Patterns and Pathways of Substance Use in Patients Attending a Community Drug Team

Objectives: Our primary aim was to describe the patterns of drug use and its consequences in a group of patients attending a Community Drug Team (CDT) in East Birmingham-"Azaadi." We also attempted to trace their sequence of progression to "hard" drug use. Methods: This was a retrospective, case-record based analysis of drug misusers attending "Azaadi." One hundred and forty case-records were reviewed by a psychiatrist (S.G.) and the relevant information was extracted using a pre-designed data sheet, which was later analyzed. Results: Ninety-nine Ss were male (71%); 41 were female (29%), 70 were Caucasian (71%), and 82 were single (58%). Seventy-nine percent of the sample were heroin users, 32% had mental health problems, and 55% had a positive family history of drug abuse. Alcohol, cannabis and glue were the substances first misused by these patients, and then they progressed to use of "hard" drugs like heroin and cocaine, with some differences between ethnic groups. Conclusions: This descriptive study describes the patient characteristics and associated features of drug misusers registered with a CDT. Results indicate the high rates of psychosocial morbidity and the sequence of progression from "soft" drug use to "hard" drug use, which is in support of the "gateway effect.".