.9) years old, p<0.001), were more likely to report heroin as their primary drug of abuse (53%vs.47%, p<0.001), and had a lower prevalence of criminal activities (19%vs.31%, p<0.001). Rural drug users were less likely to report needle sharing (1.8%vs.4.3%, p<0.01), less likely to report being HIV+(0.8%vs.2.6%, p<0.01), and less likely to report prior drug treatment participation (2.8%vs.6.8%, p<0.001).CONCLUSIONS:Drug abuse is a substantial problem in both urban and rural areas in China. The very low proportion of newly registered drug users reporting any prior drug abuse treatment points to the importance of expanding substance abuse treatments, especially in rural areas where treatment penetration is even lower than in urban areas. Part2Drug abuse in rural Hunan:a pilot study from focus groupsOBJECTIVE:To qualitatively explore drug abuse pattern and features in rural areas of Hunan province from the perspective of drug users.METHODS:We conducted6focus group interviews in rural areas of Loudi, Yueyang and Hengyang (2focus groups for each place). Each focus group had6or7participants. All interviews were audiotaped with the participants’consent. Tapes were transcribed fully, and we analyzed the data by means of interpretative description approach.RESULTS:Drug abuse was also popular in rural areas of Hunan. New drug abusers primarily used new type drugs, especially Magu and Ice. The phenomenon of using multiple drugs was common among the rural drug abusers who took drugs mainly by inhalation and injection. The majority of drug abusers initially used drugs with curiosity and vanity under the seduction of their friends. Drugs were considered to alleviate depressive mood, raise libido and relieve somatic discomfort. It was also easy to access to drugs in rural areas, and the drug dealer mainly consist of patients with fatal diseases and long-term drug users. The treatment resource is limited in rural areas. Social discrimination and incapability of separating from drug abuser community usually led to failure of detoxification treatment. Finaicial straits and fear of treatment are two principal treatment barriers.CONCLUSIONS:Drug abuse has been a substantial social problem in rural areas of Hunan. The popularity of new type drugs and using multiple drugs may make the drug control in rural areas more complicated. The government should scale-up the treatment service, strengthen efforts of publicizing the harms of new type drugs, change the attitude of the public to drug abusers, and provide psychological intervention to help drug abusers in rural areas return to the society. Part3Drug abuse in Hunan:a quantitative studyOBJECTIVE:To compare the pattern and features of drug abuse as well as impulsive personality, depressive mood, sleep quality and treatment barriers of drug abusers in rural areas with those in urban areas in Hunan.METHODS:437drug abusers were assessed by using a series of scales, including Addiction Severity Index (ASI), Barratt Impulsiveness Scale (BIS), Center for Epidemiological Survey Depression Scale (CES-D), Pittsburgh Sleep Quality Index (PSQI) and Barriers to Treatment Inventory (BTI).RESULTS:(1) In rural areas,52.7%drug abusers initially took drugs in local areas, while25.2%drug abusers initially took drugs in urban areas where they worked;(2) Compared to drug abusers in urban areas, drug abusers in rural areas were younger (32.4±6.4years vs.30.9±6.6years, p<0.05), with a higher proportion of males (55.2%vs.80.7%, p<0.001) or married (27.3%vs.41.6%, p<0.05);(3) Heorin and ketamine were used more in rural areas (p<0.05). There was no significant difference of methamphetamine use between in rual areas and urban areas (p=0.167);(4) No difference was found in injection drug rate between drug abusers in rural areas and urban areas (p=0.828), while needle sharing rate of drug abusers in rural areas was higher than in urban areas (18.5%vs.7.8%, p<0.01);(5) Drug abusers in rural areas had shorter drug use duration than in urban areas (5.3±4.2vs.6.6±5.2, p<0.01);(6) No difference was found in number of treatment, untreatment rate, compulsive detoxification rate, voluntary treatment rate between drugs abusers in rural areas and urban areas. While MMT rate of drug abusers in rural areas was lower than in urban areas (27.1%vs. 38.6%, p<0.05);(7) Drug abusers in rural areas had lower scores in Factor "conflict between treatment time and daily work" and Factor "difficulty to get access to treatment resource" than in urban areas (p<0.05).CONCLUSIONS:The findings indicated that illicit drugs have spreaded into rural areas, and the pattern of initially using drugs has changed. The drug abusers in rural areas and urban areas have similar pattern of treatment, with conpulsive detoxification as the major treatment mode. There was less MMT resource in rural areas. And the barriers to treatment from "conflict between treatment time and daily work" and "difficulty to get access to treatment resource" are even bigger for durg abusers in rural areas. Thus, we need to explore and take proper and effective measures to improve detoxification treatment rate and decrease relapse rate.