With Ineffective Rehabs, Delhi’s Drug Addicts Are Left High And Dry

Posted on June 14, 2016 in Society, Staff Picks, Stories by YKA

By Abhimanyu Kumar for YKA:

Shabbir, (name changed) a commercial driver, got married some five months ago. But there is a secret he continues to hide from his wife.

A robust looking young man, he was seeking treatment at the G.B. Pant de-addiction centre near Delhi Gate, run by the Delhi government, when I met him. The centre has the facility for admitting patients for a longer duration but only a doctor can decide that, a staffer told me. Moreover, one must come with an attendant to have a doctor look at you and even that becomes difficult for many addicts.

Addicts In The City

INDIA - MARCH 01: Imported heroin is smoked by a student in the backstreets of Delhi. New Delhi, India. (Photo by Steven L. Raymer/National Geographic/Getty Images)
Representative image. Credit: Steven L. Raymer/National Geographic/Getty Images.

Shabbir is a smack addict. He needs to smoke at least four to five cigarettes filled with smack every day to feel okay.

Smack is easily available in the area Shabbir lives in – he is a resident of Old Delhi, not too far from Delhi Gate. According to Shabbir, he has lost his appetite almost completely and he can’t catch a wink at nights. Only smack calms his nerves.

He spent a week in a private rehab, he told me. It was not a satisfactory experience which is why he dropped out so quickly. “They are the worst as you end up learning more about drugs and how to do them from others. That’s what goes on in these places,” he told me.

At the same centre, I met Bittu (name changed), a teenager, who spent a long time in a private rehab in Delhi, as his parents found out he smoked pot. He was present with his elder sister, in order to avail the facilities at the government centre for “improving his condition further”. His sister told me that there was a marked improvement in him after his stint. “He used to get so upset earlier at any small thing but he is much calmer now,” she said.

However, to me, Bittu looked a bit glum and detached. When his sister moved away a little to chat with other attendants accompanying other patients, he told me that he hated the place initially but slowly compromised. “I cried so much in the first few days but I had no other option but to continue”. Like it happens in most private rehabs, he was not allowed to meet his parents in the initial 40 days.

He added that the food at the private rehab was horrid but once again, he had to eat it to survive. “They did not even give any medication during withdrawal to patients being weaned off hard drugs and if you had a headache or fever, you just had to bear with it. They used to say that we were imagining these things,” he said.

His days were spent, like those of other inmates at the rehab, reading from a book which is regulation material at such rehab clinics. The book, I learnt from different sources, has been compiled by ex-addicts. It covers all 365 days of a year and has tips on how to overcome addiction in this period. Sharing experiences with other inmates was also encouraged at the centre, he told me. Other than that, they were kept engaged in menial tasks like sweeping the floor or helping in the kitchen, according to Bittu.

An Open Secret

Drug abuse and its ghastly cocktail with HIV is most prevalent at Jahangirpuri which lies on what is generally termed as the outskirts of Delhi. It is a colony of working-class people in the main – rag-pickers, snake-charmers, and labourers who work at the nearby Azadpur Sabzi Mandi.

It is an open secret that many of them take hard drugs, if only to relieve the tedium and bodily pain of the hard work they do all day. The easy availability of drugs, sold without prescription, from the sundry medical shops in the area, makes the situation worse.

An Indian homeless man uses a syringe to inject drugs into the arm of an addict on the streets of New Delhi on March 18, 2015. AFP PHOTO / CHANDAN KHANNA (Photo credit should read Chandan Khanna/AFP/Getty Images)
Representation only. Credit: Chandan Khanna/AFP/Getty Images.

Last year, I visited the area and saw how openly, and blatantly it was being done. I was able to easily befriend a rag-picker who was an addict and for a princely sum of Rs. 120, I could buy through him a kit, which contained a syringe, a needle, and the drug buprenorphine, an opiate.

Others have also reported on the situation prevailing in the area, which is not limited only to Jahangirpuri but extends, though not as starkly, to other places in the vicinity.

