ALARMING SIGNALS OF DRUG ADDICTION AMONG THE SOUTHERN YOUTHS IN BANGLADESH : A SURVEY BASED RESEARCH

By the definition of WHO (World Health Organization), Drug is a chemical substance of natural, synthetic and semi-synthetic origin intended for therapeutic, diagnostic and palliative use or for modifying physiological and psychological functions of man and animal. Because of the definite effect on body physiology drugs may show some addictive potential of mild, moderate or severe effects. Over the last two decades the scenario of drug abuse has increased in such a rate that it has already reached every part of the world. At this moment, no nation can claim to be immune from the claws of substance abuse [1]. Here, it won’t be unwise to mention that drugs have a wide range of adverse effects


INTRODUCTION
By the definition of WHO (World Health Organization), Drug is a chemical substance of natural, synthetic and semi-synthetic origin intended for therapeutic, diagnostic and palliative use or for modifying physiological and psychological functions of man and animal. Because of the definite effect on body physiology drugs may show some addictive potential of mild, moderate or severe effects. Over the last two decades the scenario of drug abuse has increased in such a rate that it has already reached every part of the world. At this moment, no nation can claim to be immune from the claws of substance abuse [1]. Here, it won't be unwise to mention that drugs have a wide range of adverse effects Correspondence: Debendra Nath Roy, Department of Pharmacy, Faculty of Biological Science and Technology, Jessore University of Science and Technology, Jessore-7408, Bangladesh. E-mail: dn.roy@just.edu.bd on human civilization. Apart from destroying public health, it also shows devastating effect on Socioeconomic development, corrupts institution, threatens political stability and in some severe cases endangers state security [2][3].
Drug related addiction is now prevalent everywhere in Bangladesh; in the house, institution, markets, streets, slums, workplace, and parks of both rural and urban areas [4]. Almost all segments of society are badly affected by this severe problem. Southern districts of Bangladesh are deeply troubled by the addiction problem because of alarmingly increasing numbers of drug addicts now a day, key cause being the easy availability of abusing substances. More than 65 lakh people are drug addicted and the number is on steep rise recently. With the time past, our body grows tolerance of that drug and user must take more drugs to reproduce same effect that he needed earlier. A lot of adolescent users start their experiments through smoking cannabis (marijuana), cigarettes specially prepared with higher intoxicant items. They may also graduate to out of such practices, the use heroin. They basically start snorting (sniffing) it and later promotes to use it intravenously (shooting the mainline) [5].
From different studies, it appears that in urban life, working classes of population are the major group of populations consuming low priced drugs like cannabis (marijuana), tranquilizers, injecting drugs and heroin. Population of these classes generally lives in slums and densely populated parts of cities. Yaba and Phensedyl for their very high price are mainly consumed among the upper and upper middle classes of population. As considered as a symbol of smartness, Yaba has the highest prevalence among the student communities of private universities and English medium education system. It has been found in a study that 65% addicts start with liqueur, hemp and tend to take heroin, pethidine and other more severe forms of drugs. A great percentage of them were unemployed, 25% of those numbers were students and among them 10% were female addicts. Causes of taking drugs for the first time is diverse, about 50% of addicts first took drugs through their addict friends and under pressure. 20% out of frustration and another 15% out of curiosity. Highest percentages of addicts were between the age ranges of 23-26 years [6].
It is found that, youth abuse drugs due to complex social and peer influence, curiosity, depression, frustration, influences, surrounding psychological and subcultural environment. Indiscipline, parent negligence, parent-child conflict, family disorganization, loss of spouse strife, isolation, lack of emotional support, rejection in love, over protection, failure, unemployment is considered as the major risk factors responsible for drug abuse among the peoples alongside the easy availability of abusing substances [7][8].
Drug abuse has a wide range of effects namely physical, psychological, familial, social, economic and National effects. It leads to family breakage, job problems, alienation, isolation and many a more social problem. Addicts faces a huge stratum of problems can be identified as loss of interest in work, indifference to family responsibility, loss of ability to concentrate which may result in discorded family relationships, increase in sexual desire or misbehavior, violence, boosting up criminal offences as mentioned [9][10]. It also disrupts one's decision making capabilities and disturbs the perception of outer reality. Not only have the addicts that falls victim to addiction but also their family and society felled the heat [11]. With increased addiction increased moral degradation, crimes like theft, robbery, terrorism, hijacking etc. takes place [12]. Addiction has severe effects on the function of family. It changes the relationship among the members of the family and the role of those members that they play. Suddenly it becomes the topmost priority of the family [13][14]. An irrefutable argument was presented by oruber and Taylor [15] that we should see addiction from the family perspective to understand it properly. Predominantly adults have been the focal point for the research and clinical literature for substance abuse and dependency disorders [16][17][18]. Because youths faces a bit different experience in case of substance dependancy than adults [19]. But insight on a certain family's functioning with an addict can be seen through individual stories that tell the story or experience from personal or family's perspective [20][21][22][23].
Although not being a drug producing country, drug abuse has become an epidemic here in Bangladesh because of its geographical location as it is in between the golden and crescent triangle and passing of the crescent ways through it. As a result, Bangladesh has already become a huge marketplace for the drug traders of national, international and regional roots. During the last decade drug has flooded over the whole country through a compact network of distributive channels [24].
Bangladesh is surrounded by India from three sides and shares some of its borders with Myanmar from the south-eastern side. Nearly all the 32 border districts of Bangladesh have high vulnerability for drug trafficking. For the southern districts like oopalganj, Bagerhat, Narail and Khulna, Jessore is the entrance for illegal drug trafficking and circulation as being the border district and most prone areas are Chowgacha, Benapole, Sharsha, Jhikargacha [25]. Bangladesh government has also responded to this problem through a special act named Drug Control Act-1990 and especially employed department of narcotics for constant vigilance [26].
The motive of this survey based research is to reveal and analyze the drug addiction threats, main causes, sources of drugs, sources of money, availability of drugs, effects on physical and psychological conditions and find out the prevalence of drug addiction. This survey will cover four geographically vital cities of southern Bangladesh. Attempt has been made in this paper to portray the brief picture of the condition of drug addiction in these southern districts.

