Problematic level of drug use and its associated factors among illicit drug users in Sri Lanka: Experience from a multicentre study

Abstract

Background: Illicit drug use causes a variety of consequences including medical and social problems. Proper assessment of problematic drug use is useful before selecting to manage clients as inpatients, to avoid unnecessary admissions to rehabilitation centres. This study aimed to assess the problematic level of drug use among illicit drug users in selected rehabilitation centres in Sri Lanka using Drug Abuse Screening Test 20 (DAST 20). Methods: A cross-sectional study was conducted among 431 institutionalized male drug addicts from five selected rehabilitation centres in Sri Lanka. Sinhala translation of the DAST 20 was used to assess the problematic level of illicit drug use. Data analysis was done using SPSS statistical software (Version 20). Chi-square test and binary logistic regression were used to identify the predictors of problematic drug use. The level of significance was considered as 0.05. Results: A majority (n=374, 89.4%) of the sample were addicted to heroin. Nearly 17.0% (n=73) of the illicit drug users had a severe problematic level of addiction while over half of the sample (n=233, 54.1%) had a substantial level of addiction. Exposure to abuse during childhood/adolescence (OR=3.9, 95%CI=2.5-6.3, p<0.001), initiation of drug use in adolescence (OR=2.3, 95%CI=1.4-3.8, p<0.05), high income (OR=1.7, 95%CI=1.02-2.8, p<0.05) and being a non-manual worker (OR=2.6, 95%CI=1.001-6.5, p<0.05) were predictive of a high problematic level. Conclusions: Problematic level of drug use and its associated factors varied among the sample, indicating that some of the admissions to rehabilitation centres could actually be managed as outpatients