“South Asian Cocktail” – The Predominant Drug Use Pattern in Nepal and its Association with Spread of HIV

Abstract

Introduction: Central Bureau of Statistic of Nepal (2008) shows more than 46,000 illegal drugs users, out of which 61% are injecting drug users (IDU). An injecting mixture of  medicines called “South Asian Cocktail” is prevalent in Nepal. This study was carried out to find out the knowledge on drug use behaviour and health status with a focus on HIV in “cocktail” drug users.

Methods: A cross-sectional survey among opiate users in contact with the treatment system was performed. After an initial mapping of Kathmandu valley, 300 drug users, on a random basis, in contact of different treatment and counselling centres were interviewed. The research questionnaire was designed following Europ ASI and Maudsley Addiction Profile standards.

Results: Ninety one percent of the respondents were male and 9% female. 95% are injecting drug users with an average 8.7 years of drug use history. 86% are injecting different “cocktails” usually made of buprenorphine, diazepam, Phenergan (promethazine) and/or other substances (30 day prevalence). Similarly, 48% use heroin whereas only 2% take cocaine/ crack. Amongst tested for HIV (N=223) 33% are positive (25% of sample population).

Conclusion: The “South Asian Cocktail” users have a higher risk behaviour than heroin drug users which is associated with the spread of HIV. It needs to be considered which HIV prevention measures are needed related to the specific needs of cocktail users, since the available services (like needle syringe exchange) does not seem to cover their specific needs.