Opioid use and correlative risk factors among adult male and female residents of Kabul, Afghanistan national urban drug use study (ANUDUS)

The Afghanistan National Urban Drug Use Study (ANUDUS) is the first comprehensive epidemiological study collecting both self-reported patterns of substance use and biological samples in 11 Provinces of Afghanistan. Conducted from July 2010 through April 2012, the female heads of household (HoH) were asked to report substance use and behaviors within the household. Oral fluid (saliva), urine, and hair samples were then collected for laboratory analysis from the female HoH, the eldest male, and the youngest child over 4 years. This analysis presents laboratory-confirmed opioid use among adults aged 15 years and over surveyed in Kabul, and correlative risk factors for use by gender. Throughout four geographic quadrants of Kabul, 1,343 households were surveyed, and biological specimens obtained from 2,229 adults. Overall, 1.9% of females tested positive for opioids, as compared to 4.1% of males. Among households surveyed, 1.4% reported a male within the household using opioids/heroin within the past 30 days, while 0.2% reported a female in the household using recently. For both males and females, significant predictors of opioid use included: 1) reporting a member of the opposite sex within the household who recently used opioids, and 2) corresponding laboratory-confirmed use of amphetamines, barbiturates, benzodiazepines, or cannabinoids. Valid data regarding opioid use within Kabul are sparse. These findings suggest opioid use is prevalent among adults within the city, likely occurs as polysubstance use with other drug classes, and is highly influenced by other members within the household.