Experiences and coping of family members of individuals with substance use disorder residing in an urban squatter settlements area of Karachi, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Addiction is referred as dependence of illicit drugs, physically and psychologically (1). Individuals with substance use disorders use these illicit drugs regardless of their disastrous effects on their life. As per WHO, the disease burden is almost 5.5% globally (1). It is an alarming condition that in Pakistan, 0.8 million people aged 15-64 are with substance use disorder using injectable drugs and opioids as identified by UNODC (United Nations Office on Drugs and Crime) (5). Family is the most important source in providing care and help to individuals with substance use disorder (6). An individual with a substance use disorder in the family disturbs family's all aspects leading to numerous problems (6). Studies have shown that behavioral and psychological impact has resulted better on others as comparatively to the families with substance abuse due to psycho-social stress and burden on them. In addition to this, burden is basically determined by environment, ineffective coping of family members and tolerating the behavior of individual with substance use disorder which further disrupts family's physical, mental health, social and financial aspects (6). Besides, world leaders are committed to achieve sustainable development goals by 2030 and its third goal emphasizes on good health and well-being (29). One of its targets is to strengthen the prevention of substance abuse and providing developed healthcare with trained health workforce in order to achieve universal health coverage. Where, health is referred as a state of complete physical, mental and social wellbeing (1). Thus, there is a need to explore coping mechanisms, experiences of family members of individual with substance use disorder and its contributing factors on physical and mental well-being. Study Objectives The study aims to explore the coping mechanisms and experiences of families of individuals with substance use disorder living in an urban squatter settlement area of Karachiz Pakistan. Besides, this study would identify the impacts on affected families interms of their mental and physical health. 4 Methodology Exploratory qualitative study design was used including in-depth interviews of family members of individuals with substance use disorder residing at an urban squatter settlement area of Karachi. First degree relatives of individuals with substance abuse including parents, spouse, siblings, children above 18 years of age inducted for in-depth interview through a semi-structured interview guide which was recorded during interviews. Besides this, a non-governmental organization dealing with drug addiction and its alleviation was approached to refer affected family members for counseling purposes. Besides this, researcher interviewed their psychologists as service providers who train/ counsel family members of substance use disorder. Written informed consents were taken from both family member and service provider. Transcripts of in-depth interviews were developed, and manual data analysis was carried out. Results Findings from the study revealed the experiences and coping of affected families with substance abuse. It is found that affected families living with substance abuse facing a huge financial, physical and mental stress and have a positive relationship with mal-adaptive coping. Hence, study has proposed ways to overcome their distress. Conclusion Affected families with substance abuse articulated their experiences and coping skills which were found to be in-effective and mal-adaptive coping strategies were adopted. Numerous barriers highlighted through the findings of study such as; lack of awareness, low provision of facilities for affected families and substance addicts which needs attention from law and order. Consequently, constructive strategies for example; family therapy and stress management need to be implemented for affected families.

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