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Drug use among prisoners in three main prisons in Khartoum, Sudan

El-Fatih Idris A. Karim, Hamid Mannan Mohamed, Mohamed Ibrahim Mohamed, Ali Farah Ahmed and Sana Abdel Azim Mohammed

ABSTRACT Drug use among prisoners in the three main prisons in Khartoum, Sudan in 1994 was studied. The results show variations in the use of drugs with regard to age, occupation, education, marital status and social status of inmates. Drug use was common among most prisoners, with alcohol and hashish being the most frequently used drugs. Alcohol use was more common among married prisoners; hashish use was more popular among single prisoners. Alcohol was frequently used with other drugs. Most prisoners started using drugs between the ages of 12 and 20 years. The principal reasons for drug use were temptation by friends and to escape social pressures.

La consommation de drogues chez les détenus de trois principales prisons de Khartoum (Soudan)

RESUME. La consommation de drogues chez les détenus de trois principales prisons de Khartoum (Soudan) en 1994 a fait l'objet d'une étude. Les résultats montrent des variations dans la consommation de drogues selon l'âge, la profession, le niveau d'éducation, la situation de famille et le statut social des détenus. La consommation de drogues était courante chez la majorité des prisonniers, l'alcool et le haschisch étant les drogues les plus fréquemment consommées. La consommation d'alcool était plus fréquente chez les prisonniers mariés; la consommation de haschisch était plus courante chez les célibataires. L'alcool était fréquemment consommé en association avec d'autres drogues. La majorité des prisonniers ont commencé à consommer des drogues entre l'âge de 12 et de 20 ans. Les raisons principales mentionnées pour la consommation de drogues étaient la tentation venant des amis et le désir d'échapper aux pressions sociales.

Introduction

Although until some years ago the danger of drug abuse was limited to certain parts of the world, it has now become a worldwide problem facing most countries.

Sudan, because of its geographical position, can be considered an important site for drug trafficking between the East and the West. Until recently, the use of illicit drugs in Sudan was limited to a small sector of society, mainly labourers, and was mostly associated with the use of alcohol and hashish [1]. However, no clear, detailed descriptive data on the epidemiology of drug use in the Sudan have been available.

In an attempt to obtain such data, the drug problem has been studied in a large group of subjects of different categories by means of an epidemiological survey [2]. The information has been collected from many sources, including police records, prisons, hospitals, school and university students, as well as workers and employees in some industrial localities.

This paper focuses on the use of drugs by prisoners in the three main prisons in Khartoum, namely Kobber, Omdurman and Algeraif prisons.

Subjects and methods

A questionnaire was used to collect data regarding drug use in the three main prisons in Khartoum. It consisted of three sections. Section one dealt with demographic data, including, sex, age, occupation, education, income and marital status. Section two assessed drug consumption; prisoners were asked about the use of a variety of drugs, including hashish, alcohol and inhalants. Section three enquired about the social aspects related to drug use. A person-to-person interview was conducted. To ensure reliability of results, social workers from the Kobber Mental Health Clinic, Ministry of Interior were employed to complete the forms. Statistical analyses were made with significance at P < 0.01 and the results were given as percentages.

A total of 1569 prisoners (432 at Kobber, 689 at Omdurman and 448 at Algeraif), representing 50.6% of the total number of prisoners in the three prisons, were randomly selected and interviewed. Of the prisoners surveyed, 16.0% (251) were under 20 years of age, 68.7% (1078) were between the ages of 20 and 35 years and 15.3% (240) were over 35 years of age.

Results

Drugs used

Of the prisoners surveyed, 60.1% (943) (c² = 20.37, P = 0.0000) were drug users; 64.6% (279) at Kobber, 63.1% (435) at Omdurman and 51.1% (229) at Algeraif prisons. The most frequently used drugs were alcohol 32.2% (505), hashish 17.6% (276), diazepam (valium) 3.3% (52) and barbiturates 1.8% (29). Other drugs constituted 5.2% (81) (Table 1). Alcohol and hashish users constituted 82.8% (781) of all drug users. Barbiturate and valium users constituted 8.6% (81); morphine, codeine, pethidine and other drugs were used by only 8.6% (81) of the drug users. Of the alcohol users, 52.0% (263) frequently used alcohol with other drugs. The drugs most frequently used with alcohol were hashish and valium [28.8% (145) and 7.9% (40) of alcohol users respectively] (Table 2 ).

