An ‘International Day Against Drug Abuse’ Special

June 26 is observed as the International Day against “Drug Abuse” and “Illicit Trafficking.” The drug menace has engulfed the state of Goa and it is a topic we can no longer ignore. Goan Observer.in catches up with DR AMIT DIAS of the Department of Preventive & Social Medicine, Goa Medical College & Hospital, who has been working in the area of mental health, to understand the extent of the problem and the path forward….

The drug menace is bigger and closer than you think,” warns Dr Dias. “We need to step up our efforts to reduce the availability of drugs, and at the same time work on drug demand reduction. Let’s say YES to LIFE and say NO to DRUGS.” Stop stigma and discrimination, strengthen prevention.

QUESTION: What constitutes drug abuse?
ANSWER: Drug abuse is defined as the use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in excessive amounts. It is not limited to drugs like opium, cannabis and heroin but also includes, tobacco and alcohol, prescribed medications like sleeping pills, painkillers. Buprenorphine, propoxyphene and heroin are the most commonly injected drugs. Drug abuse may lead to social, physical, emotional and job-related issues.

The drug menace is bigger and closer than you think,” warns Dr Dias. “We need to step up our efforts to reduce the availability of drugs, and at the same time work on drug demand reduction. Let’s say YES to LIFE and say NO to DRUGS.” Stop stigma and discrimination, strengthen prevention.

QUESTION: What constitutes drug abuse?
ANSWER: Drug abuse is defined as the use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in excessive amounts. It is not limited to drugs like opium, cannabis and heroin but also includes, tobacco and alcohol, prescribed medications like sleeping pills, painkillers. This is far more difficult to control becomes for limited prescription but becomes a lifelong addiction taking a toll on the organs. Buprenorphine, propoxyphene and heroin are the most commonly injected drugs. Drug abuse may lead to social, physical, emotional and job-related issues.

Q: What is the extent of the problem?
A: Drug abuse has spread its roots throughout the world. According to research, millions of Indians are dependent on alcohol, cannabis, opiates and drug misuse is a pervasive phenomenon in Indian society. The United Nations Office on Drugs & Crime, 2018 survey states that the extent of drug use among youngsters remains higher than that of older people. According to the “National Survey on Extent & Pattern of Substance Use in India” (2019), prepared by the Ministry of Social Justice & Empowerment, India has 16 crore people (14.6%) between the age of 10 and 75 years who are current users of alcohol, and out of them, 5.2% are alcohol dependents. Around 8.5 lakh people are injecting drugs. 1.18 crore (1.08%) are current users of sedatives (for non-medical use). Overall opioid users 2.06% and nearly 0.55% (60 lakh) require treatment services/health. About 3.1 crore individuals (2.8%) are cannabis users and 72 lakh (0.66%) people suffer from cannabis problems. 1.7% of children and adolescents are inhalant users. The exact extent of the problem may even be more, given the social desirability bias in such surveys. The bottom line is that it is a major public health problem and needs to be tackled on a war footing.

Q: What are the health hazards of drug abuse?
A: People get addicted and have short term and long term problems. They often have one or more associated health issues which could include lung disease, heart disease, stroke, cancer, mental health conditions, etc. The ill effects of tobacco are well known, it can cause diseases of the heart, lung, brain and numerous cancers. Methamphetamine can cause severe dental problems, known as meth mouth, and opioids can lead to overdose and death. In addition, some drugs, such as inhalants, can damage or destroy nerve cells, either in the brain or the nerves. Mental illness and drug abuse are often seen together. In some cases, mental disorders such as depression, anxiety, or schizophrenia may come before addiction. In other cases, drug use may trigger or worsen those mental health conditions, particularly in people with specific vulnerabilities. A mother’s substance or medication use during pregnancy can cause her baby to go into withdrawal after it’s born.
The use of illicit drugs or misuse of prescription drugs can make driving a vehicle unsafe—just like driving after drinking alcohol. Besides it can have a deleterious social, financial and psychological impact on the individual and also affect the family

Q: What are the hazards of using injectable drugs?
A: Using injectable drugs can also increase the risk of contracting infections. HIV and hepatitis B & C (a serious liver disease) can occur from sharing injection equipment. Infection of the heart and its valves (endocarditis) and skin infection (cellulitis) are also known to occur.

Q: What is the aim of World Drug Day this year?
A: The theme this year is “People First: Stop Stigma and Discrimination, Strengthen Prevention.” It is not a dead end. Addictions can be treated with medication, counselling and family support. Through this campaign one needs to raise awareness about the importance of treating people who use drugs with respect and empathy; fight the stigma misconceptions and misinformation, provide confidential accessible appropriate services for all; offer alternatives to punishment; prioritize prevention; and lead with compassion.

