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HEALTH: ADDICTION
Difficult To Detect
The main advantage
of prescription drugs for addicts is their easy and lawful availability
and low cost. (Calmpose for example, costs Rs 10 for 10 tablets. Ecstacy
costs Rs 1,000 per pill). These are also difficult to detect. Even better,
it can be palmed off as a legitimate tablet when caught-one just needs
to feign a cough or headache convincingly.
In contrast to the pill-poppers, injected drug
users (IDU) usually shift to these drugs from heroin. And several studies
by UNDCP and drug rehabilitation organisations show that use of injected
drug show a steep rise in all the metros. The worst case scenario is in
the North-east, where the number of IDUs is as high as 80 per cent of
all drug abusers. IDU shows a disturbing pattern. The trends here reinforce
history. When morphine and opium addiction was considered a major social
problem 104 years ago, a drug was introduced to wean the addicts off.
That drug was heroin, and it did its job only too well. Almost a century
later, a prescription drug called buprenorphine given to addicts to ease
the heroin withdrawal symptoms in drug rehabilitation centres. The new
drug proved extremely addictive, and, with a cocktail of other similar
drugs, extremely potent and dangerous. They're cheaper too, at only Rs
20 per cocktail ampoule, compared to Rs 80-150 for the same amount of
heroin.
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| BAD MEDICINE: Addiction can progress
from smoking to injecting prescription drugs |
Unlike the pills, injected drug use is common
among some students and those on the fringes of society. For them, the
prescription drug cocktail is a cheap way out of the many tragedies of
life. Says Ajay, a former rickshaw-puller who was forced to retire due
to lack of strength: "I came to Delhi from my village in Uttar Pradesh.
I sent all the money earned back to my family, and took to drugs so that
I could work longer hours and earn more without eating." Now a physical
wreck, he picks rags to gather enough money for his daily fix, which he
gets from the neighbourhood pharmacist.
Jim Dorabjee of Sharan, a drug rehabilitation
organisation with centres across the country, directly blames the Narcotic
Drugs and Psychotropic Substances Act (NDPS), 1985 for this state. "We
have always had a tradition of substances like ganja and charas which
did not do any great harm. NDPS put all of them at a par with hardcore
drugs like heroin by making all drugs illegal and equally punishable.
This led to a surge in heroin, an increase in IDU, and now the prescription
drug abuse." Apart from the harm the drugs do to the body, increasing
IDU also has severe health implication-sharing of needles has led to the
spread of HIV/AIDS and Hepatitis-C. A Sharan study in the slums of Delhi
show that 86 per cent of the IDUs share needles and syringes, drug solutions,
the water for rinsing and the drug mixing container. HIV figures among
IDUs are 80 per cent in Imphal, 15-19.5 per cent in Chennai, 7.43 per
cent in Mumbai, 2 per cent in Kolkata and an alarming 44.5 per cent in
Delhi according to a Sharan/Johns Hopkins University joint study.
While awareness is crucial, the crux of the
problem is easy availability of prescription drugs. "The law is there,
it just has to be enforced more strictly," says Jitender Nagpal of
vimhans. And that is far from impossible. For example, methylphenidate
is a new stimulant used to treat children with Attention Deficit Hyperactivity
Disorder (ADHD). It has a great potential for abuse. That has not been
the case due to strict rules-it is only available in triple-prescriptions
on a special prescription pad. "I haven't seen any addiction to methylphenidate
yet," says Mittal. "If we can be strict for one drug, why not
for others with abuse potential?" As new stresses develop in the
super-tech society of tomorrow, India's health depends on the integrity
of the neighbourhood pharmacist.
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