Kashmir on the Powder Keg of Opium and Hepatitis C

Kashmir is on multiple powder kegs, the kinds that can blow its youth and their families into an abyss of unending miseries. On one hand, substances of abuse have made deep inroads into society, the latest and most concerning being Heroin; On the other hand, the abuse of these drugs is leading to a scary increase in Hepatitis C cases. Now, doctors working here fear a rise in HIV/AIDS, the first signs of this infection spreading already visible, they say.

In the past two years, the number of people abusing heroin has increased manifold. Although there is no survey for determining the exact number of people abusing this lethal drug, hospital registrations provide a sneak peek. Before the Second Wave of COVID19 hit, data from Institute of Mental Health and Neurosciences Kashmir had an alarming message. In just one year, the number of people seeking treatment for heroin addiction had doubled from 150 to 300 a month. A doctor working with these patients had recorded all of these as “new users”. Drugs shared though syringes are known to multiply the diseases and add to the suffering of those afflicted and their families.

Since December, things seem to have gone for worse. The only full-fledged Drug De-addiction Center had to be closed down to pave the way for the admission of COVID19 patients. Curtailed services for substance abuse were started at IMHANS Rainawari, the Mental Health Hospital. Seeking treatment in a mental hospital setting comes with its own baggage but despite this taboo, 3412 patients were registered for treatment for heroin addiction in less than a year. That translates into nearly 570 patients every month, or about 20 patients a day. All of these, addicted to heroin. The mode of taking the drug in 90 percent of the cases now is intravenous. Treatment is sought by a miniscule of those abusing, so the patient registration number is just the tip of the ice-berg.

All of these figures are official.

The data has another shocker – of the 250 heroin patients admitted for treatment and de-addiction during this time, 2 in every 3 were Hepatitis C positive. The toll of the drugs and the burden of this infection is a volcano that Kashmir is silently, placidly sitting on.

Hepatitis C is a viral disease that affects the liver of the person, causing intensive damage. Without treatment, it can prove fatal. It spreads through all the routes where there is contact with blood or body fluids. Most of the infected have no symptoms and spread it silently to others, including their family members. It can get transmitted to a baby during birth from an infected mother. Many Hepatitis C positive patients have given the infection to their spouses. They are either unaware of their Hepatitis status or do not reveal it to their partners.

Last year a pilot study carried out by IMHANS found that 45 percent of substance abusers were using Intravenous Drugs (IV) drugs. The most common drug was heroin with 91 percent of this lot using IV heroin as the main drug. Sharing syringes is very common among people using injectable drugs, including heroin. The study found that 71 percent of people abusing heroin were using a common needle.

The most terrifying finding of the study has been that over half of these patients live with Hepatitis C, and approximately one in eight live with HIV.

Contrary to stereotypical notions, youth and even adolescents in every age group are falling into this trap. “Stereotypical socio demographic profile of substance users in Kashmir is changing. Easy availability of drugs, instability and inadequate rules governing trafficking of drugs can be cited as main reasons for this change,” Dr Yasir Rather who was the prime researcher of this study says. All of this in Kashmir.

This one-of-its kind study found that on an average, the daily expenditure incurred by people abusing drugs in just two districts of Kashmir is Rs 3.7 crore. Expenditure was calculated for Anantnag and Sinagar only. In these two districts together, about 2 percent of the population was recorded as abusing drugs.

Heroin is a very expensive drug and often leads to a financial catastrophe, not just for the one abusing it, but for the entire family. It forces people to beg, borrow and steal. It pushes them into unthinkable crimes. It breaks families. It creates chaos in society, destroys its fabric and ethos.

Not all is over, feel doctors who treat these patients every day. They see a ray of hope in the growing number of patients seeking treatment. Both heroin addiction and Hepatitis C can be treated. The IMHANS has tied up with the Department of Gastroenterology at GMC Srinagar for cross-referral of cases. Hundreds of patients that have been found to be infected with Hepatitis C are being referred to the Gastroenterology department for treatment of the infection from the de-addiction center. A number of patients who are diagnosed with Hepatitis C at the Gastroenterology facility are referred to IMHANS for treatment of drugs, primarily heroin addiction.

Doctors however believe that there needs to be more stringent control on drug trafficking. The supply chain, they feel, needs to be interrupted without which it would be very difficult to make any serious mark towards this goal. A holistic approach and an intensified pace of de-addiction efforts can put brakes on this crisis. People and the Government need to act and act now. The Pandemic cannot be an excuse for letting an epidemic of drugs and its resulting diseases and disorders go out of hand.

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