Monday 18 November 2013

Demand Reduction-Key to Drug Abuse Control

Drug Abuse Control
Drug addiction is increasingly becoming an area of concern as traditional moorings, social taboos, self-restraint and control-discipline of the joint family and community are gradually disappearing with urbanization. Alcohol and drug abuse has emerged as a serious socio-economic problem in India. Located between two of the world’s largest illicit drug producing regions, India has been a transit country for long, making it highly vulnerable to the problem of smuggling of drugs into and out of the country and drug abuse.
Narcotic Drugs include coca leaf, cannabis (hemp), opium, poppy straw and other manufactured goods, whereas Psychotropic substance means any substance, natural or synthetic, or any natural material or any salt or preparation of such substance or material included in the list of psychotropic substances specified in the Narcotic Drugs and Psychotropic Substances Act, 1985.
Narcotic Drugs and Psychotropic Substances have several medical and scientific uses. However, they can be and are also abused and trafficked. Natural narcotic drugs of great medical use such as morphine, codeine are produced from opium. Thus, the manufacture of natural narcotic drugs indirectly affects the demand for opium and the area in which farmers should be allowed to cultivate opium. 
India is one of the few countries that are internationally permitted to grow opium and successive resolutions of the UN Economic and Social Council require India (and other producing countries) to maintain a balance between demand and supply. Thus, on the one hand, India shares with other opium poppy growing countries the responsibility of ensuring that there is adequate supply of opium and opiates in the world and on the other has the responsibility to avoid excessive accumulation of stocks.
Article 47 of our Constitution provides that "……… the State shall endeavour to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health." India is a signatory to three United Nations Conventions, namely: (i) Convention on Narcotic Drugs, 1961; (ii) Convention on Psychotropic Substances, 1971; and (iii) Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988. Thus, India also has an international obligation to curb drug abuse.
The Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 was framed taking into account India’s obligations under the three UN drug Conventions as well as Article 47 of the Constitution. This Act prohibits, except for medical or scientific purposes, the manufacture, production, trade, use, etc. of narcotic drugs and psychotropic substances. Thus the Governments’ policy has been to promote their use for medical and scientific purposes while preventing their diversion from licit sources, and prohibiting illicit traffic and abuse. The NDPS Act is administered by the Ministry of Finance, Department of Revenue. 
However, matters pertaining to Prevention of Alcohol and Substance Abuse are handled by the Ministry of Social Justice & Empowerment (MSJE). The Ministry supports various NGOs working in this field. The Ministry of Health, which is responsible for all health issues, runs several drug de-addiction centres in the Government hospitals across the country. The Narcotics Control Bureau, under the Ministry of Home Affairs, coordinates actions by various functionaries (Central and State) under the NDPS Act. The State Governments also have their own Health Departments and Social Welfare Departments each of which has its own set of activities relating to Drug Demand Reduction.
Illegal cultivation of opium poppy (Papaver sominiferum) and cannabis (Cannabis sativa) are offences under the NDPS Act. Synthetic and semi-synthetic drugs are illicitly manufactured in clandestine laboratories (commonly known as clan labs) the world over. Diversion of licit pharmaceuticals containing narcotic drugs and psychotropic substances for abuse has been a significant problem in India. Preparations containing drugs such as codeine, buprenorphine, diazepam and alprazolam are commonly abused.
Drug abuse is a result of two factors- the availability of drugs and the psycho-social conditions which result in their abuse. Both traditional and semi-synthetic and synthetic drugs are abused. Intravenous drug use and HIV/AIDS driven by such use have added a new dimension to the problem. The United Nations General Assembly, in its 20th Special Session in 1998, has accepted demand reduction as an indispensable pillar of drug control strategies. Hence, equal emphasis is placed on supply and demand reduction. Demand reduction also has two components- treating the drug addicts and educating and enabling the society to prevent addiction and to rehabilitate addicts after they have been treated. Thus, drug abuse is a psycho-socio medical problem, which needs both medical intervention and community based interventions. Hence, the central government has a three-pronged strategy for demand reduction consisting of:
  • Building awareness and educating people about ill effects of drug abuse.
  • Dealing with the addicts through programme of motivational counselling, treatment, follow-up and social-reintegration of recovered addicts.
  • To impart drug abuse prevention/rehabilitation training to volunteers with a view to build up an educated cadre of service providers.
Of the above, treatment is the component which directly targets drug addiction. India has a two-pronged strategy towards it- (a) running deaddiction centres in Government hospitals; and (b) supporting NGOs involved in this endeavour. The Ministry of Health and Family Welfare of the Government of India runs a number of drug-de-addiction centres in various Government hospitals across the country. The Ministry of Social Justice & Empowerment has been implementing a Scheme for Prohibition and Drug Abuse Prevention since the year 1985-86. 
The approach of this Scheme is to provide the whole range of services including awareness generation, identification, counselling, treatment and rehabilitation of addicts through voluntary and other organizations. In order to reduce the demand for and consumption of alcohol and dependence producing substances, the thrust would be on preventive education programmes and Whole Person Recovery of the addicts At present, under this Scheme, the Government supports  Non-Governmental Organizations (NGOs) running Deaddiction-cum-Rehabilitation Centres, De-addiction Camps, and Counselling and Awareness Centres. The Government bears the major portion of the cost of services provided at these Centres.
While the apparent "benefits" of consumption for drug abusers is transient and health and financial burden on society considerable, there are huge profits for suppliers and traffickers of illicit drugs. Producer and trafficking countries, however, tend to pay a high social and political price for short-term economic gains. Although families have a powerful influence on shaping the attitudes, values and behavioral patterns of children and thus preventing substance abuse, peer groups often prove to have an even stronger influence. 

The negative influence of peers appears to increase when parents abdicate their traditional supervisory roles. Family factors which can lead to or intensify drug abuse include, prolonged or traumatic parental absence, harsh discipline, failure to communicate on an emotional level and parental use of drugs. Lack of household stability triggered by low and irregular income and unemployment may increase the stress on the family and its vulnerability to drug abuse. 

While the family itself can be the source of drug problems, it can also be a potent force for prevention and treatment. As most families are supported and cared for by women, women play a key role in teaching the young, ensuring health care and maintaining links with and mobilizing community support where necessary. The recognition and effective utilization of women as resources for drug prevention and treatment can therefore improve efforts to reduce both the supply of and demand for drugs. Indeed, the family unit as a whole has a clear interest in preventing individual family members from falling prey to drug abuse, and thus could become a powerful ally of government and community prevention programmes.

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