Student, MBBS, Semester VII Sikkim Manipal Institute of Medical Sciences, 5th Mile, Tadong, Gangtok 737102, Sikkim.
Indian J Psychiatry. 2006 Oct;48(4):243-7. doi: 10.4103/0019-5545.31556.
Sikkim, a state in Northeast India with a population of more than 500,000 and inhabited by indigenous population of Lepchas, Bhutias and Nepalis, lies in the foothills of the Himalayas sharing borders with Tibet, Nepal and Bhutan. Northeast India is a major source of injection drug users (IDUs) and associated HIV/AIDS. Alcohol use is traditionally prevalent in Sikkim and recently, IDU behaviour has also been reported, although systematic information on epidemiology and treatment availability of substance abuse in Sikkim is not available.
To study the sociodemographic and drug use profile of substance abusers using the emergency services in a tertiary care hospital.
A retrospective chart review was used. Patients with history of current drug use seeking emergency services for any medical or surgical consequence incident to substance abuse from July 2000 to June 2005 (60 months) were included in the study. Data were generated from emergency case register, hospital records and case sheets. SPSS 10.0 was used for data analysis.
Out of 54 patients seeking emergency services with substance abuse (1.16% of all psychiatric consultations), alcohol abusers were 77.8% and other opioid abusers 14.8%. Prevalence of IDU was 16.66%. Common opioids abused were dextrpropoxyphene and pentazocine, both analgesics. A significant number of patients (46.3%) had a history of >20 days/month frequency of abuse. Median of duration of abuse with all drugs was 12 years, while that with IDU population was 3 years. Alcohol withdrawal was the commonest cause (57.4%) of reporting to the emergency. Psychiatric comorbidity was found among 7.4%. Commonest medications used were chlordiazepoxide and clonidine, for withdrawal and naltrexone, for substitution. No standardized treatment protocol for substitution treatment was available.
This is an initial attempt to study the sociodemographic and drug use profile of substance abusers in Sikkim. Demographic and socioeconomic characteristics of substance abusers seeking emergency services are not significantly different from treatment-seeking substance abusers in other parts of India. IDU behaviour has been detected and low median duration of use suggests an emerging problem and need for urgent harm reduction. Alcohol withdrawal was the commonest cause of seeking emergency services, which is related to high prevalence of alcohol abuse in Sikkim. No standardized substitution treatment is available for substance abusers, which may lead to higher rates of relapse.
锡金邦是印度东北部的一个邦，人口超过 50 万，居民主要是雷布查人、不丹人和尼泊尔人，位于喜马拉雅山的山脚下，与西藏、尼泊尔和不丹接壤。印度东北部是注射吸毒者（IDU）和相关艾滋病毒/艾滋病的主要来源。锡金邦传统上普遍存在饮酒行为，最近也有报道称 IDU 行为，但锡金邦药物滥用的流行病学和治疗可获得性的系统信息尚不可用。
使用三级护理医院的紧急服务研究物质滥用者的社会人口学和药物使用情况。
采用回顾性病历审查。纳入 2000 年 7 月至 2005 年 6 月（60 个月）期间因药物滥用的任何医疗或外科后果寻求急诊服务的当前药物使用者的病史。数据来自急诊病例登记册、医院记录和病例表。使用 SPSS 10.0 进行数据分析。
在因药物滥用而寻求急诊服务的 54 名患者中（所有精神科咨询的 1.16%），酗酒者占 77.8%，其他阿片类药物滥用者占 14.8%。IDU 的患病率为 16.66%。滥用的常见阿片类药物是右丙氧芬和戊四唑，两者均为镇痛药。相当数量的患者（46.3%）有>20 天/月的滥用频率史。所有药物滥用的中位持续时间为 12 年，而 IDU 人群的持续时间为 3 年。酒精戒断是报告急诊的最常见原因（57.4%）。发现 7.4%存在精神共病。最常使用的药物是地西泮和可乐定，用于戒断，纳曲酮，用于替代。没有用于替代治疗的标准化治疗方案。
这是首次尝试研究锡金邦物质滥用者的社会人口学和药物使用情况。寻求急诊服务的物质滥用者的人口统计学和社会经济特征与印度其他地区寻求治疗的物质滥用者没有显著差异。已经发现 IDU 行为，使用的中位时间较短表明存在新出现的问题，需要紧急减少危害。酒精戒断是寻求急诊服务的最常见原因，这与锡金邦酗酒的高患病率有关。没有标准化的替代治疗方案可用于物质滥用者，这可能导致更高的复发率。
