Impact Assessment of the Extent of Drug Addiction on the Family Environment and Intervensions for Drug-Addicted Youth: A Quantitative Analysis

1. Introduction

Human beings face numerous challenges including illiteracy, overpopulation, poverty, inadequate health facilities, terrorism, forced migration, corruption, food and water crises, price hiking and unemployment etc. These social problems often lead to the emergence of new social problem, drug addiction being a major concern that is proliferating and exerting detrimental impact on youth (Carballo and Nerukar, 2001).

The United Nations Office on Drugs and Crime (2022) estimates that 284 million people aged 15 and 64 years used illegal drugs; representing a 26 percent increase compared to the previous year. Young people in developing countries are using emerging drugs at a high rate. Globally, the report estimates that 11.2 million people were utilizing drugs through injection. Around half of this proportion suffered from hepatitis-C, 1.4 million people having HIV and 1.2 million people suffered from both infections. Furthermore, the World Drug Report (2008) by the United Nations Office on Drugs and Crime suggests that 208 million people consumed illegal drugs aged 15 and 64 years, including youth. The report further indicates that approximately 162 million people globally used hashish (produced from cannabis), making it the most widespread drug along with many other illicit substances like opiates and cocaine etc. Beside, a total of 35 million people utilized amphetamines; 16 million people abused opiates and 13 million people worldwide consumed cocaine at the aged of 17 and 20 years. The situation of drug addiction is more severe in developed countries of the world. In European countries, the report further reveals an alarming increase in cannabis and other form of drugs among youth. The Czech Republic reported a 44% increase; Ireland documented 39%, the United Kingdom 38% and France reported 6% increase of drug-addicted youth. Similarly, the use of cocaine and other forms of drugs among youth is also rising in Spain, Italy, and Denmark respectively.

Additionally, the European Monitoring Centre for Drugs and Drug Addiction (2014) revealed that some drugs i.e. alcohol, tobacco, sedative, tranquilizer, and heroine are socially accepted in the modern world. Not only that, but they are continuously marketed to prospective consumers, particularly the youth and in some nations, the government itself markets and sells these additive products (WHO, 2021). The continuous use of chemical substance leads to drug addiction. Further, the impacts of drug addiction are not limited to physiological deterioration, but they also impacts social and economic aspects of human beings. In a vicious cycle, low income people, the working poor and unemployed who often get seduced into addiction by marketers as a temporary relief from their hardships, are thrown further into the nearly inescapable death pit of debt (Daze et al., 2003).

Moreover, the United Nation Department of Economic and Social Affair (2017) reported that extent of drug addiction among youth surpasses that of adults. As illustrated in the figure below, drug use among youth aged 15-24 is high. This pattern of drug use among youth is evident in both developing and developed countries of the world. The prevalence and extent of drugs among youth during past years (which is an indicator of regular drug use) remain significantly higher compared to adults. However, the lifetime use of drugs (which is an indicator of the extent of experience of the common people to drugs) remains higher than in adults. Conversely, drugs that have more recently emerged or have insinuated a specific lifestyle are reportedly more prevalent among youth. One example of such a drug is “ecstasy” which shows low lifetime use among adults, but high lifetime use among youth.

Further, the United Nations Office on Drugs and Crime (2017) revealed that approximately 40 % of the drugs produced in Afghanistan (heroin and hashish) are transited through unguarded routes to Pakistan, along with a substantial amount of opiate for export and local use. In 2001, Afghanistan produced 185 metric tons Opium which reached to 9,000 metric tons in 2017. Beside, the United Nation Office on Drugs and Crime (2019) conducted a survey in Afghanistan, indicating a 29% decrease in opium production to 6,400 metric tons, which was still maximum amount and second highest production in the world. The Dawn Newspaper (2010) reported that over 2,000 registered young drug addicts in different rehabilitation centers of the District Dir Lower, which is increasing day by day. The target area is significantly affected by drugs trafficking due to its close proximity with Afghanistan and boarder linkage. Nearly 200 tons of different kinds of drugs are smuggled through unguarded routes annually (Express Tribune, 2022).

