ARTICLE

Psychosomatic Medicine Research 2023;5(2):9. https://doi.org/10.53388/PSMR2023009

The phenomenology, socio-demographic, and clinical profile of substance abusers

admitted to drug de-addiction unit at eradah and mental health hospital, taif, Saudi
Arabia
Javed Ather Siddiqui 1, 4* , Shazia Farheen Qureshi 2, 4 , Ali Mahmoud Eldaous 3, 4 , Yousef Bin Ahmed Shawosh 4
1
Department of Psychiatry, Seth Gordhandas Sunderdas Medical College and the King Edward Memorial Hospital, Mumbai 400012, India. 2Department of
Psychiatry, College of Physicians and Surgeons of Bombay, Mumbai 400012, India. 3Benha University, Benha 13518, Egypt. 4Department of Psychiatry, Mental
Health Hospital, Taif 21944, Saudi Arabia.

*Corresponding to: Javed Ather Siddiqui, Department of Psychiatry, Seth Gordhandas Sunderdas Medical College and the King Edward Memorial Hospital,
Acharya Donde Street, Parel, Mumbai 400012, India. E-mail: javedsiddiqui2000@gmail.com.

Author contributions Abstract

Dr. Javed Ather Siddiqui has made substantial contributions to
material preparation, conception, design, acquisition of data,
or analysis and interpretation of data; Dr. Ali Mahmoud
Eldaous have been involved in the first draft of the manuscript
was written, drafting the manuscript or revising it critically for
important intellectual content; Dr. Javed Ather Siddiqui has
given Critical review and editing of the final manuscript was
done by Dr. Shazia Farheen Qureshi, Dr. Yousef Ahmed Bin
Shawosh. All authors read and approved the final manuscript.
Competing interests
The authors declare no conflicts of interest.
Acknowledgments
Especially thanks to the In-charge of the department of
Academic Affairs and Training and Education Abdullaziz
AlGhylani and the team of our hospital for providing support
in arranging this study.
Peer review information
Psychosomatic Medicine Research thanks all anonymous
reviewers for their contribution to the peer review of this
paper.
Abbreviations
WHO: World Health Organization.
Citation
Siddiqui JA, Qureshi SF, Eldaous AM, Shawosh YBA. The
phenomenology, socio-demographic, and clinical profile of
substance abusers admitted to drug de-addiction unit at
eradah and mental health hospital, taif, Saudi Arabia.
Psychosom Med Res. 2023;5(2):9. doi:
10.53388/PSMR2023009.
Background: Substance abuse has become an increasingly serious socio-medical issue in
recent decades. Human health is affected by the socio-cultural environment, which has a
direct impact on his psychophysical development and well-being. However, sociocultural
factors such as bad habits influence lifestyle and behavior, leading to significant health and
social problems for substance abusers. Objective: The present study is to evaluate the
phenomenology and socio-demographic characteristics of abusers and compare some of the
characteristics randomly. The main objectives of this study are a. To evaluate the
socio-demographic profile. b. To find out the pattern of substance use. c. To evaluate the
association of phenomenology. d. To find out about substance-related disorders among the
substance abuse patients. Materials and methods: There was an observational study
conducted in the drug de-addiction unit at Taif, Eradah, and Mental Health Hospital in Saudi
Arabia. This study included all substance abusers admitted to the hospital who met the
inclusion and exclusion criteria. The study included patients of both genders admitted to the
drug de-addiction unit between April 2021 and October 2022. Based on a descriptive
statistical analysis, categorical variables were presented as frequencies and percentages.
Results: An observational study was conducted for nearly one and a half years. We
interviewed 358 substance abuse patients following a systematic sampling procedure in a
peaceful, non-threatening environment. Among the 358 substance users, 353 (98.60%) were
male and 5 (1.39%) were female. According to the survey, 117 (32.68%) of the participants
reported abusing substances during their 31–40 years of age, followed by 102 (28.49%)
during their 25 – 30 years of age. The predominant level of substance abuse was among the
unemployed 163 (45.53%), followed by students 105 (29.33%). It was found that 58.66% of
all respondents had initiated abuse between the ages of 18–24 years of age. Conclusion: In
our study, combined substances like amphetamine and cannabis abusers were most
prevalent because these are the most popular illicit drugs which are easily available. Islamic
culture prohibits alcohol consumption both religiously and legally, making alcohol abuse
the least prevalent of all drug addictions.
Keywords: addiction; substance use; young adults

Executive editor: Nuo-Xi Pi.

