• Publish Date: Nov 18 2018 9:12PM
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  • Updated Date: Nov 18 2018 9:12PM

Kashmir has been through three decades of violence, resulting in an epidemic of psychosocial disturbances among its population. A number of psychiatric problems have emerged like Depression, Obsessive-Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD). The conflict ridden valley has also seen a tremendous rise in substance abusers over the past many years.

Most of the drug users use the substances out of curiosity and in the belief that it will reduce their problems like stress, trauma, anxiety or depression. Some people become addicted to these harmful drugs because of the bad company they keep, too much pocket money they possess, lack of parental direction or guidance, easy availability of drugs and so on.

The government has made the draft drug de-addiction policy public, the document has revealed that drug addiction is widespread, fast-rising and is quickly taking the form of an epidemic in the State. Several studies conducted in the valley revealed that youth particularly between the age group of 17-30 are involved in this menace of drug addiction. Government Psychiatric Hospital Srinagar, the only mental health hospital in the valley, in one of its reports had stated that most numbers of drug addiction cases belong to a very young generation. A recent study conducted by Srinagar based Institute of Mental Health and Neuroscience (IMHANS) in a Drug De-addiction centre in Srinagar found that over two-third of patients in the study had started substance abuse in the age group of 11-20 years. The most common substances of abuse identified included nicotine (94.4%), medicinal opioids (65.7%), cannabis (63.6%), benzodiazepines (45.5%), other prescription medications (43.4%), alcohol (32.5%), inhalants (11.1%), and cocaine (7.5%).  The study revealed that poly-substance abuse was found in 91.9% of the studied patients. Inhalant use was seen predominantly among adolescents (54.5%) whereas nicotine (50.2%) , cannabis (49.2%), alcohol (51.1%), opioids (58.4%), and benzodiazepines (53.48%) were more predominant in the age group of 21 to 30 years.

The studies conducted in recent years have shown an alarming shift in the pattern of substance use in terms of rise in the number of female users and decreasing age at first-use. The draft policy has laid down broad guidelines including classroom programmes delivered by teachers or peer leaders focusing on life and social skills and introducing drug-resistance skills to address the problem. The scientific data based on community surveys on drug-related problems in Jammu and Kashmir show that deaths have started occurring directly due to overdosages, convulsions, and cardiac arrests and indirectly due to road traffic accidents. The draft policy has asked for involving faith-based organizations to address the issue.

“Religious beliefs are important protective factors. Involve religious and spiritual leaders by highlighting that promotion of substance use prevention activities is already in line with their preachings,” the draft policy says. While lot of stories and articles have been published in local and international media regarding the drug abuse in Kashmir over the years, it seems the problem is growing with each passing-day. Not only youth are consuming deadly drugs like brown sugar and heroin, the use of cannabis (charas), medicinal opiates, inhalants like Fevicol SR, paint thinner, shoe polish etc. is also on rise at an alarming pace. However, unfortunately, the efforts of law enforcing agencies to deal with the problem of drug addiction in Kashmir have not been adequate so far. Police and other related agencies need to go for physical observation and undercover operations to exploit the weak links in the chain where the sellers and the buyers meet. Poppy cultivation has not only increased in southern districts of Pulwama and Anantnag, but central Kashmir’s Budgam and north Kashmir’s Kupwara districts too have high demand and supply of drugs. The real-world transfer of drugs is a vulnerable part of the transaction and it is where the police action can monitor the delivery, wait until it’s in the hands of the buyer, and then arrest the seller and the buyer. However, it is not only police action which can make the difference. The international response to illegal drugs has been to tackle production, supply and demand. The lesson of history seems to be that the more drugs are available, the greater the use. Drug trade is an economic activity and destroying fields of farmers will left them to starve. They will be even keener to plant some more. There is need of bilateral and multilateral cooperation to deal with the problem of drug production. Providing alternative crop promotion, destruction of refineries, seizure of precursors including chemicals for production, demand reduction, law enforcement and seizing of illicit profits are some of the points government agencies can work with to eradicate this menace.

Emotional distress, psychological problems and psychiatric disorders have definitely taken a toll on this most impressionable sub-group of population. Compared to a child or an adolescent of 1980s, present age kids are short-tempered and get provoked on relatively minor issues. Most of the children have witnessed many events in the last over three decades which would reflect adversely on the psyche of any human being in any part of the world. The present uncertain situation and conflict-related factors significantly contribute to the development of negative behavioural tendencies. Alarmingly high percentage of adolescents is falling prey to drug abuse and if the problem is left unattended, the situation could go out of hand in future.

