Some social evils continue to prevail in the society sinceages. One such evil that mankind failed to doom in the past centuries issubstance abuse. As drugs have been abused for hundreds of years all over theworld, their effects have been felt for just as long. Since drugs have beenused, there were always those who abused them, which led to full-blownaddiction and the bevy of side effects that come with it. Substance use isbroad in its definition, being inclusive of alcohol and other drugs. Theillicit use of substance is badly consuming the modern day youth. Whilstmoderate consumption of some can be a cultural or social norm (alcohol, forinstance in Western culture), excess consumption or dependency can have asevere and detrimental impact on overall health, mental wellbeing and in manycases, the wellbeing of the entire societal set -up. The prevalence ofsubstance use disorders is highest across Eastern Europe and the United States,occurring in 5-6 percent of the population. This means around 1-in-20 suffersfrom substance dependency. Across Western and Central Europe, the Americas andOceania, this prevalence typically ranges from 2-5 percent. Across Africa, theMiddle East and Asia, this prevalence is typically lower at 1-2 percent. Whenwe look at gender differences in substance use disorders, we see that in everycountry the prevalence is greater in men than women. Both the range of drugsand drug markets are expanding and diversifying as never before. The findingsof this year’s World Drug Report makes clear that the international communityneeds to step up its responses to cope with these challenges. Almost a quarterof the global yearly health-care bill is attributable to substance abuse andaddiction. It’s estimated that globally, around 164 million people had ansubstance or drug use disorder in 2016. The number with a substance usedisorder differentiated by gender ; around 68 percent (111 million) of thosewith a substance use disorder were male. It’s estimated that globally around 71million people had a drug use disorder in 2017. Almost 11 million people injectdrugs, of which 1.3 million are living with HIV, 5.5 million with hepatitis C,and 1 million with both HIV and hepatitis. According to the standardisedestimations, around 3 million deaths per annum taking place worldwide are thedirect result of a substance use disorder.
Drug abuse is involved in the most violent and propertycrimes, with 80% of the country’s adult inmates and juvenile arrestees eithercommitting their offenses while high, stealing to buy drugs, violating alcoholor drug laws, having a history of substance abuse/addiction, or sharing somemix of these characteristics. A total of 70% of abused children have alcohol ordrug abusing parents while 90% of homeless are alcoholics or alcohol abusers;60% abuse other drugs.
In Kashmir, the scenario is no different. United NationsDrug Control Programme (UNDCP) reported that around 70,000 people are drugaddicts in the Kashmir valley alone among which 4000 are females. Severalstudies conducted in the valley revealed that youth particularly between theage group of 17-30 are typically involved in this menace of drug addiction.According to the official survey, 3 out of every 4 drug addicts are teenagers.Most of the abusers are between the age bar 10 – 35, of which 90% are between15 and 25.This is due to the easily accessible abuse substances like cannabis,brown sugar, SR solution, inhalants like vaporub and fevicol, shoe polish,petrol, thinners, erasers, paint varnish, correction fluid, diluted phenyl,prescribed drugs and most primarily the expedient availability of heroin. Teenswho play with the fire of substances increase their chances of getting burnedby the flames of heroin, cocaine, cannabis and hallucinogens. All of thesesubstances cause an increase in dopamine levels in the brain. As dopaminelevels increase, an individual’s feeling of pleasure increases. A growing bodyof science is finding that all these substances affect dopamine levels in thebrain through similar pathways, and dopamine becomes less active in the brainsof addicts who use drugs to trigger its release, a condition which in turnreinforces the need for the drug. The studies revealed that with 14,500 casesin 2014 to 33,222 cases in 2016, the drug abuse in Kashmir has undergone astaggering increase of 130% in just 2 years.
According to the concerned authorities, the magnitude ofaddition is so high that the future generation of Kashmir is in extreme jeopardy. While talking to someleading psychiatrists of the valley, it was brought into notice that out ofevery 20 admitted patients of drug abuse,18 are consuming heroine and 2cannabis or any other substance. There has been a steep rise in the number ofheroin addicts admitted to the de-addiction centre at the SMHS Hospital sinceJanuary this year. According to the Associate Professor, Department ofPsychiatry – Government Medical College, Dr.Arshad Hussain, “Mobile andinternet plays a vital part in introducing youth to drugs. First they consumethe substance in the furtherance of enjoyment and eventually, the substancestarts consuming them.” On asking about the elevation in the figures of drugaddiction in Kashmir, he responded, “It’s just a tip of the iceberg, the majorcalamity is hidden yet.” Among the children, the major reason is familyconflict and mental disturbance caused by the prevailing turmoil in the valley.There has been a phenomenal increase in psychiatric morbidity due to continuingconflict in Kashmir during the last years. Psychological, corporeal andsocietal health – strands of a sound life that are intimately woven andenormously interdependent. But the mental health is an integral part of theoverall health and depicts the spiritual transcendence in the modern world. Atthe dawn of a new age, communities and societies, particularly youth areincreasingly facing the situations of mental distress. Mental functioning isfundamentally interlinked to physical and social behaviour and thereby thehealth outcomes. Mental intrusions can impede all the aspects of health,including emotional well-being and social development, leaving young peoplefeeling socially isolated, stigmatized, and unable to optimize their social,vocational, and interpersonal contributions to the society. No matter, even ifthey belong to economically sound families, the yen for addiction compels themto turn into peddlers. Crimes elevate and they start stealing money and goodsfor drugs. A patient revealed that he spent a huge amount of 1.5 lac inpurchasing drugs for a mere period of about 2 months. In the opinion ofspecialists, many people have a misconception that addiction is can be self –controlled by the patients in accordanceto their countenance, it rather is a disease. All the patients try to quit butthe addiction overtakes them. It leads to death at a very young age or thepatients have to strive with severe psychiatric issues for the rest of theirlives. In essence, whatever the substance, the brains of addicts are “rewired,”becoming predisposed to cravings. Dr. Joseph Frascella of NIDA points out that”in excessive behaviours such as compulsive drug abuse, the brain is changed,reward circuits are disrupted, and the behaviour eventually becomesinvoluntary”. These statistical and biological findings are underscored by thefact that most addicts are poly-drug abusers. Drug addicts are likely to abusetranquilizers, sleeping pills, or other psychotropic drugs. Older teens whoabuse prescription drugs are often found to be abusing other drugs as well.There are also social elements to the relationship among smoking, drinking andusing illegal and prescription drugs, as well as to polydrug use, particularlyamong children and teens.
The time has come for a fundamental change in our attitudeabout the pervasive and pernicious role drug abuse play in our society and arevolution in the way we deal. There is a dire need for joint mission andcollaborative approach from the government, civil society, educationalinstitutions, organisations, rehabilitation centers, counsellors, motivationalspeakers, mental health professionals and other stakeholders to curb thismenace. Courses in substance abuse and addiction should be a compulsory part ofmedical school curriculums. Physicians should be trained to diagnose thedisease and refer patients for treatment. States and medical societies shouldestablish professional standards for counsellors and accreditation systems tocertify treatment facilities. Public and private health plans should coversubstance abuse treatment and assist doctors to rehabilitate the patients. Onlythrough professionalizing the treatment system will we be able to bring itfully into the medical care system, which, in turn, is key to obtaining parityof coverage.
Mir Seeneen is pursuing her Bachelors from Cluster University,Srinagar