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    South Asia
     Jun 13, '14


SPEAKING FREELY
India not acting smart on drugs
By Kawal Deep Kour

Speaking Freely is an Asia Times Online feature that allows guest writers to have their say. Please click here if you are interested in contributing.

Everybody in Punjab has a drug story to tell. It is a poignant tale of addiction, human misery and the lack of consensus on the need to develop a humane approach to the drug problem. An encouraging corollary of the media spotlight has been the "visibility factor", which has generated a great amount of debate and discussion on ways and means to deal with it. Engagement



with the problem has opened up a lot of vistas towards understanding and analyzing a complex and multidimensional problem.

Undoubtedly, Punjab is facing a crisis. The discovery of how damaging the abuse of drugs can be for the individual, society and the nation as a whole is evident in the increase in the number of young drug users. A study conducted by doctors at Post Graduate Institute of Medical Education and Research in Chandigarh (2012) reveals 31.5% of the youth in the 16-25 age group addicted to some drug of abuse in the 1999-2008 period.

This was a 9 percentage point increase from the figures for 1978-88. Opioid dependence cases, it stated, have also shown an increase from 36.8% in 1978-88 to 53.2% in 1999-2008.The vulnerability of this population life-threatening infection as HIV, hepatitis C and tuberculosis is increased.

The lack of any comparable surveys for the drug users in different states of the country have been a major limitation. Figures and statistics which have been the outcome of surveys and studies should be accepted only after a critical evaluation of the scope, sample size, sampling method as also the variables which formed part of the survey.

The drug problem has become a political tool, and burgeoning incidences of serious human rights violations with drug users being incarcerated has served only to exacerbate the risk environment. It has resulted in an escalation of violence and health crises without any effect on drug use, production and trafficking, which continue their upward trend.

India is a signatory to United Nations conventions on drugs, yet as with a majority of countries the drug problem is considered as "evil" and the drug user as a "social deviant". The stringent penalties contained in the provisions of the NDPS Act, 1985(as amended in 2001), have only swelled the jail population.

The severely overcrowded Kapurthala jail is a grim indicator of an ineffectual policy that needs reconsideration. Another aspect associated with the serious implications of the punitive provisions is the paucity of opiod-based medicines for palliative care.

While the medical fraternity and the pharmaceutical companies urge a relaxation of stringent procedures, the rights of patients for access to medications continues to be infringed. This also includes the substitution treatments for injecting drug users (IDUs) including other therapeutic interventions for IDUs afflicted with HIV and hepatitis C infections.

Repressive practices such as forced crop eradication, interdictions and incarcerations, even death penalties, have only had a "balloon effect". The spillover is evident in escalating seizures of novel and more potent forms of synthetic and pharmaceutical drugs, and shifting modes and routes of supply to cater to demand with a concommitent increase in health hazards.

Equally alarming is the rapid progression in the number of injecting drug users. It would hardly be surprising if going by the official figures for the rising number of HIV infections, Punjab soon overtakes Manipur as the state with the highest number of HIV infected people in the country.

Criminalization of consumption has only increased the stigma and denial of access to basic health services to them. This is a flagrant violation of the basic human right to live with dignity. As long as the fear factor is not obliterated, drug users will continue to evade treatment for fear of being treated as drug offenders and locked up in jails, rather than as patients meant to be treated at hospitals.

A major fallout of the "narcophobic discourse" has been the lack of access to palliative care in many hospitals across the country. The report of a year-long study conducted by students of the University of British Columbia (2011) revealed the plight of several patients with terminal illness due to lack of access to morphine for their pain relief.

India is the world's only legal supplier of raw opium - yet only an estimated 1-2 % of patients who require morphine for pain relief have access to it. While the medical fraternity rues bureaucratic hurdles and lack of empathy on the part of the government, many patients are forced to undergo wrenching pain. This amounts to violation of the fundamental right of the right to life.

However, with India emerging as a major transit and consumption point and in view of its geographical proximity to the Golden Crescent and the Golden Triangle areas of opium production, the law enforcement component cannot also be overlooked. The situation is compounded by the fact that India is also among the licit opium producers catering to half of the global need for opium-based derivatives for medical use.

While illicit diversion of the licit opium is rampant, states having international boundaries, such as Punjab and the north-eastern states, have become a haven for drug traffickers. These and many other unintended negative consequences have followed a prohibition-centered approach and which both the central and state governments, with all their rhetoric of acting "tough on drugs", have simply failed to perceive.

It's time to act smart on drugs. India is paying too high a price by choosing a strictly punitive enforcement approach and failing to look for alternatives. The present policies are clearly ineffective, expensive and disparaging. To argue for stricter controls for supply reduction is addressing just one part of an issue that is complex and threatens to erode the very fabric of our society.

There is much that can be learned from the experiences of countries such as Switzerland, Portugal and the Czech Republic which have endorsed a "four-pillars" policy, namely prevention, therapy, harm reduction and policing. What began as an experiment in these countries has produced such positive results that it has been adopted as the federal drug policy.

While it cannot be overlooked that situations vary across countries, the problem is similar. India can learn from the experiences of other countries to bring more balance to its policies.

While the National Narcotics Policy 2012 has positively reflected the issues raised by non-governmental organizations that have advocated an evidence-based drug treatment and prevention program, as always for India, with all its noble intentions, the chance of policy success lies with the political will for its implementation. There is the example of National Aids Control Organization implementing targeted intervention for injecting drug users as a successful model for harm reduction and one that is acceptable to drug users.

India needs to re-evaluate its existing drug policies, which are punitive, in favor of a more humane and health-based approach. Drug policies should be based on science and not ideology. It is time, considering the seriousness of the issue, for civil society groups in all fields to open up a policy debate in the public domain. It is time to end the silence and search for a consistent policy rooted in pragmatism and evidence, and one that respects human rights and ultimately promotes public health.

Speaking Freely is an Asia Times Online feature that allows guest writers to have their say. Please click here if you are interested in contributing. Articles submitted for this section allow our readers to express their opinions and do not necessarily meet the same editorial standards of Asia Times Online's regular contributors.

Kawal Deep Kour, PhD (IITG) is a member of the Institute for Narcotics Studies and Analysis, New Delhi

(Copyright 2014 Kawal Deep Kour)






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