Factors associated with heroin addiction among male adults in Lahore, Pakistan.
Level 4 - case-series / case-control
Matched case-control study
PubMed 12924744 · doi:10.1080/02791072.2003.10400003
What was done
A matched case-control study was conducted in Lahore, Pakistan, to evaluate risk factors for heroin addiction among males aged 15 to 35 years. The study enrolled 233 heroin addicts (cases) matched 1:2 to neighborhood controls (466 controls, total n = 699). Multivariate conditional logistic regression analysis was performed to calculate adjusted matched odds ratios (adj. mOR) and 95% confidence intervals for hypothesized risk factors.
What was found
Heroin addiction was significantly associated with parental disharmony (frequent fights vs. no fights: adj. mOR = 6.0, 95% CI: 2.8–16.6; occasional fights vs. no fights: adj. mOR = 4.3, 95% CI: 2.4–7.8), drug-using peers (adj. mOR = 5.6, 95% CI: 2.6–12.1), alcohol use (adj. mOR = 4.2, 95% CI: 2.3–7.6), use of over-the-counter drugs (adj. mOR = 4.1, 95% CI: 1.8–10.6), father's absence (adj. mOR = 2.9, 95% CI: 1.6–5.5), non-formal schooling of the mother (adj. mOR = 2.8, 95% CI: 1.7–4.7), non-formal schooling of the respondent (adj. mOR = 2.4, 95% CI: 1.5–3.8), and presence of a drug user among similar-age family members (adj. mOR = 2.4, 95% CI: 1.3–4.8).
Why it matters
This study provides specific multivariable estimates of familial, social, and educational risk factors for heroin addiction in an urban South Asian male population, highlighting the prominent roles of peer behavior and domestic conflict.
Limits
The study is restricted to males aged 15–35 in a single city, limiting generalizability to females, other age brackets, or rural contexts. Because of the retrospective case-control design, temporal sequence cannot be definitively confirmed, and data are subject to recall bias. Unmeasured confounders such as psychiatric disorders or socioeconomic status were not reported in the abstract.
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