Received: 28 March 2023; Accepted: 08 June 2023; Available
online: 09 June 2023.
© 2023 By Author(s). Published by TMR Publishing Group
Limited. This is an open access article under the CC-BY license.
(https://creativecommons.org/licenses/by/4.0/)

Submit a manuscript: https://www.tmrjournals.com/psmr 1


Psychosomatic Medicine Research 2023;5(2):9. https://doi.org/10.53388/PSMR2023009
Introduction
Substance abuse is a major health concern around the world. Chronic
drug use leads to substance use disorders, which are characterized by
cognitive, behavioral, and physiological symptoms. In recent years,
substance abuse has become a major public health concern. As a result
of a growing and changing culture, substance use patterns have
changed dramatically. There are many factors that influence substance
use and dependence, such as age, background, gender, occupation,
and marital status. Substance use behavior generally begins in
adolescence and increases in young adulthood.
In Saudi Arabia, cultural norms and values are deeply rooted in
religion. The Saudi Arabian government prohibits the possession and
consumption of alcohol and narcotic substances both religiously and
legally. Even though many Saudis consume alcohol and other
substances [1]. The prevalence of drug use among Saudis is
approximately 7–8 percent [2, 3]. It is estimated that the most popular
illicit drugs in Saudi Arabia are amphetamines, cannabis, and heroin.
In addition to alcohol, Saudis are addicted to more than one drug [4].
During the past decade, cannabis and amphetamine use has increased,
while heroin and volatile substances have decreased [5].
In addition to affecting mental health, drug addiction can also have
physical consequences [6]. In early adulthood, males are more likely
to become involved with drugs than females [7]. Due to their inherent
vulnerability to substance abuse, adolescents and young adults
continue to abuse drugs [8]. There are a limited number of studies
that examine illicit substance use among elderly and middle-aged
people [9, 10]. Mental illness and substance abuse have a significant
impact on society, and it is under-recognized as well. As a result, such
research is necessary to provide comprehensive management,
rehabilitation, and prevention. In addition, it is necessary to formulate
a proper regional health policy. This study examines the
socio-demographic characteristics of individuals seeking treatment for
substance abuse across different age groups (young adults 18–40
years, middle-aged adults 40–60 years) as defined by the World
Health Organization (WHO). Several studies have consistently shown
that young people are at risk of substance abuse [11, 12].
Inclusion criteria
Drug abuser patients; Patients who have participated in the study are
admitted to the inpatient department; Participants who had been
diagnosed with different types of drug abuse in the past one and half
year.
Exclusive criteria
Geriatric age group patients; The age range of participants is below 16
years; Injectable route of substance abuse; Patients with cognitive
impairment; Non-cooperative and unresponsive patients.
Ethical Issues in Research
The research work started after it was approved by the Ethical
Committee of Research and Studies Department, Directorate of Health
Affairs, Taif, Saudi Arabia. IRB Registration Number With KACST,
KSA: HAP-02-T-067 Approval number : 800.
Methods and Data analysis
Data were entered and analyzed by Microsoft Excel software for
statistical analysis. We presented frequency and percentage data for
categorical variables using descriptive statistical analysis. The data
was used to compare the pattern of substance use in the subjects, the
distribution of subjects according to their socio-demographic
characteristics, the reasons for relapse, and the distribution of routes
and substances used by the respondents. Self-designed general
information questionnaire was used in this study. Additionally, it
contributes to data collection and covers study objectives.
The researcher explained the study to the hospital management and
obtained written consent for participation. Consent was obtained in
Arabic, which the patient understood, and were free to accept or reject
the study.
Submit a manuscript: https://www.tmrjournals.com/psmr
ARTICLE
Results
This study was conducted in an inpatient department (IPD) of the drug
de-addiction department. A total of 358 substance abusers were
monitored (n=358). The subjects were admitted because they wanted
to stop using drugs. Due to the common use of amphetamine and
cannabis in Saudi Arabia, about 124 (34.64%) of respondents
considered the combined substances amphetamine and cannabis as
their preferred drugs, followed by single abusers such as amphetamine
110 (30.73%) orally, and 60 (16.76%) abusing poly-substances.
Alcohol abuse is lower in number 9 (2.51%) due to prohibition in
Islamic countries, as depicted in Figure 1.
Figure 1 Pattern of Substance use in the subjects
Table 1 shows socio-demographic profiles. In the study, all age
groups were included except geriatrics. The majority of the
respondents who were abusing substances belonged to the age group
of 31–40 years, with 117 (32.68%), followed by 102 (28.49%) in
25–30 years, and the minimum number of abusers observed in less
than 18 years was 9 (2.52%). Elderly age group subjects were 13
(3.63%) due to multiple medical problems. The majority of subjects
were male 353 (98.60%), while 5 (1.39%) of the abusers were female.
A maximum of 224 abusers have been unmarried (62.57%), and 124
have been married (43.64%). There were 163 (45.53%) unemployed
subjects who used substances, followed by 105 (29.33%) students who
abused substances, whereas 90 (25.14%) employed subjects abused
substances.
Peer pressure was found to be the most influential risk factor among
substance abusers. Table 2 shows that 140 respondents with (39.11%)
are influenced by peer pressure, 50 respondents with (13.97%) are
influenced by family issues, 80 respondents with (22.35%) abuse
drugs simply for enjoyment, and 40 respondents with (11.17%)
become addicted to drugs due to unemployment.
The majority of the respondents (67.32%) took the drug orally, while
32.68% took the drug by smoking. In our study, injectable routes of
substance administration were not seen. The maximum number of
single substance abusers is 174 (48.60%), 124 (34.64%) abused two
substances, and minimum numbers were observed in abusers who
took four substances, with 10 (2.79%) shown in Table 3.
Discussion
In our study, we focused on observational data and evaluated the
socio-demographic characteristics of substance abuse in the
de-addiction unit at Eradah and mental health hospital in Taif, Saudi
Arabia. Amphetamine and cannabis remain the most consumed,
trafficked, and frequently seized illicit substances in this country
despite of their legal prohibition. Additionally, younger generations
are consuming these substances more often due to loosening
restrictions and easier accessibility. The number of new users is
increasing, especially among college students. There was a higher
prevalence of substance abuse among unmarried males. According to
our study, 224 abusers were unmarried with 62.57 percent, followed
by 124 who were married with 43.64 percent.
2
 ARTICLE
Psychosomatic Medicine Research 2023;5(2):9. https://doi.org/10.53388/PSMR2023009

