RESUMEN
BACKGROUND: Treatment provision and treatment seeking for substance use disorders is a relatively new phenomenon in the Middle East. The present study aims to study these trends among first admissions to the specialized addiction treatment Amal Hospital of Dammam over its first two decades (1986-2006). The main outcome measures were: annual inception number (AIN), relative frequency of substances (RFS), relative frequency of drug combinations (RFDC), mean number of substances (MNS), and sociodemographic changes. RESULTS: A total of 12,743 patients were admitted between 1986 and 2006. The majority were aged 20-39 years (83%), never married (60%), and with low education (81%). In the second decade, subjects were significantly older and less unemployed than in the first decade (28.9 years versus 30.2 years; 27% versus 19%). The mean AIN rose from 509 in the first decade to 765 in the second decade. In the same periods, the RFS increased for amphetamines and cannabis (from 12.1 and 17.5% to 48.1 and 46.5%, respectively), decreased for heroin, sedatives and volatile substances (from 51.1, 15.1, and 6.1% to 22.5, 7.3, and 2.5%, respectively), and remained stable for alcohol (from 27.1 to 26.7%). The overall RFDC increased from 25.5 to 43.2% with significant pair-wise increases of cannabis/amphetamine, alcohol/cannabis and alcohol/amphetamine, and heroin/alcohol. The mean number of substances per subject increased from 1.32 to 1.56%. CONCLUSIONS: Significant shifts have occurred in the types and patterns substances use among treatment-seeking subjects. These findings underscore the need for community-based epidemiologic studies and for the establishment of a comprehensive drug information system in Saudi Arabia.