title: Descriptive epidemiology and high risk behavior of male prescription opioid abusers: Cross-sectional study from Sikkim, North East India.
abstract: BACKGROUND
  Sikkim is emerging as an important area for prescription opioid abuse with frequent news of seizures and arrests due to possession of prescription opioids. However, till date there is a little information on descriptive epidemiology and high risk behavior of prescription opioid abusers from Sikkim.
  
  
  OBJECTIVE
  The aim was to describe demographic (age, sex, religion, marital status, community, occupation, etc.); socioeconomic (income, education, family information etc.); and high risk behavior (e.g., injection sharing, visit to commercial sex workers [CSWs], homosexuality etc.) among treatment-seeking prescription opioid abusers in Sikkim.
  
  
  METHODS
  Epidemiological data were collected by administering predevised questionnaires from n = 223 prescription opioid abusers (main problem prescription opioids) reporting for treatment at five different drug abuse treatment centers across Sikkim.
  
  
  RESULTS
  The mean age of prescription opioid abusers in Sikkim was 27 years; all were male, of Nepalese ethnicity and single/never married, school dropout and/or illiterate, earning < Rs. 10,000/month with most spending almost Rs. 5000 a month on prescription opioids. Most (57.4%) prescription opioid abusers belonged to the urban community. Commonly abused prescription opioids were dextropropoxyphene and codeine. Injection sharing was more in urban areas whereas syringe exchange was observed equally among rural and urban prescription opioid abusers. Among urban injectors visits to CSWs, and multiple sex partners were also common in spite of knowledge about AIDS. Limited condom use was observed among rural respondents. Incidences of arrests, public intoxication, and violence under the influence of prescription opioids were also reported.
  
  
  CONCLUSIONS
  Both the rural and urban areas of Sikkim show increasing rates of prescription opioid abuse among males. It is more prevalent among school dropouts and unemployed youth. Trends of injection drug use, unsafe injection, high risk behavior have also been observed.
authors.affiliation: Department of Pharmacology and Psychiatry, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
authors.forename: D
authors.initials: D
authors.lastname: Datta
authors.affiliation: Department of Pharmacology and Psychiatry, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
authors.forename: S
authors.initials: S
authors.lastname: Pandey
authors.affiliation: Department of Pharmacology and Psychiatry, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
authors.forename: S
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Department of Pathology, STNM Hospital, Government of Sikkim, Gangtok, Sikkim, India.
authors.forename: Y
authors.initials: Y
authors.lastname: Verma
authors.affiliation: Department of Toxicology, Regional Occupational Health Centre (Eastern), National Institute of Occupational Health, Indian Council of Medical Research, Kolkata, West Bengal, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Chakrabarti
keywords: High risk behavior; Sikkim; injection drug use; prescription opioid; substance abuse