Indian Journal of Psychiatry, 2002,44(4), 348-352
PREVALENCE AND PATTERN OF ALCOHOL AND SUBSTANCE ABUSE
IN URBAN AREAS OF ROHTAK CITY
MEENA, PARDEEP KHANNA, A.K.VOHRA & RAJESH RAJPUT
ABSTRACT
A sample of 4,691 subjects aged 14 years and above were interviewed on a schedule based
on WHO Questionnaire to collect information about prevalence & pattern of alcohol and substance
abuse The study revealed a prevalence rate of 19 78%. 42.41% of users were in the age group of
25-34 years while 44.1 % were literate (up to matric). 45.04% among labourers were alcohol users. In
terms of age of onset, 94.83% respondents had their first drink between the ages of 15-25 years.
Most common type of alcohol consumed was country liquor by 69.07%. Majority (63.44%) of alcohol
users said that they usually drink with some companion, only in the evening and night. 50.03% had
arguments with family or friends after taking alcohol while 13.57% alcohol abusers confessed that
they had neglected their family and work due to alcohol. In family history of 23.16% alcohol users,
father was abusing alcohol. 26.61% alcohol users cited to be sociable as reason for their drinking.
16.81% users were smokers also while 6.89% had the habit of taking Pan Masala/Zarda. 2.04% of
alcohol users were taking soolfa also along with alcohol while the frequency of opium and cannabis
abuse was 1.51 and 1.18% respectively.
Key words: Substance abuse, Prevalence Pattern
Global trade and liberalization of socio-
cultural interaction of the society had made easy
access to use and spread of narcotic substances
(Murray & Lopez, 1997) Progressive increase of
substance abuse in the developing countries not
only adds to increasing morbidity pattern but also
has been forming a nidus for several dreaded
infections of recent times (Neuueark & Anthony,
1997) It has been found in studies from different
countries that geographical distribution of drug
abuse co-related well with the availability of drugs
(Gossop& Grant, 1990) Tne geographical location
of India between the Golden Triangle (Burma, Laos
& Thailand) and Golden Crescent (Iran,
Afghanistan and Pakistan) makes it a transit point
for the trade of various substances (Chhabra &
Puri,1989). A key factor affecting illicit drug
demand is that the age of initiation is falling almost
every year, especially with regard to people
seeking treatment for opiate abuse. During 1995,
more young people in the age group of 15-19 years
entered treatment plan than during the entire three
years period from 1992 to 1994 (World Drug
Report of United Nations International Drug Control
Programme, UNI News, 1998). Keeping this view
in mind the present study was planned to know
the recent prevalence & pattern of alcohol and
substance abuse in urban areas of Rohtak city.-
MATER1AL AND METHOD
The present study was undertaken to
determine the prevalence and pattern of alcohol
and substance abuse in a selected population of
348
PREVALENCE & PATTERN OF ALCOHOL & SUBSTANCE ABUSE
' above 14 years males in Rohtak City Out of a
total of 124 Anganwadi centers (AWCS
) spread
over a population of 1.42 lac.(Approximately),
house to house survey was conducted in 12
Anganwadi centre areas selected by stratified
random sampling, 3 AWCs from each of the total
four sectors. For data collection, a schedule
based on the WHO Questionnaire (Alcohol and
other Addictive Substance Abuse Check List) was
administered to the study subjects.
Before embarking upon the study, proper
counselling sessions were held in the study
population to explain the aims of the study so as
to elicit fullest co-operation of study subjects and
allay their apprehensions whatsoever. The data
collected was subjected to appropriate statistical
analysis.
RESULTS
Out of 4,691 males surveyed, 928 were
alcohol users, giving a prevalence of 19 78%. The
study reveaied that 42.4% were in the age group
of 25-34 years followed by 28.01 % in 35^44 years
As regards marital status , alcohol use was higher
in married than in unmarried respondents.
TABLE 1
SOCIO- DEMOGRAPHIC PROFILE OF ALCOHOL USERS
Factors Number(928) Percentage
25-34 years
35-44 years
Illiterate
Literaate
Matric
Graduate
Married
Unmarried
Labourers
Govt Job
Private Job
394
260
157
250
410
96
836
92
418
204
109
42.41
2801
16.9
26.9
44.1
10.3
90.08
9.92
45.04
21 9
198
Alcohol use was found comparatively higher
among matriculates (44.1%) followed by
respondents studied up to primary level (26 9%).
Lower prevalence was found in respondents who
were illiterate or graduate/ postgraduate.