2. Literature Review

Drug addiction among youth has serious implications for society (Alloy et al., 1996; Butcher et al., 2004). The extent of drug addiction has not only impact the social life of youth, but also had delirious repercussions on the family environment, family members, social relation, family stability, education, and society as a whole. Drug addiction makes youth unstable, ill tempered, isolated, anti-social behavior, leads to declines in family relationship, social marginalization and devastation (Parrott et al., 2004). Further, the family, being the basic institution, serves as a primary source of emotional affection, socialization and nourishment for human development. Consequently, drug addiction significantly impacts on family and their relationships with family members. Youth grappling with drug addiction create numerous social problems for their family members which include but are not specific to insufficient needs for development, lack of affection and love, financial problems, psychological problems, adjustment problems, and occasionally hostile behavior. Additionally, there is a high tendency for youth in developing countries to succumb to drug addiction, further contributing to instability within family (Zimic and Jakic, 2012). Drug becomes the centre of addicts’ survival, existence and governing of all social relationships. Drug addicts are often entangled in many other social problems such as violence, family breakdown, manipulative sex, ethnical, radical and other forms of intolerance. It is assumed that drug addicts committed over half of all murders under the influence of drugs such as beating, stabbing, rape and family violence (Davison et al., 2004; Zastrow, 2004).

2.1. Family Interventions for Drug Addict Youth

Drug addiction interventions include a wide range of comprehensive treatment and therapy to aid drug addict. These include detoxification, assessment, rehabilitation, continuous monitoring, counseling, medications and shared supportive programs. Social, economic and family-related problems can be addressed through various means such as family assistance, vocational training, mental wellbeing, financial assistance, medical facilities, educational programs, legal supports, housing, and transportation facilities during treatment (NIDA, 2012). Moreover, many programs addressing the social recovery problems of drug addict during individual and group treatment, as these problems carry serious consequences on deterioration and quality of life of drug addict. Effective interventions can tackle problems faced by drug addict, including reducing their interaction with high-intoxicated individuals, developing new social connections, resolving relationship issues, establishing a social network with recovered friends, building resistance against substance abuse, enhancing communication skills, increasing engagement in drug-free gatherings, connecting with supportive programs and impose strict punishment for those who injured by drug addict (Wenzel et al., 2012).

Additionally, family interventions play a crucial role in convincing or socially pressuring drug addict person to seek treatment, tackling the repercussions of drug addict on the family, assisting the family in supporting drug addict and help family to cope with their own problems connected with drug addict. The final stage of family interventions may requires family support programmers, involvement in treatment or both may be needed. There is a lot of evidence and literature that supports family strategies. These strategies can help in decreasing emotional strain for family members and aiding them in managing the family member affected by drug addiction (Monti et al., 2002; Szapocznik et al., 2013)

Moreover, targeting the age factor in drug addiction is less effective without proper attention to youth. The social work approaches have shifted their focus to drug eradication and carried out efficacious work in recognizing human personality within context of a family perspective. These approaches focused on assessing the impacts of family atmosphere on drug addict youth. This shows influential role that family involvement plays in the treatment of drug addict. Further, the research findings showed that family-based treatment for drug addict has dominated by individual or group approaches for medication and treatment of drug addict (Baldwin et al., 2012). Without proper involvement of drug addict family, treatment of drug addict is less effective due to two key factors: it rejects the stressful and traumatic impacts of drugs on family and fails to identify the importance of family as a potential organization that facilitates behavioral change. Different research studies documented the adverse consequences of drug addiction on the family system, including youth. Drug disorders clearly impact many other family members, creating several problems such as emotional problems, relationship dissatisfaction, family instability, and economic burden (Daley & Douaihy, 2010).

3. Methodology

The present study employed a quantitative research approach, gathering data from 266 respondents in the selected Hospital and Rehabilitation Centre’s of District Dir Lower, Pakistan. The potential respondents were selected randomly using Proportional Allocation method from Hospital and Rehabilitation Centre’s. To collect data, an interview schedule served as the tool for gathering of quantitative information from drug addicted youth. In Bivariate analysis, Chi-Square was utilized to measure the association between dependent and independent variable. The primary data was sourced from the PhD work of principal author, which underwent evaluation by foreign evaluators.

3.1. Conceptual Framework

The study followed by the following conceptual framework;

4. Result and Discussions

4.1. Uni-variate Analysis

4.1.1. Family Environment

Drug addiction has profound repercussions on both individual and family environment. The research studies have documented the adverse consequence of drug addiction on family environment, including youth. Further, drug addiction significantly impacts not only drug addicted individual but also other family members. It frequently gives rise to various problems such as emotional problems, relationship dissatisfaction, family instability, and economic burden (Klostermann et al., 2013).

