All stakeholders should work in tandem without prejudice
if they want to end drug abuse
I used to do a little but a little wouldn’t do/So the little got more and more/I just keep tryin’ to get a little better/Said a little better than before, sang Guns ’n’ Roses in the eighties as they celebrated, and at the same time lamented, heroin addiction with ‘Mr Brownstone’.
More than two decades after, Shillong grapples with the humongous task of controlling drug abuse as ‘Mr Brownstone’ drags a large number of youth into the dark and hallucinatory world of heroin.
“Defined as a disease in 1956 by the World Health Organisation (WHO) and the American Psychiatric Association, drug abuse is the illicit consumption of any naturally occurring or pharmaceutical substance for the purpose of changing the way, in which a person feels, thinks or behaves, without understanding or taking into consideration the damaging physical and mental side-effects that are caused,” an article of Acta Chimica & Pharmaceutica Indica (ACPI), an international journal, says.
In 1964, WHO replaced the terms ‘addiction’ and ‘habituation’ with ‘dependence’. In this article, we will use ‘addiction’ that is still part of the lingua franca.
In India, heroin is among the five most common drugs being abused by children, the ACPI article finds out.
A report of the Ministry of Social Justice and Empowerment shows a similar trend pegging the number of heroin users at 1.14 per cent of the population. Though Meghalaya does not appear among the states with high number of heroin users, it is fast becoming a microcosm of the national drug scenario.
The state, once considered a transit route for drug supply, has turned into a full-fledged market in a short period of time, according to many stakeholders. Sold in puriyas (in small quantities), each priced between Rs 350-500, heroin is the choicest drug in the city now. The obvious and immediate fallout of the increased use of the drug is rise in petty crime. The pernicious impact of it is a doomed society with a generation sucked into the whirlwind of addiction.
The causes triggering the prevalent situation are as manifold as its effects and can be broadly divided into economic, social and law and order, not necessarily in the order of severity.
“Unemployment is one reason. Peddlers are addicts themselves but a major share of the drugs they possess are sold. This has become their livelihood,” says Dr Rica Lamare, secretary of Manbha Foundation, an NGO working with addicts.
Lamare also points to easy availability of drugs due to increased supply and lack of enforcement as reasons leading to the current situation.
“Use of heroin has become rampant even beyond Shillong. Now, there is a substantial number of heroin addicts in the rural pockets and Ri Bhoi. These people are primarily farmers and get into the habit unknowingly,” she explains how alarming the situation is.
The addiction is also fast spreading among children, both male and female, in their early adolescence but neither age nor economic background is the deciding factor.
A senior counsellor of Kripa Foundation, another NGO, says heroin users as young as 13 and 14 inject the drug. Manbha Foundation has got patients as young as 12 years and as old as 65 years. There is also no particular pattern in the family background of the patients.
There are more than 5,000 drug users in the city but “many addicts or affected families do not come out in the open fearing ostracism”.
A member of Alcoholics Anonymous (AA) says people usually do not get into drinking or taking drugs with the intention of becoming an addict. They get initiated either under peer pressure or for experience.
Addiction to opioid substances like heroin happens faster and even before an individual could understand, he or she would be craving for more because “a little wouldn’t do”.
Experts say for young adolescents peer pressure is one of the major reasons for getting into substance abuse. “A lot of them are experimenting with soft drugs like ganja and occasional tablets. Because of their vulnerable age, addiction spreads very fast… Their reasoning capacity is less because of the young age. For them, it is more of an impulsive decision without any knowledge about the impact of drugs on the body and brain,” says Dr Jasmine Lyngdoh, a city-based clinical psychologist.
The chairperson of the State Commission for Protection of Child Rights, Meena Kharkongor, wonders whether drug abuse has turned into a “fashion” among youths. “Can we always blame parents? I don’t think so. In today’s age, social media is also playing a key role for such behaviour,” says Kharkongor, who has filed a PIL on drug abuse in the High Court of Meghalaya.
Parents, in many cases, are helpless. When both parents are working, it becomes difficult for them to be vigilant. Lack of communication only widens the gap making their child vulnerable to adversities.
“Other factors responsible for an increase in drug abuse are absence of facilities and lack of community-driven strategies (to curb the trend),” points out Lamare.
King heroin
There are several reasons, or triggers, which prompt youths to get into drugs, natural or synthetic. Among the popular drugs are ganja and heroin, the second being the most popular. Heroin is either chased, a term used for sniffing, or taken intravenous or smoked.
“Many prefer injection as the kick is faster with less amount of heroin. This way the user can save money,” says Lamare.
Heroin, also called smack, is a highly addictive drug. It is processed from morphine and usually appears as a white or brown powder or as a black, sticky substance. The heroin sold locally is often adulterated and looks dull.
The graduation from chasing to injecting is happening fast making users more vulnerable to various diseases, including HIV+, say experts.
