Punjab will have a mixed model of abstinence and opioid substitution therapy to deal with drug addiction. For former addicts to lead a normal life, the STF has proposed Outpatient Opioid Assisted Treatment (OOAT) centres in 646 medical facilities in the state—in all district hospitals, sub-division hospitals, Community Health Centres (CHCs) and Primary Health Centers (PHCs). To start with, 100 such centres will be rolled out with gradual scale-up as per patient load and demand.
OOAT centres will combine a Hhrm reduction approach and abstinence ideology with positive features of both the models complimenting each other.“Buprenorphine (used to treat addiction) will help in abstinence from drugs and in retaining patients in treatment. Over one year, daily counselling, peer support groups and Narcotic Anonymous meetings will constitute the mainstay treatment for patients,” says Dr Rana Ranbir Singh, Psychiatrist, District Hospital Tarn Taran. Biometric registration and UID numbers will track patients. Random urine screening will be used to assess a patient’s progress.
Rana adds that the OOAT model is an evidence-based treatment modality with better patient retention rate and minimises relapses when compared to the ‘only abstinence’ focused treatment. Being an OPD-based treatment, it can cater to many patients simultaneously.
The model is also cost effective when compared to de-addiction and rehab centres. A rehab centre costs Rs 5 crore to set up, and a Rs 40 lakh for a de-addiction centre. An official said that the state government is planning to supply free medicines to addicts or at a subsidised rate of Rs 5 per tablet.
But Dr JPS Bhatia, who runs rehab centres in Amritsar, differs. “Buprenorphine is not the solution. You are putting the addict from one drug to another. The only solution is rehabilitation and detoxification. This drug can only be given in extreme and rare cases not to every one,’’ he says.
The number of patients in de-addiction centres has doubled following the crackdown on drugs. Prices of drugs have also SHOT UP—from Rs 2,000/gm, heroin now sells for up to Rs 7,000/gm and is not as freely available as before. Shortage of drugs is making addicts head to rehab centres. Apart from heroin, opium and cocaine, cheaper drugs such as tramadol, codeine and alprazolam have added to the problem.