Assessment of Opium Use Disorder and Opioid-Induced Bowel Dysfunction in a Rural Village of Western Rajasthan: A Cross-Sectional Study

Abstract

Introduction: Opioid Use Disorder (OUD) affects 2.1% of India’s population. In western Rajasthan, opium use is culturally rooted and socially accepted. Opioid-Induced Bowel Dysfunction (OIBD) and Opioid Enteropathy (OE) are complications often overlooked in community settings, requiring population-level evidence. This study determines the prevalence of OUD in a rural village and assesses OIBD in those who had OUD, identifies individuals at high risk for OE, and characterizes the associated symptom profile in high-risk participants.

Methodology: A community-based study was conducted in Khejarli, Jodhpur, using a 2-phase design. In Phase I, a universal sampling strategy was adopted, wherein eligible individuals were screened for OUD using the DSM-5 diagnostic criteria.

In Phase II, OUD patients were assessed for OIBD using the Hindi-translated GSRS scale. High-risk OE was defined based on the presence of more than two Alarm symptoms with moderate to severe anaemia. Data were analysed using SPSS v23, applying descriptive and inferential statistics.

Results: Out of 882 individuals screened, 136 (15.4%) were diagnosed with OUD (mean age: 49±14.2 years, 98.5% males). OIBD was in 113(83.1%), and 76(55.9%) of these individuals were identified as high-risk for OE, which was significantly associated with older age, lower educational status, longer duration, and greater severity of opioid use, higher morphine-equivalent consumption, financial debt due to opioid use, and presence of other substance use (p < 0.05).

Conclusion: This study shows that a considerable burden of gastrointestinal complications exists among opioid users in rural communities. These findings recommend the need for early community-level screening and integrated public health interventions that address both opioid dependence and gastrointestinal health, particularly in resource-limited rural areas.

Keywords: Opioid enteropathy, Opioid-induced bowel dysfunction, Opioid use disorder, Rural Population.