Estimating Prevalence of Illicit Drug Use in Yunnan, China, 2011–15

Background and Aims: Yunnan has been one of the provinces most afflicted by illicit drug use in China. However, there have been few systematic studies on the prevalence of illicit drug use in the area.Method: Using data on illicit drug users registered in the police system, this study aims to estimate the population size of illicit drug users and the annual prevalence of drug use in Yunnan from 2011 to 2015 using Zelterman's capture-recapture method.Results: In the 15–64 year-old population, the estimated prevalence rate of any illicit drug use was 0.81% (0.76–0.86%) in 2011 and 0.94% (0.90–0.98%) in 2014, representing a significant increase. The prevalence rate of heroin use decreased from 0.67% (0.63–0.73%) in 2011 to 0.57% (0.53–0.61%) in 2015, while the prevalence rate of methamphetamine use doubled from 0.20% (0.17–0.24%) in 2011 to 0.48% (0.46–0.50%) in 2015. The mean age of the 141,702 identified illicit drug users in Yunnan from 2011 to 2015 was 32.2 years, and the majority were male, low educated, and peasants; nearly half were single and ethnic minorities. The ratio of the number of identified illicit drug users to the number of hidden users increased from 1:12 in 2011 to 1:5 in 2015.Conclusion: The prevalence of illicit drug use in Yunnan has been increasing. Although the prevalence of heroin use decreased, methamphetamine use increased dramatically from 2011 to 2015. Preventive strategies that are more effective in reducing illicit drug use are urgently needed in Yunnan

Factorial structure of the brief symptom inventory (BSI)-18 among chinese drug users

BACKGROUND: Although the Brief Symptom Inventory-18 (BSI-18) has been widely used for mental health screenings in both clinical and non-clinical populations, the validation of its application to Chinese populations has been very limited. The objective of this research is to assess the factorial structure of the BSI-18 within a Chinese drug using population. METHODS AND RESULTS: A total sample of 303 drug users recruited via Respondent Driven Sampling (RDS) from Changsha, China was used for the study. Our results show: 1) The BSI-18 item scores are highly skewed; 2) With dichotomous items measures (1-problem at least moderately caused respondent discomfort during the past week; 0-otherwise), our findings support the designed 3-factor solution of the BSI-18 (somatization, depression, and anxiety); 3) The BSI-18 has a hierarchical factorial structure with 3 first-order factors and an underlying second-order factor (general psychological distress); 4) Tentative support should also be given to a single dimension of general psychological distress in Chinese drug using populations. Our study recommends a useful alternative approach for evaluating the factorial structure of the BSI-18 – i.e. CFA with dichotomous item measures. Both the total BSI-18 score and the three subscales (SOM, DEP, and ANX) can be used in applications of the BSI-18. CONCLUSION: Overall, our findings suggest the BSI-18 is useful with Chinese drug users, and shows potential for use with non-Western and substance using populations more generally

Factors related to psychosocial barriers to drug treatment among Chinese drug users

Although substance abuse treatment has been considerably scaled up in China, impediments to accessing these services remain among drug users. The authors examine the primary psychosocial barriers to drug treatment in this population and evaluate factors associated with these barriers. Barriers to accessing drug treatment were measured using the Barriers to Treatment Inventory (BTI). A Structural Equation Model was used to examine whether the internal barriers were associated with treatment history and frequent methamphetamine use as well as how demographic characteristics influence such barriers. We found four primary factors of internal barriers to drug treatment – absence of problem, negative social support, fear of treatment, and privacy concerns – to fit well. Demographic factors, notably age and employment status, indirectly influence barriers to treatment via other factors. Frequency of methamphetamine use and drug treatment history are directly associated with the absence of problem and negative social support dimensions of the BTI, and it is through these pathways that demographic factors such as age and employment status shape barriers to treatment. The findings indicate that perceived absence of a problem and negative social support are the barriers most influenced by the personal domains of Chinese drug users’ lives. Efforts to engage drug users in China about drug treatment options may consider how these barriers are differentially perceived in order to effectively reach this population

Perceived risk of methamphetamine among Chinese methamphetamine users

BACKGROUND: Methamphetamine use has grown considerably in China in recent years. Information about perceptions of risk on methamphetamine is important to facilitate health promotion efforts. METHODS: Using both survey data and qualitative interview data, the authors evaluate the perceived risk of methamphetamine use among Chinese users using a mixed-methods approach. Through Respondent Driven Sampling, the authors recruited a sample of 303 methamphetamine users in Changsha, China. RESULTS: A majority (59.1%) perceive that infrequent methamphetamine use poses no risk to the user, while 11.2% perceive at least moderate risk for light use. A majority (56.7%) perceived at least moderate risk associated with regular methamphetamine use. Most (82.2%) also perceive methamphetamine to be easily obtainable. A path model indicates that perceived risk shapes intentions to use and expectations of future use, as does perceived availability. Qualitatively, while addiction was the most common risk discussed by users, they differed on whether they perceived the drug addictive. Other concerns raised by interviewees included impaired cognition, mental health problems, physical harm, and social dysfunction. DISCUSSION: While some users identify significant risks with methamphetamine, others do not perceive its use to be problematic. Collectively, these findings indicate that intervening upon perceptions of risk among Chinese methamphetamine users may be a means to influence intentions to use