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Table 1 General description of the included SUD studies (n = 21)

From: Substance use disorders in Saudi Arabia: a scoping review

Author/ Year

Design

Location

Sample size

Sample age

Sample source, Gender:

(M = male, F = female)

SUD diagnostic criteria

Main findings

Epidemiological description of SUD:

 Alkhalaf et al., 2019 [46]

Cross sectional (records)

Al-Amal Hospital, Dammam

2048

1993 (n = 720),

2013 (n = 1328)

Older than 15

Patients (M)

Not mentioned

Significant differences were observed in type of addiction and socio-demographics (age, criminal record, educational level, employment status, relapse, and type of substance abused) between 1993 and 2013.

 Ibrahim et al., 2018 [7]

Cross sectional

Psychiatric Rehabilitation Center (PRC), Buraidah

612

(10–80)

73% were 21–40 years

Patients (M)

Not mentioned

Majority were polysubstance users (60%); amphetamine users (24%).

No significant association between positive family history of substance abuse or mental and type of substance abused.

 Bassiony, 2008 [28]

Cross sectional

Al-Amal hospital in Jeddah

101

(14–61)

Patients (M)

DSM-IV

Adolescents started using drugs at a younger age than adults (p = 0.006). Adolescents and adults also differed in the first (p = 0.001) and the second (; p = 0.002) stages of progression in drug involvement.

 AbuMadini et al., 2008 [29]

Cross sectional (records)

Al-Amal Hospital, Dammam

12,743

(83%)

were 20–39 years.

Patients (M)

ICD-9 &10

Use increased for amphetamines and cannabis, decreased for heroin, sedatives and volatile substances and remained stable for alcohol.

 Abalkhail, 2001 [30]

Cross sectional

(Comparative study)

Al-Amal hospital, Jeddah

303

Mean (SD)

30.4 (0.4) heroin, 29.4 (1.0) non-heroin

Patients (M)

Not mentioned

Heroin addicts were seven times more likely to develop hepatitis B or C infection than non-heroin addicts.

 Iqbal, 2000 [31]

Cross sectional (records)

Voluntary detoxification unit, Jeddah

799

(17–66)

83% were 20–39 and 68% were under 35.

Patients (M)

DSM-IV

Heroin was the choice of substance (63%) abuse; 14% were poly drug users. Among heroin users, 91% were injecting it and 69% had Hepatitis C.

 al-Nahedh, 1999 [32]

Cross sectional

Al-Amal Hospital, Riyadh

160

(20–60)

(Mean 29.5)

 

Not mentioned

Age, unemployment, peer pressure and family and social stresses were significantly associated with repeated admissions.

 Hafeiz, 1995 [33]

Cross sectional

Al-Amal Hospital, Dammam.

116

(20–61)

83% were 21–32 year

Patients (M)

DSMIIIR

84% used heroin either alone or in combination with other drugs. 31% used alcohol, 26% used cannabis, and 10% used stimulants. Heroin user were younger and less likely poly-drug abusers than alcoholics.

 Osman, 1992 [17]

Cross sectional

Jeddah Psychiatric Hospital

485

(15–65)

Mean 29.04 (8.67)

52% were 20–29.

Patients

(M, F)

(F 2.7%, n = 13)

Substance abuse predefined criteria

43.5% were heroin addicts and 16.1% alcohol abusers; 14.6% were poly-drug abusers.

Reasons for drug use: curiosity and peer influence and traveling abroad. 4.9% had criminal history.

 Qureshi, 1992 [34]

Cross sectional

Buraidah Mental Hospital

240

–

Patients and controls (M)

DSM III R

Single and/or disruptive marital life, poor social class, unskilled job and/or unemployment and financial issues were significantly associated with drug abusers as contrast to control group (p < 0.0001).

 Omer and Ezzat, 1999 [47]

Cross sectional

(Description of two studies)

Al- Amal hospital, Jeddah

Study A: 43 cases of volatile and similar number control from opiate patients

Study B: 50, no comparison control

Older than 15 years

Patients

(M)

DSM III R for study A,

Not specified for study B

The majority of admitted volatile substance abusers were young, single and unemployed. The two main abused substances were paint and glue. Volatile abusers had no difference in age distribution as compared to the control group of heroin addicts but scored more in the psychosis scale.

 Iqbal, 2001 [35]

Cross sectional

Al- Amal hospital, Jeddah

302

> 18 years

adult with substance dependence (M)

DSM-IV

On admission, 57.14% expressed no desire to complete the program. Unaided abstinence was reported by 42.71% and post-treatment abstinence by 57.52%.

Prevalence and detection of infectious viral diseases among SUD patients:

 Alshomrani, 2015 [36]

Cross sectional

Alamal Complex for Mental Health in Riyadh, Addiction center.

