Youngsters high on drugs, low on mental health: Sikkim's continued drug abuse a grim reality
A recent drug consignment busted by the police on 18th December 2020, at Topa Khani along the National Highway-10 route, East Sikkim is said to be one the biggest drug seizures in Sikkim till date. According to sources, 23,184 loose capsules of Spasmo Proxyvon, 24 files of the same drug, 52 grams of brown sugar, 457 cough syrup bottles and 2000 capsules of Nitrosun-10 was brought into the state in a Red wagon R taxi from Siliguri.
The DIG range, Sikkim Police, Pravin Gurung stated, “The Superintendent of Police for East, Siva Prasad Yellasiri along with his team had been keeping a close eye on a suspect pedlar. We knew when the vehicle with the consignment left Siliguri at 4.30 am in the morning. We had been following them but we were unable to intercept them at Rangpo check post. Only an hour later were we able to intercept them at Topa Khani along the NH-10 route heading towards the capital.”
“Following the drug arrest, we conducted a raid in various places in Sikkim. We recovered 3684 loose capsules of Spasm Provoxyin, 380 capsules of Nitrosun-10, 21.24 grams of brown sugar and one lakh, thirty thousand in cash from the house of a suspect that was acting as a store for the drug consignment.” He added.
The culprits were booked under various acts of SAD and NDPS Act of 1985. The worth of the drug consignment was estimated to be 14 lakh rupees.
Drug abuse or substance abuse refers to the use of certain chemicals to create pleasurable effects on the brain. There are over 190 million drug users around the world and the problem has been increasing at alarming rates, especially among young adults under the age of 35, which in itself is a huge loss of human potential. Apart from the long-term damage to the body drug abuse causes, drug addicts who use needles are also at risk of contracting HIV and hepatitis B and C infections.
Many people don't understand why or how other people become addicted to drugs. They assume that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will.
Factors contributing to drugs and substance abuse
Dr. Satish Rasaily, MBBS, MD Psychiatry & Postdoctoral Fellowship in Addiction Medicine states, “No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental, and developmental factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. The society has a belief that drugs and substance abuse is a social disease, it’s a social evil and a weakness of character. But contrary to that, science and research indicate biological factors which depend on genetic vulnerability.”
“There are external traits and internal traits. In external traits, there is a condition called ADHD (attention deficit hyperactivity disorder). People with ADHD have low dopamine levels because of which they continuously seek pleasure. In such conditions, people have really short attention spans. They’re very restless, hyperactive and impulsive. They make decisions without thinking about the consequences. They cannot sustain their interest.”
“There’s also an internalizing trait. People with internalizing traits are very introverted. They are very anxious. They lack confidence and self-esteem. They suffer from panic attacks, anxiety and social phobia along with. So, any children who are very notorious, anti-social in school, can actually identify a set of characters which can be vulnerable to substance abuse in the future. It is not that all children with these characteristics become drug addicts and alcoholics in the future but more than 60-70 per cent are at risk for substance abuse in the future.”
“Drug addiction usually starts between 10-12 years of age. I feel that peer pressure is the biggest risk factor for substance and alcohol abuse. Also, in the adolescent period, people are very much vulnerable to take risks. During this period, anyhow the people’s brain is wired to experiment with new things every day. This is also the period for creating an identity for oneself like associating oneself with different groups. During adolescence there’s so much peer pressure that the children are forced to do certain wrong things in order to be accepted by that group,” he adds.
He also adds, “I’ve seen even people with mental disorders such as anxiety, depression, bipolar disorder, schizophrenia, psychotic disorders also have the tendency to take drugs. We have many schizophrenic people that come to us and most of these people mostly indulge in cannabis consumption. So, there’s a link between cannabis and schizophrenia. That is why people who consume cannabis develop schizophrenia and have to get admitted for a long period of time.”
Treating substance use disorder
People struggling with addiction usually deny that their drug use is problematic and are reluctant to seek treatment. However, addiction is treatable and can be successfully managed. Studies and research show that combining addiction treatment medicines with behavioural therapy ensures the best chance of success for most patients.
