- Email: [email protected]
Drug addiction—A pilot study in Dhaka city
Person.individ.01% Vol. 13,No. 1,pp. 119-121, 1992 Printed in Great Britain. All rights reserved
DRUG
ADDICTION-A
0191~8869/92 %5.00 + 0.00 Copyright 0 1991 Pergamon Press plc
PILOT STUDY
IN DHAKA
CITY
ANISUR RAHMAN Psychology
Department,
Dhaka
University,
Dhaka-1000,
Bangladesh
(Received 12 October 1990; received for publication 13 June 1991) Summary-A availability, investigation
study is reported of 70 drug addicts of Dhaka city. It was found that peer influence, boredom and curiosity were the causal factors of substance use. The subjects of this were found to be inordinately tough-minded and highly emotional.
INTRODUCTION
Alcoholism and drug addiction have added a new dimension to social problems across the world. Recent times have found little distinction between rich and poor nations in this regard. Like other parts of the Indian subcontinent, Bangladesh has been experiencing this menacing social malady. Major natural drugs like opium, hashish, marijuana, heroin and cocaine have a long history of both use and abuse and continue to present problems for society. Whatever the consequence of taking such substances into the body, their effects are usually pleasing, at least initially. The identification and definition of drug problems are the result of a tangle of social, moral and political factors. This is true at the individual as well as at the wider social level. Drug addiction is a severe form of disturbance in which there is physiological dependence on the drug, besides the abuser’s other problems. It involves tolerance and withdrawal reactions. However, not all drugs lead to tolerance or withdrawal reactions. That is why the term psychological dependence is often applied to reliance on drugs that are not addicting. A drug may be taken because its effects make stressful or anxiety-arousing situations relatively bearable and because of the pleasant feeling and euphoric state that the drugs produce. Drug taking is also considered to be part of the thrill-seeking behaviour of the sociopath. On various personality questionnaire measures, drug addicts have been found to be deviant. Curiosity, boredom and aggravation are probably contributing factors. The social context affects drug-taking in many ways from the broadest sociocultural level to the specific circumstances in which a drug is taken. The immediate social influences upon drug-using are probably of great importance in terms of assessment as well as treatment. Peer pressure, availability, disrupted family life, culture, social and economic disadvantages, poor education and crowded housing conditions have been found to be related to addiction. Many of those who are drug addicts take more than one drug at any given time. Polydrug abuse poses a serious health hazard because effects of some drugs when taken together are synergistic, i.e. the effects of each interact to create an especially strong reaction. Gossop (1987) is critical of the current American system, DSM-III, which clings to a substance-based approach emphasizing the particular drug being used. He observes that: “The main weaknesses of this approach are that in its emphasis upon specific drugs, it fails to take account of the vast range of individual differences between users. Few addicts confine themselves to a single drug, indeed some addicts use drugs in such an indiscriminate fashion as to make this substance-based approach completely inappropriate.” The meaning that drug-taking has for the individual is an important aspect that cannot be underrated. People do not fall victim to drug addiction suddenly or inexplicably. They are actively involved in the use of drugs, and their attitudes, beliefs, intentions and expectations play a vital role in this involvement with drugs. Failure to acknowledge the personal significance of drug-taking are likely to provoke resistance or hostility on the part of the addict and may well interfere with their efforts to give up drugs. Both the clinician and the client must explore and try to comprehend the social and psychological meaning of drug-use. 119
120
ANIXJR RAHMAN
The present study was carried out to identify some factors, be associated with drug addiction in Bangladeshi society.
especially
psycho-social,
which might
METHOD
A group of 70 drug addicts, 59 males and 11 females, constituted the sample of this study. Fifty of them were personally contacted by 2 field workers from different parts of Dhaka city while 20 were found at the Institute of Post-graduate Medicine and Research, Dhaka. The Ss ranged in age from 19 to 53 years, with a large concentration in the 19-30 age group. Their average age was about 25 years. Two questionnaires, one regarding biographic factors of the respondents and their substance use prepared by the author of this study and the other regarding personality configuration, the Eysenck Personality Questionnaire (EPQ) (Eysenck & Eysenck, 1975; translated and standardized, Rahman & Eysenck, 1980) were administered individually and confidentially to the SS.
