Surging Number Of Drug Addict Patients And Condition Of Drug De-Addiction Centre In Kashmir

For this 32-year-old patient, drugs came accidentally into his life. Waiting for his turn to be examined by a doctor at the drug de-addiction centre at Srinagar's SMHS hospital last Friday, he seemed restless and was eager to jump the queue but his mother was holding him back. There was only one doctor at the OPD and the queue was long. "I started taking drugs by chance. It all happened in 2016. It was my bad luck. I was living otherwise a happy life and had everything,” he says.

“That year in June I took some youths to a tourist spot in south Kashmir. I was a driver. During the travel, I got close to them,” he says with a grim face. “During their stay at a hotel, they invited me to their room and asked me to smell a foil. It was opium. And I couldn't realise it then, but it gave me immense pleasure, and I had felt nothing like that in my life and I got used to it,” he says, with his mother beside him.

He was then unmarried and was doing well in his life, having two transport sumo vehicles of his own. In subsequent months, he started taking opium, and he would travel to South Kashmir's Kulgam area to get it on his own. “I would get the drugs from a woman peddler,” he says. In subsequent months, he started spending a huge amount of money on drugs, taking injectables. With it, he started selling his property and vehicles. His family thought that marriage was an antidote to all his ailments including drug addiction. He was married in 2018 and had a child. When his wife came to know about his addiction, she, along with family members, took him to the Institute of Mental Health and Neurosciences (NIMHANS), Srinagar. He was admitted and put on medicine. For one and a half years since 2022, he improved and stopped taking drugs.

Now, for the past month, he has met some of his old drug-addict friends, and he has started using again. Frustrated, his wife left him. Ironically, his mother blames her daughter-in-law. “She couldn’t keep an eye on him and this happened to him again,” she says. The patient is remorseful and wants to get rid of the drugs. “This time if they admit me for 15 days, I will be able to get out of it,” he says. The patient also has some advice for the parents: “Once you see your son is not going with his routine friends, is not taking interest in sports as he used to, you should realise something is seriously wrong with him. Once you are a drug addict, you give up on your routine friends, and new people come into your life,” he adds.

At the Drug De-addiction Centre in Srinagar (DDCS), most of them are drug addicts who had visited the centre located at the SMHS hospital premises either on their own or under family pressure or on follow-up.

The DDCS has only one consultant psychiatrist and one senior resident. The latter was on leave. The technical and support staff at the centre are worried because, after 13 years of service, the government is not ready to grant them an extension. There are around 26 contractual employees, initially hired on an extension basis under the NMHP scheme in 2011 with an initial salary of Rs 3,000 which was later increased to Rs 9,300. Of the 26, only 10 are posted at the Drug De-addiction Centre. They have been taking care of the patients over the years, and now they are unsure of their future.

"It seems the government wants to close down this only facility. Instead of hiring us permanently, the government wants to oust us," says one of the contractual employees who was ensuring patients should wait for their turn.

During the departmental meeting held on August 25, it was decided to close the centre until the manpower crisis was resolved. Following the meeting, the centre stopped admitting patients out of fear of closure. However, the government later issued a statement stating that the centre, which is the nodal centre for Jammu and Kashmir, will continue to function. The contractual employees also moved to the court, and the High Court has directed the government to maintain the current position.

41,110 Addiction Patients And Growing

Over the years, the centre has witnessed a significant increase in the number of drug-addicted patients. In 2016, only 489 patients sought treatment at the centre. This number surged to 3,622 in 2017, including follow-up, marking a substantial increase. In 2018, there was another significant jump, with 5,113 patients visiting the centre. By 2019, the number had risen even further to 7,420.

In 2020, the centre recorded 1,682 new patients, and when considering follow-up visits, the total reached 5,721, resulting in a cumulative number of 7,403 patients for the year. In 2021, 2,313 new patients sought treatment, and with follow-up visits, the total rose to 21,090, resulting in a cumulative number of 23,403 patients for that year, with 374 patients being admitted.

Last year, the centre registered 3,036 new patients, and follow-up visits were 38,074, leading to a cumulative total of 41,110 patients. During that year, 370 patients were admitted for treatment. This year has been no different. In January, 133 new patients and 3,525 old patients were seen leading to 3,658 patients. In February, 134 new patients and 3,205 old patients brought the total to 3,339 patients. March saw 151 new patients and 3,821 old patients, totalling 3,972 patients. In April, 117 new patients and 3,167 old patients added up to 3,284 patients. May had 175 new patients and 4,058 old patients, resulting in a total of 4,233 patients. June recorded 120 new patients and 3,566 old patients, making it a total of 3,686 patients. July saw 147 new patients and 3,978 old patients, with a total of 4,125 patients. 

Up to August 20th, there were 92 new patients and 2,669 old patients, making it a total of 2,761 patients. The cumulative total up to August 20 is 1,069 new patients and 27,989 old patients, with a total of 29,058 patients treated at the Drug De-addiction Center SMHS Hospital GMC Srinagar.
 
