International Research Journal of Social Sciences_____________________________________ ISSN 2319–3565Vol. 3(8), 30-34, August (2014) Int. Res. J. Social Sci. International Science Congress Association 30 Self Reported Reasons for Continuing Substance Use and Not Seeking Treatment and Quitting Substance Use and Seeking Treatment by Kashmiri Youth Khan Imran and Shah Showkat Ahmed Psychologist at Drug De-addiction Centre and Stress management Helpline, Police Control Room Srinagar, Jammu and Kashmir, INDIA Department of Psychology University of Kashmir Srinagar, Jammu and Kashmir, INDIAAvailable online at: www.isca.in, www.isca.me Received 5th June 2014, revised 14th July 2014, accepted 11th August 2014 AbstractThe present study investigates the self reported reasons for continuing substance use and not seeking treatment and quitting substance use and seeking treatment by Kashmiri youth. For the present study 150 substance dependent males were selected using Alcohol, Smoking and Substance Involvement Screening Test- V 3.0 (2010) from District Srinagar (JandK). These 150 participants consist of two groups. One group (N=50) was taken from different drug de-addiction centres. Another group (N=100), include those substance dependents who continue substance use and don’t seek treatment and were taken from different areas of District Srinagar. A self designed semi-structured interview schedule was used to collect the responses of the subjects pertaining to their reasons for continuing substance use and not seeking treatment or quitting substance use and seeking treatment. “Denial” (64%), “feeling in control of life and substance use” (23%) and “recreational drug use” (20%) emerged as the major self reported reasons for continuing substance use and not seeking treatment. Whereas “Adverse impact on health” (78%), “dignity of self and their families” (44%) and familial/parental concern and pressure (42%) emerged as the major self reported reasons for quitting substance use and seeking treatment. These results were discussed in light of previous research. Keywords:Substance dependence, drug addiction, subjective perspectives, continuing use, quitting use, treatment seeking. Introduction Substance (drug) abuse not only leads to immense human distress but also is a significant cause of crimes and violence all over the world. Today almost every part of the world seems engulfed with the curse of substance abuse and trafficking. A significant number of substance dependents (drug addicts), throughout the world live miserable lives. The world statistics on the drugs/substance abuse show a horrifying picture. With a huge turnover it has become a growing business. It has been estimated that about 190 million people throughout the world are involved in the abuse of one substance or other. The United Nations Office on Drugs and Crime (UNODC) in its 2012 World Drug Report estimates that between 153 million and 300 million people in the age range of 15–64 used illicit drugs at least once in the past year and attributes 1 in every 100 adult deaths annually to illicit drug use. The report further added that drug/substance use, especially injection drug use, is a significant cause of global burden of disease and as per the report 20% of injection drug users (IDUs) have HIV; 46.7% of IDUs have hepatitis C; and 14.6% of IDUs have hepatitis B, the report further mentioned that nonmedical use of prescription drugs continues to surge and is increasingly reported in poly-drug use combined with illicit substances. India too is engulfed with the problem of substance (drug) abuse, and the number of substance dependents (drug addicts) are increasing with every passing day. Recent surveys and studies show a very grim situation with reference to substance use in India3,4,5. Though a very comprehensive survey with regard to drug abuse has not been done in Kashmir valley of Jammu and Kashmir state but the situation here is not any different6,7. Considering the negative impact drug abuse has on the individual, his/her family and society and in a society where substance abuse is not an acceptable behaviour at all onemight wonder why certain people use psychoactive substances and then continue the use and not seek treatment while others quit substance use and seek treatment. Substance use behaviour can be understood in the light of multiple causes and there are different ways to comprehend those causes. Further several factors tend to determine whether a person is going to continue substance use and not seek treatment or whether he/she is going to quit substance use and seek treatment8,9,10. One way to understand all this is to simply ask the users about his/her substance (drug) use behaviour and not seeking treatment, or their quitting substance use and seeking treatment. Thought considerable research has been conducted into the causes of drug abuse, and the factors that determine whether such individuals will continue substance abuse or quit substance abuse, but it is equally important to understand the subjective