Occupation- wise, 45.04% alcohol users were
labourers, 21 9% Govt, servants and 19.8% were
private workers (Table 1).
TABLE 2
FREQUENCY OF ALCOHOL INTAKE
Alcohol consumption
(Frequency)
< Once in a month
Once In a month
2 to 3 times a month
Once a week
2 to 5 times a week
Every day
Number(928)
338
173
152
143
26
96
Percentage
36 43
1865
1638
15.40
280
1034
In terms of age of onset, the study revealed
a significant fact that 94 83% respondents had
their first drink between the ages of 15-25 years.
Most commonly consumed type of alcohol was
country liquor (by 69 07%) followed by english and
country liquor (both by 10 99%) When alcohol
users were asked about their frequency of intake,
36.43% responded that they took less than once
a month. 16 38% took it 2-3 times a month while
15 40% once a week (Table2) Analysis of amount
of alcohol taken in a single sitting revealed that
46.01% had one-two pegs at a time while 29 74%
had three-four pegs Another 12 72% had five-six
pegs and the rest (11.53%) had seven-eight pegs
at a single sitting
TABLE 3
PSYCHOSOCIAL IMPLICATIONS OF ALCOHOL
CONSUMPTION FREQUENCY OF ALCOHOL INTAKE
Psycho-social
implication
Number(928) Percentage
Arguments 464
Shortage of money 83
Physical fights 46
Husband-wife strained relations 31
5003
894
4 95
334
When users were asked to analyze their
amount of drinking. 56 14% labeile^ it iess than
or equal to average Regarding me place of
drinking, majority consumed it at home or friends
place usually with some company only in evening
and night Only those who were chronically
addicted drink the whole day 50.03% had
arguments with family or friends after taking
349
MEENAefa/.
alcohol, 4.95% had physical fights while 8.94%
had shortage of money in the family due to alcohol
abuse. In 3.34% cases husband wife relationships
were strained(Table 3).
When medical implications of alcohol were
analyzed,25.75% alcohol abusers replied that they
had remained intoxicated for more than 48 hours.
32.21% became unsteady after taking alcohol
while 31.89% had slurring of speech after drinking.
39.43% had increased argumentativeness due
to drinks while 12.93% took alcohol to steady their
nerves. 0.54% was convicted at the time of
interview due to their anti-social behaviour after
taking alcohol (Table 4).
TABLE 4
MEDICAL IMPLICATIONS OF ALCOHOL
CONSUMPTION
Medical Number(928) Percentage
Implications
lntoxication(>48 hrs) 239 25.75
Unsteady 299 32.21
Slurring of speech 296 31.89
Argumentativeness 366 39.43
In family history of alcohol user's father was
abusing alcohol in 23.16% cases while in 7.5%
cases abuse in family was present in uncle/
grandfather. 26.61% alcohol users cited to be
sociable as reason for their drinking, 22.95% drink
to overlook worries/frustrations, 13.68% replied
that they drunk to cheer up while 14.26% drank
to think and work better (Table 5).
TABLE 5
REASONS FOR ALCOHOL CONSUMPTION
Reasons Number Percentage
To be Sociable 247 26.61
To forget worries 213 22 95
To think & work better 132 14.26
To cheer up 127 13.68
To relax 68 7 32
On analysis of alcohol users for other
substance abuse it was found that 16.81% users
were smokers also. 6.89% had the habit of taking
Pan Masala/Zarda. 2.04% of alcohol users were
taking soolfa also along with alcohol. Frequency
of opium and cannabis abuse came out to be
1.51% and 1.18% respectively. 42.11 % of soolfa
abusers were taking it less than once weekly,
31.57% once weekly or more while 26.32% were
abusing soolfa almost daily. Among opium
abusers 35.71% were consuming it less than
once weekly, 42.86% consumed opium once
weekly or more while 21.43% were abusing daily.
Analysis of cannabis abusers revealed that
63.64% were abusing less than once a week while
27.27% were abusing it once a week or more.
57.69% alcoholic smokers replied that they took
1-4 cigarettes/day (only while drinking), 35.89%
took 5-8 cigarettes/day while 6.42% took 9-15
cigarettes/day.
DISCUSSION
Alcohol was used by 19.78% of the
subjects in the study sample. This finding is
consistent with prevalence figures of Sethi et
al.(1979) and Thacore et al.(1971). Alcohol use
was maximum in the age group of 25-34 years.