RESULTS
AND
DISCUSSION
In response to the question regarding initiation of drug taking 50% of the respondents reported that they contracted the habit from peers/friends, 32% said they took to it out of frustration/boredom and 18% stated that they started the habit out of curiosity. Thus immediate social environment seems to play a major role, followed by psychological factors, in inducing individuals to substance-use. It was gathered from the Ss that the drugs they took were hashish/charash, alcohol, heroin and pathedine. All the respondents of this sample expressed that they were addicted to more than one drug. Enquiry as to the sources of supply of the drugs revealed that they were obtained from friends (50%); bought from shops (30%); and procured from both sources (20%). This finding also underlies the dominant influence of immediate social environment as far as drug-taking is concerned. As to the reason for using those particular substances, 60% of the Ss mentioned pleasure derived from them, 23% mentioned their competitive price, while 17% reported about their easy availability. So, epicurean considerations seem to be the principal motivating factor behind substance-use. In response to the query regarding the effects experienced following drug-intake, 65% of the Ss reported light and pleasant feelings, 20% mentioned feelings of weakness, whereas 15% reported mixed feelings. Asked if they faced any problems because of substance-use, 54% of the respondents reported somatic symptoms like insomnia, nausea and trembling of hands and legs, 30% said they were bothered by psychological disturbances, e.g. ‘this is a bad habit I have contracted’, ‘people think ill of me’, while 16% expressed no problem. Asked if they were aware of harm caused by drugs, 82% of the Ss replied in the affirmative while only 18% responded in the negative. This shows how the pleasure principle outbids knowledge of deleterious effects as far as addicts are concerned. To the question, ‘why don’t you give up the habit?‘, the responses were, ‘have been trying without success’ (38%); ‘experience very pleasant feelings, so the question of forsaking it does not arise’ (32%); ‘suffer from withdrawal symptoms’ (18%); and ‘are still trying’ (12%). These findings adduce that kicking the habit of substance-use is an uphill task. Asked if they sincerely wanted to get rid of the addiction, 42% of the Ss replied in the affirmative, 35% in the negative and the rest were undecided. These findings also indicate that derivation of pleasure is a dominating factor in sustaining the craving for drugs. It is particularly interesting to observe the differing personality pattern of the drug addicts as Tables 1 and 2 demonstrate. It can be seen from Tables 1 and 2 that P and N scores of both the comparative groups are much higher than those of the normative groups (7.53 + 4.09 vs 3.25 f 2.81; 13.21 k 2.81 vs 8.51 + 4.20 Table
I. EPQ scores of the male drug addicts compared
P Drug addicts (n = 59) Norms (n = 544) lP < 0.05; **p < 0.01
7.53 * 4.09 3.25 + 2.81
I 4.72*’
E 9.10 + 3.70 10.34 + 3.32
to the norms
I
N
2.67
13.21 f 2.81 8.51 f 4.20
f
L
I
5.27**
8.34 + 2.77 II.71 i4.07
3.761
Drug
121
addiction
Table 2. EPQ scores of the female drug addicts compared
P Drug addicts (n = 11)
Norms
(n = 531)
5.63 + 3.86 2.69 + 2.60
f
E
5.17**
8.67 f 2.62 9.98 + 3.56
to the nmms
t
N
2.83
14.01 + 3.14 9.52 + 4.51
t
L
t
5.83**
9.23 + 2.87 12.54 + 3.83
3.63*
‘P < 0.05; “P < 0.01
and 5.63 + 3.86 vs 2.69 + 2.60; 14.01 &-3.14 vs 9.52 + 4.51 for males and females, respectively. These findings suggest that both male and female drug addicts are inordinately tough-minded as well as highly emotional. An adult high P-scorer may be described as being solitary, insensitive, lacking in feeling and empathy, cruel and inhumane, hostile to others, aggressive, has a liking for oddand A high N-individual is a ‘worrier’, his/her main characteristic being a constant preoccupation with things that might go wrong, and a strong emotional reaction of anxiety to these thoughts which interferes with his/her proper adjustment making him/her react in irrational, sometimes rigid ways. He/she is moody, frequently depressed and sleeps badly. The findings of this study correspond to those of Teasdale, Seagraves and Zacune (1971) in England and Cepelak (1973) in Czechoslovakia. It is interesting to observe that the findings also bear out Eysencks’ hypothesis that personality is involved in drug-using and drinking behaviour. That is, a high P and N personality characterizes drug-users and alcoholics. Criminals also show high P and N scores (Eysenck & Eysenck, 1971). Since illicit use of drugs may be likened to criminality it is of further interest to note that P and N scores of both criminals and addicts are similarly elevated. The E scores of both the comparative groups are, however, slightly lower than those of the normative groups (9.10 f 3.70 vs 10.34 f 3.32 and 8.67 f 2.62 vs 9.98 f 3.56 for males and females, respectively). According to these findings both the male and female drug addicts seem relatively introverted, i.e. less outgoing. This finding is also in the expected direction. Akter (1991) in a study of 56 drug addicts of Bangladesh observes that personality is certainly an important factor in drug addiction. The Ss of that study were also found to be highly emotional, venturesome/indulging in strange experiences-disregarding their consequences-and introverted. Also in that study, peer pressure was reported to be a potent factor in starting the habit, other factors involved being curiosity, boredom and lack of conscience and self-control. The results of this study are very much in line with other work on drugs, It is of