Open Access Research Article
SUBSTANCE ABUSE IN INDIA (By-Raajshree Vardhan)
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Article Details
SUBSTANCE ABUSE IN INDIA
Authored By-Raajshree Vardhan
Abstract
This
research paper gives an introduction to substance abuse in India. The author
speaks about the problem and its aspects in detail to make readers understand
better about the issue. As the paper unfolds, the author also lays emphasis on
the challenges surrounding substance abuse. The author has also taken under consideration
a few activities don for the betterment of people. The overall purpose of this
research paper is to give an explicit idea to readers about the need to have a
good knowledge about drug abuse. The aforementioned topic has been a subject of
debate, drawing a multitude of diverse opinions from various segments of the
society. This research paper includes introduction, narcotic drugs and
psychotropic substances act, strategies and challenges, future vision followed
by a conclusion.
Introduction
Substance abuse is the harmful or
risky use of psychoactive substances, such as alcohol and illegal narcotics.
Abusing psychoactive substances has detrimental effects on a person's health
and social life, as well as those in their family an community. Substance
addiction includes using alcohol, opiates, cocaine, amphetamines,
hallucinogens, prescription and over-the-counter drugs, and many more
substances. (Drugs that change mental functions when ingested or administered
into the body are known as psychoactive substances.)) Abuse of psychoactive
substances threatens the physical, social, and economic health of people as
well as the wellbeing of their families, communities, and countries. In comparison
to substance use disorders, alcohol use disorders are far more common
worldwide. Men are more likely than females to experience problems with alcohol
and other drugs. In contrast to cigarettes, which are responsible for 4.1
percent of the total illness burden, the use of psychoactive substances
accounts for 8.9% of it, according to the World Health Organization Report 2002
(WHO). According to the WHO regions, different substances are used more
frequently in different
places. For example, alcohol is used
more frequently in Africa, the Americas, and the Western Pacific than tobacco
is in Europe and Southeast Asia. Between 155 and 250 million people, or between
3.5 and 5.7 percent of people in the world between the ages of 15 and 64,
consumed other psychoactive substances, such as marijuana, amphetamines,
cocaine, opiates, and non-prescribed psychoactive prescription drugs.
(WHO-2008). Cannabis is the most commonly used drug worldwide (129–190 million
users), followed by cocaine, painkillers, and stimulants similar to
amphetamines.
People who inject pharmaceuticals
(psychoactive drugs taken for non-medical reasons) are more likely to contract
HIV, hepatitis B, and hepatitis C. 1.7 million of the 13 million persons who
inject drugs around the world also have HIV, making up 10% of all new HIV
infections. Around the world, 67 percent of drug users who inject themselves
are considered to have hepatitis C. Opioids are regularly used by IDUs in
India. Included in this group of opioids are heroin (sometimes referred to as
"smack" or "brown sugar") and pharmaceutical opioids (such
as buprenorphine, pentazocine and dextro-propoxyphene). The most frequently
used opioids include heroin and dextropropoxyphene in the northeast; impure
heroin (smack) and buprenorphine are most frequently used opioids in major
cities like Delhi, Mumbai, Chennai, and Kolkata. The most popular injected
opioid in Karnataka, Andhra Pradesh, and Chhattisgarh is pentazocine.
Buprenorphine is extensively used by injectors in the states of Punjab and
Haryana. According to the HIV sentinel monitoring report, there are 7.2 percent
of IDUs in India who are infected with HIV. However, some states have far
higher HIV prevalence rates among IDUs, with rates of 21% in Punjab, 18% in
Delhi, and about 12% in Manipur and Mizoram.
Psychoactive drug usage among drivers
has been associated with impairing driving and a higher risk of collisions. By
being more aware of how to employ appropriate public health measures,
individuals, families, and societies can prevent health and social issues
related to the use and dependence on tobacco, alcohol, and illicit substances.[1]
NDPS Act,
1985
Production/manufacturing/cultivation,
possession, sale, purchase, transport, storage, and/or consumption of any
narcotic drug or psychotropic substance are all prohibited under the NDPS Act.
I.
The
Act was first passed in 1985 and has been revised three times since then: in
1988, 2001, and 2014.
II.
Narcotic
drugs are defined as coca leaf, cannabis (hemp), opium, and poppy straw,
whereas psychotropic substances are defined as any natural or synthetic
material, as well as any salt or preparation protected by the 1971 Psychotropic
Substances Convention.
III.
Any
natural or manufactured material, as well as any salt or preparation protected
by the Psychotropic Substances Convention of 1971, is considered a psychotropic
drug.
IV.
This Act's penalties are severe given the
consequences of drug use and trafficking.
V.
Depending on the offence, the Act contains
fines and prison sentences that can range from one year to twenty years.