Regular users (using drugs more than once a week) constituted 85.2% (803) of the drug users in the three prisons.

Drug use and education

The use of drugs was more frequent [37.2%, (351)] among prisoners with primary education (Table 3). The use of alcohol and hashish was more frequent among prisoners of this level of education (38.5% and 46.4% of alcohol and hashish users respectively). However, at Omdurman prison the use of alcohol was more frequent among illiterate prisoners (55.5% of alcohol users at Omdurman prison). The use of diazepam and barbiturates was also more frequent among prisoners with primary education (47.3% and 66.5% of diazepam and barbiturate users respectively).

Drug use and marital status

Of the prisoners surveyed, 42.7% (670) were single, 50.5% (792) were married, 2.2% (35) were widowed and 4.6% (72) were divorced. Use of drugs was almost equally distributed among single and married prisoners, 46.45% (438) and 44.9% (423) of drug users respectively. Widowed or divorced prisoners constituted 8.6% (81) of drug users. Alcohol use was more widespread among married prisoners [49.9% (252) of total alcohol users] while hashish use was more frequent among single prisoners [56.2% (155) of total hashish smokers]. However, at Algeraif prison the use of alcohol was more common among single prisoners [62.6% (72) of alcohol users at Algeraif prison].

Starting age of drug use

Most drug users [46.9% (442)] had started using drugs between the ages of 12 and 20 years. A considerable proportion of the drug users in the three prisons started using drugs before the age of 12 years.

Drug use and occupation

The use of drugs was more common among skilled labourers and prisoners with unlawful jobs (thieves, drug dealers) [44.9% (423) and 18.3% (173) of all drug users respectively]. The use of alcohol and hashish by prisoners with unlawful jobs varied from one prison to another; it was found to be the highest at Omdurman and they constituted 61.8% (176) and 22.1% (19) of alcohol and hashish users respectively.

Reasons for drug use

The principal reasons for the use of drugs among prisoners in the study were: encouragement by friends [29.7% (280)], social pressures [27.8% (262)], pleasure [22.6% (213)], curiosity [15.4% (145)] and treatment [4.5% (42)]. Diazepam and barbiturates were principally used for treatment.

Drug use and income

Drug use was common among prisoners with high and low monthly income; these constituted 39% (368) and 36.8% (347) of the drug users respectively. Alcohol and hashish use was more prevalent among prisoners of low monthly income [52.0% (263) and 50.4% (139) of alcohol and hashish users]. The use of diazepam and barbiturates and other drugs was more common among prisoners with high monthly income.

Social aspects of drug use

Prisoners used drugs either alone [49.8% (470)] or in groups [50.2% (473)]; 61.8% (312) of alcohol users in the three prisons tended to use alcohol in groups. With regard to hashish, 60.6% (57) of hashish smokers at Kobber prison used hashish alone while at Algeraif 52.1% (50) used it in groups.

With regard to accesibility, 43.8% (413) of drug users at the three prisons reported that drugs were difficult to obtain while 56.2% (530) reported easy accessibility to drugs. At Algeraif, 61.4% (59) and 65.2% (75) of hashish and alcohol users respectively reported easy access to these drugs. However, at Omdurman prison 65.1% (56) and 62.1% (177) of hashish and alcohol users respectively reported difficulty in obtaining these drugs.

Drug users in the three prisons reported that the main sources of drugs outside the prison were drug traffickers, other users and pedlars [40% (377), 25.5% (240) and 18.7% (176) of the drug users respectively]. At Algeraif prison, 43.5% (50) of alcohol users reported that middlemen were the main source of drugs. The source of drugs inside the prison was reported to be hawkers, who were usually prison guards and visitors.

Of all drug users, 74.2% (700) intended to give up drugs but they had not tried, mainly because of temptation [79.0% (553)] or lack of guidance [21.1% (148)]. However, 20.9% (197) of drug users did not intend to stop using drugs because of the happiness and pleasure they experienced.

