The recent controversy over ‘Udta Punjab‘ has left many thinking about the rampant use of drugs by the youth in our country. The internet is abuzz with conversations about how easy it is to access illegal drugs, the lack of correctional and rehabilitation services and, state and central government’s disinterest in addressing the problem.
As a recovering ‘addict’, I find that our current approach is often limited to only preventive care. The focus still remains on what constitutes as illegal drugs and our government’s inability to control the mass production and distribution of these ‘illegal’ substances. If we look at the distress caused by drug and alcohol addiction, and the growing crime rate due to its illegal production and distribution, sure, these discussions become important. But we need to go deeper and understand the cultural causes that lead to initiation into substance abuse. We need to question if addiction is a ‘disease’ at all.
According to reports, 63.6% patients coming in for treatment were introduced to drugs at a young age – below 15 years. In India, 13.1% people using drugs and alcohol are below the age of 20 years. In absence of other drugs, children end up using easily accessible substances such as cough syrups, pain relief, glue, paints and cleaning fluids. However, prevention of drug abuse cannot be limited to hindering people from getting hooked onto drugs. It isn’t about the substance involved or it’s legal status. It’s about why someone chooses to become dependent on a substance. Changing cultural values, economic stress and lack of supportive relationships have left young people vulnerable to deal with strains and stresses of their modern lives. While the focus for a long time has been on behavioural prevention rather than correctional prevention, our approach has been to directly influence people’s behaviour rather than to change the conditions and structures that affect their lives.
Access to mental health services and de-addiction centres is limited and while it’s important for us to hold our government accountable for not caring, it is also necessary for us, as a society, to think about how we, too, are enabling dependency on drugs. People consume drugs for multiple reasons and there aren’t enough safe spaces for them to talk about their desire to use drugs.
Telling your friends and family about your addiction isn’t an option. In a country where we choose to remain silent about issues of violence and abuse, where talking about gender and sexuality is frowned upon, it is not surprising that children and young people often see substance use as a form of an escape. And I don’t think, as a society, we are ready to listen to these reasons or cope with what comes with it. Everyone has issues, some people cope with them in a healthier, socially acceptable way, while some of us, choose addiction to get through our daily lives.
When I began using illegal chemical drugs, it was only occasional, once in a few months. But then, one day, it just took over. Soon I started consuming it more often than I thought I would. It didn’t take much time for my psychological and physical dependency to surface. And the only way to contain my dependency was to cut off myself from all the possible sources I could procure drugs from. Few years later, I had a relapse, and it was worse. And the only reason I decided to alter my ways was when a health professional was not interested in my habits but the reason why I want to escape. And within a few days, something changed. Rather than feeling scared, I felt more confident about rerouting my desires and I became more patient with myself. I realised that my addiction isn’t a disease and that the process of rehabilitation is a long one that would require me to reinterpret my emotional state.
What we need is diversified and personalised treatment that targets the health and social needs of the particular individual. And while we advocate and lobby for high-quality treatment, we need to prevent drug users from being marginalised, and instead promote their health and well-being. In India, for far too long, the focus has been on stopping addicts from using drugs completely rather then reducing the use of drugs and its negative consequences for users.
In 1994, Switzerland introduced ‘Heroin Clinics’, a safe environment where heavily addicted, long-term drug users receive the Heroin-Assisted Treatment (HAT). Currently, 1300 people are registered in different centres across Switzerland, where they go to be prescribed and inject heroin. There is a strict code that is followed before a heroin prescription is given to a patient – they should have a full-time job, give up their driving license and should have been on the conventional treatment at least twice. There has been a reported 60% drop in felony crimes by patients and 82% decline in patients selling heroin. Moreover, new infections of HIV have been reduced for patients in the program. Also, this is not the primary form of treatment that is available; the government offers treatment-on-demand. Of about 22,000-24,000 addicts, 16,500 are in treatment and 92% are given daily doses of methadone at conventional clinics.
The sharing of used injecting equipment also makes people who inject drugs particularly vulnerable to HIV and hepatitis C. It is estimated that an average of 13.1% of the total number of people who inject drugs are living with HIV. Globally, the number of men who have sex with men and who are also injecting drug users are growing, which has led to an increase in the number of people living with HIV. With regressive laws like Section 377 and lack of specialised sexual health clinics, the problem only continues to aggravate.
The fact remains that the people will continue to find psychoactive substances to influence their emotional state; new drugs will infiltrate the market and therefore it becomes important for us to adopt strategies that provide necessary help to reduce drug use and the socio-economic impact it has, both on the user and the people that surround them. Our aim should be to reduce the physical, mental, economic and social harm for both the user and the people close to them. There is a need for trans-cultural work to break socio-cultural barriers. We need to listen to various target groups and understand how cross-sectoral collaboration can help us develop a more rational approach to the problem.
We need to stop judging people who use drugs and also, using their stories to create fear and unrest amongst the others. At the end of the day, it’s just a substance and there are reasons as to why some of us get addicted to it. We need to shift our perspective, and discuss addiction as a whole, including consumption of other legal psychoactive substances.