Table 1 Distribution of total subjects by socio-demographic Table 3 Distribution of routes and number of substances among
characteristics the responders
Groups Groups
Age distribution Routes of substances
Age in Years Frequency Percentage Routes Frequency Percentage
<18 9 2.52%
Oral 241 67.32%
18–24 58 16.20%
Smoking 117 32.68%
25–30 102 28.49%
31–40 117 32.68% Injectable 0 0%
41–50 59 16.48%
Total n=358 358 100%
>51 13 3.63%
Total 358 100% Substance abuse in life times
n=358
No of substances Frequency Percentage
Gender
Male 353 98.60% Single Substance 174 48.60%
Female 5 1.39% Two substances 124 34.64%
Total 358 100%
n=358 Three substances 50 13.97%
Marital Status Four substances 10 2.79%
Married 124 34.64%
Total n=358 358 100%
Unmarried 224 62.57%
Divorced 10 2.79%
The most common combined substance abuse was amphetamine and
Total 358 100% cannabis with 34.64 percent, followed by amphetamine with 30.73
n=358 percent and poly-substance abuse with 16.76 percent. Cannabis has
Occupation been used by humans since 4000 BC, usually taken by smoking dried
marijuana leaves or hashish, which a viscous resin is made from
Students 105 29.33%
cannabis [13, 14]. The risk of morbidity and mortality associated with
Employed 90 25.14% alcohol abuse is well documented [15]. Religious and legal
Unemployed 163 45.53% prohibitions prevented alcohol abuse in Islamic countries, and other
substances only made up a small proportion of the sampled
Total 358 100% substances.
n=358 Substance abuse is likely to be influenced by peer pressure. There
Age of onset are various factors that contributes to its initiation, such as peer
Years Frequency Percentage influence, curiosity, a sense of growth and exploring nature of
<18 60 16.76% adolescents. Therefore, in our study, the maximum number of
respondents took substance due to peer pressure. In college, students
18–24 210 58.66%
strive to be self-reliant in order to make independent decisions, such
25–40 50 13.97% as finding a job, selecting romantic partners, obtaining higher
>40 38 10.61% education, achieving financial independence, and establishing a
support system, which is heavily influenced by their peers. In our
Total 358 100%
study, unemployed abused substances in the highest numbers,
n=358
followed by students due to peer influence. It is essential for students
to display certain behaviors in order to gain power, status, peer
acceptance, and recognition in the social network [16, 17]. In
addition, poor emotional attachments, permissive parenting, and easy
Table 2 Reason to relapse the substances financial access may contribute to college students to perceive to
Reason Frequency Percentage abusing substances [18]. In our study, the majority of 140 respondents
(39.11%) are influenced by peer pressure, followed by 80 respondents
Peer influence/pressure 140 39.11%
(22.35%) who abuse drugs simply for enjoyment, then 50 respondents
Getting Pleasure 80 22.35% (13.97%) are influenced by family issues and 40 respondents
(11.17%) become addicted to drugs due to unemployment.
Family related problem 50 13.97% Studies show that people abuse drugs most frequently in their late
Unemployment 40 11.17% twenties and beginning of thirties. The present study shows a similar
pattern in age distribution seen. The majority of respondents who
Anger /impulse 25 6.98% abuse substances are between the ages of 31–40 years with 117
(32.68%), followed by 102 (28.49%) who are between the ages of
Depressive symptoms 12 3.35%
25–30 years. According to some researchers, there are innate
Family history 5 1.40% differences between the way men and women learn certain behaviors.
Males are associated with aggression, violence, independence, and
To enhance sexual power 3 0.84% adventurism, all of which are potent factors in initiating substance
Occasional celebration 3 0.84% abuse. Women, on the other hand, are conceptualized as emotionally
more sensitive, less aggressive, dependent, and less adventurous. As a
Total n=358 358 100% result, they are abused at a lower rate. There is still controversy
surrounding these explanations. It is still considered shame for women
to abuse drugs, so they try to hide it from others [19]. There are fewer

