Patterns of Addiction Behavior in Patients with Hemophilia: A Cross-sectional Study in Southeastern Iran

Abstract

Background: Hemophiliacs experience multiple comorbidities, including acute and chronic pain, primarily due to recurrent bleeding episodes. While pain management often necessitates the use of strong analgesics, emerging evidence suggests a high prevalence of substance abuse among this population. Objectives: This study aimed to assess drug dependence and its association with pain in hemophilia. Patients and Methods: In this descriptive cross-sectional study, 80 patients with hemophilia (PWH) aged ≥ 12 years who received regular follow-up or replacement therapy at Ali-Asghar Hospital in Zahedan, Iran, were recruited consecutively. Patients with incomplete clinical records or unwillingness to participate were excluded. Data collected included demographic and clinical characteristics, pain intensity [measured via a Visual Analogue Scale (VAS)], and substance use risk assessed with the alcohol, smoking, and substance involvement screening test (ASSIST). Data were analyzed using descriptive and inferential statistics, including t-test, ANOVA, and chi-square tests to examine associations between demographic variables, pain, and substance use risk, with statistical significance set at P < 0.05. Results: The frequency of substance abuse disorders was 28 patients (35%), and 22 of them (78.6%) had experienced pain. Descriptive analysis showed that male gender, age over 20 years, lower education levels, and a family history of substance abuse were associated with higher rates of substance abuse. Furthermore, the frequency of greater than moderate risk degree of drug dependence in PWH with tobacco and opium abusers was 85.7% and 95.5%, respectively. Conclusions: The high prevalence of substance dependence in PWH underscores the urgent need for standardized, multidisciplinary protocols to address the prevention and treatment of drug abuse in this population within Iran. However, this study was limited by its single-center design and relatively small sample size, which may restrict the generalizability of its findings. Larger multicenter studies are recommended to validate and expand upon these results. Psychosocial contributors such as loneliness and interpersonal difficulties may intersect with pain to influence substance use risk and merit evaluation in future studies.