Table No. 4.1.1 elaborates a detailed overview of data concerning to the family system of drug addict youth. The majority (68.0%) of respondents reported that drug addiction adversely impacts the family environment at both macro and micro level, while 32.0% disagreed with the statement. The impact of drug addiction on the family environment varies, depending on gender role within family. For instance, a family with drug-addicted youth is more predominately affected the family as compared to the parents with drug addiction disorder. Further, the behavior of the family member against drug addiction is also crucial, influencing interventions and treatments for drug addict. Family education regarding drug use disorder, growth, succession, and treatments management will be desirable to prevent family member from becoming involved in drug addiction. The results of previous studies showed that Community Reinforcement and Family Training (CRAFT) have effective intervention against the drug addiction within family (Roozen et al., 2010).

Furthermore, responding to the statement, 72.9% of respondents affirmed that family is a fundamental source of socialization and emotional attachment, while 27.1% disagreed. Families with Drug addicts commonly followed by several problems, including anti-social behavior, psychological problems, financial problems, domestic and accommodation problems. Further, families with drug addicts are often recognized by low integration, low solidarity, depression and low patience, role conflict and poor parental management (Semidei et al., 2001).

Moreover, 70.7% of respondents mentioned that an educated family significantly prevents young people from drug addiction as compared to an uneducated family, while 29.3% disagreed. Social work approaches have increasingly focused on assessing the effects of the family environment on drug addict, highlighting effective role of family in treatment and care. The previous research findings showed that family-based treatments of drug addicts have been dominated on individual or group approaches for medication of drug addicts (Baldwin et al., 2012).

Correspondingly, the majority (72.2%) of respondents argued that drug addiction among youth evoked family instability which result violent behavior, While 27.8% disagreed. The adverse consequences of drug addiction include aggression, hostility, family separation, divorce, and children’s removal from the home, leading to family instability (Klostermann et al., 2013).

Likewise, 82.0% of respondents reported that drug addict is considered a major burden for their family and relatives, while 18.0% negated the statement. Research studies showed that drug addiction having negative consequences for families and their members, including children’s. The drug disorder clearly influence a large number of people along with drug addict, placing additional burdens on both family and its members, including emotional burdens, economic burdens, relationship distress or dissatisfaction, family instability and effects on parents relationship (Daley et al., 2010).

Additionally, 71.8% of respondents mentioned that drug addict experience high level of dissatisfaction in relationships with their family, whereas 28.2% rejected the statement. Family with drug addict are frequently followed several problems, including psychological problems, dissatisfaction in relationship, financial problems, educational problems and adjustment problems (Nolan et al., 2001).

Furthermore, 72.2% of respondents documented that drug addict showed high level of hostility and violence which often ending with divorce, while 27.8% of respondents disagreed with the statement. Drug addiction has been identified as an important hazardous factor for family hostility, particularly in situations of extreme violence such as assassination (Easton et al., 2000). Partner violence has been associated with both alcoholism and drug addiction. The research studies revealed that couple hostility and alcohol usage were found to be one of the constant threats to husband violence (Stuart et al., 2003).

Similarly, answering that family of drug addict is characterized by low cohesion; role conflict and tolerance were disclosed by 63.5% of respondents, whereas 36.3% disagreed with the statement. Hereditary and social surrounding (environmental) play an important role in the involvement of youth in becoming drug addict (Boyd and Holmes, 2002). The research findings emphasize the significance of the family in which an individual is raised, progress, developed, influenced and is socialized according to the culture (Brookoff et al, 1997). So, it is essential for social scientists to assess and investigate the impacts of drugs on the family environment, as it leads to several problems such as low cohesion, low tolerance, economic difficulties and hostility (Haber, 2000).

Table 4.1.1. Family Environment.

Statements	Yes	No
Drug addiction adversely impact family environment at macro and micro level.	181 (68.0%)	85 (32.0%)
Family is a fundamental source of socialization and emotional attachment.	194 (72.9%)	72 (27.1%)
An educated family significantly prevents young people from drug addiction compared to uneducated family.	188 (70.7%)	78 (29.3%)
Drug addiction of youth evoked family instability which result violent behavior.	192 (72.2%)	74 (27.8%)
Drug addict is considered a major burden for their family and relatives.	218 (82.0%)	48 (18.0%)
Drug addict experience high level of dissatisfaction in relationships with their family.	191 (71.8%)	75 (28.2%)
Drug addict showed high level of hostility and violence often ending with divorce.	192 (72.2%)	74 (27.2%)
Family of drug addict is characterized by low cohesion, role conflict and tolerance.	169 (63.5%)	97 (36.5%)

Source: Sep-Oct Survey, 2021.

Table 4.1.1. Family Environment.

