Addicts in misery as rehab centres idle : The Tribune India

PUNJAB’S WAR ON DRUGS: HEALTH

Addicts in misery as rehab centres idle

CHANDIGARH:In the last two years of its rule, the SAD-BJP government spent around Rs 100 crore to build a chain of drug de-addiction and rehabilitation centres across the state, but there seemed to be no plan to bring in the patients.

Addicts in misery as rehab centres idle

Photo for representation only.

Vishav Bharti

Tribune News Service

Chandigarh, May 4

In the last two years of its rule, the SAD-BJP government spent around Rs 100 crore to build a chain of drug de-addiction and rehabilitation centres across the state, but there seemed to be no plan to bring in the patients. The result is that over the past one year of Congress rule, which in its manifesto promised “an elaborate policy of rehabilitation”, the centres have become ghost buildings with even fewer patients.

On the other hand, private drug de-addiction and rehabilitation centres are treating more patients than their bed strength.

The Congress inherited 37 de-addiction centres built at a cost of Rs 27 crore, of which 32 are functional today. There were also 22 rehabilitation centres built at a cost of Rs 62 crore, of which 20 are functional. While de-addiction centres treat the patients medically, rehabilitation centres aim to engage them in social or productive activities.

Over the past year, the 32 functional drug de-addiction centres have offered treatment to around 8,000 addicts; an average of 247 in a year per centre. The work done per centre has seen a drop of around 50 per cent since the time of the SAD-BJP government. According to experts, this number is far below expected in proportion to the drug addiction prevalence in the state.

Govt vs private centres

When it comes to intervention, for the past six months, the main emphasis of the Health Department has been on opening ‘Outpatient Opioid Assisted Treatment (OOAT) Centres, which provide free-of-cost medicines, including buprenorphine, to addicts. After the opening of 26 OOAT centres in Amritsar, Tarn Taran and Moga districts, the government also announced that all districts in the state will be covered.

As per the Health Department’s own data, in the four months till March, these centres had registered a little more than 3,000 new patients. Around 17 per cent of these patients got themselves registered but didn’t complete the treatment.

Compared to the prevalence rate of drug addiction in the state, the programme does not seem to have made much headway. A study released by the Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, last year had revealed that there were around 3.15 lakh drug addicts (1.14% of the population).

PGIMER experts have also disassociated themselves from the programme undertaken at OOAT centres. They have raised concerns over the location of these centres, lack of training of doctors, and have recommended that these centres should be established within the existing medical infrastructure (see box).

However, Health Minister Brahm Mohindra has already stated that the OOAT programme will be extended to all districts.

White elephants

According to experts, the most common reason for the failure of government centres to attract patients despite the crackdown on drugs is their distance from hospitals. As a result, patients have to travel long distances to hospitals for psychiatric consultation and medical examinations.

A senior functionary of the Health Department, who has remained associated with the drug de-addiction programme, says there is also a problem due to health officials not being interested in running the centres. This issue has even been raised at coordination meetings of the Home and Health Departments.

On the other hand, torture, forced confinements, lack of amenities such as toilets, inhuman conditions, and patients commonly suffering from scabies, were the highlights of an internal report of the Health Department prepared last year on private drug de-addiction and rehabilitation centres. Yet, 16 private drug de-addiction centres and 69 private rehabilitation centres continue to treat more patients than their bed strength. Certain centres even had patients three times the capacity.

“Human rights are being violated in these private centres,” the report observed. Many of these centres have patients sent there forcibly by their families. Also, the medicines are administered at the centre itself without following the prescribed protocol.

“The previous government built beautiful buildings of de-addiction and rehabilitation centres, but did little to get patients into them. Now we have come up with a completely new approach like OOAT clinics, which has helped build faith in the de-addiction programme even in remote areas,” said Brahm Mohindra. As far as private centres were concerned, he said they commonly indulged in unethical practices like prescribing the de-addiction drug even when not required.

Between the government’s policy experimentation and the private centres’ greed, getting the addicts off drugs remains a challenge, even as cutting down the demand has been identified by the police as key to ending the drug trade in the state.

Drug prevalence

  • As per a PGIMER study, among addicts in Punjab, the population dependent on banned opioids is around 2.7 lakh. Natural opioids, including opium and poppy husk, are most common.
  • Injection-based opioid use is the second most common form of opioids — one in four of all addicts. Heroin is the most common type.
  • Of the total injection-opioid users (around 78,000), one-third abuse buprenorphine, a de-addiction medicine.
  • The common source of drugs is drug peddlers, followed by pharmacies.
  • Only 2.1% of opioid-dependent population reported criminal convictions.

PGIMER concerns on OOATs

  • Those who prescribe de-addiction medicine buprenorphine must be rigorously trained and certified, with training extending up to six months.
  • MBBS doctors are not exposed to addictive disorders, and have minimal exposure to psychiatry.
  • Standalone OOATs would stigmatise people, and thus reduce treatment seeking. These should ideally be part of hospitals.
  • Death due to other medical complications among addicts is also common. A standalone service would have difficulty in diagnosing and treating such problems.

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