Substance abuse among under trial murder and sexual assault accused in Raichur district prison, Karnataka - A cross sectional descriptive study

 

Sunil Kumar Kainoor¹, Gopinath M^2*, Suraj³, Ravi Shankar M G⁴

 

 

Abstract               Background: The study has been carried out to find out the pattern of substance abuse and socio-demographic factors, among under trial murder and sexual assault accused in Raichur district prison, Karnataka. Materials and Methods: It is a cross sectional descriptive study, designed and carried out among under trial murder and sexual assault accused in Raichur district prison, Karnataka. With their consent, information about the pattern of the substance abuse was assessed by the use of WHO-based ASSIST¹ questionnaire (Alcohol, Smoking, and Substance Involvement Screening Test) with few modifications to screen problem or risky use of tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, sedatives, hallucinogens, inhalants, opioid, and “other drugs” that do not fall into the previous nine categories. Later with the help of Microsoft excel data was analyzed and explained in turns of mean and percentage. Prior permission from concerned jail authority was taken. Results: Among the 117 under trail prisoners interviewed, 96 persons had one or the other form of substance abuse whereas 21 persons had no history of any substance abuse in their life time. Out of 96 prisoners, 89 are male and remaining 7 are females. Among 96 persons, 85 persons are charged under murder and 11 person’s trialled under sexual offences cases. Age group between 20 years-30 years and 31years-40 years are common victims of substance abuse with 53 cases and 28 cases respectively. In our study, 32 persons had history of single substance abuse whereas 64 persons had multiple substance abuse patterns. Tobacco, Alcohol, Chloral hydrate powder, Marijuana and sedatives are the common substances abused. Conclusion: There are several socio-demographic factors which are responsible for or instigate person for substance abuse, taking the matter into serious note its responsibility of all of us including government, society, media and family to educate and spread awareness about ill effects of substance abuse.

Key Words: Substance abuse, under trial, prisoners.

 

 

 

INTRODUCTION

Substance abuse is often used interchangeably with “substance dependence,” though abuse and dependence occupy different ends of a continuum of destructive behavior. Substance abuse is persistent or sporadic excessive drug use, inconsistent with or unrelated to acceptable medical practice. It arises out of a maladaptive pattern of substance use, manifested by recurrent and significant adverse consequences related to the repeated intake of the substance. These problems must occur recurrently during the same 12 months of period. It includes only harmful consequences of repeated use. Substance dependence arise out of a maladaptive pattern of substance use, leading to a cluster of behavioral, cognitive and physiological phenomenon that develops after repeated intake. It includes strong desire to take drug, difficulties in controlling its use, persisting in its use despite harmful consequences; a higher priority is given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.² Substance abuse has been associated with violent behaviour for many decades. While the relationship is the same today as it was in the past, the pervasiveness of the association, and the consequences, are more dramatic. There are two ways in which substance abuse is related to violence. First, violence can be and is perpetrated under the influence of substances, and second, violence related to substance abuse stems from the trade in drugs.³ Criminal acts can range from activities such as driving under the influence of alcohol or drugs, domestic violence, robberies, assaults, prostitution and rape.⁴ As far back as 1995, the Journal of Health Care for the Poor and Underserveddescribed the relationship between substance abuse and violence as a case of “cause and consequence.” The connection between drug addiction, alcoholism, and violence crosses many thresholds (individual psychology, public health, and domestic violence).³ The complex relationship between substance abuse (alcoholism and drug dependence) and crimes can be differentiated into three types according to Aggression and Violent Behaviour journal i.e: Use related crimes, Economic related crimes and System related crimes.⁵ Raichur is one of the district of Karnataka state (India) which is predominantly agricultural based; small scale industries, thermal power stations and large APMC (Agricultural Produce Market Committee) trade centres bring different types of individuals in different age groups from neighbouring district and states for work and trade. Two medical and engineering colleges along with number of degree colleges gather thousands of students from neighbouring villages and talukas. This will bring exchange of views, opinion, and customs along with substance abuse habits, in people and students. Even though it is difficult to carry out a study in a large scale, as for as substance abuse considered, we made a sincere effort to know the pattern of substance abuse in under trial accused in Raichur district jail.

MATERIALS AND METHOD

Information about the pattern of the substance abuse was assessed by asking set of questions similar to WHO-based ASSIST¹ questionnaire with few modifications to screen problem or risky use of tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, sedatives, hallucinogens, inhalants, opioid, and “other drugs” that do not fall into the previous nine categories. The set questions are as follows:

Question 1 asks about history of substance abuse at any stage of their lifetime.

Question 2 asks about age of the prisoner.

Question 3 asks about their residential background like urban/rural.

Question 4 asks about the educational qualification.

Question 5 asks about their occupation.

Question 6 asks about form of substance abuse like whether he/she is using single/multiple substances.

Question 7 asks about type of substance abused.

Question 8 asks about reason for starting the substance abuse.

Question 9 asks about people with whom they started substance abuse.

