Prevalance Of Substance Abuse Among Street Children In West Bengal, India

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Introduction
Substance abuse encompasses the excessive or improper use of various substances, including tobacco, alcohol, marijuana, glue, opioids, gasoline, and both legal and illegal drugs.Among these, inhalants, which are volatile substances (VS), are the most frequently abused.Recent research has highlighted that inhalants are the most prevalent among these substances.This issue predominantly affects a highly vulnerable group of street children aged between 5 and 15 years old in India.They are favored because they are affordable, easily accessible, and legally obtainable in the market.In 2000, UNICEF reported that India had approximately 18 million street children, possibly the highest number in the world (Sharma N., 2013).UNICEF defines street children as those for whom the streets have become more of a home than their family, where they lack protection, supervision, or guidance from a responsible adult (Mukharjee C., 2014).Due to their hidden nature, accurately quantifying the population of street children is a daunting task without government intervention (Mondol N. K., 2013; Sharma N., 2013).The United Nations has established 17 Sustainable Development Goals (SDGs) to achieve by 2030, with the third goal focusing on good health and well-being.One of the targets under this goal is to prevent the use of harmful substances such as alcohol, tobacco, glue, and cigarettes, as well as reducing the associated deaths and injuries (Sharma N., 2013).The global situation has deteriorated further during the pandemic.UNICEF's 2020 report for India revealed that interrupted education had a devastating impact on 286 million children worldwide as the pandemic began.While street children are a result of various contributing factors, poverty is one of the most significant, and it has notably increased following lockdowns across the globe.According to the State of the World's Children 2021 report (Singh P., 2022), 356 million children are living in extreme poverty.
These children, often from broken families or lacking a caregiver, experience extreme poverty and food insecurity, which frequently drives them to a life on the streets and into these forms of addiction.Initially, the primary motivation behind substance abuse is often hunger, with some studies indicating that these substances are used as a means to alleviate hunger pangs.Tragically, substance abuse is a major contributor to the loss of lives among India's street population.This type of substance abuse is widespread throughout India, particularly in the state of West Bengal.The objective of this study is to assess the prevalence of substance abuse among street children in West Bengal, India.Here are the summarized findings from the provided references regarding substance abuse in various contexts: A study by Roy and Chakraborty (1981) among 705 medical college students in West Bengal revealed that smoking and drug use habits were more common in students from lower-income family backgrounds, particularly among males.Students from urban backgrounds had a higher prevalence of substance abuse, and the rate of abuse tended to increase as students progressed through medical college.Hembram et al. (2015), conducted a survey among 555 male students from tribal areas in Paschim Medinipur, West Bengal, and found that 53.87% were lifelong substance abusers.Peer group activities were a major influence on substance abuse.The survey also indicated a connection between substance abuse and the literacy rate of the mother, with children of illiterate mothers being more inclined to use alcohol.A survey highlighted that many street children in Kolkata migrated from different states or localities, with Kolkata serving as a major hub for street children.Cities like Birbhum, Bardhaman, North 24 Parganas, South 24 Parganas, and Samastipur, Bihar, were reported as significant sources of migration to Kolkata (Mukharjee, 2016).
Data from a survey of 340 tribal adults in West Bengal revealed that 196 males and around 50 females (46.7%) used alcohol.Females tended to start using alcohol at a later age than males (Roy et al., 2018).Among 144 adolescents in Bardhaman, West Bengal, substance use was more common among school dropouts (approximately 56.8%) compared to school-going adolescents.Family problems and a family history of substance abuse were identified as factors highly relevant to substance abuse among adolescents (Dalui et al., 2018).Study by Gorai and Roy (2018) found that 31.3% of students in grades 9 to 12 regularly used one or more substances, including tobacco and alcohol.A study among nicotine-dependent participants from West Bengal found that 27.3% had high dependency, 27.3% had medium dependency, and 45.4% had low dependency on tobacco.The majority of tobacco users were male, Hindu, and from joint families (Islam et al., 2019).A community-based survey among street children in Kolkata revealed that substance abuse was most common among children with a median age of 13 years.Most of them were male, illiterate, unmarried, and engaged in some form of work (Basu et al., 2021).Debnath and Modak (2021) reported that peer groups were the most common source of information about substance use among 160 adolescent students, followed by family, television, and the internet.Mukhapadhyay et al (2022) found that inhalant abuse as a substance was prevalent among 26 unmarried males from urban and low socioeconomic backgrounds in West Bengal.They mostly came from nuclear families and had a mean age of 15.2 years.Tobacco was commonly used alongside inhalants.Street life often exposes individuals to challenging environments that can lead to drug addiction and criminal behavior (Roy et al., 2023).These studies provide insights into the prevalence and factors associated with substance abuse in various populations and contexts in West Bengal, India.

