By Ahhana Verma, Anam Aamer, Aryan Satiya, Dhruv Srivastava and Ridah Shanavas
Disclaimer: The views expressed in this article are solely of the authors and do not represent the views of YLAC as an organisation.
Trigger warning: mentions of substance abuse
A problem plagues the emerging generation of adolescents, and it is a plague across social classes and backgrounds. The problem is that of substance abuse. A while back, a Gurgaon-based NGO school was having its campus renovated.
While this was happening, a student came across some paint thinner and started sniffing it to the point where he got high on it.
He even dipped a rag cloth in it and licked it. A staff member found him with red eyes, and his parents were contacted. A counselor was provided by the NGO, but the lack of education and sensitivity caused the parents of the student to withdraw him from the school.
Substance abuse takes 11.8 million lives globally every year. In India, adolescents and young adults account for the largest share of substance users with alcohol and tobacco being the most widely abused substances.
Genetics, family and school environment, mental health conditions, and social pressures are some of the major reasons for substance abuse among adolescents. Substance abuse can result in social, medical, physical, and psychological issues as well as socio-economic problems such as draining of family resources, distortion of relationships, and violence.
When it comes to the causes, it can be broken down into family history and genetics, and other socio-economic and environmental factors. Having users in the family creates an easily available supply of substances, and also normalises their use in the eyes of adolescents.
Substance use can also alter neural pathways and functions. These changes are permanent and hereditary. If passed onto offspring, they could become genetically susceptible to substance dependency.
Media also plays a role in glorifying substance use, to the extent that alcohol and drug consumption is almost synonymous with fun and partying which adds to peer pressures.
The fact that most alcohol ads are targeted towards the youth doesn’t help either. Another major factor that causes substance abuse is stress. This could include academic stress, abuse at home, or socio-economic pressures.
What is the impact of substance abuse like? When talking about the impact of substance abuse we tend to focus on their immediate consequences such as overdose, psychotic episodes, impaired judgement, and risky behaviours such as driving under influence (DUI), unprotected sex, and needle sharing.
We tend to miss out on their long-term effects, such as changes in memory, learning ability, and attention span, and development of medical conditions such as infection of heart valves, respiratory conditions, kidney failure, and HIV.
The hidden costs incurred by the society include impaired productivity at a society level, unintended pregnancies, increase in crime rates and interpersonal violence, and increased levels of stress within families.
Furthermore, society has to pay for the cost of substance abuse in the form of taxes which cover substance-abuse-related criminal justice expenses, social services, medical care, and treatment.
Substance addiction can be considered a chronic illness when a dependency on substances is formed. This process can be broken down into three main stages which are: use and intoxication, withdrawal, and preoccupation. This cycle becomes more severe over time.
Addiction results in three main disruptions to the brain: formation of substance-related cues and triggers, damaging of the reward system, and reduction in control over one’s stress systems.
The Indian government has implemented multiple policies and schemes towards mitigating the issue. The Scheme for Prevention of Alcohol and Substance Misuse by the Ministry of Social Justice and Empowerment (MSJE) aims to protect a variety of at-risk groups including the youth.
Some initiatives of this scheme include rehab centres, training facilities for service providers as well as awareness camps, especially in rural areas.
Unfortunately, the rehabilitation centers have an inpatient care stay of 15-20 days which is too long of a time for individuals from lower socio-economic backgrounds who rely on daily wages to provide for their families.
The Rashtriya Kishore Swasthya Karyakram (RKSK, or the National Adolescent Health Programme) is another scheme by the Ministry of Health and Family Welfare that aims to improve adolescent health through objectives like mitigating substance addiction.
This is accomplished through peer educators in rural areas and adolescent friendly health clinics that conduct check-ups and provide treatment.
However, one of the biggest problems with the RKSK is its lack of preventive measures that can incentivise young people. Apart from government interventions, local communities also run undertakings to mitigate substance abuse among the youth.
A Gurgaon-based NGO that our team interviewed conducts substance abuse workshops for underprivileged children in metropolitan areas.
Furthermore, a leading school in Gurgaon that we interviewed explained that it has implemented multiple measures including awareness in classes and increased monitoring to ensure that its students do not fall prey to addiction.
If a child is caught using substances, the school brings in the child, parents, and school officials to ensure that such instances do not repeat. Although mass awareness campaigns are useful in the fight against drugs, our research suggests that excessive awareness can lead to the victim becoming unreceptive to the content taught to them, making it ineffective.
Multiple initiatives, from both the government and NGOs, have been established to tackle this issue. But, they fail to address the crucial role played by the social and familial conditions. Hence, a multi-pronged approach involving all stakeholders, i.e. the individual, family, community, NGOs, and the government, needs to be established.
Mantente REAL is the Spanish adapted version of the US-originated “keepin’ it REAL” program, implemented in Mexico that teaches students (11-19 years) to refuse drugs through a four-way strategy—refuse, explain, avoid, and leave (REAL).
It can be taught by school teachers over three months. It is cost-effective and based on a multi-cultural model, making it feasible in India. In addition to this, the CQC program of Colombia can also serve as an effective model.
The program is aimed at teaching communities to make decisions based on data regarding drug and alcohol consumption and the identification of protective and risk factors. It requires active participation from parents of adolescents, local authorities, and the community.
While preliminary studies prove that the program is effective in preventing substance use at a community level, this may not be feasible in India due to the wide-spread stigma around addiction and substance abuse.
Firstly, de-stigmatisation of the problem of substance abuse is essential for adolescents. This is only possible through making schools safe spaces so that students struggling with substance abuse can freely open up without fearing backlash.
As seen earlier, school-based programs have proven to be effective in preventing substance abuse. Additionally, NGOs can help provide vocational education to former addicts facing withdrawal issues. Vocational education helps develop skills used in multiple jobs.
These skills can then help addicts find employment with more efficiency. Lastly, a holistic joint monitoring plan should be created by the MSJE keeping in view the at-risk individual, family, community, and government to ensure that the individual is not exposed to addictive substances.