On the internationalday against drug abuse and illicit trafficking, drug users gathered outside Shastri Bhavan (New Delhi, India), to reject “sham” programmes for addiction and demand meaningful involvement in policies. Protesting torture and cruelty in de-addiction centres, drug users called upon the Ministry of Social Justice and Empowerment, to “clean up” drug treatment and introduce evidence based services in consultation with persons who use drugs.
In his message on June 26th last year, the United Nations Secretary General Ban Ki Moon had called on Member States to ensure access to health and social services for people struggling with addiction and that no one is stigmatized or discriminated against because of their dependence on drugs. This message seems to have been forgotten. We are here to remind various agencies of their responsibility towards persons who are dependent on drugs” said R.K Raju, President of the Drug User Forum and convenor of the protest.
According to the World Health Organisation (WHO), drug dependence is a chronic medical condition that requires multi-disciplinary and comprehensive services. Drug treatment in India , is however, provided by some agencies utilizing unproven, outmoded and unscientific modalities. “Opioid dependent patients must have the benefit of Methadone and Buprenorphine, medicines that are on WHO's list of essential drugs. It is time to promote and ensure wider access to drug substitution therapy, which reduces HIV and other blood borne infections related to injecting, lessens illicit drug use and improves health” recommends Dr. M. Suresh Kumar, a Chennai based psychiatrist who has been treating drug dependence for over twenty years. Presently, services for drug dependence are offered through:
* Government hospitals that provide inpatient and outpatient care, mostly detoxification. Barring premier centres like the National Drug Dependence Treatment Centre of AIIMS in New Delhi, most of the government clinics do not offer opiate substitution.
* NGOs, who receive grants from the Ministry of Social Justice and Empowerment to run de-addiction centres that house addicts for 15 to 20 days. NGOs impart awareness and counseling but do not always follow clinical methods to treat addiction.
* Private centres that operate without registration or government approval. Such centres charge anything between Rs 3,000 to 7,000, from addicts' or their families. There is no professional assistance; instead inmates are 'punished' for addiction. No government department monitors these clinics, which violate norms with impunity.
Of the above, the third category is the most dangerous. Recollecting horrific memories of his stay at a private de-addiction centre in Delhi , Anil said -“Forty of us were locked up in a dingy basement. One boy fell sick with cholera because of the dirty water we were made to drink. The owner allowed us to eat only 3 thin rotis a day, if some one asked for more, he was tied up and thrashed. Our heads were shaved off. We were treated like animals…worse than animals...”
“Many drug users have died in these centres, because of physical torture and/or lack of timely medical attention” complained Tripti Tandon of the Lawyers Collective, an NGO that advocates for rights of people dependent on drugs. The Narcotic Drugs and Psychotropic Substances Act tasks the government with setting up treatment facilities, but this responsibility has largely been ignored. “Schemes of the Ministry of Social Justice and Empowerment are not binding on private centres. There is an urgent need to regulate treatment and protect the health and safety of drug users” urged Tandon.
Another grouse was the non-involvement of drug users in policies that affect them. “Community participation is essential for widening the reach of programmes. The Ministry has ignored us far too long. This must change.” – demanded Raju, flagging the banner of nothing about us, without us. Earlier in the day, more than 40 international groups and experts worldwide issued a call to action that presses governments to adopt a humane approach to drug policy and enact measures based on scientific and medical research.
Bobby Ramakant, CNS
(The author is a World Health Organization (WHO) Director-General's WNTD Awardee 2008, a HDN Key Correspondent and writes extensively on health and development. Email: [email protected])