Ahmadi J, Arabi H, Mansouri Y. Prevalence of substance abuse among offspring of opioid addicts. Addictive Behaviors (2003) 28:591-595
Dear Colleagues,
This fascinating study from Iran tells us some basic facts about drug use and inheritance in that population. With major differences with western experience in drug and alcohol use there, the significance for our own populations is somewhat limited.
The authors interviewed 500 randomly chosen adult offspring of 2000 addicts in treatment in Shiraz, Iran. Evidently the average age of those in treatment is much higher than our patients since 28% of their offspring were over 40 years of age and 80% married (but still living under the one roof, a condition of the survey).
The authors remind us of the ‘old tradition of drug use’ in Persia, including opium which is used for pleasure as well as as a medicine. While all these drugs are currently illegal, and penalties severe, drug use and dependency are still common. Even alcohol, which is ‘both religiously and legally prohibited’ has significant reported use and dependency. In the first degree relatives of opioid addicts there was substantial ‘ever used’, ‘current use’ and ‘dependency’. There was no reported use of cocaine or psychodelics. Stimulants were not mentioned.
In short, the findings were that among the offspring of opioid addicts in Iran, 20% had ‘ever used’ opium or heroin and 6.4% were currently opiate dependent. Tobacco was ‘ever used’ by 36% with 24% being currently dependent by DSM-IV criteria. In 95% of the opioid used was opium and 5% heroin. Males greatly outnumbered females for most forms of drug use by up to 9:1. The survey was evenly split, however.
Alcohol was ‘ever used’ by 18.2% and cannabis products by only 4.2%. Thus over half of the population had used a psychoactive drug (56.4%) excluding caffeine.
These researchers asked the respondents the reason for their drug use. ‘Enjoyment’ was the prime answer (57%). Next came ‘modeling’ (50%) [which I take to be something akin to ‘peer pressure’] and then ‘release of tension’ (34%).
In our own patient population in Redfern we have a median age of 37 years. On cursory exmination, we could identify only twelve patients out of 328 from the past three years who had adult children and only two of these had a known drug dependency history. Hence, while this paper shows distinct differences between drug use in different countries, drug use can certainly run in families as with other habits, partially as a result of genetics and partly environmentally induced (see elegant twin studies from Minneapolis St Paul).
Comments by Andrew Byrne ..
