Substance use and traumatic events among Afghan general population: findings from the Afghanistan national mental health survey

Abstract

Purpose: Substance use and traumatic events are prevalent in Afghanistan, but their relationship is under-investigated.

Methods: A nationally-representative, cross-sectional survey was conducted in 8 regions of Afghanistan in 2017 (N = 4474). First, we examined the burden of substance use, and demographic correlates (e.g., gender, age) in the Afghan general population; second, we examined the association between traumatic and stressful experiences, including PTSD, and any substance use, tobacco use and sedative use.

Results: Substance use disorder is prevalent in Afghanistan, with prevalence of any substance use at 5.03%, tobacco use at 21.82%, and sedative use prevalence at 6.71%. Women and people with middle and high economic status were less likely to use any substance and tobacco, however, women were more likely use sedative compared to men. People who had collective violence and experienced any traumatic event more likely to use any substances, tobacco and sedative compared to their counterparts. Finally, individuals with PTSD, depression and generalized anxiety were more likely to use any substances, tobacco and sedative compared to individuals without these psychiatric disorders.

Conclusion: Substance use and dependence are prevalent in Afghanistan, an area with exposure to conflict and trauma for a majority of the population, underscoring the pervasive impact of trauma exposure on population health in this area. As resources are deployed to assist the Afghan population through conflict, attention to substance use and psychiatric disorders is needed to fully address population health.

Keywords: Depression; Generalized anxiety; PTSD; Substance use; Tobacco use; Traumatic event.

Fig. 1

Percent of moderate and high risk of any substance, tobacco and sedative use along with 95% CI

Fig. 2

Prevalence of substance use with 95% CI