VI.
Under
the Act, aiding and abetting, criminal conspiracy, and even attempts to commit
an infringement are all penalised in the same manner as the actual offence.
VII.
There
is a 50% penalty for planning to conduct an offence.
VIII.
In some cases, the death penalty is also
imposed on repeat offenders in addition to a one-and-a-half-time sentence.
IX.
The Narcotics Control Bureau was founded in
1986 in accordance with the NDPS Act.The NCB is a nodal body in charge of
coordinating drug law enforcement and drug abuse issues with various
ministries, other offices, and state/central enforcement authorities.
X.
The
Act permits the government to seize, freeze, and forfeit property acquired by a
person who has been found guilty of drug-related offences.
XI.
All
NDPS Act offences are non-bailable, according to clause XI.
Additionally, drug convicts are not
eligible for relief through the termination, remission, or commute of their
sentences.[2]
Strategies
To Address The Problem
In accordance with Article 47 of its
constitution and as a signatory to the International Conventions of the United
Nations, India is responsible for outlawing the use of illicit drugs,
establishing policies to prevent drug use, and ensuring the accessibility of
treatment for those who suffer from drug use disorders. India has put the
three-pronged strategy of supply, demand, and harm reduction into practise.
India's Ministry of Health and Family Welfare established an Expert Committee
to look into the issue of drug and alcohol abuse in the nation after the United
Nations Convention on Psychotropic Substances of 1971. The Drug De-addiction
Programme (DDAP) was started in 1985–1986 after the Planning Commission gave
its approval following the submission of the Committee's report in 1977. The
major objective of the DDAP was to lower drug demand. The Narcotic Drugs and
Psychotropic Substances (NDPS) Act was adopted by India in 1985. It has had
three revisions, the most recent of which was in 2014. With a focus on supply
reduction, the NDPS' main goal was to "prevent and combat drug usage and
illicit trafficking." In 1988, the consultative group—a body of advisors
established under the NDPS Act—created a national programme to reduce drug use.
The committee established the National Fund for Drug Abuse Control and
attracted a few other significant partners, such as the Ministries of Health
and Welfare, to work with them (currently Social Justice and Empowerment). The
Ministry of Welfare was in charge of drug users' rehabilitation and social
integration, while the Ministry of Health was in charge of drug addiction
prevention and treatment. The Ministry of Health established seven treatment
facilities during the initial phase (in 1988). These facilities sought to give
therapy, create educational materials, and educate medical and paramedical
staff on how to handle the issue of drug abuse in the future. Under the DDAP,
122 De-Addiction Centers (DACs) of various psychiatry departments at government
medical colleges and district hospitals also received a one-time payment.
The Ministry of Welfare provided
funding to a number of non-governmental organisations (NGOs) all throughout the
nation to establish counselling and DACs with the aims of raising community
awareness, providing treatment rehabilitation, and developing human resources.
The Ministry then created ten Regional Resource and Training Centers (RRTCs) to
guide, educate, and provide technical support to a range of various
non-governmental organisations (NGOs). The National Institute of Social Defense
is in charge of regulating RRTC operations (NISD). Over the past three decades,
services have significantly increased in all areas. A draught policy for
lowering drug demand was produced by the Ministry of Social Justice and
Empowerment in 2013 called the National Drug Demand Reduction Draft Policy. In
order to improve upon current initiatives, the Ministry has introduced the
"Central Sector Scheme of Assistance for Prevention of Alcoholism and
Substance Abuse and Social Defence Services." The "National Action
Plan for Drug Demand Reduction" was a five-year plan published in 2018 by
the Ministry of Social Justice. Around 400 non-governmental organisations
(NGOs) are currently working as Integrated Rehabilitation Centers for Addicts
throughout the nation. In addition to the former DACs, the DDAP has broadened
its mandate to include the recently established Drug Treatment Centers (DTC).
