This study gives data on 513 patients who presented to the psychiatry polyclinic of STRH within the scope of P between October 2009 and December 2014. All of the study participants were diagnosed with a “drug addiction” following the conduct of a clinical interview and were thereby included in a 6-week treatment program.

The evaluation conducted on the distribution of drug addicts according to year found that the figure by year increased up to the year 2013 but slightly decreased in 2014. The number of new patients in 2013 was significantly higher than the number found in other years. These results were obtained after verification through laboratory tests. The decrease seen in the addiction rate in 2014 was a promising outcome, but this result could be attributed to the fact that the use of substances such as synthetic cannabinoid, which can- not be detected in our urine analyses, could have been wide- spread during the period of the study (synthetic cannabinoids could be detected during only last two months of the study), making it possible that it passed by unnoticed.10

In this study, responses from the patients showed that the age range for first use of a drug extended from the lowest age of 7 years up to the highest age of 45 years. The highest risk period found in the study was the mid-20s. A study conducted in 72 provinces of Turkey in 2002 revealed that drug use frequency was higher in the age group of 15–24 years than in the age group over 25 years.11 In another study conducted through P cases in Turkey, it was found that the youngest and oldest persons diagnosed with addiction were 17 years and 64 years, respectively, and that the average age was 32.47±10.55 years. The ages of first drug use, however, were not specified in said study.12 Another study conducted on this issue showed that the average age of first drug use was 25.64 years range: 14–43 years and that the average age of application was 33.79 years (range: 18–83 years).13 These data are consistent with our data. Reports from the US demonstrated that drug use age decreased below 11 years, and that almost three-quarters of the users begin to use drugs below the age of 17 years.14 It has been well established throughout Europe and the world that drug use is a problem that primarily afflicts the young population.2,15

Considering the education levels of the patients, primary school graduates constitute the highest share. However, the distribution of secondary school- and high school graduates is similar, and college graduates also constitute a proportion of the patients. Comparable findings were detected in the studies conducted through P cases in Turkey.12,13,16 The relationship between drug addiction and education level has been shown by international studies as well.17,18 Raising awareness about drug addiction among all education levels of society seems to be a measure that needs to be taken.19,20

Most of the patients, in our study, lived with their families and had regular jobs. Although it is well known that drug addiction causes the user to become alienated from his/her family and stop going to work, our study is important for showing that our drug addicts do not always fit the conventional image of being “unemployed and alone”, but on the contrary, any person in society is under the risk of drug addiction. Similar results were obtained by other studies made through P cases in Turkey.12,13,21 A review published in 2011 showed an inverse relationship between unemployment and drug use, where unemployment led to drug use and likewise, drug use led to unemployment.22

According to our data on distribution of particular drugs, marijuana is the most frequently used substance. Heroin was the second with 1.9%, and in our 2-month data analysis, synthetic cannabinoid has reached 1.6%. Considering that other data reflect the result of almost 5 years and both use and detection of synthetic cannabinoid have only recently started, 2015 data on this issue are estimated to be more realistic. Similar results were received for the studies conducted through P cases in Turkey.12,13 In 2014, cannabis remained the most widely consumed drug worldwide. Global annual cannabis use prevalence is estimated to be between 2.7% and 4.9% of the population aged 15–64 years.2 Moreover, a majority of the studies con- ducted on drug addiction report that marijuana is the most widely used illegal substance, both in Turkey and the rest of the world.23–26 In the study’s patient provided responses to drug use frequency, final results showed that 16% of the patients used drugs daily, 9% used them 2–6 days a week, and 23% used them at most once a week. One of the more interesting outcomes of this study was seen in the patients who had tested positive for drug use. Of the patients who were determined, via a urine analysis performed within 35 days pursuant to P practices, to have substance positivity, 45.5% of them declared that they had not used drugs within the last month and 2.3% of them stated that they had never used drugs. This particular matter requires that further studies be performed, wherein information about the patients can be verified through toxicological analyses.

In this study, early onset of drug use, longer durations of drug use, male sex, and having a prior treatment history (except judicial process) were related with negative response to the treatment program in immediate evaluations at the end of the program. These results are in line with previous studies except sex12,27,28. Having a prior treatment anamnesis is supposed as being a chronic user with at least one recurrent treatment and drug use periods. Interestingly, prior judicial practices were not related with treatment response. We thought that judicial procedure may have a preventative role on substance use disorders but not effective enough to meet the expectations in chronic and long-term users. Long-term results are needed to make a clear evaluation, but according to results of this study, alternative models of treatment programs should be researched for long-term users and treatment-resistant patients.

This study is beneficial for its use of a strong sample in providing 5-year data on the individuals diagnosed with drug addiction within the scope of judicial P in Sakarya. Furthermore, the information obtained, the first of its kinds in the province of Sakarya, offers a general profile of the social status of the drug addicts. The retrospective design of the study acted as a constraint, however, as only a small amount of data approved by the ethics committee for use in file records was obtained. More detailed prospective studies will facilitate a better understanding of the addiction profile.