KOCHI: Jithin and Aswin (name changed), siblings with a substance abuse problem, were brought to the Vimukti de-addiction centre at the Government General Hospital, Muvattupuzha, recently. The adolescent duo were under the influence of many drugs, including MDMA and brown sugar. When they ran out of funds, they turned to pick-pocketing. But when the pandemic hit, they had fewer opportunities to get and spend money, and to keep the high, they attempted to inject alcohol directly into the blood stream.
“Their family were oblivious to the situation. The brothers were brought in for pick-pocketing. When we talked to them, we found that they have tried every available drug out there. Injecting alcohol directly into the body was a temporary solution they found. They relapsed multiple times during the treatment. Later, one of them died,” said Bibin George, a social worker in the psychiatric department at Vimukthi.
“This was the first case reported in the state in which alcohol was injected into the blood. The only known case happened in Pakistan. This practice is life-threatening and most addicts are unaware of the dangers,” Bibin added. Recently, the Social Justice And Empowerment Ministry suggested treating drug addicts as victims and not criminals.
This applies to users, or people caught with small quantity of drugs and not those who are peddling or selling them in large quantities. The ministry suggested state governments to provide them with compulsory rehabilitation instead of charging a case. According to experts, this will support the victims through the journey of recovery instead of making them feel ostracised.
As of now, people getting caught with even a small amount of drugs face court proceedings and possible jail time. “Instead of recovering from the addiction, they appear in court and are subjected to a long legal struggle,” said an officer from the excise department. He said so far, an official directive hasn’t come from the Central government.
How prepared is Kerala?
Truth be told, Kerala is way behind when it comes to helping victims of drug use. Social stigma, lack of awareness and poor funding is holding back rehabilitation of victims. The state has 14 Vimukthi centres run by the excise department and 23 de-addiction centres run by NGOs that offer free treatment to patients.
“So far, we don’t even have a state-run rehabilitation facility. We only have de-addiction centres. Rehabs come with the provision to treat patients for six months, which is when the victim bounces back to normal life. The Vimukthi centres by the excise department admit patients for 21 days,” said Francis Moothedan, Global DDR Trainer of the United Nations Office of Drug Control.
“Currently, all the government-funded facilities work on different patient care systems. At patient care facilities run by Central government, patients are to be cared for 31 months and then provided counselling, including house visits. We need centres capable of providing long term inpatient care - three months and six months,” he said.
He adds how addiction is a brain disorder. Much like lifestyle disorders like diabetes, it needs lifelong care and support. “Though the patients may not need medication for a long time, they would need counselling and emotional support,” said Francis, who is the project director of MMM IRCA at the Medical College in Kolenchery, a deaddiction centre funded by the Central government.
The Social Justice And Empowerment Ministry recently suggested treating drug addicts as victims and referring to them as users or substance dependent, instead of criminals
But how well equipped is our drug rehabilitation system when it comes to helping these victims rather than throwing them in jail?
Need for better system
The fact remains that hundreds are being apprehended every year for drug addiction in Kochi alone. The list now includes even teenagers and school kids, women and other vulnerable groups. Bibin from the Vimuthi centre in Ernakulam says that with the resources available now, very little can be done to help this massive social dysfunction. “For many, accepting they are addicts is a difficult process. There’s shame attached to getting treatment. This is especially true for adults who are mostly dependent on alcohol,” said Bibin. “Young children are mostly addicted to sniffing whiteners and gums.
Teenagers and youth below the age of 25 are mostly addicted to cannabis and other synthetic drugs like MDMA and brown sugar,” Bibin added. The Vimukthi centre in Ernakulam district has provided treatment to 4,251 patients in the past three years, according to department data. However, the centre has stopped taking in-patients since pandemic started. “All the Vimukthi centres in the state have only 10 beds each. Of them, we have to reserve two for victims under 18. We need at least 20 beds per centre to do a decent job of helping these people,” he says.
State’s de-addiction centres lack funds
There are 23 de-addiction centres in Kerala funded by the social justice ministry of the Central government under the Nasha Mukt Bharat Abhiyan, said Francis Moothedan. One in Fort Kochi got closed down recently due to the pandemic. The Federation of Non-Government Organizations Against Drug Abuse (FONGOADA) is an umbrella organisation of NGOs that run de-addiction centres.
Francis, who is the state general secretary of FONGOADA, said most of these centres have just 15 beds each. Only one facility in Thiruvananthapuram can admit 30 patients. The rest usually keep five more beds in reserve, taking the total capacity to 20 at each centre. However, according to him, most of the centres are yet to receive the funds sanctioned by the Central government for the financial year 2021-22.
“Last year, citing Covid, the Centre didn’t release the full fund. The government asked us to sign an affidavit urging us not to ask for the remaining amount. The proposed yearly expenditure of our centre is Rs 35.46 lakh. But till November, we haven’t received any support from the Central government,” he added.
Father Joseph Parecattil of N N Mukthisada, another de-addiction centre in Pookkattupady, Ernakulam, said last year, the government cut 40 per cent from their funding. “Currently, we have taken loans to pay the staff and keep the facility afloat. We haven’t received even the first instalment for this year,” he said.
“Even if we get the funds, it is not enough to provide even minimum salary to existing staff. Of the total amount, 10 per cent is shelled out by the organisation and the government pays the remaining 90 per cent. Even a qualified nurse gets only Rs 15,000 as salary, which is way below their minimum salary. We can provide only two nurses for the 15-bed facility using government funds,” Francis added.
The situation is the same in the other 22 centres, he adds. “Some can provide extra funding to the staff, but many are suffering especially since the funding is late,” he said.