Q: What is the way forward?
A: Dealing with drug abuse is a complex issue and needs committed support and coordination between multiple sectors. As a roadmap, the Government of India has released the National Action Plan for Drug Demand Reduction for 2018-2023 in line with the guidelines from the United Nations Conventions and the existing Narcotic Drugs and Psychotropic Substances Act, 1985. We need to have the determination to implement it and deal with the drug menace.
The action plan focuses on preventive education, awareness generation, identification, counselling, treatment and rehabilitation of drug-dependent persons and training, and capacity building of the service providers through collaborative efforts of Central and State governments and NGOs.
In the state of Goa, we have many organizations such as NOTE, Alcohol Anonymous, and Sangath working in this area. The Human Touch Foundation has launched the ‘Yes to Life’ campaign to target the youth with the aim of drug demand reduction. Programs should be carried out in collaboration with political leaders, panchayat members, students, teachers, social workers, mental health professionals, police, paramilitary forces, and judicial officers to make an impact. The stigma that surrounds it forms a formidable barrier for people to seek help.
It is a major public health problem, often hidden, but quietly destroying lives. There are many people trapped in the clutches of drugs and substance abuse. It is bigger and closer than you can ever think. Let’s embrace life and say no to drugs. It is a difficult task, but where there is a will there is a way.

QUESTION: What constitutes drug abuse?
ANSWER: Drug abuse is defined as the use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in excessive amounts. It is not limited to drugs like opium, cannabis and heroin but also includes, tobacco and alcohol, prescribed medications like sleeping pills, painkillers. This is far more difficult to control becomes for limited prescription but becomes a lifelong addiction taking a toll on the organs. Buprenorphine, propoxyphene and heroin are the most commonly injected drugs. Drug abuse may lead to social, physical, emotional and job-related issues.

Q: What is the extent of the problem?
A: Drug abuse has spread its roots throughout the world. According to research, millions of Indians are dependent on alcohol, cannabis, opiates and drug misuse is a pervasive phenomenon in Indian society. The United Nations Office on Drugs & Crime, 2018 survey states that the extent of drug use among youngsters remains higher than that of older people. According to the “National Survey on Extent & Pattern of Substance Use in India” (2019), prepared by the Ministry of Social Justice & Empowerment, India has 16 crore people (14.6%) between the age of 10 and 75 years who are current users of alcohol, and out of them, 5.2% are alcohol dependents. Around 8.5 lakh people are injecting drugs. 1.18 crore (1.08%) are current users of sedatives (for non-medical use). Overall opioid users 2.06% and nearly 0.55% (60 lakh) require treatment services/health. About 3.1 crore individuals (2.8%) are cannabis users and 72 lakh (0.66%) people suffer from cannabis problems. 1.7% of children and adolescents are inhalant users. The exact extent of the problem may even be more, given the social desirability bias in such surveys. The bottom line is that it is a major public health problem and needs to be tackled on a war footing.

Q: What are the health hazards of drug abuse?
A: People get addicted and have short term and long term problems. They often have one or more associated health issues which could include lung disease, heart disease, stroke, cancer, mental health conditions, etc. The ill effects of tobacco are well known, it can cause diseases of the heart, lung, brain and numerous cancers. Methamphetamine can cause severe dental problems, known as meth mouth, and opioids can lead to overdose and death. In addition, some drugs, such as inhalants, can damage or destroy nerve cells, either in the brain or the nerves. Mental illness and drug abuse are often seen together. In some cases, mental disorders such as depression, anxiety, or schizophrenia may come before addiction. In other cases, drug use may trigger or worsen those mental health conditions, particularly in people with specific vulnerabilities. A mother’s substance or medication use during pregnancy can cause her baby to go into withdrawal after it’s born.
The use of illicit drugs or misuse of prescription drugs can make driving a vehicle unsafe—just like driving after drinking alcohol. Besides it can have a deleterious social, financial and psychological impact on the individual and also affect the family

Q: What are the hazards of using injectable drugs?
A: Using injectable drugs can also increase the risk of contracting infections. HIV and hepatitis B & C (a serious liver disease) can occur from sharing injection equipment. Infection of the heart and its valves (endocarditis) and skin infection (cellulitis) are also known to occur.

Q: What is the aim of World Drug Day this year?
A: The theme this year is “People First: Stop Stigma and Discrimination, Strengthen Prevention.” It is not a dead end. Addictions can be treated with medication, counselling and family support. Through this campaign one needs to raise awareness about the importance of treating people who use drugs with respect and empathy; fight the stigma misconceptions and misinformation, provide confidential accessible appropriate services for all; offer alternatives to punishment; prioritize prevention; and lead with compassion.

Q: What is the way forward?
A: Dealing with drug abuse is a complex issue and needs committed support and coordination between multiple sectors. As a roadmap, the Government of India has released the National Action Plan for Drug Demand Reduction for 2018-2023 in line with the guidelines from the United Nations Conventions and the existing Narcotic Drugs and Psychotropic Substances Act, 1985. We need to have the determination to implement it and deal with the drug menace.
The action plan focuses on preventive education, awareness generation, identification, counselling, treatment and rehabilitation of drug-dependent persons and training, and capacity building of the service providers through collaborative efforts of Central and State governments and NGOs.
In the state of Goa, we have many organizations such as NOTE, Alcohol Anonymous, and Sangath working in this area. The Human Touch Foundation has launched the ‘Yes to Life’ campaign to target the youth with the aim of drug demand reduction. Programs should be carried out in collaboration with political leaders, panchayat members, students, teachers, social workers, mental health professionals, police, paramilitary forces, and judicial officers to make an impact. The stigma that surrounds it forms a formidable barrier for people to seek help.
It is a major public health problem, often hidden, but quietly destroying lives. There are many people trapped in the clutches of drugs and substance abuse. It is bigger and closer than you can ever think. Let’s embrace life and say no to drugs. It is a difficult task, but where there is a will there is a way.