further interest to note that both the comparative groups scored much lower on L than the normative groups (8.34 f 2.77 vs 11.71 f 4.07 and 9.23 + 2.87 vs 12.54 + 3.83 for males and females, respectively). These findings adduce that the respondents of this study did not dissimulate. Moreover, they demonstrate that drug addicts are much more straightforward than most people, as the former seem less concerned about social desirability than the latter. A large scale research project on drug addiction throughout the country would throw more useful light on this baffling problem. REFERENCES Akter, N. R. (1991). Personality assessment of drug addicts. Unpublished M.Sc. Thesis. University of Dhaka, Dhaka. Cepelak, J. (1973). ‘Psychoticism’ in toxicomans-imprisoned delinquents. Actiuifas Neruosa Superior, 15, 155-156. Eysenck, H. J. & Eysenck, S. B. G. (1975). Manual of the Eysenck Personaliry Questionnaire (Junior and adult). London: Hodder & Stoughton. Eysenck, S. B. G. & Eysenck, H. J. (1971). A comparative study of criminals and matched controls on three dimensions of personality. British Journal Social and Clinical Psychology, IO, 362-366. Gossop, M. (1987). Major addictions: Investigation. In Lindsay, S. J. E. & Powell, G. E. (Eds), A handbook of clinical adult psychology. Aldershot (England): Gower. Rahman, M. A. & Eysenck, S. B. G. (1980). National differences in personality: Bangladesh and England. Bangladesh Journal of Psychology, 6, 113-I 19. Teasdale, J. D., Seagraves, R. T. & Zacune, J. (1971). Psychoticism in drug-users. British Journal of Social and Clinical Psychology, IO, 16c-171.
DRUG
ADDICTION-A
0191~8869/92 %5.00 + 0.00 Copyright 0 1991 Pergamon Press plc
PILOT STUDY
IN DHAKA
CITY
ANISUR RAHMAN Psychology
Department,
Dhaka
University,
Dhaka-1000,
Bangladesh
(Received 12 October 1990; received for publication 13 June 1991) Summary-A availability, investigation
study is reported of 70 drug addicts of Dhaka city. It was found that peer influence, boredom and curiosity were the causal factors of substance use. The subjects of this were found to be inordinately tough-minded and highly emotional.
INTRODUCTION
Alcoholism and drug addiction have added a new dimension to social problems across the world. Recent times have found little distinction between rich and poor nations in this regard. Like other parts of the Indian subcontinent, Bangladesh has been experiencing this menacing social malady. Major natural drugs like opium, hashish, marijuana, heroin and cocaine have a long history of both use and abuse and continue to present problems for society. Whatever the consequence of taking such substances into the body, their effects are usually pleasing, at least initially. The identification and definition of drug problems are the result of a tangle of social, moral and political factors. This is true at the individual as well as at the wider social level. Drug addiction is a severe form of disturbance in which there is physiological dependence on the drug, besides the abuser’s other problems. It involves tolerance and withdrawal reactions. However, not all drugs lead to tolerance or withdrawal reactions. That is why the term psychological dependence is often applied to reliance on drugs that are not addicting. A drug may be taken because its effects make stressful or anxiety-arousing situations relatively bearable and because of the pleasant feeling and euphoric state that the drugs produce. Drug taking is also considered to be part of the thrill-seeking behaviour of the sociopath. On various personality questionnaire measures, drug addicts have been found to be deviant. Curiosity, boredom and aggravation are probably contributing factors. The social context affects drug-taking in many ways from the broadest sociocultural level to the specific circumstances in which a drug is taken. The immediate social influences upon drug-using are probably of great importance in terms of assessment as well as treatment. Peer pressure, availability, disrupted family life, culture, social and economic disadvantages, poor education and crowded housing conditions have been found to be related to addiction. Many of those who are drug addicts take more than one drug at any given time. Polydrug abuse poses a serious health hazard because effects of some drugs when taken together are synergistic, i.e. the effects of each interact to create an especially strong reaction. Gossop (1987) is critical of the current American system, DSM-III, which clings to a substance-based approach emphasizing the particular drug being used. He observes that: “The main weaknesses of this approach are that in its emphasis upon specific drugs, it fails to take account of the vast range of individual differences between users. Few addicts confine themselves to a single drug, indeed some addicts use drugs in such an indiscriminate fashion as to make this substance-based approach completely inappropriate.” The meaning that drug-taking has for the individual is an important aspect that cannot be underrated. People do not fall victim to drug addiction suddenly or inexplicably. They are actively involved in the use of drugs, and their attitudes, beliefs, intentions and expectations play a vital role in this involvement with drugs. Failure to acknowledge the personal significance of drug-taking are likely to provoke resistance or hostility on the part of the addict and may well interfere with their efforts to give up drugs. Both the clinician and the client must explore and try to comprehend the social and psychological meaning of drug-use. 119
120
ANIXJR RAHMAN
The present study was carried out to identify some factors, be associated with drug addiction in Bangladeshi society.