perspectives of substance dependents about their continuing substance use behaviour and not seeking treatment or quitting International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(8), 30-34, August (2014) Int. Res. J. Social Sci.International Science Congress Association 31 drug use and seeking treatment. Further Substance dependents drug use may be highly correlated with their subjective reasons for it and thus highly important in determining whether they will continue drug use or whether they will quit drug use and seek treatment. The topic of substance dependence and various variables related to it has been extensively studied at global level but little is known about the subjective perspective of substance dependents about their continued substance use and not seeking treatment or their quitting of substance use and seeking treatment in the politically disturbed Kashmiri population. To date, very few studies have been published about subjective perspective of substance dependents in Kashmir, also the political unrest has led to many problems in Kashmir particularly increase in drug abuse. Due to lack of research on substance dependence in Kashmir province of J and K the intervention programmes and planning to deal with this social menace has not been too much successful instead the menace is increasing day by day. The authors made an attempt to understand the subjective perspective of drug dependents/substance dependents about their continued drug use and not seeking treatment and quitting substance use and seeking treatment. Thus this study may help us understand the problem of substance abuse from substance dependent’s point of view, it can also help health care professionals, counselors, and social workers to frame plans and policies for intervention programmes. Objectives: i.To identify the self reported reasons for continuing substance use and not seeking treatment as given by substance dependents. ii. To identify the self reported reasons for quitting substance use and seeking treatment as given by substance dependents. Material and Methods For the present study 150 drug addict/substance dependent males were selected using Alcohol, Smoking and Substance Involvement Screening Test- V 3.0 (2010)11 from District Srinagar. These 150 participants consist of two groups. One group of participants (N=50) were taken from different drug de-addiction centres viz. Drug De-addiction Centre Police Control Room Srinagar and Raahat Rehabilitation Centre Srinagar and include those substance dependents who had quitted substance abuse and were under treatment. Another group of participants (N=100) were taken from different areas of District Srinagar and comprised of those substance dependents who continue substance use and don’t seek treatment. Table-1 shows the detailed description of sample group. Tools: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, 2010): Alcohol, Smoking and Substance Involvement Screening Test is an internationally developed reliable and valid screening questionnaire to find out about people’s use of psychoactive substances11. The ASSIST contains total 8 questions, there are set of responses for each question and the subject has to choose one response for each question. Each response on ASSIST has a numerical score. At the end of the interview these scores are added together to produce a substance involvement and dependence score for each substance.Table-1 Detailed description of sample group Demographic variable Groups Frequency Percentage Total Age 16 to 20 54 36% 150 21 to 25 52 34.66% 26 to 30 30 20% 31 to 35 14 9.33% Occupation Government employee 20 13.3% 150 Private Employee 19 12.7% Business 43 28.7% Student 48 32 % Other 20 13.3% Education th to 10 th 60 40 % 150 11 th to Graduation 88 58.7 % Above graduation 2 1.3% Residential areaRural 50 33.3% 150 Urban 100 66.7% Marital StatusMarried 30 20% 150 Unmarried 120 80% FamilyNuclear family 79 52.7% 150 Joint family 71 47.3% International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(8), 30-34, August (2014) Int. Res. J. Social Sci.International Science Congress Association 32 Self Designed Semi-Structure Interview Schedule: A semi-structured interview schedule was prepared to collect the responses from subjects pertaining to their reasons for continuing substance use and not seeking treatment or quitting substance use and seeking treatment.Analysis: Content analysis was used to analyse the self reported responses of the substance dependents to open ended question. Results and Discussion Results: The content analysis of the self reported reasons for continuing substance/drug use and not seeking treatment as given by drug addicts/substance dependents brought many reasons to surface. As can be seen in the table-2 Denial emerged as the first major self reported reason (64%). Majority of the participants deny being addict/dependent and deny the presence of any problem as a result of drug/substance use. After denial “feeling in control” emerged as the second most reported reason (23%) and “Recreational