Drug De Addiction Policy In J&K

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Tasneem Kabir
On January 11, 2019, the Government of Jammu and Kashmir under the Governor issued a circular to sanction the adoption of Drug De-addiction Policy in J&K State, and released along with it a policy document for drug de-addiction for our state. The step is a welcome one, and begs the question that what could possibly be the reason for a spike in substance misuse in the state, to the point that the government has had to step in.
According to the said document supplementary to the circular, addiction is the chronic disease of brain characterized by compulsive engagement in rewarding stimuli despite adverse consequences. Addiction is caused more often than not by substance abuse, prescription drug misuse over time or over-dosing on medicines frequently. Scientific data, based on community surveys on drug related problems in Jammu and Kashmir, shows that deaths have started occurring directly (viz. due to over dosages, convulsions, and cardiac arrests) and indirectly (viz. road traffic accidents). No wonder drug over-dose is quickly becoming a common emergency in our hospitals.
Statistics paint a very grim picture of the status quo of the drug scenario in the State. A recent study conducted by Rather et al. from The National Institute of Mental Health and Neurosciences (NIMHANS) in a Drug Deaddiction centre in Srinagar found that over two-thirds of the patients in the study had started substance abuse as early as in the bracket of 11-20 years. Poly-substance abuse was found in 91.9% of the studied patients. Inhalant use was seen pre-dominantly among adolescents { 54.5%} whereas nicotine {50.2%). cannabis {49.2%}, alcohol {51.1%}, opioids {58.4%}. and benzodiazepines {53.48%} were more pre-dominant in the age group of 21 to 30 years. Another interesting study conducted by Ismail et al. from NIMHANS, in the year 20 l 6-17, on phenomenology of inhalant use found that two-third of the study population were in the adolescent age group. About 99% of study population were males belonging to middle socio-economic class. “Bagging” was found to be the predominant mode of inhalation followed by ·sniffing’. Associated psychiatric co-morbidities were found in 25% of the patients. A recent independent study conducted by Khan and Tariq of GMC, Srinagar, found a 7.1 % prevalence of androgenic anabolic steroids use in 198 young males attending various gyms across the state of Jammu and Kashmir. In the same study population, about 1.3% of the participants accepted use of diuretics, amphetamines and thyroid hormones for weight loss.
The quoted statistics and surveys, few amongst the thousands relevant to the issue at hand, show that addiction and abuse is not working under a black-and-white framework – there exist reasons that cut across social background and recreation, motivating our population to misuse narcotics. Studies conducted in recent years have shown an alarming shift in the pattern of substance use in terms of rise in the number of female users, decreasing age at first-use, increasing use of solvents, injectable opiates as well as increasing drug related deaths (over- dose and accidents). We see young children resorting to inhalation of seemingly harmless substances like hand sanitizers or correction fluids/whiteners just because the sensation is pleasant, and everyone else seems to be indulging in it. This in turn stems from an unhealthy and misinformed culture at schools and institutions with insufficient safeguards and awareness against this menace.
Next, we see that our youth has assumed that they can beat the world of Science at its own game and have started using drugs for achieving means that they aren’t meant for: weight loss, as supplement to gym workout routines and for increasing musculature. All this at the risk of their mental health, and just in order to meet the image of the “ideal” body that the hyper-sensational, unrealistic and phony media houses feed their very existence with. Indeed, not enough has been said and done in J&K to promote a culture of body positivity and satisfaction both inside and outside the household. Every now and then, we hear adults taunt the youth for being too skinny for a man, or too plump for a woman – who, sensitive as the youth is, resort not to healthy exercise and lifestyle but to the “easier” way of drug abuse. This also calls attention to the lack of sports and outdoor recreation infrastructure in our urbane-obsessed, sedentary society and lifestyle.
The tracing of reasons and sources of this tragedy that has befallen the state involves connecting various threads and making the semblance of a connection. Studies as well as my practical exposure have shown that individuals living in conflict-sensitive areas of the state, as well as those who have lost family members to the ongoing tensions are likely to harbor drug abuse in the household. At the same time, we are also faced with addiction as a problem of affluence. A large number of persons among thousands involved in drug abuse across Kashmir came from nuclear families and families with higher than average incomes, combined with a messy or broken family status. It is sad that addiction found its way into a certain section of society due to problems than can easily be taken care of in therapy centers or by psychiatric help. But again, the taboo surrounding psychiatry and its equation to madness by society hinders the development of these centers and prevents distraught individuals from seeking their help. This may also be contributing the rising use of narcotics for reasons that have nothing to do with healing in the medical sense.De-Addiction
That said, it becomes imperative to chart a way forward and not stand ignorant of the threat that drug addiction poses to our society and our future generation right now. The foremost way we can adopt is to start extensively sensitizing our children and youth to the consequences these chemicals can have on their life, by means of seminars, media productions, literature and workshops. Next, we must focus on boosting employment in the state, for the twin problems of unemployment and conflict compound to the point that drug abuse seems like the natural recourse. Further, the state must work on training teachers and community health workers in identification, risk reduction and timely referral of children and adolescents with traumatic/negative life experiences who are vulnerable to substance use disorders alongside teaching basic counselling skills to teachers, physicians, policemen and the like who are likely to come into direct contact with drug abusers before anyone else. Lastly, we must work on getting rid of the negative connotation that surrounds de-addiction centers and increase the number and scope of such facilities. Only then can we give a head-start to our trajectory of ending the drug abuse and addiction mania that has gripped our homeland.

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