Why drugs in Punjab are a reality even if the Censor Board thinks otherwise

Punjab's drug problem isn't going anywhere fast, and the authorities don't seem to know how to deal with it

The Censor Board's perturbation with Udta Punjab, what with its profanities and a dog named after prolific Chinese actor Jackie Chan, might appear to be hilarious to observers but the business of enabling others to get high is a serious one in Punjab.

While Censor Board chairperson Pahlaj Nihalani sees a political conspiracy behind the film and its title, the dealers and peddlers in Punjab are liable to like what they see — a market which is yet to lose its enthusiasm for their wares, if the numbers are anything to go by.

There are an estimated 2.3 lakh opioid-dependent people in Punjab, reveals a recent survey. Despite cries from certain political sections over Punjab's name being maligned, the malaise of drug abuse in the state is serious enough that the Union Ministry of Social Justice and Empowerment, supported by the Punjab government's department of health, felt it was necessary to commission a "Punjab Opioid Dependence Survey". 

The data for the survey, conducted between February and April 2015, was collected from a total of 3,620 opioid-dependent individuals across 10 districts of the state. The study used a respondent driven sampling method and a "multiplier technique" was applied for estimating the size of the state's dependent population.  

After collecting the data, employing the multiplier technique, and adjusting for the total population of the state, it was found that the state is home to anywhere between 1,74,642 (lower bound estimate) to 3,22,416 (upper bound estimate) opioid-dependent individuals, with the study settling on the figure of 2,32,856. 

Of course, the survey warns, the number of users is always higher than the number of dependents. The purpose of the survey is to only ascertain the number of opioid-dependent individuals in the state. "The estimates for opioid users in Punjab could be around 8.6 lakh," the survey says.

Heroin rules the roost

Using the data collected, the study concludes that the most widely used opioid in the state is heroin, with opium a distant second.  

"Most common opioid drug used by this group is heroin (reported by 53 per cent), followed by opium, doda or phukki (reported by 33 per cent). Rest (14 per cent) report using a variety of pharmaceutical opioids," the survey says. 

The survey also throws light on the method of ingestion. About one-third of the dependent individuals surveyed take their opioid drugs through injections and among them, almost 90 per cent (29 per cent overall), inject heroin, the survey reveals.  

No cure in sight

Additionally, if the numbers thrown up by the study are anything to go by, any successful intervention is far from taking place. 

The study indicates that as many as 80 per cent of opioid-dependent individuals have tried to kick the habit. However, it adds that only about 35 per cent of them have received any help or treatment. Evidence-based, effective treatment has been received by only about 16 per cent of dependents, "ever", the report goes on to point. 

Opioid substitution therapy, which the study describes as "providing an opioid medication like buprenorphine to the patients on a long-term basis" and states to be "the most evidence-based treatment" available, has been accessed by less than 10 per cent of the dependent individuals in the state, according to the survey. 

Additionally, in the year before the study was conducted, the survey says, only about 8 per cent of such individuals received any in-patient treatment or were admitted to a de-addiction centre.

"If the treatment strategies remain focused on only a single modality of treatment (i.e. admission to a de-addiction centre), it will take about 10 years to provide a single episode of treatment to the entire opioid-dependent population in the state," the study concludes. 

Costly venture 

If the above data is an eye-opener, what follows only reinforces the point that the problem needs to be addressed urgently. 

  

The survey also provides data on average expenditure on opioid drugs incurred by the opioid

dependent individuals per day.

"After multiplying the figures on expenditure with the estimated number of dependent users in the state, we can project that opioid-dependent people are spending around 20 crore rupees per day on opioid drugs. This amounts to an annual expenditure on opioid drugs to be about Rs 7,575 crore per year," the survey says.  

Prisons can't solve the problem 

The aforementioned report is not the only bearer of bad news, a recent investigation by The Indian Express reveals that the Narcotic Drugs and Psychotropic Substance (NDPS) Act isn't helping things either. 

According to the national daily, scrutiny of first information reports in the most affected districts of the state has revealed "an average of over 25 addicts being booked each day — in effect, dragging 25 families into a broken penal system". The report adds that at least 174 individuals charged under the NDPS Act have died in prisons — 88 in 2014 and 86 in 2015.

While it comes as no surprise that Udta Punjab has raised hackles, given that the state is due for elections by February 2017 and the Aam Aadmi Party has made the drug issue one of its major elections planks, it would serve the state and its denizens better if the Centre and its ally in the state, the ruling Shiromani Akali Dal, came together to combat the drug menace.