Yasir Rather
All Authors:Y. H. Rather1, F. Roub1, Z. Mir1, H. Susami2,3, D. S. Metzger4. 1Institute of Mental Health and Neuro Sciences–Kashmir, India; 2Abhipraya Foundation, Indonesia; 3Indonesia International Technology Transfer Center, Indonesia; 4University of Pennsylvania, United States
Background
To provide data necessary to inform public health policy, a national survey was conducted in Kashmir in 2022. The research was designed to provide district level estimates of proportion and absolute number of people who use substances and meet criteria for substance use disorder.
Method
1,500 substance users from 10 districts of Kashmir were enrolled using respondent-driven sampling (RDS). Inclusion criteria were 18-74 years or older, living in Kashmir for at least 1 year, reporting regular use of illicit substances or misuse of prescribed medication, and agreeing to participate in the study.
Results
Study participants were mostly 25-30 years of age, male (98.3%), less than high school education( 67%), and unmarried (61.7%). 25% reported no paid employment during the prior year. Opioids (85.3%) and cannabis (11.6%) were the substances most often used by the participants. For opioids, about 52% of the participants preferred injection and 48.5% injected daily. Overall, participants spent about INR 88,183.58 monthly (~USD 1,065) on heroin. Reusing syringes (65.1%) and sharing drug paraphernalia (53.5%) were common practices. 19.9% reported being diagnosed with HCV. Using the benchmark-multiplier methodology, opioid dependence in Kashmir is estimated to be 2.23% with total number of opioid dependent individuals estimated to be 52,404, of whom 32,097 inject.
Conclusion
This survey described a high prevalence of opioid use and injection among young people in Kashmir. These findings suggested the need for expanded substance use prevention interventions, access to evidence based treatments for opioid use disorder, testing and treatment for HIV and HCV.