Submit a manuscript: https://www.tmrjournals.com/psmr 3


Psychosomatic Medicine Research 2023;5(2):9. https://doi.org/10.53388/PSMR2023009
females in substance abuse facilities because of the stigma and
embarrassment attached to substance abuse, besides the male
predominance [20]. According to our study, males 98.60 percent
abuse substances more frequently than females 1.39 percent. The
mortality associated with injectable drugs is a serious health concern.
When compared to the general population, injecting drug users have a
crude mortality rate of 4.25 [21]. In our study, injectable drug abusers
were not found.
As a result of substance use, there is an increased risk of depression
and suicidal behavior. The use of acute and chronic drugs can impair
judgment and impulse control, inhibit neurotransmitter pathways, and
lead to suicidal tendencies through disinhibition. The risk of suicide
increases with almost all substance use disorders. According to
researchers, approximately 22 percent of suicide deaths involve
alcohol intoxication; opiates were present in 20 percent of suicide
deaths, cannabis in 10.2 percent, cocaine in 4.6 percent, and
amphetamines in 3.4 percent [22]. In studies, the suicide hazard ratio
for cocaine use is 1.35, for psycho-stimulant use it is 2.10, for
benzodiazepine use it is 3.83, for cannabis use it is 3.89, and for
sedative use it is 11.36 [23]. It was found that alcohol, amphetamines,
and volatile substances were significantly associated with suicidal
ideation [24]. Substance use, such as heroin and amphetamines, was
significantly associated with depression [25]. In our study, patients
suffered from depression and suicidal ideas but improved after taking
anti-depressants.
Limitations of the study
A study will be conducted only on admitted patients who abused
substances in the past one and a half years.
Despite all assurances of confidentiality, substance abuse may have
been under-reported.
The study was observational, and there was no control group.
This study focused primarily on treatment-seeking individuals.
Conclusion
The results suggest that combined substances, such as combined
amphetamine and cannabis, are the most commonly abused
substances in this area. They are followed by oral amphetamine and
poly-substance abuse. In Islamic cultures, alcohol abuse is also
common, but less prevalent since the consumption of alcohol is
prohibited. As there are a large number of males involved, increased
awareness is necessary to motivate them to seek treatment. Based on
the results of this study, we can design interventions to prevent
substance abuse patients from relapsing. There is a need for more
cross-sectional and longitudinal studies on illicit drugs.
References
1. Bassiony M. Substance use disorders in Saudi Arabia: review
article. J Subst Use 2013;18(6):450–466. Available at:
http://doi.org/10.3109/14659891.2011.606349
2. Saquib N, Rajab AM, Saquib J, AlMazrou A. Substance use
disorders in Saudi Arabia: a scoping review. Subst Abuse Treat Prev
Policy 2020;15(1). Available at:
http://doi.org/10.1186/s13011-020-00285-3
3. Al-Musa HM, Al-Montashri SDS. Substance abuse among male
secondary school students in Abha city, Saudi Arabia: prevalence
and associated factors. Biomed Res. 2016;27(4):1364–1373.
Available at:
https://www.alliedacademies.org/articles/substance-abuse-amon
g-male-secondary-school-students-in-abha-city-saudi-arabia-prev
alence-and-associated-factors.pdf
4. Ibrahim Y, Hussain SM, Alnasser S, Almohandes H, Sarhandi I.
Patterns and sociodemographic characteristics of substance abuse
in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric
rehabilitation center. Ann Saudi Med 2018;38(5):319–325.
