The impact of Bam earthquake on substance users in the first 2 weeks: a rapid assessment

In the final days of the year 2003, an earthquake in the city of Bam, Iran, led to the death of some 35,000 of its inhabitants. The rate of opium abuse, which had been high among the male population in this city, caused problems after the earthquake. The aim of the following study was to examine the status of substance abusers during the first 2 weeks after the earthquake. The study was carried out in the city of Bam, one of its nearby villages and eight hospitals admitting earthquake victims. One hundred and sixty-three individuals were interviewed, including substance abusers, their family members, people living in Bam, service providers, and the authorities. During the first 2 weeks after the earthquake, about half of drug-dependent interviewees suffered from withdrawal symptoms. About half reported their problems to health care providers and asked for morphine or other analgesics. Around one third had used opium on the first day and two thirds in the course of the second day to the end of the second week after the earthquake. Although smoking had been the most common means of abuse before the earthquake, oral intake has become the most prevalent route after the disaster. Almost all obtained their opium from inhabitants of other cities as gifts. Members of rescue and health delivery systems had a lot of encounters with opium abusers, especially in the first 3 days after the earthquake, and had prescribed morphine and other analgesics. In societies with a considerable prevalence of substance abuse, this issue becomes a matter of utmost health care and social importance at times of disasters, and the necessary arrangements to deal with it should be present beforehand.