Udta Punjab has a new crisis to manage as the cure has become a curse. After abusing drugs and alcohol, the addicts in Punjab are now hooked on de-addiction drugs.
Thousands of Punjab addicts being treated at government and private centres have been found addicted to de-addiction drugs like buprenorphine. The drug is given in combination with naloxone to opioid addicts.
Punjab Health Minister Balbir Singh had in March informed the state Assembly that there were 8.74 lakh drug addicts in the state. Balbir Singh said 2.62 lakh addicts were in government de-addiction centres while 6.12 lakh were in private centres.
Singh suspected that the number of addicts in the state could be higher.
Punjab’s huge problem with drugs like heroin, or ‘chitta’ as it is commonly referred to, has been highlighted in the Shahid Kapoor and Alia Bhatt-starrer ‘Udta Punjab’.
The Punjab government was spending Rs 102 crore annually on providing free de-addiction medicines to the state and private de-addiction centres.
An estimated 20 crore tablets of buprenorphine were being purchased every year by the state government for free distribution through registered de-addiction centres.
Despite huge sums being spent from the state exchequer, the rate of success was just 1.5 per cent in government-run de-addiction centres and only 0.04 per cent in privately run centres. A network of 198 Out Patient Opioid Assisted Treatment (OOAT) centres, and 35 government and 108 private de-addiction centres could rid just 244 addicts of their addiction between 2017 and 2022.
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CRACKDOWN HOOKS ADDICTS TO DE-ADDICTION DRUGS
Punjab police and central agencies have launched a massive crackdown against drug smuggling.
According to Inspector General of Police (IGP) Sukhchain Singh Gill, the police alone seized 1,135.25 kg of heroin and arrested 14,952 drug smugglers from July 5, 2022 to June 12 this year.
The widespread heroin seizures — the most abused drug in Punjab — on one hand, increased the street prices of the drug and pushed more addicts into de-addiction centres.
The addicts during their stay at the de-addiction centres learnt to abuse the de-addiction drug buprenorphine, which itself is an opioid agonist. This drug has all the addictive and psychoactive properties of opiates.
According to psychiatrists, if abused, buprenorphine can mimic heroin.
Sources said 67,000 patients in Punjab were addicted to buprenorphine. Psychiatrists said the patients were not consuming this drug to get rid of the addiction but to get a high.
DE-ADDICTION CENTRES MINTING MONEY
Officially, buprenorphine should only be available through government supplies, but the drug is freely available through shady chemist shops as the demand has shot up.
“No doubt people are hooked on it (buprenorphine) and it is being misused after being procured from non-government sources, but overall, this drug is part of the harm-reduction therapy. Those who are using this drug are no longer IV users, which has reduced the harmful effects of IV use and they are back to normal life. We cannot deny that many people are addicted to it,” says Punjab government psychiatrist Dr Puja Goyal.
While the government-run de-addiction centres were only dispensing a couple of doses per patient, the private centres were allegedly dispensing the drug recklessly to mint money.
The drug was also being given to alcoholics and low-potency drug addicts who use poppy husk. While the government price per tablet was below Rs 10, the private de-addiction centres were allegedly selling each tablet for up to Rs 50.
Another reason which contributed to the gross abuse of this drug was the state government’s decision to allow the patients to take home the prescribed quantity of the drug for 21 days.
Head, Department of Psychiatry, PGIMER, Chandigarh Dr Subodh BN also confirmed that the third category of drug addicts after heroin, opium and alcohol was that of those who frequently abuse analgesics.
“We get patients who are addicted to various drugs. This also includes pharmacological and opioids. Besides alcohol abuse, we have also found people abusing analgesics (painkillers). Now, we are getting an increased number of addicts abusing analgesics,” says Dr Subodh BN.
The doctor added that abuse of pharmacological protocol and opioids could lead to seizures. Misuse of analgesics could increase the severity of seizures.
ADULTERATED OPIUM, HEROIN HAMPER TREATMENT
A key reason why de-addiction centres were not able to cure more patients and why the de-addiction medicines were not able to treat patients was the sale of adulterated opium and heroin.
“The opium and heroin being sold to the addicts were adulterated. These drugs were being laced with habit-forming drugs and harmful chemicals. People were not only abusing the painkillers but also drugs like oxytocin, which is generally given to milch cattle to get more milk,” says Mohali-based social worker Sonu Sethi. Sethi works with drug-de-addiction centres and recently got an addict who injected himself with oxytocin admitted in a hospital.
Zirakpur-based psychiatrict Dr Vinay Bansal says treating addicts who use adulterated drugs becomes difficult as there is no laid-out procedure to treat such patients.
“The heroin is not pure and the ingredients are not known. Buprenorphine is being administered based on clinical expertise only, as we don’t have a scale to measure the ingredients available in the substance being given or abused as heroin. At times, the patients are manipulated and don’t reveal the exact substance they abused,” says Dr Vinay Bansal.
Punjab, according to the psychiatrists, was facing a shortage of mental health experts like psychiatrists and psychologists. Many de-addiction centres are getting patients in large numbers and aren’t able to treat them properly.