A 41-year-old reformed addict says he got into the habit at the age of 21 when a few friends from outside the state asked him to join the revelry. Within six months, he switched to intravenous as the “kick would be faster and longer”. Soon, he was stealing money and articles from his house.
“Short-term effects of heroin include a surge of euphoria and clouded thinking followed by alternately wakeful and drowsy states. Heroin depresses breathing, thus, overdose can be fatal. Users who inject the drug risk infectious diseases such as HIV/AIDS and hepatitis. The common effects change perception of painful stimuli; decrease anxiety; pinpoint pupils during intoxication; relaxed state (sedation). Because heroin is commonly injected into a vein (used intravenously), there are health concerns about sharing contaminated needles…” points out the ACPI article.
Desolation row
There is a need for a holistic approach to tackle the rising number of heroin addicts and society should play an important role in this.
Addicts are always seen as ‘menace’ or ‘nuisance’ to society. They are treated as criminals and castigated by the community. Some people also think that drug addicts have no chance to get back to a normal life and they are better driven to the periphery to maintain a ‘healthy neighbourhood’. But this mindset should change to make rehabilitation of addicts and their reintegration into the mainstream easier.
Relapse is common among rehabilitated addicts and lack of support from family and the community can often be a trigger. “We always tell parents and others not to blame a child for addiction. This can have a negative impact, especially when a person is trying hard to stop substance abuse,” says Lamare.
According to Lyngdoh, an addict’s inability to rehabilitate himself or herself into the mainstream makes the individual frustrated and chances are high that he or she will fall into the relapse pattern. The rehabilitated addict mentioned earlier had two phases of relapse. “Relapse is very high and many people do not understand this. It is what we called flips. A lot of time they are unable to help themselves in these situations,” she says.
The term ‘menace’ can also have psychological implications both for addicts and their families. “We have to have a new attitude towards the whole concept of addiction,” the AA member asserts.
It is imperative that we change our approach towards addicts and the problem of drug abuse. The community should involve youths in various social activities and sports so that they stay away from bad habits.
Families of addicts should also be sensitive and patient. There should be an effort to reach out to the vulnerable person and understand his or her problems. Instead of treating a reformed addict with suspicion, which may often lead to depression or suicide, parents should be cooperative and supportive.
With more school-going children falling for heroin, the role of schools becomes important and they cannot wash their hands of the problem.
SCPCR’s Kharkongor says schools often hand over transfer certificates to students found using heroin but “they should not be pushed aside”.
“It is time that schools recruit professional counsellors who have experience in handling such cases. Individual counselling of vulnerable children is necessary without disclosing their identity. Schools should be vigilant,” she maintains.
Kharkongor points out that there is a dearth of professional counsellors in the state and says SCPCR is planning to tie up with NIMHANS in Bengaluru for training local counsellors.
The SCPCR and the city-based NGOs working with addicts organise frequent awareness programmes involving students, teachers, parents and community leaders. The SCPCR especially targets government schools on the outskirts of the city and in rural pockets where knowledge about drugs and its ill effects is less.
The police department, which is the key stakeholder in truncating the supply chain, is already cracking down on suppliers. Several seizures have been made in the last few months. The East Khasi Hills police have already formed a core team of 10 personnel who are working on the field. The team is on the drug trail since April this year.
“A small team is always effective. There is less chance of information getting leaked and there will be accountability in case of any mistake. It is easier to vet each member too,” a senior officer explains.
The media too should be sensitive when reporting on cases of drug seizures and photographs of addicts should not be flashed on television or in print, says Lamare.
Finally, the government should show sincerity to address the crisis. War of words and thumping of tables in the Assembly over the issue are not enough. It is time for action. The draft drug policy that has been hanging fire for eight years now should be presented immediately.
Lamare says the Social Welfare Department abruptly stopped fund to two of Manbha’s dropping centres in Khliehriat and Jowai. This has affected the NGO’s works. Since the state government does not have any de-addiction centre, it should at least support those who are doing a yeoman service.
Drug problem needs attention of various departments like the Social Welfare, Education, Health and Law and Order. All these departments should work in tandem to not only reduce drug abuse but also to rehabilitate the addicts and help them get back to the mainstream. There are many dropouts who later find it difficult to start with a clean sheet. These youths need the necessary support to bounce back to life.
In June, Chief Minister Conrad Sangma had said the issue of drug abuse should be discussed at the regional level.
What the state needs is a rehabilitation facility in every district to help treat addicts coming from the lower stratum of the society. Besides awareness, proper infrastructure and right mindset are necessary to make the vulnerable feel safe and confident. “We have to understand… the addicts and what they feel,” says Lamare.
Rejection is not the solution, acceptance is. Without this attitude, it will be a difficult task to bring the vulnerable youth back from the brink.
~ NM