Statements	Yes	No
Drug addiction adversely impact family environment at macro and micro level.	181 (68.0%)	85 (32.0%)
Family is a fundamental source of socialization and emotional attachment.	194 (72.9%)	72 (27.1%)
An educated family significantly prevents young people from drug addiction compared to uneducated family.	188 (70.7%)	78 (29.3%)
Drug addiction of youth evoked family instability which result violent behavior.	192 (72.2%)	74 (27.8%)
Drug addict is considered a major burden for their family and relatives.	218 (82.0%)	48 (18.0%)
Drug addict experience high level of dissatisfaction in relationships with their family.	191 (71.8%)	75 (28.2%)
Drug addict showed high level of hostility and violence often ending with divorce.	192 (72.2%)	74 (27.2%)
Family of drug addict is characterized by low cohesion, role conflict and tolerance.	169 (63.5%)	97 (36.5%)

Source: Sep-Oct Survey, 2021.

4.2. Bivariate Analysis

4.2.1. Association between Family environment and Extent of Drug addiction

Family plays a crucial role in human development, providing essential emotional affection, socialization, and nourishment. Consequently, drug addiction significantly impacts family and their relationship with other members. Drug addict create many social problems for their family members, including but not limited to inadequate developmental needs, a lack of affection and love, financial problems, psychological distress, adjustment problems and occasionally even to hostile behavior (Zimic and Jakic, 2012).

Table 4.2.1 portrays a significant association (P=0.003) between negative impacts of drug addiction on family environment and the extent of drug addiction. The result aligned with the findings of a study by Nolan et al., (2001), which indicates that drug addict in the family, is frequently associated with many problems, including mental health problems, family hostility, and financial challenges. Moreover, the study reveals a significant association (P=0.005) between family is a fundamental source of socialization and emotional attachment and the extent of drug addiction. The finding supports the research by Brook et al., (1990), which emphasize the importance of the family in an individual rise, progress, develops, influence and socialize within their culture context. So, it is essential for social scientists to assess and investigates the impacts of drug on the family environment, as it can result in several problems such as low cohesion, low tolerance, economic difficulties, and hostility.

Furthermore, a highly significant association (P=0.000) was revealed between educated family significantly prevents young people from drug addiction than uneducated family and the extent of drug addiction. The result aligned with findings of the study by Roozen et al., (2010), which emphasize the importance of providing proper education to family regarding drug addiction, growth, preventions, rehabilitations, and treatment. Family can play a significant role in preventing and treating of drug addict if they are equipped with education about drugs. Besides, Community Reinforcement and Family Training (CRAFT) have confirmed that effective intervention and strong therapist management tools can lead to an increased ratio of drug addicts seeking family treatment.

Likewise, a significant association (P=0.003) was accorded between drug addiction of youth evoked family instability, resulted violence behavior and the extent of drug addiction. The Similar findings were revealed by Hawkins et al., (2009), which suggest that when an individual wants to alter his or her behavior within a family, it affects the functioning of the entire family structure. Family structure is like mobile phones, if one part of the family is not properly functioning, it will affect the functioning of the entire structure just like mobile phone. To maintain smooth running, each component of the family must adopts its responsibilities to preserve equilibrium within the system. One repercussion of family disequilibrium and instability is that, family members may unintentionally harm interventions and treatment for drug addict through their attitude and behavior.

In addition, a significant association (P=0.005) was observed between drug addict is considered a major burden for their family and extent of drug addiction. The result was in line with Daley et al., (2010), who stated that drug use disorders (SUDs) have negative consequences on family structure and members particularly youth. The drug use disorders affect a large number of other people and placed additional pressure on the family system. Moreover, a significant association (P=0.001) was found between drug addict experience a high level of dissatisfaction in relationships with their family and the extent of drug addiction. The finding is consistent with the result of a study conducted by Daley et al., (2010), which revealed that drug addict family face a significant level of distress, dissatisfaction, tension and conflict as a result of drug addiction, further exacerbating family problems.

Furthermore, there is a significant association (P=0.003) between drug addict showed a high level of hostility and violence within the family often ending with divorce and the extent of drug addiction. The similar results were noted by Nolan, (2001), which indicates that drug addict in a family is frequently accompanied by many problems, including mental illness, domestic violence, economic difficulties, housing needs, and residence in dangerous neighborhood environments. Correspondingly, a significant association (P=0.001) was found between drug addict family is characterized by low cohesion, role conflict and extent of drug addiction. The same result was revealed by Johnson et al., (2002), which suggests that family with substance-abusing member tends to have low levels of cohesion, low tolerance, role conflict and isolation, as a product of drug addiction.

Table 4.2.1. Association between Family environment and Extent of Drug addiction.

