Salient features of substance use in India Prevalence of substance use in India Social Determinants of Health (SDH) and substance abuse among children and adolescents SDH Rainbow model Protective factors and Risk factors for substance use Approach to SDOH

1. SOCIAL DETERMINANTS OF SUBSTANCE USE
BY CHILDREN & ADOLESCENTS
Prof. Rajesh Nair, PhD, PGDH&FW, FRSPH
Director
Amity Institute of Behavioural and Allied Sciences (AIBAS)
Amity University Gurugram
E-mail: rnair@ggn.amity.edu

2. Presentation outline
➢ Salient features of substance use in India
➢ Prevalence of substance use in India
➢ Social Determinants of Health (SDH) and substance
abuse among children and adolescents
➢ SDH Rainbow model
➢ Protective factors and Risk factors for substance use
➢ Approach to SDOH
➢ Summary

3. Salient features of substance use in India
➢ Large No. of people including children & adolescents
use Psychoactive substances
➢ Wide variations in prevalence across different states
➢ Tobacco and Alcohol are most common substance
use including in the age groups 10-17 years
➢ Onset of substance use is reported as early as 10
years of age
➢ Cannabis and Opioids are next commonly used
substances
➢ Sedatives, Inhalants, Cocaine, Amphetamines,
Hallucinogens are also used by sizeable population

4. Extent of substance use is higher among
young people compared older people
➢ Peak levels of drug use are seen among those aged 18-
25 years
➢ Extent of drug use among young people in particular
based on past year and past month prevalence (which
indicates recent and regular use) remains much higher
as compared to older population
➢ However, lifetime prevalence (which indicates extent of
exposure) of general drugs remains higher in older
people

5. Prevalence of current Alcohol use in
different population groups (%) in India
Source: MSJE, 2019

6. Prevalence of current Opioid use in
different population groups (%) in India
Source: MSJE, 2019

7. Prevalence of current Cannabis use in
different population groups (%) in India
Source: MSJE, 2019

8. Prevalence of current Inhalants use in
different population groups (%) in India
Source: MSJE, 2019

9. Annual prevalence of Cannabis use among
GPs aged 16-64 yrs and among students
aged 15-16 yrs, 2016
Source: UNODC-World Drug Report, 2018

10. Adolescent Tobacco Use: Prevalence
➢ Adolescence most susceptible age for tobacco initiation
➢ Every day between 68,000 and 84,000 people of 20 year of age
become long-term smokers in LMICs
Jha & Chaloupka,
2000
➢ 9.5% of adolescents in the age group of 13-15 years currently use
cigarettes
 Nearly a quarter reporting trying their first cigarette before the
age of 10 years
 19.1% susceptible towards initiating smoking during the next
year
GYTS 2000-2007
• Initiation at an early age increases dependency and makes
quitting harder as an adult
USSGR, 1989, Lando HA et al, 1999

11. Social Determinants of Health
➢ Health starts in our homes, schools, workplaces,
neighborhoods, and communities
➢ Social Determinants of Health (SDH) are "the
conditions in which people are born, grow, live, work
and age, including the health system
➢ Effective case management requires management of
immediate clinical problems, then of the patients risk
factors and ultimately the underlying social
determinants so as to prevent the occurrence of risky
behaviours such as substance use

12. Social Determinants of Health Rainbow

13. Social Determinants and Risk factors of
substance use among children
Source: UNODC-World Drug Report, 2018

14. Protective factors and Risk factors for
substance use
Source: UNODC-World Drug Report, 2018

15. Approach to SDOH
Source: Healthy people 2020

16. Summary
➢ Extent of substance use is higher among young
people compared to old people
➢ SDH can be considered as root causes or causes of
causes of ill health including the substance
dependence
➢ Social Determinants refers to underlying
characteristics of society that ultimately shape health
including mental health
➢ Effective case management requires management of
immediate clinical problems, then of the patients risk
factors and ultimately the underlying social
determinants so as to prevent the occurrence of risky
behaviours such as substance use