Prasad Sambhu, Verma Anant, Kumar Santosh, Gupta Sweta
Department of Psychiatry, All India Institute of Medical Sciences, Patna, Patna, IND.
Department of Psychiatry, Vardhaman Medical College and Hospital, Nalanda, IND.
Cureus. 2024 Jul 2;16(7):e63692. doi: 10.7759/cureus.63692. eCollection 2024 Jul.
Background and objective Substance use disorders pose significant global public health challenges, with India being no exception. Bihar, one of India's most populous states, implemented alcohol prohibition in April 2016 to address the adverse effects of alcohol abuse. However, the impact of this policy on overall substance use behavior among patients in healthcare settings remains to be explored. This cross-sectional study aimed to evaluate the changing trends in substance use behavior among patients in the tertiary care setting following the prohibition of alcohol use in Bihar. Methods A total of 372 patients diagnosed with substance use disorders were recruited from tertiary care facilities in Bihar. Data on demographic characteristics, types of substances used, frequency and quantity of use, reasons for use, and awareness of prohibition laws were collected through structured interviews and reviews of medical records. Descriptive and inferential statistics were used for data analysis. Results The majority of the participants were male (n = 346, 93.01%), with a mean age of 38.5 years. While tobacco use remains stable, there are significant increases in opioid and cannabis consumption post-prohibition, highlighting unintended consequences (p-values - opioids: 0.008, cannabis: 0.021). Additionally, heightened daily and weekly substance use after prohibition is evident (p-values: daily: 0.008, weekly: 0.021), emphasizing the necessity for nuanced policy considerations. Reasons for substance use, including coping with stress and peer pressure, showed significant differences before and after the prohibition (p<0.05). Moreover, awareness of alcohol prohibition laws increased significantly after the implementation of the prohibition (p = 0.003). Conclusions Our findings suggest that while alcohol prohibition in Bihar did not significantly lead to any changes in terms of the types of substances used among patients in tertiary care settings, it did influence the frequency and quantity of tobacco and cannabis consumption. Increased awareness of prohibition laws underscores the importance of policy enforcement and public education initiatives in addressing substance use behavior.
背景与目的 物质使用障碍给全球公共卫生带来了重大挑战，印度也不例外。比哈尔邦是印度人口最多的邦之一，于2016年4月实施了禁酒令，以应对酒精滥用的不良影响。然而，该政策对医疗环境中患者总体物质使用行为的影响仍有待探索。这项横断面研究旨在评估比哈尔邦禁酒令实施后三级医疗环境中患者物质使用行为的变化趋势。方法 从比哈尔邦的三级医疗机构招募了总共372名被诊断为物质使用障碍的患者。通过结构化访谈和病历审查收集了有关人口统计学特征、使用的物质类型、使用频率和数量、使用原因以及对禁酒法律的知晓情况的数据。数据分析采用描述性和推断性统计方法。结果 大多数参与者为男性（n = 346，93.01%），平均年龄为38.5岁。虽然烟草使用保持稳定，但禁酒令实施后阿片类药物和大麻的消费量显著增加，凸显了意外后果（p值 - 阿片类药物：0.008，大麻：0.021）。此外，禁酒令实施后每日和每周物质使用量增加明显（p值：每日：0.008，每周：0.021），强调了进行细致政策考量的必要性。物质使用的原因，包括应对压力和同伴压力，在禁酒令前后存在显著差异（p < 0.05）。此外，禁酒令实施后对酒精禁令法律的知晓度显著提高（p = 0.003）。结论 我们的研究结果表明，虽然比哈尔邦的禁酒令在三级医疗环境中患者使用的物质类型方面并未显著导致任何变化，但它确实影响了烟草和大麻的消费频率和数量。对禁令法律知晓度的提高凸显了政策执行和公共教育举措在解决物质使用行为方面的重要性。