However, despite so much overload, apart from the installation of the CCTV, no additional infrastructure and manpower has been added to the centre. There is no clinical psychologist at the centre. Sources say that DDCS has all the necessary medicine available for treating drug addicts, unlike other centres but the government medical college’s move to depute one postgraduate and one senior resident to the centre for a month, and then replace them with another senior resident and a PG is disrupting the system. The centre has currently only one consultant.

"The centre needs a lab facility, clinical psychologists, at least five to six psychiatrists on a permanent basis, as the number of patients is substantial. But no one seems to be listening. It appears that the government established the centre and then forgot about it," says a GMC faculty member, requesting anonymity. “If the government is serious about treating drug addicts it has to empower drug-de-addiction centres in all possible ways and the first is to depute at least a nearly half a dozen psychiatrists to the centre on a regular basis.”

Kashmir's Drug Addiction History

Drug addiction is not new to Kashmir, where militancy has been raging since the 1980s, leaving hundreds of civilians dead or maimed for life. The use of charas-ganja or cannabis among Kashmiris is traditional and even socially sanctioned. Between 1980 and 1990, only seven opium users were treated at the valley’s psychiatric disease hospital. In 1990, when militancy erupted in Kashmir Valley, grocery and medical shops came up in localities as security issues confined people to their homes and localities. With the conflict, stress levels among people also went up and they started visiting local medical shops, which would give them over-the-counter medicinal opioids.

Doctors would later see patients who were taking medicinal opioids for sleep, anxiety and stress for years on the advice of chemists. Its implications became visible by 2000 when patients started visiting the psychiatric disease hospital, now called the Institute of Mental Health and Neuroscience (IMHANS) and Drug De-addiction Centre, for treatment of complaints of seizures and drug overdose. Other drugs that became popular among addicts were Spasmoproxyvon, codeine and pentazocine, which were abused for their euphoriant effect and sedating properties as happiness seemed elusive in the valley of sadness. Doctors say that cannabis took off as a popular drug from 2005 onwards but soon the addicts turned to hard drugs, mostly heroin.

As the Kashmir Valley has witnessed a surge in the number of cases of substance use in the past few years, drug overdose deaths among youth and frequent seizures of illicit drugs by the police indicate that substance use has engulfed Kashmir.

According to the latest survey, “Prevalence and Pattern of Substance Use Disorders in Ten Districts of Kashmir”, carried out by the IMHANS, Kashmir, the Valley has an estimated sizable population of 67,468 substance-dependent individuals. While opioid dependence prevalence in all 10 districts of Kashmir is 2.23%, the total number of opioid dependents is estimated to be 52,404 in the Kashmir valley. The survey says heroin is the most widely used opioid in every district of Kashmir and 53.5% of opioid users were sharing needles while injecting drugs and 65.1% of opioid users were reusing the needles while injecting drugs. The survey reveals an epidemic of opioids in the young population with a prevalence of 2.23% making Kashmir valley among areas having high opioid use in the country, surpassing Punjab and only after North East.

The Principal Investigator of the survey, Dr Yasir Hassan Rather, says the report indicates that Kashmir youth are engulfed in the web of substance use disorders and need immediate and effective help from all the stakeholders. He says the study shows that in every district, opioids were the predominant substance used by the study participants.

Government Efforts

While drug addicts say the drug addiction could resolved only once the drug peddlers, the government says they are out to resolve the issue. In July this year the Chief Secretary, Arun Kumar Mehta, announced that districts, municipalities, and panchayats showing outstanding performance in addressing narcotics-related issues will receive suitable rewards from the administration. The Chief Secretary says officers should take all necessary measures to eradicate this menace entirely and they should gradually expand the areas free from drugs and designate them as 'Drug-Free' after thorough assessment.

He says the formulation of well-thought-out guidelines for declaring panchayats as 'Drug-Free' in collaboration with various agencies, including PRI members, the police, health, education, RDD, revenue, and social welfare departments is in process. The CS says it is necessary for pharmacy shops to have functional CCTVs and maintain registers to record the sale of scheduled drugs.

The Chief Secretary says instructions have been given to the police and district administration to seize the properties of drug dealers in accordance with relevant regulations.

The Additional Chief Secretary of Home, RK Goyal, says the police administration has been asked to organize capacity-building workshops for officers responsible for handling cases under the PITNDPS Act. He says the a need for these officers to be sensitized to the nuances of handling such cases in a professional manner. He suggested that a Panchayat should only be declared 'Drug-Free' after certification by the relevant institutions confirming the absence of drug dealers, cultivators, and consumers in the village.

The special DGP of Crime, AK Chaudhary, reported that in 2022, 1,850 cases were registered, resulting in the arrest of 2.756 individuals. He says 1.410 cases have been registered up to June this year, with 2,068 persons named in the FIRs being arrested.
This year saw the seizure of 251.42 kgs of Charas, 124.47 kgs of heroin, brown sugar, 92.24 kgs of ganja, 3374.69 kgs of fuki, poppy straw, and 105,588 cap bottles and capsules of contraband substances under the NDPS Act up to June 2023.