A matched case control study of factors of heroin addiction among male adults in Lahore, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Illicit drug use, especially narcotic addiction is on a continuous rise all over the world. In Pakistan, the number of heroin addicts increased from 20,000 in 1981 to an estimated 1.53 million (3.01 million drug addicts) in 1993. While a number of risk factors have been identified for narcotic addiction in developed countries, information on such factors in developing countries including Pakistan still needs evaluation, as to suggest proper interventions. This matched case control study aimed to evaluate the factors associated with heroin use among male heroin addicts of age 15 to 35 years in Lahore. We enrolled a total number of 233 triplets matched on neighborhood, at a case control ratio of l: 2, during July to September 1999. We defined a case as "a male, aged 15 to 35 yrs, has been using at least 0.5 gms of heroin twice weekly for the last 6 months, but not more than 05 years." The neighborhood matched control was "a male aged 15 to 35 yrs., who had never used heroin, hash or marijuana in his life." Data were collected through a structured interview, by trained interviewers, using a pre-tested questionnaire. Conditional logistic regression was done to study the independent effect of individual variable. Adjusted matched odds ratios with corresponding 95Vo confidence intervals were used to interpret the model. Formal schooling of the respondent (adj. mOR=2.4; 1.5-3.8), alcohol use (adj. mOR=4.2, 95% Cl ,2.3-7.6) use of prescribed psychoactive drugs (adj. mOR=4.1, 95VoCl; 1.8-10.6) and the presence of drug using peers (adj. mOR=5.6,95% CI;2.6- 12.1), were significantly associated with heroin addiction. Among childhood and early adulthood experiences, absence of father in the childhood (adj. mOR=2.9, 95% CI: 1.6-5.5), and parental disharmony in the family showed statistically significant IY relationships. We measured parental disharmony by categorizing the variable into frequent serious fights (adj. mOR=6.0, 95% CI ;2.8-16.6) and occasional serious fights (adj. mOR=4.3,95VoCI;2.4-7 .8) and comparing it against no serious fights among the parents. Similarly the presence of a drug user among similar age group family members is associated with heroin addiction (adj. mOR=2.4, 95% Cl; 1.3-4.8). Mother's non-formal schooling also showed to be an individual predictor of heroin use (adj. mOR=2.8, 95% CI; 1.7 -4.1) Based on these results, narcotic addiction seems to be a multi-factorial problem. We recommend a public awareness campaign, addressing the various facets of the problems i.e., alcoholism, misuse of licit drugs, educational programs for married couples especially the younger age groups.

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