Family Environment	Dependent Variable	Statistics
Drug addiction adversely impact family environment at macro and micro level.	Extent of Drug addiction	χ2= 8.719 (P=0.003)
Family is a fundamental source of socialization and emotional attachment.	Extent of Drug addiction	χ2= 8.035 (P=0.005)
An educated family significantly prevents young people from drug addiction than uneducated family.	Extent of Drug addiction	χ2= 12.368 (P=0.000)
Drug addiction of youth evoked family instability result violent behavior.	Extent of Drug addiction	χ2= 8.723 (P=0.003)
Drug addict is considered a major burden for their family and relatives.	Extent of Drug addiction	χ2= 8.014 (P=0.005)
Drug addict experience high level of dissatisfaction in relationships with their family.	Extent of Drug addiction	χ2= 11.187 (P=0.001)
Drug addict showed high level of hostility and violence often ending with divorce.	Extent of Drug addiction	χ2= 8.723 (P=0.003)
Family of drug addict is characterized by low cohesion, role conflict and tolerance.	Extent of Drug Addiction	χ2= 11.211 (P=0.001)

Source: Sep-Oct Survey, 2021.

Table 4.2.1. Association between Family environment and Extent of Drug addiction.

Family Environment	Dependent Variable	Statistics
Drug addiction adversely impact family environment at macro and micro level.	Extent of Drug addiction	χ2= 8.719 (P=0.003)
Family is a fundamental source of socialization and emotional attachment.	Extent of Drug addiction	χ2= 8.035 (P=0.005)
An educated family significantly prevents young people from drug addiction than uneducated family.	Extent of Drug addiction	χ2= 12.368 (P=0.000)
Drug addiction of youth evoked family instability result violent behavior.	Extent of Drug addiction	χ2= 8.723 (P=0.003)
Drug addict is considered a major burden for their family and relatives.	Extent of Drug addiction	χ2= 8.014 (P=0.005)
Drug addict experience high level of dissatisfaction in relationships with their family.	Extent of Drug addiction	χ2= 11.187 (P=0.001)
Drug addict showed high level of hostility and violence often ending with divorce.	Extent of Drug addiction	χ2= 8.723 (P=0.003)
Family of drug addict is characterized by low cohesion, role conflict and tolerance.	Extent of Drug Addiction	χ2= 11.211 (P=0.001)

Source: Sep-Oct Survey, 2021.

5. Conclusion

The study focused on assessing the impact of the extent of drug addiction on the family environment and the need for family-based interventions for drug addicted youth in the rural area of Dir lower Khyber Pakhtunkhwa. The extent of drug addiction on sampled respondents was measured in context of dimension i.e. family environment. The independent variables were quantitatively measured and found to have an impact on the dependent variable. The data for the study was gathered from drug addicted youth in rehabilitation centre’s and hospitals. The analysis involved using frequencies and percentage in Uni-variate analysis and the Chi-Square test. The findings confirmed that drug addiction is always associated with many risk and social factors, including family problems. These social problems pose challenges for both family and society as well. There are many effective interventions and mutual support programs which assist drug addicted youth and their family to address these social problems. Further, the results of the study revealed that the extent of drug addiction significantly impacts the family environment. This impact includes creating an unpleasant family environment, a lack of emotional attachments, an inability to fulfill basic needs, considered as a burden by family and relatives, experiencing high levels of dissatisfaction in relationship with their family members, and displaying high levels of hostility and violence often ending with divorce. Additionally, Based on these findings, it is evident that addressing the family environment is crucial in addressing drug addiction among youth. Interventions should focus on improving family dynamics, emotional support, and meeting basic needs to mitigate the negative consequences of drug addiction on both the individual and the family unit.

6. Recommendations

A numbers of recommendations have been made for drug-addicted youth based on current study. These recommendation include;

• Increase awareness and education: It is important to raise awareness about the negative impact of drug addiction on the family environment. Educational programs should be developed to inform individuals and families about the potential consequences of drug addiction and the importance of seeking help.
• Provide support for families: Families dealing with drug addiction should be provided with adequate support systems. This can include counseling services, support groups, and access to resources that can help them navigate the challenges they face. Financial assistance programs may also be beneficial in alleviating some of the economic difficulties associated with drug addiction.
• Enhance mental health services: Given the association between drug addiction and mental health problems within the family, it is crucial to improve access to mental health services. This can involve increasing the availability of counseling and therapy options, as well as promoting early intervention and prevention strategies.
• Strengthen socialization and attachment within families: Recognizing the importance of the family in an individual's development and socialization, efforts should be made to strengthen family bonds and promote healthy relationships. This can be achieved through family therapy, parenting programs, and activities that foster communication, trust, and emotional attachment.