Similar types of observations were made by
Ghulametal.(1996). Mushtaqetal.(1993), Jena
et al.(1996), and Bhowmick et al.(2001). While
Sethi et al.(1979) in a study in rural population of
Uttar Pradesh found maximum alcohol abusers
in the age group of 35-44 years. This difference
could be due to change in people's attitude
towards alcohol use over these two decades, the
points of time at which these studies were carried
out. The finding of the present study of initiation
of alcohol at younger age is in close consistence
with respect to a WHO study group on " young
and drugs" which stated that most of the
experimentation and initiation of dependence
producing drugs takes place during adolescence.
In the study population alcohol use was
most common in matriculates. Results were
similar to the findings of Ghulam etal.(1996) but
dissimilar to the findings of Sethi et al.( 1979) who
reported maximum alcohol use in illiterates or
had those who attained education upto primary
standard (88.30%). Only 7.7% had studied upto
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PREVALENCE & PATTERN OF ALCOHOL & SUBSTANCE ABUSE
middlle. The difference was because itwas a rural
study wheareas index study was done in urban
population.
The present study showed more alcohol
use among married men similar to the findings
reported by Lai & Singh (1979), Ghulam et
al.(1996), and Singh et al.,(2000). Higer alcohol
use in married men is because of increased social
responsibilities of married life as well as they also
constitute major fraction of sample. Maximum
alcohol use was among labourers followed by
government employees; high alcohol use in service
class population was due to their need to maintain
social relations and alcohol acts as a media for
interaction. Labour class took alcohol for seeking
relief from fatigue and for relaxation purposes.
Age at which alcohol users had started
taking alcohol illustrated that alcohol use was
starting at a younger age as 94.8% respondents
had their first drink between 15-25 years. Singh
etal.(2MD) also reported similar finding. Reasons
stated w initiation of alcohol use so early in life
were pressure from friends or peer groups and
experimentation and curiosity. Most common type
of alcohol consumed was country liquor by 69 07%
as it was of low cost and maximum users were
from low socio-economic status. Jena (1996) also
reported that most commonly consumed alcohol
in Bihar was locally brewed hadia (rice beer or
mahua).
In present study 36.43% of alcohol users
were using alcohol less than once in a month
while 18.65% were using once in a month. About
16.38% were using 2-3 times a month while
15.40% once in a week. Sethi (1979) also
observed similar frequency in his study in Uttar
Pradesh. On analyzing their drinking quantity
62.76% labeled they are drinking less than or
equal to average. Average level of drinking was
decided by the assesses it self and it was not
given in the tool.
When effects of alcohofuse on familial and
social life were studied, it reflected that 50 03%
users had arguments or physical fights with family
or friends. 8.94% reported financial hardships in
the family due to money spent on alcohol while
3.34% subjects had strained marital relationships
due to alcohol consumption.
Family history of alcohol users in the
present study suggest that if there is some user
already present in the family it has a strong effect
at the initiation of use in the next generation This
point was further strengthened by a study among
child labourers of Surat city (Bansal and Banerjee
1993). They reported 99.5% substance abuse at
work place followed by 94.3% abuse among
neighbours This high prevalence of substance
abuse in the surrounding significantly prompted
child labourers in their initiation of substance
abuse.
Most common reason cited for alcohol use
in index study were to be sociable (26.61%), to
forget worries/ frustrations (22.95%). to think and
work better (14.26%) and to cheer up (13.68%)
Proportions of these reasons may vary from one
society to another due to cultural heterogeneity.
On analysis of alcohol users for other
substance abuse opium abuse was prevalent
among 1.51% of the study subjects which is
similar to findings reported by Gupta etal (1987)
from Ludhiana and Ghulam et al (1996) from urban
population of Madhya Pradesh Prevalence rate
for cannabis abuse came out to be 1 18% while
Lai and Singh (1979) reported 2.2% cannabis
abuse in Punjab and Thacore (1971) reported
1 9% from Lucknow These findings are consistent
with the present study Prevalence of
tobacco(cigarettes) abuse in alcohol users came
out to be 16 81 %, which is very low, compared to
prevalence reported by Sethi & Gupta (1972)
39.5% in a general population survey of Uttar
Pradesh. The reason for low prevalence in the
index study was that instead of ever somker's
only current smokers were included
The study presents a variable picture of
substance abuse in urban population of Rohtak
City, the study area While potential toxicity of
excessive tobacco and alcohol abuse need not
be elaborated, practicing of substance abuse other
than these two though in small numbers is quite
alarming. Harmful effect on health from substance
abuse in the area needs in-depth study. Access
351
MEENA eta/.
to availability of narcotic substances and its
spread should be checked in the entry points by
creating awareness among people and
implementing other legislative measures.
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* Correspondence
352