Question 10 asks about did they faced problems due to substance abuse

Question 11 asks about did they tried to stop substance abuse at any stage

Question 12 asks about did they took any treatment for substance abuse

Information on the socio-demographic data, criminal profile, and expenditure on drugs was taken through the investigator-designed Proforma from each subject. All the 117 prisoners completed the study. Results are expressed as number of cases and percentages. Prior to the start of the study, visited the district jail Raichur, Karnataka and explained about proposed study to the district jail superintendent and got the permission letter.

 

RESULTS

Table 1: Prevalence of substance abuse among under trial prisoners

Out of 117 under trial prisoners interviewed, 96 people (82%) gave history of substance abuse and 21 people (18%) are free from any form of substance abuse.

 

Table 2: Reason for trial

In our study, out of 96 cases of substance abuse 85 cases are under trial for murder (88.54%) where as 11 cases are under trial for sexual offences (11.45%) cases.

Table 3: Male: Female Ratio

Male: Female ratio of substance abuse in our study is 12.7:1, indicating male predominance of substance abuse.

 

Table 4: Marital Status

In our study, the substance abuse was more common among married people (68.75%) compared to unmarried people (31.25%).

 

Table 5: Residential Background of Prisoners

In our study, urban background prisoners (59.4 %) show more prevalence of substance abuse compared to rural background prisoners (40.6 %).

 

Table 6: Age of the prisoners

In our study, age group between 18-30 years (55.2 %) are the most common victims of substance abuse, followed by age group 31-40 years with 29.1 %, age group between 41-50 years- 8.32 %, and age group 51-60 years-6.24 %.

Table 7: Education

The study showed that, prevalence of substance abuse is more in uneducated prisoners (39.52 %), followed by prisoners who have education between 1^st std-5^th std (17.68 %). With 14.56 % each the 8^th std-10^th std and 11^th std-12^th std come in 3^rd position.

 

 

Table 8: Occupation

In our study, farmers (35.36 %) are the most common sufferers of substance abuse. With 19.76 % cases coolies are second most common victims followed by drivers (14.56 %) and businessman and factory workers who accounts for 7.4 % cases each.

 

Table 9: Monthly Income Of Family

It was observed that, substance abuse was most commonly observed among income group of Rs.2001-3000/- (65.62%), followed by income group of Rs.3001-6000/- (17.70%) and Rs.1000-2000/- (10.41%). From this it is clear that more than 90% of the substance abuse prisoners have income of Rs.1000-6000/- i.e. low income group.

Table 10: Form of substance abuse

Out of 96 cases of substance abuse, we observed 66.66% cases showed multiple forms of substance abuse whereas 33.33% cases showed single form of substance abuse.

 

Table 11: Type of substance abused

In our study, we observed that 83.33% individuals abused tobacco in one or the other form and 81.25% individuals abused alcohol. Interestingly 7.29% individuals abused chloral hydrate powder, 5.20% people marijuana and 3.12% people sedatives.

 

 

Table 12: Reason for starting substance abuse

In 53.12% cases, people started abusing substance because mere pleasure whereas in 19.79% cases it is due to stress. In 9.3% cases it is due to financial problems, in 7.29% cases it is due to peer pressure, love failure in 6.25% cases, marital problems in 3.12% cases and lack of family in 1.04% case.

 

Table 13: How got into substance abuse

Out of 96 cases of substance abuse individuals interviewed, 50% people told that they have entered web of substance abuse through their friends. Whereas 40.65% individuals told they have started it by themselves and in 9.37% cases they have trapped by relatives.

 

Table 14: Substance abuse lead to problems

Out of 96 cases of substance abuse, 46.87% individuals told that they have faced many problems due to this substance abuse regularly.

 

Table 15: Type of problems faced due to substance abuse

Ill heath/health upset/diseases (31.11% cases) is the most common problem faced by substance abuse victims, followed by financial problems (22.22% cases). Family discard and accidents accounted for 17.77% cases each. In 6.66% cases individual faced problem in working place and there is a 2.22% cases of suicidal attempt also.

Table 16: Tried To Stop

Out of 96 cases of substance abuse, 67.70% individuals tried to stop their substance abuse without any positive results.

Table 17: Approached For Treatment

In 19.79% cases, they have approached to the concerned person for treatment, since substance abuse had interfered with his normal daily life.

 

