An Observational Study of Treatment Seeking Users of Natural Opiates from India.

BACKGROUND

The type of opioid used influences the severity and complications experienced. Natural opiates (opium and poppy husk) use is a socio-culturally accepted phenomenon reported in India. However, studies on their profile, quality of life, and addiction severity are limited.

OBJECTIVES

The objective of this cross-sectional, observational study was to assess the socio-demographic profile, clinical profile, addiction severity, and quality of life of treatment-seeking natural opiate users.

METHOD: Hundred subjects aged 18-65 years using opium or poppy husk seeking outpatient treatment at a tertiary addiction treatment center in India were interviewed to collect information on their socio-demography, natural opiate, and other substance use. Additionally, their addiction severity and quality of life were assessed using Addiction Severity Index-Lite and WHO Quality of Life-Bref instrument, respectively.

RESULTS

All subjects were male with a mean age of 44.6 (±11.0) years. Majority (97%) used poppy husk daily orally. Curiosity/experimentation (63%) was the most common reason for starting opiate use. The past month rates of tobacco, alcohol, cannabis, and sedative-hypnotics use was 58%, 33%, 3%, and 12%, respectively. Only 4% injected any opioid. Inability to afford opiates (72%) was the most common reason for seeking treatment. Rates of medical, familial, social, psychological, and legal complications were low, while the WHOQOL-BREF scores fell between 40 and 50 across various domains. Conclusions/

Importance

Natural opiate users may constitute distinct subgroup of opioid users with fewer/no complications despite long duration of uninterrupted use. These findings would be important in planning management strategies for people dependent on natural opiates.