5 months on, prohibition leaves Bihar in paroxysms

Fortwin, a surgical anesthetic, is the State’s new drug of choice, costing as little as Rs 7 a shot; doctors fear addicts as young as ten are taking 15-20 injections a day

Published: 28th August 2016 03:40 AM  |   Last Updated: 28th August 2016 05:18 AM   |  A+A-

PATNA: It is 4 a.m. and Raghuveer Prasad wakes up in a cold sweat. “There are ants crawling over me, somebody help!’’ he cries out and begins to brush them off. Two nurses rush to his bed and try to calm him down. But the man screams even more, imagining they are ghosts  out to kill him. Security guards restrain him as a duty doctor administers a dose of an anti-psychotic drug and puts him back to sleep. This time, his hands are tied to the bed post.

Raghuveer, 28, is a patient being treated in the de-addiction unit of the psychiatry ward of the Nalanda Medical College and Hospital in Patna. He is suffering from audio, video and tactile hallucinations. There are several patients like him in different wards.

The de-addiction unit has been witnessing an increase in the number of patients who are psychotic, suffering from bipolar disorder, schizophrenia and other serious psychological or other ailments. The influx began imperceptibly three months ago, two months after the Nitish Kumar government brought in the Bihar Excise and Prohibition Act, 2016. It’s now a steady trickle. Some of the arrivals are children in the age group of 10-15.

This is the other side of prohibition. Almost all of these patients in the de-addiction unit are habitual drinkers who switched over to other forms of intoxication, much more dangerous than alcohol, since the law came in. Most of them are hooked to an array of substances: injectible drugs, particularly Fortwin, adhesives used to patch up cycle tubes or soles of footwear, different forms of glue, whiteners, cough syrups, and of course the old favourites, bhang, ganja, hash, what have you. Doctors also report a spurt in cases of addicts becoming habituated to multiple combinations of intoxicants.

In the bed adjacent to Raghuveer Prasad is Lallan Kumar. Before prohibition, he was used to guzzle desi hooch, or, if there was money, cheap IMFL. Since April 1, when prohibition came in, he turned to scoring ganja, a chore he used to find laborious. But prohibition left him with no choice. Three months on, he is here in the de-addiction unit, being looked after by his aged mother, Tara. Sitting under a tree in Nalanda Hospital, Mrs Tara narrates her travails.

Sitting under the shade of a tree in the forecourt of the Nalanda Hospital, Mrs Tara relates her travails impassively. “After the ban came in, he became irritable. We took him to a doctor who said it was a withdrawal symptom and that he will be alright soon. A few weeks later, his behaviour began to turn strange. Sometimes he would just lie unconscious. One day, I found an injection in his pocket and then we noticed needle pricks on his hand, which was swollen. Last week, the swelling increased and we brought him here.”

It’s been five days and the doctors say they are doing their best.

So is prohibition good then? Mrs Tara is not sure. “Women forced the chief minister into it. It’s good but the government has to do something to prevent people from getting addicted to other even more dangerous things.’’

For a few weeks after prohibition was imposed, hooch was still available in some villages in Nalanda, Lallan’s district as also that of Nitish Kumar’s. Addicts like Lallan and Raghuveer went there of course. The illicit distillers stocked the hooch underground, but the police and excise, newly vigorous, got wise and cracked down on them. Hooch supply stopped but ganja and injections and glues and adhesives were available and needed no effort to get. Sitting next to Mrs Tara under the tree are the brother and father of Sohan, another prohibition refugee from Lakhisarai district. The father, Om Prakash, tells us the story. It’s a familiar passage. “One of Sohan’s friends works in a government hospital. He himself used to take injections and when liquor was banned he hooked my son.”

“I don’t know whether prohibition has helped or ruined us.’’

Now here in the Nalanda Hospital, Sohan, 19, is laid up, showing symptoms of bipolar disorder. There are at least 18 children in the age group of 10-15. “Their hands are swollen due to countless needle pricks,” says Madan, Sohan’s brother.

