Psychological Distress and Its Associated Risks Among People Who Use Drugs in Cambodia

Abstract Background: People who use drugs are at a disproportionately higher risk of mental disorders as a consequence of prolonged exposures to social and psychological issues. However, studies on mental health among people who use drugs in resource-constrained countries are scarce. This study sheds lights on the prevalence and correlates of psychological distress among people who use drugs in Cambodia.Methods: This national survey was conducted in 12 provinces in 2017 using the Respondent Driven Sampling method. A structured questionnaire was used for face-to-face interviews. Psychological distress was measured using the General Health Questionnaire (GHQ-12). A total score of GHQ-12 > 2 indicated high psychological distress. A multiple logistic regression analysis was performed to examine factors associated with psychological distress.Results: This study included 1677 people who use drugs who had an average age of 28.6 years (SD = 7.8). Of the total sample, 41.9% had high psychological distress – 49.7% in women and 37.3% in men. In the regression model, the odds of having high psychological distress was significantly higher among participants who were 25–34 years old (AOR 1.30, 95% CI 1.01–1.70) and 35 years and above (AOR 1.68, 95% CI 1.19–2.35), had been to a drug rehabilitation center (AOR 2.06, 95% CI 1.48–2.86), had been insulted by family members (AOR 2.09, 95% CI 1.62–2.70), and had been sexually harassed/abused by someone (AOR 1.80, 95% CI 1.38–2.36). The odds of having high psychological distress was significantly lower among participants who were male (AOR 0.53, 95% CI 0.41–0.69), lived in own dwelling (AOR 0.56, 95% CI 0.41–0.77), reported injecting as the mode of first drug use (AOR 0.56, 95% CI 0.34–0.91), and had someone taking care of when getting sick when they were growing up (AOR 0.68, 95% CI 0.47–0.99).Conclusions: This study documents a high prevalence of psychological distress among people who use drugs in Cambodia. Older people who use drugs and those in more vulnerable subpopulations were more likely to exhibit a higher level of psychological distress. Interventions that attempt to address mental health issues among people who use drugs should be gender- and age-sensitive and target more marginalized subpopulations.