Available at:
http://doi.org/10.5144/0256-4947.2018.319
Submit a manuscript: https://www.tmrjournals.com/psmr
ARTICLE
5. Sweileh WM, Zyoud SH, Al-Jabi SW, Sawalha AF. Substance use
disorders in Arab countries: research activity and bibliometric
analysis. Subst Abuse Treat Prev Policy 2014;9(1). Available at:
http://doi.org/10.1186/1747-597X-9-33
6. Islam MA, Hossen MT, Hossain MK, Fatima K, Khatun M. Impact
of drug addiction on social environment focused in Mymensingh
district. Res Agric Livest Fish 2015;2(3):411–417. Available at:
http://doi.org/10.3329/ralf.v2i3.26163
7. Zaman B, Ahmed SM, Hossain MM, Kamal MM. Psychosocial
illness among the drug abusers undergoing detoxification in
Dhaka, Bangladesh. SE Asia J Pub Health 2015;4(2):36–41.
Available at:
http://doi.org/10.3329/seajph.v4i2.23693
8. Ilgen MA, Schulenberg J, Kloska DD, Czyz E, Johnston L,
O’Malley P. Prevalence and characteristics of substance abuse
treatment utilization by US adolescents: National data from 1987
to 2008. Addict Behav 2011;36(12):1349–1352. Available at:
http://doi.org/10.1016/j.addbeh.2011.07.036
9. Schlaerth KR, Splawn RG, Ong J, Smith SD. Change in the Pattern
of Illegal Drug Use in an Inner City Population Over 50. J Addict
Dis 2004;23(2):95–107. Available at:
http://doi.org/10.1300/J069v23n02_07
10. Simoni-Wastila L, Yang HK. Psychoactive drug abuse in older
adults. Am J Geriatr Pharmacother 2006;4(4):380–394. Available
at:
http://doi.org/10.1016/j.amjopharm.2006.10.002
11. Miller PM, Plant M. Drinking, smoking, and illicit drug use among
15 and 16 year olds in the United Kingdom. BMJ
1996;313(7054):394–397. Available at:
http://doi.org/10.1136/bmj.313.7054.394
12. Byrd RS. Increased Drug Use Among Old-for-Grade Adolescents.
Arch Pediatr Adolesc Med 1996;150(5):470. Available at:
http://doi.org/10.1001/archpedi.1996.02170300024006
13. Chopra IC, Chopra RN. The use of the cannabis drugs in India.
Bulletin on Narcotics. 1957;9(1) :24–29. Available at:
https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bu
lletin_1957-01-01_1_page003.html
14. Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse Health
Effects of Marijuana Use. N Engl J Med 2014;370(23):2219–2227.
Available at:
http://doi.org/10.1056/NEJMra1402309
15. Rehm J, Mathers C, Popova S, Thavorncharoensap M,
Teerawattananon Y, Patra J. Global burden of disease and injury
and economic cost attributable to alcohol use and alcohol-use
disorders. The Lancet 2009;373(9682):2223–2233. Available at:
http://doi.org/10.1016/S0140-6736(09)60746-7
16. Gopiram P, Kishore MT. Psychosocial Attributes of Substance
Abuse Among Adolescents and Young Adults: A Comparative
Study of Users and Non-users. Indian J Psychol Med
2014;36(1):58–61. Available at:
http://doi.org/10.4103/0253-7176.127252
17. Rice E, Milburn NG, Rotheram-Borus MJ, Mallett S, Rosenthal D.
The Effects of Peer Group Network Properties on Drug Use Among
Homeless Youth. Am Behav Sci 2005;48(8):1102–1123. Available
at:
http://doi.org/10.1177/0002764204274194
18. Patrick ME, Wightman P, Schoeni RF, Schulenberg JE.
Socioeconomic Status and Substance Use Among Young Adults: A
Comparison Across Constructs and Drugs. J Stud Alcohol Drugs
2012;73(5):772–782. Available at:
http://doi.org/10.15288/jsad.2012.73.772
19. Srivastava M, Mehndi A, Patel A. Factors related to female
substance abuse: A hospital-based study from a tertiary care
de-addiction center in India. Telangana J Psychiatry.
2015;1(1):49–52. Available at:
https://www.ipinnovative.com/journal-article-file/1341
20. Gul D, Sharma N. Socio-Demographic Profile and Pattern of
Substance Abuse among Patients Presenting to a Deaddiction
Centre in a Teaching Hospital of Punjab. Int J Med and Dent Sci
4