These are areas of general hospitals where outpatient substance abuse treatment
is offered by a specialised service with a specialised personnel. In 2005, the
community-based, low-threshold opioid substitution therapy was added to the
harm reduction function. (OST). Up until 2007, the Department of International
Development provided funding for it; after that, the Ministry of Health and
Family Welfare took it. The OST and Needle Syringe Exchange Programs were
maintained by the National AIDS Control Organization (NACO) as part of the
targeted interventions (NSEPs). From 0.41 percent in 2001 to 0.35 percent in
2006 to 0.27 percent in 2011, the prevalence of adult HIV infection has
dropped. However, it was asserted that the number of new HIV infections had
plateaued and that injection drug users (IDUs) were to blame for this. Under
the National AIDS Control Programme-IV, a particular focus was placed on
increasing the accessibility and availability of therapy for patients who used
illicit drugs. There were 150 OST centres with roughly 15,000 IDU patients
registered there, according to data released in 2012. The All-India Institute
of Medical Sciences (AIIMS) in New Delhi's National Drug Dependence Treatment
Centre (NDDTC) has created a brand-new OST service delivery model called the
GO-NGO model in an effort to scale up services. Under this strategy, the
psychiatry divisions of government hospitals served as OST centres and worked
closely with NGOs. The NGOs acted as a conduit between the OST centres and the
IDU patients. Problems with alcohol and other drugs are now covered by the
Mental Health Care Act (2017). It is hoped that this action will encourage
adherence to human rights, non-discrimination, respect for autonomy and
confidentiality, and availability and access to the bare minimum of care and
rehabilitation for those who have substance use disorders. While the NDDTC and
AIIMS wrote one for government DACs, the NISD and RRTCs produced a minimum
standard of care for NGOs.
Current
Status
In the
last three decades (following the inception of the NDPS), the Ministry of Social
Justice and Empowerment has conducted two nation-wide drug surveys, published
in 2004 and 2019. The results of these surveys suggest that
drug use in India continues to grow unabated. Opioid use has increased from 0.7
per cent in the previous report to a little >2 per cent in the present one -
in terms of magnitude from two million to more than 22 million. More
disturbingly, heroin has replaced the natural opioids (opium and poppy husk) as
the most commonly abused opioids. A comprehensive epidemiological investigation
from Punjab also supported this conclusion. The usage of cocaine and other
synthetic substances has also greatly increased. The survey results indicate a
need to improve our current system, to make a more coordinated effort, and to
close the gaps.
I.
The
National Mental Health Survey (2015–2016) found a treatment gap of more than
70% for substance use disorders. Recent national research on substance use
disorders, which found a nearly 75% treatment gap for drug use disorders,
supported the result. Even worse, only 5% of persons with problems involving
illegal drug use received inpatient care. This large treatment gap demonstrates
the poor quality, underutilization, and accessibility of healthcare. Treatment
and rehabilitation centres for substance use disorders are available to meet
this unmet need should be expanded. The DTC programme of the Ministry of Health
and Family Welfare may be an excellent place to start, but it is insufficient.
The NDDTC, AIIMS, is currently putting the plan into action. There's a
possibility that additional centres will get involved. In order to close the
treatment gap with a low level of service, a coordinated and motivated effort
is needed because the ministries of Health and Social Justice are both directly
accountable for reducing drug demand. Drug surveys would be conducted across
the nation on a regular basis to reveal the undercurrents of substance misuse
in India and to assist the government in making informed decisions.
II.
The
harm reduction component of the three-pronged strategy needs to be strengthened
even more. Despite the NACO and GO-NGO models' advancements, only 7% of IDUs
have access to the OST12. It calls for a safe and efficient scaling up of the
OST. Despite being a cornerstone of the damage reduction work done by the NACO,
the NSEP is forbidden by the NDPS policy. A time-limited OST is another demand
made by the NDPS strategy; however, it lacks scientific backing and could be
harmful (than good). Recovery-oriented OST could take the place of this
time-limited OST method. It is necessary to fix these weaknesses and
contradictions in policy.
III.
Current
and upcoming challenges in the supply reduction arm include the early detection
and scheduling of new psychoactive substances. India's threat from mephedrone
and captagon was recently revealed in a report by the International Narcotic
Control Board (INCB) (a combination of amphetamine and theophylline). The
report also made reference of the potential issue that the nation may have with
precursor chemicals. Additionally, it has been advised against highlighting the
rapid growth of online pharmacies and bitcoin-based transactions for the use of
illicit drugs in India. The misuse of over-the-counter medications with known
or potential addictive properties (such as benzodiazepines, codeine, and
tramadol) was another issue brought up by the global conference (e.g.,
pregabalin).
Conclusion
In conclusion, India has made
proactive and decisive actions to solve its drug-related issues. Despite the
fact that the government has an all-encompassing blueprint, a dedicated
workforce, and a number of dedicated programmes and policies at its disposal,
there is a need to improve current programmes (to address unmet needs), to have
a coordinated effort between Ministries, to achieve policy uniformity, to make
scientifically informed decisions, and to strengthen supply reduction chains.
Article Information
SUBSTANCE ABUSE IN INDIA (By-Raajshree Vardhan)
Authors: Raajshree Vardhan
- Journal IJLRA
- ISSN 2582-6433
- Published 2022/10/06
- Volume 2
- Issue 7
About Journal
International Journal for Legal Research and Analysis
- Abbreviation IJLRA
- ISSN 2582-6433
- Access Open Access
- License CC 4.0
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