Drug use and incarceration

This was only investigated at Algeraif prison where 68.6% (157) of drug users reported that there was a direct or indirect relationship between their drug use and entry into prison. This result correlated with the data regarding entry into prison obtained from the prisoners' records at the prison, where 82.3% (79) of hashish users reported a relationship between hashish use and being in prison. However, 56.5% (65) of alcohol users did not report any such relationship.

Discussion

To the best of our knowledge, this is the first study of its kind to be conducted in the Sudan. The reliability and validity of results obtained by a self-administered questionnaire on drug use remain questionable [3-5]. In this study, to ensure high reliability, a friendly, person-to-person questionnaire was used with the help of social workers who had access to the prisons.

The report showed that drug use was common among prisoners, especially among those at Kobber and Omdurman prisons. As in the case of other countries, alcohol was found to be the most frequently used drug (53.6%), followed by hashish (29.3%) [6-9]. Alcohol use was more common among married prisoners, while hashish smoking was more prevalent among single prisoners. A high percentage of alcohol users also used other drugs, hashish being most frequently used in conjunction with alcohol. Drugs were primarily and more regularly used by skilled labourers with primary education and ranging in age from 20 to 35 years. Drug users reported that drugs could easily be obtained, usually from drug traffickers. The source of drugs inside the prison was reported to be pedlars, who were generally prison guards and visitors. The majority of drug users intended to give up drugs but weakness and lack of will power were the principal reasons for not doing so.

Some differences in drug use and related factors between the three prisons have also emerged. These can be summarized as follows:

• Drugs were more frequently used at Kobber (c² = 16.35, P = 0.0001 ) and Omdurman (c² = 16.14, P = 0.0001 ) prisons than at Algeraif.

• The use of drugs other than alcohol and hashish was more common at Kobber than Omdurman (c² = 20.2, P = 0.0000 ) and Algeraif (c² = 46.73, P = 0.0000 ).

• Due to the presence of a large number of convicted alcohol dealers at Omdurman prison, alcohol use in this prison was more frequent than at either Kobber (c² = 34.06, P = 0.0000 ) or Algeraif (c² = 29.32, P = 0.0000 ).

• Because of the accessibility and lack of entry restrictions at Algeraif prison, drugs were more easily obtained at this prison than at the other two.

• Judging by the results obtained for Algeraif, drug use was highly related to incarceration.

Acknowledgements

The underlying investigation received financial support from the World Health Organization. The cooperation and collaboration of the Kobber Mental Health Centre and the Commissioner of Prisons, Ministry of Interior, Khartoum, Sudan are greatly acknowledged.

References

1. Mahgoub T. Threats of drug abuse. A seminar organized by Unity Centre for Information, Education and Training, Ministry of Culture and Information and the Hanns-Seidel Foundation, Germany, Khartoum, Sudan, 5-9 June, 1988.

2. Declaration of the international conference on drug abuse and illicit trafficking and comprehensive multidisciplinary outline of future activities in drug abuse control. New York, United Nations Publication, 1988.

3. King FW. Anonymous versus identifiable questionnaires in drug use surveys. American psychologist, 1970, 25:982-5.

4. Whitehead PC, Smart RG. Validity and reliability of self-reported drug use. Canadian journal of criminology and correction, 1972, 38:118-21.

5. Duble KC et al. The question of anonymity and onymity of a questionnaire in a drug use survey. Bulletin on narcotics, 1981, 333:45-8.

6. Queipo D, Alvarez FJ, Velasco A. Alcohol consumption among university students in Spain. Drug and alcohol dependence, 1986, 18:41-9.

7. Clayton RR, Ritter C. The epidemiology of alcohol and drug abuse among adolescents. Advances in alcohol and substance abuse, 1985, 4:69-97.

8. Maddux JF,. Hoppe SK, Costello RM. Psychoactive substance use among medical students. American journal of psychiatry, 1986, 143:187-91.

9. Queipo D, Alvarez FJ, Velasco A. Drug consumption among university students in Spain. British journal of addiction, 1988, 83:91-8.