Research design
Various methods have been employed to study the prevalence of substance abuse among street children.Literature offers various approaches for identifying this vulnerable group.Many studies, including those by Dalui et

Discussion
The phrase "substance abuse" encompasses the harmful use of both legal and illegal substances available in the market.It involves a repeated pattern of using these substances to the point of developing substance dependence, which is characterized by both mental and physical reliance on drugs (Pacific Health System, 2019).Both legal and illegal drugs contain chemicals that provide pleasure, reduce stress, and help individuals avoid unpleasant circumstances by altering the functioning of the mind and body (Bhandari S., 2022).The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) by the American Psychiatric Association (APA) in 2000 identifies nine drugs associated with substance abuse: amphetamines, alcohol, cannabis, cocaine, inhalants, hallucinogens, opioids, phencyclidines, and anxiolytics or sedatives.This identification is based on the diagnosis of substance dependence (APA Dictionary of Psychology, 2023).Several studies have indicated that males tend to exhibit a higher prevalence of substance abuse compared to females.Specifically, about 34% of individuals with substance abuse issues are from the Hinduism community, while approximately 20% come from the Islamic faith.However, it's worth noting that there is no significant relationship between one's religious affiliation and substance abuse, as evidenced by research conducted by Agarwal et  Various factors contribute to the promotion of substance abuse, including easy access to items such as biri, cigarettes, glue, and more.Peer pressure also plays a significant role in encouraging substance use.Additionally, family-related factors are at play, including an unhealthy family environment, the absence of a caregiver, a tumultuous and abusive family atmosphere, and using substances as a means to cope with stress.An applied research methodology known as Respondent Driven Sampling (RDS) has uncovered the root causes of substance abuse, particularly among street children.These causes include homelessness, poverty, a lack of affection, broken families, and family abandonment.Among these factors, poverty stands out as a primary driver, as it compels many children to turn to substance abuse.Additionally, the struggle to cope with hunger plays a significant role.Substances like ganja, glue, and alcohol are readily available to children and provide them with a psychoactive effect while temporarily alleviating hunger pangs.As a result, some forms of substance abuse can be seen as a means of relieving hunger-related discomfort (The Borgen Project, 2020; Acharya A et al., 2021).According to published reports, the use of substances and the problem of illicit drug abuse are influenced by various sociodemographic factors, including population size, age, gender, and urbanization rates.On average, the worldwide rate of pure alcohol consumption is 17 liters per year.Approximately 38.3% of the global population consumes alcohol in equal measure.Furthermore, at least 15.3 million people suffer from Drug Use Disorder (DUD), Substance Use Disorder (SUD), or Inhalant Use Disorder (IUD).This means that the worldwide alcohol consumption rate averages 13.5 grams of pure alcohol per person per day.A previous estimate from 2008 suggested that approximately 120-155 million people, or 3.5-5.7% of the world's population aged 15-64, had used psychoactive substances other than alcohol.Among these substances, cannabis was the most commonly used (129-190 million people), followed by various types of amphetamines, cocaine, and opioids (WHO, African Region, 2023).
In the context of India, there have been some studies on substance abuse among street children, with one study specifically examining the socio-demographic and psychosocial circumstances of street children in Kolkata, West Bengal.This research provides valuable insights into the prevalence and factors associated with substance abuse in the regions of West Bengal (Reference to overview of West Bengal data).Among all substance abusers, two-thirds (approximately 67%) primarily used a variety of substances.The most commonly used substance among them was VS, accounting for 41.3% of the cases.The reasons behind the use of these substances were predominantly driven by the perceived positive benefits, which accounted for 54.7% of the cases.Another significant factor contributing to substance use was the desire to experience feelings of happiness and alleviate pain, which was reported by 17.3% of the individuals.Other expectations from substance use included a decrease in hunger, temporary relief from sorrows, and a boost in confidence, among others.The data also revealed gender differences in substance preference.Males showed a stronger preference for using VS, while females tended to use a variety of substances from the group.

Conclusion
The preceding conversation illustrates that the global incidence of substance abuse among street children is on the rise, particularly following the pandemic, while research in this field is diminishing.Existing literature has revealed a noticeable absence of studies examining the situation in West Bengal.Consequently, to gain a more comprehensive understanding, we have identified potential avenues for future research in various regions of West Bengal, a state in India.
al. (2018), Ray et al. (2018), and Bal et al. (2015), have employed cross-sectional research designs within specific time frames.Sampling methods recommended for gathering data from hard-to-reach populations like street children include conventional cluster sampling and snowball sampling, as advocated by Bal et al. (2015) and Acharya et al. (2022).Researchers have commonly used a pre-designed, pre-tested, and semi-structured questionnaire, as demonstrated by Hembram et al. (2015).Additionally, obtaining permission from the institutional ethical committee is imperative before conducting such surveys, as emphasized by Dalui et al. (2018) and Hembram et al. (2015).
In many cases, children vulnerable to street life are influenced by two main factors: "pull factors" and "push factors."Those who are abandoned by their families or sent to cities to escape poverty fall under the push factor, while the pull factor often entices children or families to move from their old lives to new ones, attracted by urbanization (Sharma N. et al., 2013).Street children can be categorized into three distinct segments: (a) "Children 'of' the street," who fully embrace street life and spend most of their time there, guarding their territory; (b) "Children 'on' the street," who occasionally visit their families but engage in street trades; and (c) "Abandoned children," who survive on their own with no ties to families (Thapa K. et al., 2009; Julien G., 2022; Acharya A. et al., 2022).Most studies indicate that the vulnerable age range for substance abuse among street children is between 9 and 15 years old (Bal B. et al., 2010; Islam F et al., 2014; Barman P. J., Ojah J., 2016; Basu G. et al., 2021).In a survey titled "Surviving the Streets," conducted in Delhi in 2010 as an initiative by Save the Children in 2011, it was reported that the cities of Kolkata, Delhi, and Mumbai have the largest populations of street children (Dutta N., 2018).