Are we doing enough?

Substance abuse continues to challenge Sikkim

TSHERING EDEN

International Day against Drug Abuse and Illicit Trafficking was observed across the world on 26 June and Sikkim too saw a host of events held to mark the day. The State has been battling substance abuse and trafficking for a long time now, and on this occasion, it is only fitting to ask - are we really doing enough?
Despite efforts at creating awareness on drug abuse, the social stigma attached to addiction and users is still prevalent. The vacuum, in terms of figures and studies on drug abuse in the State is yet to be filled. Almost every week there are news reports of drug busts by the police. Apart from all of these, there is also the big problem of providing proper rehabilitation and de-addiction facilities to those who have fallen prey to this “social evil”.

Treating addiction involves prevention efforts, awareness generation, treatment and rehabilitation, sustained follow-up care, and also involving and mobilising the community. The focus in Sikkim and perhaps the country as well has clearly been more on creating awareness. While this is not a bad thing per se, the other aspects of treatment need more public and government attention than they are receiving at present.
KC Nima, who has been working in this field for the past 14 years and is associated with a number of rehabilitation initiatives, says we are not doing enough at all. 
“If you talk about actual rehabilitation facilities, I would have to say there are sadly none in the state. The centres that do exist are only providing shelter to drug users,” he says. The professional hands required are in very short supply.
Providing psychological assistance to drug users in recovery is an important element in all rehabilitation programmes. Not just in rehab centres, but the state as a whole lacks such counseling centres. There is not a single functioning counseling centre in the State, leave alone those meant specifically for drug users.
Counseling can help nip the problem at the bud and therefore is part of prevention efforts that has for long been ignored. Due to the lack of any such facility, as Mr Nima puts it, “The rehab centre is the only help available to drug users in the state”.
“There are altogether seven registered rehabilitation centres in the State that can accommodate approximately 300-400 inmates at a time. There are more than 10,000 drug users in the state! Only two of the rehab centres have a qualified counselor and maybe one has a qualified psychologist. None of the centres have their own counseling centre,” he details.
He points out that the counselors at most rehab centres are counselors by experience and not qualification. Many of the counselors are also former drug users and while this might help them empathise with the victims and offer counsel from experience, it is hardly experience or training enough.
Further, the problem here is also about the lack of funds. Mahendra Tamang of Sikkim Rehabilitation and De-toxification Society, Nimtar, says, “It is difficult to hire counselors or specialists because we cannot afford them. Till recently, we had a psychologist working here. Since we could not afford to pay the full salary, she worked part time here coming to work 3-4 times a week”.   
Government assistance to rehab centres is only in the form of annual grants. And even in this regard, out of the seven rehabs in the State, only three are awarded these yearly grants. The other source of funds is from the fee collected from the inmates.
The five-month rehabilitation course at the Nimtar rehab costs Rs 31,000, working out to a monthly fee is Rs 4,500. For those belonging to BPL families, fee for the first month is waived.
What about those who cannot afford even the remaining Rs 26,500 fee?
All seven rehab centres in the state are privately operated. There is no government run facility.
Government support in the form of training for rehab centre staff, whether within or outside the state, is also lacking.
“Send us for training. That is not much to ask,” says Mr. Tamang.
He also suggests that linking rehab centres here with the government's capacity building initiatives, which are doing very well, would be a boon for the centres.
An important aspect of rehabilitation is the reintegration of recovering drug users into mainstream society and what better way than enabling them with skills that could also earn them a livelihood.
“This is something that recovering addicts need and we find hard to address on our own. They have to feel they are of value in the society. The government already has in place capacity building initiatives and linking them with rehab centres could help immensely in the reintegration process,” says Mr. Tamang.  
Social stigma and reintegration are two sides of the same coin and are inversely proportional to each other. The lesser the stigma attached to drug abuse, easier it is for drug users to reintegrate with mainstream society. Sadly, the level of stigma in Sikkim is still very high. We are prone to look down upon those addicted to drugs or alcohol or dismiss them as “useless”. This does not make it any easier for a person trying to come out of addiction.
It is typical of schools to abandon any kind of responsibility for its students, especially those who are found abusing drugs, by expelling them or transferring them to other schools. Mr. Nima urges, “Please do not terminate or hand out Transfer Certificates to students who are caught using drugs”. The message that this sends out to the user as well as his/her friends is one of shame. This only prevents kids from seeking any kind of help and does not discourage abuse.
He also adds that very often, those suffering from drug addiction become “topics of discussion”. This also does nothing for them.
Putting drug users in prison is another practice that should be avoided, says Mr Tamang.
“Just think what kind of self image and identity the person will have when he/she is put in prison,” he says.
Among the growing trends in drug abuse in the state is the alarming rate at which females are taking to drugs.
Mr. Nima says this is something that is soon going to become a major challenge in the fight against drug abuse. The number of young girls and women using drugs has been steadily increasing and this section is also the most vulnerable to HIV and AIDS because sex for drugs/money, casual sex and abuse become rampant in an environment of addiction and substance abuse.
Women are also increasingly being used as ‘carriers’ for drugs as well where they are only involved in delivering a package of drugs because they are less likely to be caught.
He also adds that the problem of drug abuse exists across wide cross sections of society. It is not just school or college goers, but a large number of government servants also use drugs which is a huge worry.
Another trend is the growing ease of access to drugs. While mephradrone, also known as Meow Meow and many other names that made news in the West and in metros of the country for its easy availability through online sites, in Sikkim it is mobile apps like WhatsApp and the like that have made it easier to get one’s hands on drugs.
Mr. Tamang informs that nowadays all people have to do is send a message on WhatsApp and the drugs are delivered at their doorsteps. Usually it is a female who makes such deliveries, he adds.
About the Sikkim Anti Drugs Act 2006, Mr Nima says that it is only snaring the underprivileged. “The more privileged ones never get caught or booked under it. If you go to Rongyek jail you will find out that most inmates there caught under SADA are from underprivileged and poor backgrounds”.
Mr. Tamang adds, “SADA is in fact producing more addicts. Putting  drug users in jail leads to them having very poor self image which does not help them is giving up drugs in any manner”.
As we mark another Anti-Drug day with rallies, posters, seminars, etc, we must continue to ask ourselves if we are doing enough.
“Society talks big, government talks big but there is no action. Today if someone says we should put that addict in jail or hang that addict. I will say please do that… Put him in jail, hang him. But do something! Don’t ignore the problem,” Mr. Nima appeals.