especially
psycho-social,
which might
METHOD
A group of 70 drug addicts, 59 males and 11 females, constituted the sample of this study. Fifty of them were personally contacted by 2 field workers from different parts of Dhaka city while 20 were found at the Institute of Post-graduate Medicine and Research, Dhaka. The Ss ranged in age from 19 to 53 years, with a large concentration in the 19-30 age group. Their average age was about 25 years. Two questionnaires, one regarding biographic factors of the respondents and their substance use prepared by the author of this study and the other regarding personality configuration, the Eysenck Personality Questionnaire (EPQ) (Eysenck & Eysenck, 1975; translated and standardized, Rahman & Eysenck, 1980) were administered individually and confidentially to the SS.
RESULTS
AND
DISCUSSION
In response to the question regarding initiation of drug taking 50% of the respondents reported that they contracted the habit from peers/friends, 32% said they took to it out of frustration/boredom and 18% stated that they started the habit out of curiosity. Thus immediate social environment seems to play a major role, followed by psychological factors, in inducing individuals to substance-use. It was gathered from the Ss that the drugs they took were hashish/charash, alcohol, heroin and pathedine. All the respondents of this sample expressed that they were addicted to more than one drug. Enquiry as to the sources of supply of the drugs revealed that they were obtained from friends (50%); bought from shops (30%); and procured from both sources (20%). This finding also underlies the dominant influence of immediate social environment as far as drug-taking is concerned. As to the reason for using those particular substances, 60% of the Ss mentioned pleasure derived from them, 23% mentioned their competitive price, while 17% reported about their easy availability. So, epicurean considerations seem to be the principal motivating factor behind substance-use. In response to the query regarding the effects experienced following drug-intake, 65% of the Ss reported light and pleasant feelings, 20% mentioned feelings of weakness, whereas 15% reported mixed feelings. Asked if they faced any problems because of substance-use, 54% of the respondents reported somatic symptoms like insomnia, nausea and trembling of hands and legs, 30% said they were bothered by psychological disturbances, e.g. ‘this is a bad habit I have contracted’, ‘people think ill of me’, while 16% expressed no problem. Asked if they were aware of harm caused by drugs, 82% of the Ss replied in the affirmative while only 18% responded in the negative. This shows how the pleasure principle outbids knowledge of deleterious effects as far as addicts are concerned. To the question, ‘why don’t you give up the habit?‘, the responses were, ‘have been trying without success’ (38%); ‘experience very pleasant feelings, so the question of forsaking it does not arise’ (32%); ‘suffer from withdrawal symptoms’ (18%); and ‘are still trying’ (12%). These findings adduce that kicking the habit of substance-use is an uphill task. Asked if they sincerely wanted to get rid of the addiction, 42% of the Ss replied in the affirmative, 35% in the negative and the rest were undecided. These findings also indicate that derivation of pleasure is a dominating factor in sustaining the craving for drugs. It is particularly interesting to observe the differing personality pattern of the drug addicts as Tables 1 and 2 demonstrate. It can be seen from Tables 1 and 2 that P and N scores of both the comparative groups are much higher than those of the normative groups (7.53 + 4.09 vs 3.25 f 2.81; 13.21 k 2.81 vs 8.51 + 4.20 Table
I. EPQ scores of the male drug addicts compared
P Drug addicts (n = 59) Norms (n = 544) lP < 0.05; **p < 0.01
7.53 * 4.09 3.25 + 2.81
I 4.72*’
E 9.10 + 3.70 10.34 + 3.32
to the norms
I
N
2.67
13.21 f 2.81 8.51 f 4.20
f
L
I
5.27**
8.34 + 2.77 II.71 i4.07
3.761
Drug
121
addiction
Table 2. EPQ scores of the female drug addicts compared