What is frightening that the Delhi and Central governments have, it seems, abandoned the locals living here to their fate, especially in Jahangirpuri.

In order to get a low-down on these private rehab centres, I called a number I found advertised across a wall in Jahangirpuri. I had seen the number scribbled across many walls in the area.

Prescription: No Hope, Maybe ‘Love’

The man who answered my call picked up and gave me the directions to the rehab centre which is located in Narela. I had to present myself as someone keen on admitting an acquaintance there in order to be allowed to visit and ask questions. He asked me what I did for a living – which I believe was his way of ascertaining if I had the means to pay up.

If Rajat Verma (name changed) suspected anything amiss about my claims, he did not say it when we met at the clinic the same day. A lanky individual with a stubble, and peering eyes – common to most addicts and so was he till a few years ago, by his own claim – he met me in his small office behind which the recovering addicts stayed. On the gate, which looked rather forbidding, was written an instruction: “Leave your ego outside.” On the wall behind me was an aphorism scribbled: “No gain without pain.”

Claiming to be an ex-MBBS student who quit in the third year, Verma told me that he had been in the business of de-addiction, recovery and rehabilitation since 2000 when he finally managed to quit his own habit of several years. Ravish, the proprietor of the centre, also an ex-addict, has been his friend for this entire duration that he has been ‘clean’. Ravish, a beefy looking man was much more taciturn than Rajat. He told me that the centre had been operational for less than a year and was duly registered under the Delhi government.

Rajat then went on to explain how things work at the clinic.

Usually, they receive a call from a relative of the addict who asks them to fetch the latter from home or some other place. Voluntary admissions are almost non-existent. In fact, this was an errand to which recovering addicts from the centre were deputed so that it could be observed if they were still susceptible to the craving for the drugs or alcohol when outside.

Once in, the addict is forbidden from any contact with family members, except in exceptional cases. Visits were completely discouraged. “This 40-day period is the most difficult. If we let them speak to parents, they might even lie that they are being beaten up and this might make the parents withdraw their wards,” Verma explained the reasoning behind such a move.

Initially, the patients are provided with medication which contains the same substance that the drugs do, and the dosage is reduced slowly. “Once the addict starts to recover, he undergoes counselling so that we can brainwash him,” said Verma, using the word ‘brainwashing’ several times subsequently, with a casual nonchalance.

An Indian drug user covers himself with a blanket as he smokes smack,heroin, in the old sector of New Delhi on December 1, 2012. Drug use in India is on the rise but there are no proper statistics on the number of people suffering from this 'hidden disease' with the first and last national survey on drug abuse carried out in 2000-01 and showed a figure of 70 million drug users in the country. AFP PHOTO/ Anna ZIEMINSKI (Photo credit should read ANNA ZIEMINSKI/AFP/Getty Images)
Representation only. Credit: Anna Zieminski/AFP/Getty Images.

I could not help but think how Bittu and others were asked at their centre to believe that any physical ailments they suffered from were imaginary. The psychological counselling, Verma said, takes place two to three times a day.

Expanding further on his thesis, Verma said that there were three aspects to de-addiction: mental, physical and spiritual – and indeed, Bittu had told me that a Maulvi used to come to the rehab he stayed in every once in a while.

But the most important thing was ‘love’, said Verma. “That’s what the addict needs the most,” he said. Right then, a young man entered with two cups of tea in a tray. “He is also a patient. But he has recovered sufficiently so we have put him to minor tasks. In fact, he has started accompanying our men to fetch addicts,” Verma said, with a tinge of pride in his voice.

I asked Sonu (name changed) if that was true and if he felt he had succeeded in kicking his habit. He answered in the affirmative but I did not expect him to contradict anything Verma said in front of me in any case.

