Some social evils continue to prevail in the society since ages. One such evil that mankind failed to doom in the past centuries is substance abuse. As drugs have been abused for hundreds of years all over the world, their effects have been felt for just as long. Since drugs have been used, there were always those who abused them, which led to full-blown addiction and the bevy of side effects that come with it. Substance use is broad in its definition, being inclusive of alcohol and other drugs. The illicit use of substance is badly consuming the modern day youth. Whilst moderate consumption of some can be a cultural or social norm (alcohol, for instance in Western culture), excess consumption or dependency can have a severe and detrimental impact on overall health, mental wellbeing and in many cases, the wellbeing of the entire societal set -up. The prevalence of substance 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 suffers from substance dependency. Across Western and Central Europe, the Americas and Oceania, this prevalence typically ranges from 2-5 percent. Across Africa, the Middle East and Asia, this prevalence is typically lower at 1-2 percent. When we look at gender differences in substance use disorders, we see that in every country the prevalence is greater in men than women. Both the range of drugs and drug markets are expanding and diversifying as never before. The findings of this year’s World Drug Report makes clear that the international community needs to step up its responses to cope with these challenges. Almost a quarter of the global yearly health-care bill is attributable to substance abuse and addiction. It’s estimated that globally, around 164 million people had an substance or drug use disorder in 2016. The number with a substance use disorder differentiated by gender ; around 68 percent (111 million) of those with a substance use disorder were male. It’s estimated that globally around 71 million people had a drug use disorder in 2017. Almost 11 million people inject drugs, 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 standardised estimations, around 3 million deaths per annum taking place worldwide are the direct result of a substance use disorder.
Drug abuse is involved in the most violent and property crimes, with 80% of the country’s adult inmates and juvenile arrestees either committing their offenses while high, stealing to buy drugs, violating alcohol or drug laws, having a history of substance abuse/addiction, or sharing some mix of these characteristics. A total of 70% of abused children have alcohol or drug abusing parents while 90% of homeless are alcoholics or alcohol abusers; 60% abuse other drugs.
In Kashmir, the scenario is no different. United Nations Drug Control Programme (UNDCP) reported that around 70,000 people are drug addicts in the Kashmir valley alone among which 4000 are females. Several studies conducted in the valley revealed that youth particularly between the age 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 between 15 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. Teens who play with the fire of substances increase their chances of getting burned by the flames of heroin, cocaine, cannabis and hallucinogens. All of these substances cause an increase in dopamine levels in the brain. As dopamine levels increase, an individual’s feeling of pleasure increases. A growing body of science is finding that all these substances affect dopamine levels in the brain through similar pathways, and dopamine becomes less active in the brains of addicts who use drugs to trigger its release, a condition which in turn reinforces the need for the drug. The studies revealed that with 14,500 cases in 2014 to 33,222 cases in 2016, the drug abuse in Kashmir has undergone a staggering increase of 130% in just 2 years.
According to the concerned authorities, the magnitude of addition is so high that the future generation of Kashmir is in extreme jeopardy. While talking to some leading psychiatrists of the valley, it was brought into notice that out of every 20 admitted patients of drug abuse,18 are consuming heroine and 2 cannabis or any other substance. There has been a steep rise in the number of heroin addicts admitted to the de-addiction centre at the SMHS Hospital since January this year. According to the Associate Professor, Department of Psychiatry – Government Medical College, Dr.Arshad Hussain, “Mobile and internet plays a vital part in introducing youth to drugs. First they consume the substance in the furtherance of enjoyment and eventually, the substance starts consuming them.” On asking about the elevation in the figures of drug addiction in Kashmir, he responded, “It’s just a tip of the iceberg, the major calamity is hidden yet.” Among the children, the major reason is family conflict and mental disturbance caused by the prevailing turmoil in the valley. There has been a phenomenal increase in psychiatric morbidity due to continuing conflict in Kashmir during the last years. Psychological, corporeal and societal health – strands of a sound life that are intimately woven and enormously interdependent. But the mental health is an integral part of the overall health and depicts the spiritual transcendence in the modern world. At the dawn of a new age, communities and societies, particularly youth are increasingly facing the situations of mental distress. Mental functioning is fundamentally interlinked to physical and social behaviour and thereby the health outcomes. Mental intrusions can impede all the aspects of health, including emotional well-being and social development, leaving young people feeling socially isolated, stigmatized, and unable to optimize their social, vocational, and interpersonal contributions to the society. No matter, even if they belong to economically sound families, the yen for addiction compels them to turn into peddlers. Crimes elevate and they start stealing money and goods for drugs. A patient revealed that he spent a huge amount of 1.5 lac in purchasing drugs for a mere period of about 2 months. In the opinion of specialists, many people have a misconception that addiction is can be self – controlled by the patients in accordance to their countenance, it rather is a disease. All the patients try to quit but the addiction overtakes them. It leads to death at a very young age or the patients have to strive with severe psychiatric issues for the rest of their lives. 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 becomes involuntary”. These statistical and biological findings are underscored by the fact that most addicts are poly-drug abusers. Drug addicts are likely to abuse tranquilizers, sleeping pills, or other psychotropic drugs. Older teens who abuse prescription drugs are often found to be abusing other drugs as well. There are also social elements to the relationship among smoking, drinking and using illegal and prescription drugs, as well as to polydrug use, particularly among children and teens.
The time has come for a fundamental change in our attitude about the pervasive and pernicious role drug abuse play in our society and a revolution in the way we deal. There is a dire need for joint mission and collaborative approach from the government, civil society, educational institutions, organisations, rehabilitation centers, counsellors, motivational speakers, mental health professionals and other stakeholders to curb this menace. Courses in substance abuse and addiction should be a compulsory part of medical school curriculums. Physicians should be trained to diagnose the disease and refer patients for treatment. States and medical societies should establish professional standards for counsellors and accreditation systems to certify treatment facilities. Public and private health plans should cover substance abuse treatment and assist doctors to rehabilitate the patients. Only through professionalizing the treatment system will we be able to bring it fully into the medical care system, which, in turn, is key to obtaining parity of coverage.
Mir Seeneen is pursuing her Bachelors from Cluster University, Srinagar