Experts say the geographical location of Jammu and Kashmir helps in easy availability of drugs in the state. The ongoing turmoil has also played a huge role in pushing many to drugs, which many see as a means to escape the pain of the never-ending war. “Stress and the turmoil naturally play a role but other factors like peer pressure, unemployment, easy availability (of the drugs) and the fact that no one wants to talk about the issue is an area of concern, too,” said one of the leading psychiatrists of Kashmir. But despite the problem, there are only two operational de-addiction centres in Srinagar — one run by the police at Batamaloo and the other at the SMHS Hospital. Jammu and Kashmir police started the drug de-addiction centre in 2008 with a five bed capacity when every one was in denial that there is no drug abuse in Kashmir. “This vision of police in 2008 has led to a present de-addiction movement in Kashmir region where everyone is talking about this issue, which also led to drug de-addiction policy by the J and K government,” said Dr Muhammad Muzaffer Khan, Consultant clinical psychologist and director drug de-addiction centre Police Control Room Srinagar. Dr Khan said seeing the response and need the present capacity of PCR de-addiction centre has been increased to 25. He said that centre has a qualified and diverse manpower following bio-psych social model of drug addiction. The centre has high end facility like AC wards, recreational facilities like gymnasium and yoga. “The centre is highly preferred as a treatment facility across J and K,” he said. “It has become a preferred service for the affected population of Pir Panchal area also. The centre, he said, is highly involved in community and school prevention cum awareness programs.

Giving the break-up, Dr Khan said that in 2017 total patients seen in outdoor patient department was 2284 and total patients admitted and rehabilitated 331. In year 2018 the OPD seen till 30 Oct is 2518 and total patients rehabilitated 374 which has already crossed the last year target. “The changing scenario is more and more patients are diagnosed with heroin addiction and throw many treatment cum rehabilitation challenges.”

Talking about the issue is still considered a taboo — the de-addiction centre at SMHS hospital is called a “community centre”. Officials said this has been done to ensure that those seeking help don’t face social stigma. For past one decade various proposals, including sanctioning 12 posts of faculty for 40 bedded de-addiction center at SMHS Hospital, submitted by department of psychiatry for strengthening of infrastructure for mental health and de-addiction have been repeatedly ignored by the state government. The gross shortage of nurses has also been a serious shortcoming for delivery of care at the two facilities run by the department. As per nursing council norms, there must be at least one nurse for five beds. However, the department runs with a handful of nurses. At 100-bedded psychiatry hospital, which has been rated as “institute of excellence”, there are only eight nurses posted. “Often, it seems the system might collapse if our staff refuses to stick to tough duty hours and job profile even for a day,” said one of doctors at the facility. “Our doctors, paramedics and nurses are always multitasking. That’s how we are still running,” he added, grimly.

From cannabis to medicinal opioids to inhalants such as glue and paint thinner, the youth of Kashmir are getting hooked to different substances, officials said. But it is cannabis that is most commonly used, largely due to its easy availability. A senior doctor said between 2000 and early 2008, substance abuse was seen mostly in the age group of 18-35 years. “It was limited to the use of medicinal opioids. However, currently the addiction has reached as low as 10-year-olds getting into solvent abuse. It is in schools that they are getting introduced to cannabis now,” he said. He also pointed to a correlation between mental illness and the use of cannabis. “In most of the cases of psychiatry problems, we found that 70% tested positive for cannabis, especially in the case of men.” “The stigma has to be removed. It is still considered a taboo subject. Naturally, those who want help will think twice before coming forward. The government needs to ensure that school authorities counsel students at the young age itself,” he added.

A senior official in education department said that the problem is there but it is minuscule as far as schools are concerned. He said that it is certainly not alarming. “Young students get influenced in this age especially due to the peer pressure. There is also a huge disconnect between the parents and children these days. The environment in the Valley also plays a part. We have asked schools to ensure there is proper counselling provided to students,” the official said.

Although the issue of substance abuse is being discussed at every forum, by government and civil society, absence of planned and concrete measures to plug supply of drugs, sensitisation and awareness among masses and high risk groups, lack of adequate facilities for patient care and manpower shortage is resulting in this problem “slowly devastating Kashmir’s younger generation, said a psychiatrist.