P Drug addicts (n = 11)
Norms
(n = 531)
5.63 + 3.86 2.69 + 2.60
f
E
5.17**
8.67 f 2.62 9.98 + 3.56
to the nmms
t
N
2.83
14.01 + 3.14 9.52 + 4.51
t
L
t
5.83**
9.23 + 2.87 12.54 + 3.83
3.63*
‘P < 0.05; “P < 0.01
and 5.63 + 3.86 vs 2.69 + 2.60; 14.01 &-3.14 vs 9.52 + 4.51 for males and females, respectively. These findings suggest that both male and female drug addicts are inordinately tough-minded as well as highly emotional. An adult high P-scorer may be described as being solitary, insensitive, lacking in feeling and empathy, cruel and inhumane, hostile to others, aggressive, has a liking for oddand A high N-individual is a ‘worrier’, his/her main characteristic being a constant preoccupation with things that might go wrong, and a strong emotional reaction of anxiety to these thoughts which interferes with his/her proper adjustment making him/her react in irrational, sometimes rigid ways. He/she is moody, frequently depressed and sleeps badly. The findings of this study correspond to those of Teasdale, Seagraves and Zacune (1971) in England and Cepelak (1973) in Czechoslovakia. It is interesting to observe that the findings also bear out Eysencks’ hypothesis that personality is involved in drug-using and drinking behaviour. That is, a high P and N personality characterizes drug-users and alcoholics. Criminals also show high P and N scores (Eysenck & Eysenck, 1971). Since illicit use of drugs may be likened to criminality it is of further interest to note that P and N scores of both criminals and addicts are similarly elevated. The E scores of both the comparative groups are, however, slightly lower than those of the normative groups (9.10 f 3.70 vs 10.34 f 3.32 and 8.67 f 2.62 vs 9.98 f 3.56 for males and females, respectively). According to these findings both the male and female drug addicts seem relatively introverted, i.e. less outgoing. This finding is also in the expected direction. Akter (1991) in a study of 56 drug addicts of Bangladesh observes that personality is certainly an important factor in drug addiction. The Ss of that study were also found to be highly emotional, venturesome/indulging in strange experiences-disregarding their consequences-and introverted. Also in that study, peer pressure was reported to be a potent factor in starting the habit, other factors involved being curiosity, boredom and lack of conscience and self-control. The results of this study are very much in line with other work on drugs, It is of further interest to note that both the comparative groups scored much lower on L than the normative groups (8.34 f 2.77 vs 11.71 f 4.07 and 9.23 + 2.87 vs 12.54 + 3.83 for males and females, respectively). These findings adduce that the respondents of this study did not dissimulate. Moreover, they demonstrate that drug addicts are much more straightforward than most people, as the former seem less concerned about social desirability than the latter. A large scale research project on drug addiction throughout the country would throw more useful light on this baffling problem. REFERENCES Akter, N. R. (1991). Personality assessment of drug addicts. Unpublished M.Sc. Thesis. University of Dhaka, Dhaka. Cepelak, J. (1973). ‘Psychoticism’ in toxicomans-imprisoned delinquents. Actiuifas Neruosa Superior, 15, 155-156. Eysenck, H. J. & Eysenck, S. B. G. (1975). Manual of the Eysenck Personaliry Questionnaire (Junior and adult). London: Hodder & Stoughton. Eysenck, S. B. G. & Eysenck, H. J. (1971). A comparative study of criminals and matched controls on three dimensions of personality. British Journal Social and Clinical Psychology, IO, 362-366. Gossop, M. (1987). Major addictions: Investigation. In Lindsay, S. J. E. & Powell, G. E. (Eds), A handbook of clinical adult psychology. Aldershot (England): Gower. Rahman, M. A. & Eysenck, S. B. G. (1980). National differences in personality: Bangladesh and England. Bangladesh Journal of Psychology, 6, 113-I 19. Teasdale, J. D., Seagraves, R. T. & Zacune, J. (1971). Psychoticism in drug-users. British Journal of Social and Clinical Psychology, IO, 16c-171.