Dr Abhishek Chowhan
In a psychiatry OPD about half a decade ago one used to see a ‘modest’ number of psychiatric patients suffering from anxiety, depression, headaches, rarely severe mental disorders and very rarely patients with drug abuse problems. The scenario has changed. Cut to 2018, for every one psychiatric patient at least three with drug related issues are lining up for consultation. Stories are distressing. There are parents who have already lost one son to addiction and are trying to save the other son from this sludge of drug dependence. A single earning widow has come to make better of her son who has sold everything in home to procure the drugs. A daughter has come with mother on the pretext of headache but secretly telling the psychiatrist that she is also entrapped in this flimsy situation. A patient with end stage alcoholic liver disease is still not able to leave alcohol despite it being a clear threat to his life.
About half a decade ago the monstrous tentacles of harder and illicit drugs like heroin started spreading in our state particularly in Jammu region. Before this time, alcohol and to a lesser extent crude opium, cannabis and medical drugs were the main substance of abuse. Although it was supposed to be a short term phenomenon assumed to be controllable and containable, it gradually spread from few districts to almost all of Jammu and Kashmir provinces.Heroin is from a class of substance derived from opium which is the dried exudate of opium poppy flower. Ironically opium is a classified poison. Drugs like cannabis, crude opium and other illicit medical substance are still widely prevalent in youth and may corrode the younger population functionally and physically. However, heroin holds a special ‘power’, the power to kill with even slightest mismatch of the dose. And in the hands of our naïve and impulsive younger generation, fatal overdose is a clear danger and happens very frequently. Those who are somehow surviving ‘luckily’ with heroin are hooked to the substance in such a way that all of their daily activities revolve around getting the ‘dose’ of the drug. How to gather money? Beg, borrow or steal? How to procure the drug? How to evade law? And essentially, how to survive? These are all the questions in a drug addicts mind from dawn till dusk. At the most complex level of drug use, drugs and crime are directly and highly correlated and serious drug use can amplify and perpetuate pre-existing criminal activity. Crimes can be as a result of the effect of drug on thought and behaviour or it can be in order to fund a drug habit. The last include theft and prostitution. Only a small proportion can buy the substance directly.
With such burden of unproductive youth in society the development of society and country takes a back seat. The drugs erodesocial and human capital thus undermining the development. Apart from degrading the quality of life drugs force the skilled labour out of work and into the drug related activities. Drugs and consequent crime also drives away business. Afterall who would like to invest in a drug laden society with a rusty workforce.Same is the issue with tourism as this sector is too sensitive to crime issues. Moreover, drugs and crime undermine the ability of state to promote development by destroying trust relationship between people and the state and undermining democracy and confidence in criminal justice system. When people lose confidence in state and criminal justice system they engage in vigilantism, which further destabilise the state.
The worst part about drugs is that they not only affect the current generation but future generations as well. A number of studies have shown that parents who use drugs have higher frequencies of children who pick up this habit. Some studies have postulated that drug use produce transmissible genetic changes. That is, the parental drug use modifies the genetic makeup of our future generations thus predisposing them to drug abuse. Also in an environment where most are using drugs, a trend is set which can seep down to future generations.
More deaths, illness and disabilities stem from substance abuse than from any other preventable health condition. Today, one in four deaths is attributable to drug use. Our generation going through drug problem have a high risk of all the negative outcomes including unintentional injuries, accidents, risk of violence, legal issues, financial problems, psychological issues (impulsiveness, poor judgement, depression, suicide, etc.), medical problems (infections like HIV, heart problems, overdose issues, etc.) and death. All these problems directly or indirectlyaffect the productivity and moral structure of society.
What needs to be done is to sensitise the younger generation to harms of drug abuse. Parents, teachers and community leaders can yield a significant influence on young children and can prevent them from going towards drug abuse. Accordingly, family, school and community based programmes are required for education, awareness and prevention of younger generation from evil of drug use. Parents can be of help in educating children regarding harms of drug use, dealing with peer pressure, to monitor their behaviour and activities and being a friend who is there and is ready to listen when they need it the most. Education regarding drug prevention should be included in school curriculum. Socially, civic and law enforcement agencies, NGO’s, religious institutions and media should be roped in for spreading awareness against the menace of drug abuse.
What state needs to do is to develop an effective policy on drug abuse. It should address issues such as drugged driving, prescription drug abuse, workplace drug use, preventive activities, drug use among specific populations, education and rehabilitation programmes. Additionally, it should include sensitisation programmes in schools and colleges about ill effects of drug abuse. What currently we have in our country is Narcotic Drugs and Psychotropic Substances Act (1985) and the Prevention of Illicit Trafficking in Narcotic Drugs and Psychotropic Substances Act (1985) which deals with legal and punitive aspects of drug use. But punishment is not always the real solution. Policies which can mitigate the harms of drug abuse, and for medical treatment are also badly needed.
(The author is MD Consultant Psychiatrist GMC, Jammu)
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