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Drug abuse affects more people than Covid yet we bury the issue

We, in India, are debating one health crisis by bringing science and research to the foreground and, strangely, throwing science out of the window while debating another health-related disaster.
Bring up the topic of the Covid-19 pandemic and the debate immediately shifts to the vaccine, the speed at which it has been developed and whether enough science has gone into it to make it safe. But bring up drug abuse in the country, and the focus immediately shifts to Sushant Singh Rajput, who was responsible for his untimely death and how many more film stars are likely to be questioned for smoking ganja. We don’t ask how serious the drug problem is nationally, which states are worst affected, and whether we have adopted the right approach to fighting the menace.

If you believe that drug abuse can’t be compared to the Covid-19 pandemic, do browse through India’s first-ever large-scale, nationwide survey of drug abuse, published in 2019 just before Covid-19 reached India. The ‘Magnitude of Substance Abuse in India’ report by AIIMS Delhi’s National Drug Dependence Treatment Centre has established that there are roughly 63 lakh people in the country addicted to heroin and 25 lakh to pharmaceutical opioids. Another 50 lakh people are addicted to cannabis and 40 lakh to bhang.

And we haven’t even come to alcohol, which has roughly 5.7 crore people who have problems related to drinking while 2.9 crore who are dependent on it. Keep in mind that these numbers represent only the addicted and those with related problems. The actual number of drug and alcohol users is much higher.

By comparison, the Covid-19 pandemic has seen roughly 1.05 crore cases so far. Most of these people have recovered with the number of active cases till mid-January 2021 being a little more than two lakh across India. In sheer numbers, the drug abuse problem in India is worse than Covid-19. But the intention here is not to undermine the severity of pandemic. It is to highlight the fact that we have a serious drug abuse problem on our hands and to find a solution, we will need more than just a momentary emotional outburst over a film star’s death.

Talk to authors of the AIIMS report and they will tell you some home truths. One, attempts to stop supply of drugs with brute policing have failed spectacularly around the world. The US’ ‘War on Drugs’ is the best example. Trying to cut drug supply lines only led to a dramatic increase in the street price of drugs, encouraging smugglers to pump in greater quantities of deadlier drugs into the US.

This could be happening in India as well. “Findings indicate that despite the existence of strict drug control laws and a multitude of agencies working towards drug supply control, a wide variety of the controlled drugs are being used and a sizeable number of Indians suffer from addiction to these drugs,” the AIIMS report says. “Results also indicate a shift in demand for psychoactive substances, from traditional, low-potency, plant-based products (opium) to more potent and processed products (heroin).”

Instead, the focus should be on reducing drug demand. Countries like Portugal have decriminalised drug consumption. People caught with drugs for personal use are not sent to jail. Instead, they are counselled and provided mental health care support. It has led to a reduction in addicts.

Two, governments often get bogged down with the total number of people using drugs. Instead, they should focus on drug use disorders. Taking drugs is not as much a problem as addiction is.

And three, governments must categorise various drugs by the problems they cause and then devise a plan. Chasing ganja users is a waste of time. The AIIMS survey shows that the major drug problem category for India is opioids, and among opioids heroin is the biggest concern. In fact, many experts feel that India’s drug supply control measures are disproportionately geared towards seizing minor drugs and jailing petty users rather than catching the big fish smuggling deadly heroin. As one expert told this writer in Hindi, “Ye chindi chor pakadne wali baat hai (we are only catching small fry).”

The AIIMS report also points to the severe paucity of treatment facilities for drug and alcohol addicts in the country and the need for regional strategies for prevention and treatment. Just one single national level plan may not help. The drug problem in Punjab may differ from Mizoram.

As a first step in this, AIIMS experts have helped the Union government kickstart the Nation Action Plan for Drug Demand Reduction. But, this is just the beginning of the fight. Real change will come when we, the  citizens, will discuss drug demand reduction like we are discussing the merits and demerits of Covishield and Covaxin.

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Disclaimer

Views expressed above are the author’s own.



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