Psychosomatic Medicine Research 2023;5(2):9. https://doi.org/10.53388/PSMR2023009
2017;6(2):1504. Available at:
http://doi.org/10.18311/ijmds/2017/18840
21. Solomon SS, Celentano DD, Srikrishnan AK, et al. Mortality
among injection drug users in Chennai, India (2005–2008). AIDS
2009;23(8):997–1004. Available at:
http://doi.org/10.1097/QAD.0b013e32832a594e
22. Wilcox HC, Conner KR, Caine ED. Association of alcohol and drug
use disorders and completed suicide: an empirical review of
cohort studies. Drug Alcohol Depend 2004;76:S11–19. Available at:
http://doi.org/10.1016/j.drugalcdep.2004.08.003
23. Bohnert KM, Ilgen MA, Louzon S, McCarthy JF, Katz IR.
Substance use disorders and the risk of suicide mortality among
Submit a manuscript: https://www.tmrjournals.com/psmr
ARTICLE
men and women in the US Veterans Health Administration.
Addiction 2017;112(7):1193–1201. Available at:
http://doi.org/10.1111/add.13774
24. Youssef IM, Fahmy MT, Haggag WL, et al. Dual diagnosis and
suicide probability in poly-drug users. J Coll Physicians Surg Pak.
2016;26(2):130–133. Available at:
https://www.jcpsp.pk/archive/2016/Feb2016/13.pdf
25. Alzahrani H, Barton P, Brijnath B. Self-reported depression and its
associated factors among male inpatients admitted for substance
use disorders in Saudi Arabia. J Subst Use 2014;20(5):347–353.
Available at:
http://doi.org/10.3109/14659891.2014.923054
5