Doctors wouldn’t let this correspondent into that ward. But Dr Rajkishore Singh, the medical officer in-charge of the de-addiction unit, speaks freely.

Each Fortwin injection cost `7. These children were taking 15-20 injections per day. Each injection keeps them high for about six hours. Many of them became used to a combination of ganja and injections plus bhang.

Before admitting his patients, Dr Singh asks them a set of 10 questions to map their addiction pattern. “Most of them told me that they were using other intoxicants in the absence of liquor,’’ he explains.

And how do they manage to these injections without any prescription?

“This is Bihar. It is not at all surprising how they are able to lay their hands on prescription drugs. There could well be a mafia.’’

Fortwin is a surgical anesthetic, used to treat moderate to severe pain. It works on the brain and nervous system to decrease pain.

A nurse tells this correspondent that attending to these patients is a nightmare for her: “They are violent people. They attack us when they in a hallucination. They don’t sleep and their behaviour when the craving comes over them.’’

The nurse refuses to give her name and rushes off to take a patient, a 13-year-old, to the activity room, where the addicts are kept engaged.

The hospital takes in only the worst-affected cases but that number has been rising. Besides Nalanda Hospital, which is the nodal centre for all de-addiction centres in Bihar, the state government has opened 10-bed de-addiction centres in each district to the deal with this unanticipated fallout of prohibition.

In the first two months of prohibition, the authorities allowed themselves to believe that there would be the handful of cases of withdrawal symptoms due to forced abstinence. This, they imagined, would last about 48-72 hours or a maximum of a week and then, after a bit of counselling, the reformed addict was good to go home.

“But now we are getting these type of patients,’’ said a nurse in the ward, gesturing at the inmates inside. Asked about reports that one of the inmates even ate soap out of craving for liquor, she said, “People here do all kind of things.”

The de-addiction wards — one of which is air-conditioned and has a television set, which is supposed to be good for recovery — is under constant watch of CCTVs. Security personnel are stationed round-the-clock, just in case a patient has a fit of violence. Dr Rajkishore says it takes at least 10-15 days to get rid of the peak intensity of craving. The patients are given anti-psychotic drugs along with anti-craving agents. But there are side effects.

“The problem is that once they get better, most of them go back to their old habits and develop complications again,” says the doctor. “Patients keep coming and going. In the last three months, I have treated hundreds of patients with bipolar disorders and many of them told me that they used to get high on a mix of ganja and injections.”

“There have been a few deaths,” Dr Rajkishore adds, without specifying the number.

Dr Deepak Chaudhary is a well-known neuropsychiatrist in Patna. He runs a private rehabilitation centre for alcoholics. He says that it is true that the number of youngsters taking injections, ganja or adhesives has gone up drastically.

“Ever since prohibition came into force, almost all government hospitals are full of patients who are using dangerous alternatives to liquor. Bihar is not new to injections or ganja but the number of users was low. Over the last two months, we have seen a sharp increase,’’ he says.

Alarmed by the spurt in addiction post-prohibition, private and government doctors met the administration officials to discuss the sale of Fortwin and other such drugs, sale of cough syrups without prescription. As an outcome of that meeting, sales are now being tightened.

However, officials in the excise department, who are busy with enforcement of prohibition, say they are coordinating with the police on cracking down on ganja and illegal sale of prescription drugs. “We have been seizing ganja as and when we have information. It is not correct to say that ganja is freely available in the State including Patna,’’ says Om Prakash Mandal, assistant commissioner in the department. The senior superintendent of police for Patna, Manu Maharaj says his men are keeping strict watch as well. “But then, we can raid only when there is specific information. We can raid but we have to be tipped off.’’

Senior police officers say it is the lower-rung officials who turn a blind eye to peddling of alternatives psychotropic substances. “We have learnt that there are gangs that procure these injections from outside the State and sell them in Patna,” said one officer.

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