Study design:
The study was a prospective, cross sectional survey Ethics approval: The study was conducted following the general principles of World Medical Association (WMA) declarations of Helsinki and which was performed in collaboration with all the persons associated with their full consent. Voluntary participation of the respondents as well as the confidentiality of their information was strictly maintained. Alongside that, informal oral consent from each respondent was obtained. Inclusion criteria: Participants above the age of 10 years are included and those below that are excluded from the study.

Exclusion criteria:
The patients who were mentally retarded or disabled and who were suffering from psychiatric disorders were voluntarily excluded from the study.
Sample size: Total 300 substance abusers were participated in this study

Methodology:
The study was based on primary data. A set of questionnaires was self-designed and was evaluated and validated by the "Board of Research Evaluators" formed by the faculty members of the Pharmacy department of the two universities. Respondents were requested to answer the question on the questionnaire. Total 300 substance abusers were investigated by majorly visiting at their home and sometimes visiting the places where they usually take drugs. Some of the questionnaires were excluded from the study during the analysis due to inadequate information.
Statistical analysis: Descriptive statistics were applied to the collected data using Microsoft Excel. Simple statistical methods like Bar and Pie diagram were used to calculate the data and finally expressed in percentages.

RESULTS
This survey which is actually cross sectional and is carried out in the southern districts namely oopalganj, Khulna, Bagerhat and Narail. Peoples investigated were sub-divided into four groups for statistical purpose and all the participants are above 10 years of age. From these areas we have found that among the peoples of these areas a lot of peoples are currently taking drugs and a considerable percentage of population among these peoples have developed dependence and are addicted to it.
From our cross-sectional survey, we found that here in our prospective area addicts are predominantly young males mostly between the ages of 10-30. Here 9% of all the addicts are between 10-18 years' age, 73% between the age of 18-30 and 12% between the age of 30-45 and 6% between the ages of 45-60 ( Figure 1).
Various kinds of drugs are currently being used by the addicts the major and mostly used being the cannabis because of its availability and lost cost of purchasing. Addicted peoples are currently using cannabis the most (48%), Yaba being the second most common drug with the percentage of 19%, Phensedyl being the third (17%) and percentage of using sedative and hypnotics are 4% and shown in (Figure-2). Peoples using drugs are predominantly men (95%).
Among the diverse cause of starting drug use, curiosity, surrounding environment and Influence of friends has been the major ones. Depression and emotional stress being the less prominent ones (Figure-4).
Addicts usually get their drugs from diverse sources mostly from the local dealers who collect their drugs from the smugglers and other bigger dealers. Addicts here in these areas mostly collects drugs from locality (53%) like friends, other addicts, acquaintances etc., local dealers (30%) being the second most common source of drug for addicts (Figure-5). In these southern parts the locality is the most prominent drug distribution source as these drugs can be purchased from anywhere in the locality as the drug regulation here in these areas are not so strict.
As most of the addicts are youths, most of them are collecting drug from their pocket money (30%), some from business (20%) and some from their job (23%) and others (27%) (Figure-6). There are humongous types of ways to collect the money for purchasing the drugs and some of them don't hesitate to commit crimes to for that purpose.
Among the people doing drugs, about 61% addicts are having either physical or psychological complications while other 39% of users haven't noticed any complication yet (Figure-7).
About 65% of current drug addicts have tried to give up addiction before and other 35% haven't ( Figure-8). Some of the addicts are also considering to give up addiction as they are facing some complication, mostly physical and somewhat mental.

DISCUSSION
Our study attempts to find out the recent condition of drug addiction in the population of these four districts of southern Bangladesh. The result in this study shows the current findings of the condition in these districts and this reveals the severity of the condition of addiction. Addiction has become very common among the youths of these areas, mostly between the age of 10-30. Among them 73% are of 18-30 years range. Main cause of this addiction prevalence is the easy availabil- This threat is so high to the youth and social balance that immediate measures are a must. The highest recommendation is to control illegal drug trafficking, followed by enforcing and implementation of proper laws, creating social awareness and resistance, arrangement of proper treatment and rehabilitation of addicts [28].

CONCLUSION
After finishing the study of the survey on the peoples of these places it is confirmed that the present condition of drug addiction in these area is quite alarming and needs immediate and appropriate steps so that the present condition can be prevented from being worst.
Suggestions: The existing system should be reformed and new laws should be promulgated to lessen the availability of abusive substances. Doctors should be extra careful in prescribing abusive drugs so that it cannot be used for abuse. Drug stores and pharmacy shops mustn't sell drugs without prescription. Law enforcement agency should be strict to stop the entire illegal drug trafficking through the border areas and lessen the availability of drugs. Programs regarding awareness rising can be organized to make youth aware of the threats of addiction. Family members should consider strengthening family bondage and government should design proper plan for treatment of addicted personnel's. Regarding the recent ominous threat of addiction, we have no further time to lapse and the information available thereby, would help to formulate an effective national policy to combat the deadly epidemic more efficiently in near future.