357

(13–71)

Mean (SD)

40 (8.6)

Inpatients heroin users (M)

Not mentioned

Prevalence of HBV surface antigen was 7.7%, antibodies for HCV 77.8%, and HIV 9.8%.

A significant association was found between positive HCV and positive HIV tests.

 Alzahrani AJ et al., 2009 [37]

Cross sectional

Local rehabilitation center, Dammam

344

–

intravenous drug users (M)

Not mentioned

The prevalence of HBV and HCV was 12% (n = 41) and 38% (n = 131) compared with prevalence rates in the general population in Saudi Arabia of 1.7 and 5%, respectively.

Mixed genomes of HBV, HCV and TTV were observed.

 Alzahrani AJ 2008 [38]

Case-Control

Local rehabilitation center, Dammam

Cases (n = 297)

Control

matched blood donors (n = 305).

Mean (SD)

31 (2.2)

Patients followed up or admitted to a drug rehabilitation hospital (M)

Not mentioned

The seroprevalence of HBsAg was 6.1%, HCV antibodies was 37.7% (n = 112), and HIV antibodies was 0.67%

39% (116) were positive by the new HCV Ag/Ab combination ELISA assay, from which

95% have detectable HCV core Ag.

 Alzahrani AJ 2005 [39]

Cross sectional

Local rehabilitation center, Dammam

201

Mean 33

Patients enrolled in drug rehabilitation (M)

Not mentioned

The seroprevalence of HBsAg was 5.9%, the HCV antibodies was 35.6%, and HIV antibodies was 0.99%.

Drug users were found to be responsible for approximately 60% of the new cases of HCV infection.

 Njoh and Zimmo, 1997 [40]

Cross sectional

Al-Amal Hospital, Jeddah

2628 serum samples

–

Patients admitted for drug dependence (M)

DSM-IV

The overall HIV prevalence of 0.15% (1.5 persons per 1000).

Factors/ conditions associated with SUD users:

 Almarhabi et al., 2018 [41]

Cross sectional

Al-Amal hospital addiction center in Jeddah

101

Mean (SD)

33.28 (9.46)

Substance users admitted for rehabilitation (M)

Not mentioned

93% drove under the influence of an abused substance. Current substance use: Amphetamines (38.6%), Cannabis (24.8%).

Amphetamines and alcohol were the choice of drug for initiation

 Khalawi et al., 2017 [9]

Case control study

Al-Amal Hospital, Jeddah

207 cases

416 controls

Mean (SD)

Cases 29.9 (10.9),

Controls 33.7 (10.9)

Cases: substance users; (F)

Controls: visitors at the primary health center (F)

Not mentioned

Significant risk factors for substance use: presence of family conflicts, substance abuse by husband, substance abuse by peers, substance abuse by siblings, sexual abuse, low family income (p < 0.05).

 Youssef et al., 2016 [42]

Case control study

Al-Baha Psychiatric Hospital

239 cases, 117 controls

Cases: 18–45 years

31.35 (6.25)

Controls 31.66 (7.84)

Cases: patients admitted for substance use; Control: Non drug users (M)

DSM-IV-TR

Amphetamine (87.7%) and cannabis (70.49%) were the most abused substances. Depression and suicide probability are common consequences of substance abuse.

 Chinnian et al., 1994 [43]

Case-Control

De-Addiction Hospital, Riyadh

320 experimental (n = 250 heroin, n = 70 alcohol),

70 medical control

70 normal control

(18–35)

Mean:

heroin (25.27), alcohol (30.58), control (25.97)

Cases: heroin or alcohol abusers

Control 1: patients from general medical trauma wards

Control 2: Normal undergraduate students at the Islamic University

Not mentioned

Alcohol abusers scored higher than all the other groups in terms of psychoticism, neuroticism, and anxiety.

With the lie scale, the substance-abusing group as a whole recorded significantly higher scores than the controls.

 Alzahrani H et al., 2015 [44]

Cross sectional

public health hospital in Jeddah

165

(18–50) 38% were 31–40 years

Inpatients admitted for substance use disorders (M)

Not mentioned

High prevalence of depression (95.2%) among substance users (100% in heroin, 80% in amphetamine users).

Prevalence and comorbidity were significantly associated with duration of substance abuse.

Assessing reliability and validity of a scale among SUD users:

 Khalil, 2011 [45]

Cross sectional

Al-Amal Hospital of Substance Abuse in Dammam

175

(18–60)

Mean (SD)

34.7 (10.2)

Patients from the detoxification and rehabilitation wards (M)

DSM-IV

The Arabic version of the University of Rhode Island Change Assessment (URICA) showed good psychometric properties, supporting the validity and reliability of the four factors of the scale.