drug use” (i;e they reasoned using drugs for enjoyment and fun) emerged as the third major reported reason (20%) for continuing substance use and not seeking treatment. The other reasons for continuing substance use and not seeking treatmentwere found as “relieving tension or tension reduction” (16%). “Unawareness about treatment (de-addiction process)” and “stigma” were equally reported (13%), “inability to stop substance use and feeling dependent on substances/drugs” (10%), “hope that the problem will solve on its own” (7%) “Treatment would not help” (5%) (Perceived the treatment as not helping). Further stress and peer pressure were equally (3%) reported as reasons for not seeking treatment and continuing substance use. Interestingly “not able to afford treatment” was very less reported (2%). 6% of the participant gave reasons other than those mentioned above for continuing drug use and not seeking treatment. The analysis of the self reported reasons for quitting substance use and seeking treatment as given by the participants (substance dependents undergoing treatment in de-addiction centres) brought many important factors to the surface. Table-3 shows that “Adverse impact on health” (78%) came out to be as the major self reported reason for quitting substance use and seeking treatment. After “adverse impact on health” dignity of self and family” (44%) came out to be as the second and “family concern and family pressure”(42%) was found as the third major self reported reason for quitting substance use and seeking treatment as reported by the participants. The other self reported reasons for quitting substance use and seeking treatment were as: “Future life concern” (26%). “Conscience (because of the calling from their conscience)” and “social consequences or social pressure” were reported equally (16%). “Occupational impairment” (14%), “economic adversity (10%), fear of losing control (fear of going crazy or the fear of committing some crime in drugged state) (6%), “revival of normal functioning” (4%) and “positive peer influence” (2%). Discussion: The present endeavour aimed at studying the self reported reasons given by drug addicts/substance dependents forcontinuing substance use and not seeking treatment or quitting Substance use and seeking treatment. Table-2 Showing frequency and percentage of various self reported reasons for continuing substance use and not seeking treatment as given by drug addicts/substance dependents Self reported reasons for continuing substance use and not seeking treatment. Frequency Percentage Denial (denial of problem and denial of being addict) 64 64% Feeling in control 23 23% Recreational use (Enjoy drug use/use drugs for fun)20 20% Relieve tension/ Tension reduction 16 16% Unawareness about treatment options 13 13% Stigma 13 13% Inability to stop/control drug use 10 10% Hope the problem will solve on its own 7 7% Other. 6 6% Treatment would not help/ Perceived treatment as not helping. 5 5% Peer pressure 3 3% Stress 3 3% Not able to afford treatment 2 2% N=100 International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(8), 30-34, August (2014) Int. Res. J. Social Sci.International Science Congress Association 33 Table-3 Showing frequency and percentage of various self reported reasons for quitting substance use and seeking treatment as given by drug addicts/substance dependents Self reported reasons for quitting substance use and seeking treatment Frequency Percentage Adverse impact on health 39 78% Dignity/honour of self and Family 22 44% Family /parental concern and Pressure 21 42% Future life concern 13 26% Conscience 8 16% Social consequences/Pressure 8 16% Occupational Impairment/Concern 7 14% Economic adversity /Economic Reason 5 10% Fear of losing control 3 6% Revival of normal functioning 2 4% Positive peer influence 1 2% N= 50 While using content analysis of the self reported reasons for continuing substance abuse and not seeking treatment “denial” (64%) emerged as the first major self reported reason given by substance dependents for continuing drug/substance use and not seeking treatment followed by “feeling in control of life and substance use” (23%) and “Enjoying drug use (recreational drug use)”(20%). Further “not being able to afford treatment” (2%) emerged as the least reported reason for continuing substance abuse and not seeking treatment. The above reasons point towards the fact that substance dependents don’t acknowledge being dependent on any substance (being addicted) or having any problem as a result of substance abuse, and thus their continued substance abuse and not seeking treatment is self understood. When a person doesn’t acknowledge being dependent on a substance/drug or having a problem because of substance abuse, how come he/she will quit substance abuse and seek treatment. Similarly “feeling in control of substance use and life” will not draw substance dependents to treatment or quitting substance use. Drug addicts/substance dependents who feel that things are in their control and not out of control