The temporary high that leads to abysmal lows

Street kids openly abuse whatever substance they can buy, clearly visible to the public but somehow not to the police
Street kids openly abuse whatever substance they can buy, clearly visible to the public but somehow not to the police

Sonu, 15, a homeless ragpicker, can be seen crouched in a dingy corner of Delhi’s Connaught Place, openly inhaling smack from pieces of aluminium foil or sniffing other intoxicants. The sight of such drug addicts is also common under flyovers and at railway stations. It gives a fair idea of the massive drug abuse by the impoverished and homeless population.

According to a study conducted in June last year by the Delhi Commission for Protection of Child Rights (DCPCR) on substance abuse by children, the average age of children indulging in drug abuse in the capital is 13.07 years. The study revealed that 93 percent of street children and 100 percent of children in conflict with the law use narcotic substances. Another study, by NGO Childhood Enhancement through Training and Action (CHETNA), reveals that there are 1.5 to 2 lakh street children in Delhi, who collectively buy narcotic substances worth Rs 27 lakh every day from the money they earn by doing odd jobs.

The most popular drugs among street dwellers, both minors and adults, are inhalants such as glue, fevibond, ink eraser fluid, paint and petrol. Smack or brown sugar, adulterated byproducts of heroin, are also a favourite, apart from ganja (marijuana). These are as cheap as 50 or 100 per unit, sufficient for a day’s use and easily accessible. Over-the-counter medicines like cough syrups and sleeping pills are also widely misused.

According to activists working with street dwellers, taking drugs is more of a compulsion than a choice for impoverished homeless persons. These substances help relieve the distress that such persons feel and also curb hunger, apart from insulating them from extreme weather conditions such as the cold or heat.

In Delhi, marijuana and hashish are also highly popular among the educated, especially college students and young professionals. Both herbs are crushed and rolled into cigarettes, usually mixed with tobacco, and smoked. Marijuana can be obtained for as little as 100 or 200 for a few buds that last a single regular user for a few days. Hashish comes in different varieties, the starting price being Rs 1,500 for 10g, which can be used for rolling 10-15 joints. The cost of the cream variety of hashish can go up to Rs 4,000 for 10g. These two narcotics, both derivatives of the cannabis plant, are easily available from multiple dealers in the city, especially in the vicinity of campuses.

Then there are the rich man’s drugs, such as cocaine, synthetic psychedelic amphetamines like MDMA or ecstasy, methamphetamine or speed, and hallucinants such as LSD or acid. These banned substances are usually indulged in by those with deep pockets. Cocaine costs around Rs 5,000 to Rs 6,000 per gram, which is enough for snorting 15 lines. A cheaper and unprocessed form of cocaine called crack is consumed through cigarettes. MDMA, one of the most expensive drugs, costs Rs 5,000 to Rs 8,000, depending on the quality, for a small unit that is enough for one-time use by a group of 4-5 persons. One stamp or drop of LSD, costing just Rs 1,000, is sufficient to give a high for 14 hours, often referred to as a hallucinatory ‘trip’.

The last survey of the number of people who use narcotic substances was carried out in 2001 and the data published in 2004

A young professional in his late twenties who is a recreational drug user told Tehelka that Meow Meow is common in Mumbai and Pune but hasn’t picked up much in Delhi. It’s one of the most lethal drugs ever and is better avoided, he says, requesting anonymity. “I haven’t tried Meow Meow and don’t know anyone in Delhi who has. I’ve heard it’s one hell of a drug that turns you into a scary zombie. It’s quite popular in Mumbai and Pune circles, though,” he said.

Another youngster, a post-graduate student in Delhi in his mid-twenties who confessed to using party drugs, says that a lot of youngsters who use LSD, cocaine and MDMA do it for fun and get bored after using the same stuff over a long time. “There are changes in demand and supply. That’s when there are some changes in prices too. People get bored with the same drugs and want to try something different. There’s always something new in the market. Meow Meow is deadly but you never know, it might soon become the new rage in Delhi too,” he said, requesting that his identity be with-held.

According to National Crime Records Bureau (NCRB) data tabled in the Rajya Sabha during the past monsoon session, 10 suicides take place daily in India due to problems associated with drug abuse. While the national average is three suicides per million population, the average in Delhi is two suicides per million people.

Sparse statistics
It is, however, not possible to determine the total number of people in Delhi or even in the whole country using drugs. The last survey of the number of people who use narcotic substances was carried out in 2001 and the data published in 2004.

After a gap of 15 years, the Ministry of Social Justice and Empowerment (MoSJE) in collaboration with AIIMS’ National Drug Dependence Treatment Centre (NDDTC) announced in July this year that a survey will be conducted over a period of two years to compile national and state-level estimates of the exact number of people involved in drug abuse. The survey, for which a project cost of Rs 22.41 crore has been estimated, will map the presence of services and interventions for drug-dependent individuals and identify the gaps in service delivery.

Earlier, such surveys did not provide any data on the prevalence of substance abuse at the state level or among women. According to MoSJE officials, there will be focused thematic studies on specific topics or vulnerable populations which will include studying the pattern of drug abuse among the homeless, prisoners, transgenders, sex workers and transport workers.