DISCUSSION

There is some gray area in understanding why some substance users will commit crimes and others do not. Robberies are often committed to support drug habits; assaults, rapes and violent crimes are often linked to drug use. Poverty, personality disorders, social and cultural factors, association with other users and previous incarceration or drug use will influence individual one or the other way as for as crimes are concerned. These issues all have an important role in understanding the risk of criminality and drug use.⁴ Singh GP at al. in their study at central jail Punjab observed that, average median age when subjects first started taking drugs is 20 years and started us­ing intravenous route for drugs is 26 years.⁶ An Indian survey in 2004 says that, the common age group when the subjects first started taking drugs is 21-30 yrs (46%).⁷ WHO report in the year 2010 says that, in the year 2004 India forms 0.42% (female) and 3.47 % (male) global burden of Prevalence alcohol use disorders. The same report also says that, India forms 0.03 % (female) and 0.24 % (male) global burden of Prevalence for drug use disorders.^8,9 Singh GP at al. in their study at central jail Punjab observed that, majority of the drug users were men (98.4%). Over representation of men in this study is in accordance with the prevalence of addiction in the society at large in the region. This disproportionate representation is indicative of the role of social factors in the epidemiology of substance dependence.⁶ Singh GP at al. in their study at central jail Punjab observed that, the rural background (63.6%) people were suffered a lot by drug use habbits.⁶ Karla I at al. in their study at one of the dead diction centre in Punjab observed that, resident of rural areas (85.5%) were common victims of substance abuse.¹⁰ Singh GP at al. in their study at central jail Punjab observed that, under matriculate (51.5%) were soft victims of drug abuse.⁶ We observed that, under matriculation (71.76%) constitutes major chunk of the substance abuse. We also observed in our study that, as the education level increases which in turn spread awareness among people the chances of substance abuse is less likely.

In both studies i.e Singh GP (30%) ⁶ and Karla I (42.5%) ¹⁰ the drug abuse was most common among farmers.

Singh GP at al. Observed that, the median monthly family income of the subjects was found to be 20,000 per month and “the problem is prevalent in middle-class enclaves.⁶ Another report says that, drug use on a national level is most noticeable “among the working poor.¹¹ Both Singh GP (53%)⁶ and Karla I (76%)¹⁰ observed that, substance abuse was common among married. Singh GP in their study observed that, 30% of subjects admitted of abusing more than two substances.⁶ Similarly 2004 national survey observed that, 22.3% are poly-drug users.⁷ An Indian survey in 2004 gives prevalence of substance abuse in India as follows, Alcohol: 21%, Cannabis: 3%, Opiates: 0.7% (heroin 0.2%), Any illicit drug: 3.6% (excl. tobacco and alcohol), IDUs (‘ever’): 0.1%.⁷ Singh GP in their study at central jail of Punjab, observed that, predominant substance used was poppy husk (45%).⁶ UN Report, based on the data from 203 drug treatment centres’ across India (collected during March 2000–November 2001), which singled out Punjab as the state with the highest levels of abuse of opium as well as propoxyphene, a commonly injected drug.¹² In a study conducted at central jail of Punjab by Singh GP at all. say that 73% of the study subjects were currently facing charges under NDPS Act.⁶ Drug use is intrinsically linked to prostitution, especially street prostitutes. Many prostitutes, men and women, are selling sex to support their drug habits.⁴ An Indian survey conducted in 2004 gives a view of Treatment Seekers as follows, Age: <20 yrs - 5%, 21-30 yrs - 33%, 31-40 yrs - 37%, >40 yrs - 25%, Unemployed: 20%, Single: 23%, Illiterate: 16%, Rural: 52%. Overall people who approached for treatment is 27%.⁷ Problems with substance use most often emerge during adolescence and young adulthood. Adolescent-onset SUDs are becoming the most significant public health problem affecting adolescents. Recent work by Merikangas and colleagues showed that 11.4% of adolescents have an SUD.¹³

 

CONCLUSION

Even though it’s wrong to quote that, all people who are having history of one or the other form of substance abuse are involved in anti-social activities and crimes, at the same time it’s also true that, people who are frequently involved in anti-social activities and crimes are victims of substance abuse. There will be frequent history of substance abuse, prior to or during the occurrence of crime. Commonly substance abuse leads to increase in crime rates; on the other hand in some instances crimes drag the persons into the web of substance abuse. There are several socio-demographic factors which are responsible for or instigate person for substance abuse like living conditions, family, employment, marital status and mental health.⁴, taking the matter into serious note its responsibility of all of us including government, society, media and family to educate and spread awareness about ill effects of substance abuse.

 

LIMITATIONS

The major limitation is that it is a cross-sectional study, with limited subjects and the findings are based on one time observation and the inmates belongs to a single prison, but still sincere efforts have been made to adequately assess the pattern and the associated factors related to substance abuse among the jail inmates.

 

RECOMMENDATION

• It is now an established fact beyond doubt that lifestyle management has got essentially an important role in handling the recurrent nature of this bio-psychosocial problem, which has attained a dangerous proportion in our society. Govern­ments and society should share their responsibility to overcome this burden and help substance abuse suffers to come out of this uphill task.
• Regular educational campaigns are organized to inform and empower youth to stay away from drugs.
• Peer educators be trained and empowered to use counselling skills in encouraging their peers to say no to drugs.
• Parental education must be given to ensure that parents do not expose their children to substance use.
• Law enforcement on the selling of drugs as well as the arrest and prosecution of abusers.
• Despite of the fact that there is a growing demand worldwide to acknowledge addiction as a medical problem, rather than an issue with Criminal Justice System, there are still many executions and penalties that occur worldwide for drug offences each year.
• Attract drug users to treatment. Develop programmes for vulnerable groups like youth, street children, women, prisons, etc.
• Periodic collection of data to monitor progress (multiple methods, parameters and sites)
• Funding for evidence-based interventions.

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