Exploring help-seeking pathways and disparities in substance use disorder care in India: A multicenter cross-sectional study.

Autor:	Ghosh A; Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Mahintamani T; Department of Addiction Medicine, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India., Somani A; Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India., Mukherjee D; Department of Addiction Medicine, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India., Padhy S; Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India., Khanra S; Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India., Arya S; Institute of Psychiatry, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India., Suthar N; Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India., Prasad S; Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India., Haokip HR; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Guin A; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Rina K; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Basu A; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Mishra S; Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India., Das B; Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India., Gupta R; Institute of Psychiatry, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India., Singh LK; Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India., Nebhinani N; Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India., Kumar P; Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India., Kaur R; Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Basu D; Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Jazyk:	angličtina
Zdroj:	Indian journal of psychiatry [Indian J Psychiatry] 2024 Jun; Vol. 66 (6), pp. 528-537. Date of Electronic Publication: 2024 Jun 19.
DOI:	10.4103/indianjpsychiatry.indianjpsychiatry_123_24
Abstrakt:	Background: Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. Aim: We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. Methods: This was a cross-sectional study of consecutive, consenting adults (18-65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization's pathway encounter form. Results: Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4-6%) and self-medication (2-8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. Conclusion: There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Indian Journal of Psychiatry.)
Databáze:	MEDLINE
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