The course, Verma said, lasted for six months and the expenses per patient came to Rs. 6500 per month. He told me that I could be offered a discount for my (imaginary) patient. He also told me that in case they had an HIV patient, this was not disclosed to other patients. “The treatment for HIV is carried on simultaneously through the government hospitals,” he clarified.

Too Little, Too Late

For a problem that is clearly rampant in the area, only one treatment centre, and that too primarily for HIV, is operational in Jahangirpuri. It’s run by the NGO Sharan, which has two other such centres in the city. One in Paharganj and the other in Yamuna Bazar, both not far from Jahangirpuri, and which form a part of what can be called the drug-zone of Delhi. This extends till and includes Connaught Place in Central Delhi, among other areas like Sadar Bazar and Chandni Chowk in Old Delhi.

I spoke to Alokji (one name), who runs the shelter with the help of some former drug addicts of the area, about the situation which according to him is bad and getting worse. No improvement has taken place, he tells me, in the last one and a half years, the time elapsed since we last met. The mortality rate in the area remains high. Around twenty addicts died last year, Alokji told me. “This is the usual number per year. This can be reduced if the government heeds our suggestions. I have written to the Delhi AIDS Control Society about it,” he said.

What complicates his work further is that the shelter he runs is primarily focussed on making treatment available to patients suffering from HIV and to prevent them from falling prey to it. The use of syringes for injecting drugs by the addicts makes them liable to contract HIV easily. Hence, Alokji says that they have to follow a dual-pronged strategy of weaning them off the needle, while helping them with the treatment if required. “Anyone who injects drugs is susceptible to HIV,” he explained.

He added that earlier National AIDS Control Organisation had sanctioned some amount for the purpose for de-addiction as well, but they have lately stopped it which has made their work much harder by trapping them in a catch-22 situation.

“The Ministry of Social Justice and Empowerment runs several de-addiction centres in Delhi but they charge for food although other facilities are for free. Recovering addicts do not have the money to pay for that and hence, we can’t send them there as well,” he told me. According to him, there should be official co-ordination between the MSJE, NACO and the Ministry of Health which he finds lacking at present.

NEW DELHI, INDIA - JUNE 24: A view inside of Michaels care home on June 24, 2006 in New Delhi, India. Michaels is a shelter for the HIV+ and for drug users. Many of Sahara's counsellors are former drug users and sex workers and understand the needs of the patients very well. Getty Images is partnering with the Global Business Coalition on HIV/AIDS ongoing projects. Getty Images is partnering with the Global Business Coalition on HIV/AIDS ongoing projects. (Photo by Brent Stirton/Getty Images for the GBC)
Care home. Representative image. Credit: Brent Stirton/Getty Images for the GBC.

At the moment, his NGO’s work is limited to recommending drug users to government hospitals for check-ups. At least 800 such users in Jahangirpuri and neighbouring areas have been identified by them. “The government could also link us to one of their hospitals. That will also make it easier for us to operate. Currently, we just recommend but are unable to follow-up properly as addicts are not admitted without an attendant,” he told me.

To make it worse, the employees of Sharan, which has been operational here for almost a decade, are still not being paid regularly, and this has been the situation for the last few years. “We get some payment for our daily expenses off late. The Out-Reach Workers (ORWs) who go out in the field also need some money to carry on with their tasks. But salaries have not been paid for the longest time. Last time we were paid was in August last year,” Alokji alleged.

I spoke to a couple of ORWs at the shelter who said that they had gone back to working as labourers in the Mandi nearby to manage their expenses. “I work there every morning before coming here,” said Sarabjit (name changed), also an ex-addict. They also agreed that it had become very difficult to manage their affairs and to continue with the work.

The Last Drag

Due to lack of any rehabilitation facilities provided by the government in the area, where the addicts can stay and recover, private operators (the kind I visited in Narela) are making money, Alokji said. “Very few are able to kick the habit in these centres. Many young people are forced to stay there by their parents. They just bide their time and relapse once they are out.”

One can only hope the government pays some attention to a problem that is getting worse due to continuous neglect before it blows up.