Oman is witnessing an increase in issues pertinent to alcohol and psychoactive substance use. As yet, no studies have examined the trend in the country. Taking the cue from this fact, a group of researchers from the College of Medicine and Health Sciences, Sultan Qaboos University and the Ministry of Health conducted a study to identify the characteristics of Omanis with substance use disorder attending a specialized hospital in Oman and the pattern of their utilization of healthcare services. The study was published in the Public Library of Science (PLOS One) entitled “The characteristics and patterns of utilization of healthcare services among Omanis with substance use disorders attending therapy for cessation” (https://doi.org/10.1371/journal.pone.0210532 January 31, 2019).
The cross-sectional study was conducted in a tertiary care center (Al Masarra Hospital) which is specialized in the treatment of those engaging in substance use in Oman. The participants were selected from a convenience sample among patients seeking consultation at the center for alcohol and substance use. The research team contributed to this work include Nabila Al Wahaibi, Anwaar Al Lawati, Falaah Al Ruqeishy, Abdulla Al Khatri, Yahya Al- Farsi, Tahira MA Juma, Fatma Al Hinai, Nasser Al-Sibani, Sangeetha Mahadevan and Samir Al-Adawi.
A six-part questionnaire was designed to obtain information regarding socio-demographic background, clinical history, healthcare utilization and perceived hurdles to access. The main goal of this study was to expand the literature surrounding substance use in Oman and those who seek treatment, as there is little information that currently exists about this population. This study explored socio-demographic factors, factors related to the initiation of substance use, types of substances used, comorbid health and psychiatric conditions, healthcare utilization and hurdles to accessing healthcare among people that use psychoactive substances in a substance use disorder treatment facility in Oman.
According to Dr. Nabila Al Wahaibi, the principal author of the study, among the patients seeking cessation therapy, 99% were male and less than 30 years of age. “Peer influences on the initiation of substance use were significant. Most patients had a history of polysubstance use, including intravenous substance use. Cannabis and alcohol were the first substances consumed by most patients”.
Despite the availability of most common compounds used for cessation treatment for Alcohol and Psychoactive Substance in the region, relapses are common. Dr. Nasser Sibani, Senior consultant at the Department of Behavioral Medicine, Sultan Qaboos University said, “this study clearly indicates that people who have abused cannabis and benzodiazepines have better outcomes compared who were abusing heroin.
The age factor is also important and according to Dr. Anwaar Al Lawati, one of the authors, males below 30 years were more prone to succumb to drug addiction. She added that in this study, most patients engaged in polysubstance use. Intravenous psychoactive substance use has been reported in many parts of the world and appears in different contexts within the Arabian Peninsula as well.
Data from the World Health Organization, as reported by, mention the prevalence of substance use in the Eastern Mediterranean region (which include Oman) to be 3,500/100,000 while the prevalence of intravenous substance use disorders is at 172/100,000 people. According to the 2017 report of the United Nations Office on Drugs and Crime, the prevalence of injecting psychoactive substances has been estimated at 0.2% of the population in the region defined as “Near and the Middle East” (which includes Oman). In the present study, approximately 67% of the participants admitted to having used intravenous substances.
The most consumed substances were opioids (including heroin), cannabis and alcohol. As often the case, accessibility defines the type of controlled substances that are more likely to be used. Oman lies close to the opioid and cannabis producing “Golden Crescent” region of Central Asia. Alcohol availability has increased with the influx of expatriate contract workers from different parts of the world who currently constitute about 45% of the total population, the majority of whom are young, single men. The growth of the tourism industry has also contributed to the easy availability of alcohol. Dr. Nasser Al-Sibani noted, “Alcohol is apparent more harmful than heroin but it is widely used as a source to generate revenue and on the other hand, heroin is a bad user but it has the insidious burden to the society”.
Substance use has been known to compromise several health parameters, which are likely to worsen if administered intravenously. With reference to the data in 2007 from the WHO’s Oman Atlas of Substance Use Disorders, among 384 Omanis that were documented to inject themselves with psychoactive substances, 6.5% had HIV/AIDS, 42.5% had contracted Hepatitis B and 3.9% had Hepatitis C. In our study, Hepatitis C infection was the most common (41.3%) disease, followed by HIV/AIDS (4.1%), Hepatitis B virus (3.1%) and Tuberculosis (0.3%). The presence of Hepatitis C has the potential to trigger inflammation and infection of the liver. Hepatitis C is the most common among the present sample.
According to Al Lawati, the trend in Oman appears to echo the situation in the regional countries. “If the link between people who inject psychoactive substances and proliferation of the infectious diseases would withstand further scrutiny, Oman ought to contemplate evidence-based prevention”.
Various studies from the Arabian Gulf have reported a strong link between the presence of psychiatric disorders and personality disorders and the development of substance use disorders. In the present study, 35% of the patients exhibited depressive symptoms while 18% had made suicidal attempts. This view is consonant with the literature suggesting a strong link between depressive symptoms or suicidality and substance use.
Dr. Nabila Al Wahaibi added that while the majority of patients endorsed that the interventions at the rehabilitation center had improved their well being, they were apprehensive about returning to their communities since re-exposure to their previous social life would likely trigger boredom, which, in turn, are likely to heighten craving for drug and the likelihood of relapse. “Oman, like the rest of the world, has to contend with the fact that it is so far difficult to keep youngsters astray from drug and once they are hooked, it is difficult to wean them off”.