India is signatory to various international conventions on drug abuse and is expected to report to international agencies such as the United Nations Office on Drugs and Crime (UNODC) and the World Health Organisation (WHO) on questions related to data on the extent of substance abuse in the country. In such instances, India’s place has been shown as vacant for several years
in the annual World Drug Report of the UNODC.

De-addiction efforts
Sabbie, who is comfortable with his nickname being published, is a 25-year-old graduate student based in Delhi. He lost out on three years of college because he was addicted to certain narcotic substances and no one knew how he could be helped. He was sent to a private drug de-addiction treatment centre in Ghaziabad by his family twice for six months and blames that place for making things worse.

“That place should be shut down. I don’t know how they are allowed to operate. Instead of helping me, they turned me into a complete maniac,” he told Tehelka. According to Sabbie, he started doing drugs at 19 as he was depressed. “I was young and highly upset because of what was happening at my home. Many of my friends were doing drugs and I too gave it a shot,” he said, adding that while he started with smoking up marijuana, he soon took up hashish and cocaine regularly.

It’s not necessary to admit a patient for de-addiction. It is best that the person quits drugs in the environment in which he takes it

He says he could have come out of it with the right kind of support. “All I needed was some psychological help. I didn’t know it earlier, I realised it later. But my family had no idea what to do. They thought I was crazy and were highly embarrassed. So they just sent me to this unauthorised rehab without going into its merits,” he said.

Narrating his ordeal at this private rehabilitation centre, Sabbie said that it was like a jail where people addicted to drugs were intimidated into quitting the habit by bulky bouncers or pehelwans who beat up the inmates, sometimes for no reason. “There was no psychological counselling available. I was highly motivated to leave drugs but in the absence of psychiatric help and due to physical and mental bullying, I became frustrated and started doing drugs two days after coming out. I didn’t need to stay there for so many months in the first place. That place has a high rate of relapse because instead of helping people it does the opposite,” he says.

While there are a number of drug de-addiction centres run by the government in Delhi and across the country, unauthorised centres and clinics run by quacks usually follow a moralistic rather than clinical approach to de-addiction, especially by convincing the families of patients that they be admitted for many months at a stretch and using physical force on them.

Dr Rakesh Lal, senior faculty at the National Drug Dependence Treatment Centre (NDDTC) in Ghaziabad run by AIIMS, told Tehelka that both medicines and psychological counselling play a very important role in treating patients with drug abuse and it’s not at all important that all such patients be admitted to de-addiction clinics. “When a patient comes to us, we certainly assess the need for admission along with many other parameters. People, including doctors, think that for drug de-addiction there’s no hope without admission. This is not true because we feel that for a long-term prognosis, it is best that the person quits drugs in the environment where he is taking it. Even if he is admitted here for a particular time period, he has to go back to the same place. He can’t change his job and location. So if a person stays in an environment where drugs are available but he learns how to say no to drugs in that environment, that’s when the long-term prognosis is good,” he says.

“Only some people need admission,” he adds. If we expect the withdrawal symptoms to be complicated, such as seizures or if the amount of drugs used is too large or there’s multiple drug use, or if you run into a lot of physical complications or psychological complications — these are the kind of people we prefer to give priority in admission, including distressed homeless persons.”

In Delhi-NCR, other de-addiction centres are at GB Pant Hospital, Lady Hardinge Hospital, Dr RML Hospital and the Institute of Human Behaviour and Allied Sciences (IHBAS) where either no fee or a minimal fee is charged. They are run by the respective hospitals’ psychiatry departments and follow a three-step procedure for treatment — detoxification, rehabilitation and prevention of relapse. The departments of women and child development and social welfare are also closely associated with some NGOs who run specialised de-addiction and rehabilitation centres in the city. Many private hospitals also provide such treatment, but at a high cost.

The Ministry of Health and Family Welfare funds 124 de-addiction centres all over the country, with the agreement that the recurring costs — staff salary, medicines — will be borne by the states while the central government builds the infrastructure. The MoSJE has about 450-500 counselling centres across the country. Both the ministries work in tandem. While the Ministry of Health pays more attention to treatment and detoxification, the MoSJE works to prevent drug abuse and rehabilitates victims.

According to Dr Lal, the government is very forthcoming as far as funding is concerned. “We are 100 percent funded by the Health Ministry and they give us whatever we ask for. There’s a provision for recurring costs to be incurred by the government. But for that you have to give a year’s requirement. Some centres don’t do that, so funding gets stuck. The government has no issues at all in funding, especially when they get an assurance that the money is being optimally utilised. They only want accountability, which is a fair thing to ask for,” he says.

In our country, the problem of drug abuse increases manifold due to lack of awareness and misconceptions. According to Dr Lal, there is nothing sensational about drug abuse. “Drug abuse is definitely an illness. Almost 100 percent drug abusers have psychological distress. Some have got a disease, which is not just distress, and needs separate treatment. Sometimes it’s a psychotic illness, sometimes biological. Drug abuse is a disease which leads to behavioural problems such as violence, crime, accidents. Some people are more vulnerable to drug abuse. There are many reasons for this
vulnerability. One is genetic vulnerability, then there are several biochemical parameters,” he says.

Other psychiatrists too aver that if substance abuse is looked at as a medical problem rather than as self-inflicted moral ineptitude, many lives can be saved from being ruined.