Dr. Rasaily says, “We have a very flexible course. We have medicines to treat various drug addictions such as heroin addiction, SP, N_10, Cannabis and many more. We also have specific detox programs where we do medical management of people who are addicted to drugs. Every month there is a follow-up counselling and we provide them with medicines to treat alcoholism and other drugs.”
“People who are recovering from an addiction will be at risk for relapse for years. lt is common for a person to relapse, but relapse doesn't mean that treatment doesn’t work. We also have a management system to manage the relapse. Lapse and Relapse is a part of the process. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs.”
“I’ve been in the service for almost 10 years now and I’ve realized that just medical treatment and counselling isn’t enough. They would come here and sit here the whole day. So, we have come up with various activities like gardening and farming to engage them. came up with the various activities like farming to keep them engaged. We have morning activities; exercises and we also make them sing the National Anthem. We have a volleyball court that was built by the patients. We have indoor games like chess and we organize competitions and tournaments occasionally where the staff participants are a must.” He adds.
Treatments for women addicts; a fable?
Women face unique issues when it comes to substance use, in part influenced by:
- sex—differences based on biology
- gender—differences based on culturally defined roles for men and women
In the past, women were not included in most research because of the belief that women are more biologically complicated than men and that women were too busy caring for their children to participate in studies. Although significant strides have been made to include women in clinical research, most animal-based research still tends to over-rely on males. There are more men than women in treatment for substance use disorders.
Dr. Rasaily on this issue states, “Right now, we do not have a separate wing for women, we take them in the OPD. And the number of women that come seeking help is very less. We do not even know the actual number. The treatment for women drug addicts poses many different challenges. Firstly, seeking help for them is a big challenge. Unless we do not take a survey we will not know the number. However, there is a demand for service for female patients.
It’s not that the women aren’t suffering but the problem is that they aren't seeking help. So, we need to do something about de-stigmatizing addiction issues for females because until now all the treatments and services are male-oriented. There are more acceptance problems for women than men in society.” He adds.
Untreated drug and alcohol use contribute thousands of deaths every year and impact the lives of many more. Healthcare already has effective tools including medications for drugs and alcohol use disorder but they are not being utilized widely enough, and many people who could benefit do not even seek them out. One important reason is the stigma that surrounds people with addiction.
He advises, “In order to eliminate the stigma surrounding substance and drug abuse we need to create awareness among people, starting from home. People consider drug abuse and alcoholism to be a social disease but the truth is, every disease has a social impact and as soon as we start accepting alcoholism and drug abuse as a medical illness, it will open doors for the patient and family to seek help. This is the first thing that we should do to erase the stigma, giving them a medical model.”
“We need to especially educate the parents to recognize early threatening signs of misusing drugs and alcohol. Also, we need to equip them with required necessary tools and information to the parents and teachers for them to be able to connect with services such as doctors, counsellors, rehab centres and NGOs.” He adds.
Role of community
In India, by the time most boys reach the ninth grade, about 50 per cent of them have tried at least one of the substances of abuse nature, with Sikkim not being an exception. According to World journal of pharmacy and pharmaceutical sciences, 2019, At least seven of 10 teenagers in Sikkim abuse drugs.
With the surge in drug cases in Sikkim, Dr. Rasaily believes the society now has to take a strong stand against drug distributors. He appeals to the community to become proactive. He states, “The trend of drug abuse has changed significantly over the years. Back then, people would abuse alcohol, cannabis and prescription medicine. Those are harmful and dangerous but comparatively not as much as brown sugar, heroin and N-10. So, it is very important that we as a community work together with the law and authority to combat alcoholism and substance abuse. We must start community policing via SHGs, schools and clubs.”
He adds, “I’ve seen a lot of cases where the parents do not seek help for their children because they’re ashamed of the stigma. The need of the hour Is that we need to encourage people to seek help without fear and hesitation because when you seek help there’s hope.”
By Mahima Grace Rai
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