may continue substance abuse and may not realise the need for treatment. Further if a person enjoys any behaviour, it is most likely that the individual may continue such behaviour and will not stop it. There are some research evidences pertaining to self reported reasons of continuing drug/substance use as given by substance dependents. In a study by Johnston and O’Malley the reasons which drug addicts gave for using drugs were “to have a good time with friends” , “to get high” ,“to get through the day,” “to relieve boredom,” “to deal with anger and frustration,” etc12. Similarly Johnston, L. D in a study found that the reasons given by the sample for using drugs were , “to experiment”, “to feel good and get high”, “to have a good time with friends”, “to relax or relieve tension”, “to get away from my problems”, “to seek insight”, and “to deal with anger or frustration”13. While analysing the self reported reasons for quitting substance use and seeking treatment, “Adverse impact on health” (78%) came out to be as the first major self reported reason for quitting substance use and seeking treatment. Since continued substance use tends to have very negative effect on the health of the user, so deterioration of health because of drug use might compel a person to seek treatment and join de-addiction centre. This is consistent with a study conducted by Johnston, L.D. In his study it was found that two most commonly mentioned reasons for abstainers were concerns that they might damage themselves psychologically and/or physically13. The second major reason found for quitting substance use and seeking treatment was “dignity of self and their families” (44%). Since drug use is not an acceptable behaviour at all in the target population because of cultural and religious sensitivity of the region, so if a person is found using drugs, people tend to have a very negative image of him/her, he/she is perceived as a criminal, and is not given any respect at all. Moreover the dignity and honour of the family of the substance abusers is also highly affected. Such an impact on the honour and dignity of the individual and his/her family might draw an individual towards quitting substance abuse and seeking treatment. Drug use tends to have negative effect not only on the individual but also on his family. It may hamper marriage/relationships, home/family life, mental health and wellbeing of the family members. It is also quite natural that the family might be concerned about the health and future life of their ward as well. So it can be understood that an addict may seek treatment either because of the family concern or sometimes the family may pressurise a person to seek treatment. The results of the present study point towards the fact that it is very important to raise awareness among the general population particularly youth about the adverse impact of drug use particularly on health, social life of the individual and his/her family and also about different psychoactive substances/drugs, so that the drug users will understand that how initially they may feel not dependent on drugs/substances when actually they may be and how they may be in denial of such a problem. Further as the study suggests that that many drug addicts feel in International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(8), 30-34, August (2014) Int. Res. J. Social Sci.International Science Congress Association 34 control of their drug use and feel like they can quit drug use any time they like so it is again important to raise awareness among general public regarding how an individual feels in control of drug use when he/she actually is not and how this is just a false reason given by drug addicts for their continued drug use behaviour. Also in this study many drug addicts reported recreational drug use or using drugs for fun and pleasure, again such a results suggest it is important to make such individuals aware about the fact that initially the drug addict may feel happiness and pleasure by their drug use but with continued use they may become tolerant to the effects of drugs and have withdrawals after stopping drug use and may finally develop dependence. Conclusion The results of the present study provided significant insight into the reasons for continued substance use or quitting substance use behaviour of substance dependents.“Denial”, “feeling in control of life and substance use” and “recreational drug use” emerged as the major self reported reasons for continuing substance use and not seeking treatment. Whereas “Adverse impact on health”, “dignity of self and their families” and familial/parental concern and pressure emerged as the major self reported reasons for quitting substance use and seeking treatment. These findings can be very helpful for policy makers and health professionals in the field of mental health and rehabilitation. References 1.Miller W.R. and Sanchez V.C., Motivating young adults for treatment and lifestyle change. In G. Howard (Ed.) 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