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Alone, afraid, addicted
Drug rehabilitation centres run as unregulated businesses actually treat addicts as truants and petty criminals. Therapy often means confinement and humiliation.
They tried to make me go to rehab but I said no, no, no/Yes I've been black but when I come back you'll know know know..." Anyone who has been inside a de-addiction /rehab centre will understand the lyrics of this song by Amy Winehouse who was recently found dead in her London home, allegedly because of drug overdose. She was no stranger to the rigours of rehabilitation - the isolation, the disgrace of being stripped of self-esteem and the loneliness - having been in and out several times in her short life.
India is home to many like her. According to the ministry of social empowerment and justice, there are 3 million drug addicts (this does not include those dependent on alcohol). But people working in the field of rehabilitation put the number closer to 100 million. But consider this - the ministry runs only 41 counselling and 401 drug de-addiction centres, and assists voluntary agencies in managing another 376 de-addiction-cum-rehabilitation centres. Off the radar of any monitoring agency are thousands of unregistered facilities, run by unscrupulous agents or former addicts. The stories of indignity, humiliation and even torture that emerge from these centres are horrific.
Suresh, a former addict, was assigned as a counsellor to one such rehab centre in Alibaug near Mumbai. It offered nothing more than boarding and lodging. "It had no doctor, counsellor or psychiatrist. The management would get reformed addicts, like me, to counsel other patients. They were ill-equipped to handle any emergency and resorted to violence to control difficult patients. Someone who asked for a painkiller for a headache could be tied up for days. Worse, they would have buckets of ice-cold water flung at them. In fact, this had lead to the death of an older patient with an existing heart condition - he simply could not handle the cold, " recalls Suresh.
Patients are confined to dorms with little attention to personal space and hygiene. Manya, a 34-year-old banker, is back at a de-addiction centre in Delhi after her first attempt at drying out in Hyderabad failed. "I didn't see the sun for four months because no one was allowed out. There was no privacy for female patients and I was made to work like a slave, " she recalls.
But what hurts those undergoing rehab the most is the denial of dignity to addicts. Many allege that they are treated like petty thieves and kept like prisoners - drug abuse is obviously seen as a crime. The more severe cases are often beaten, tied up or not allowed to speak to their family for months. It's not surprising that few want to stay to the end of the programme.
When they come out, they are raging against their families for putting them in the facility in the first place. "I've counselled patients who have had thoughts about killing their wives once they leave rehab, " says a member of Al Anon (Mumbai), a support group for families of addicts.
The problem is that addiction is seen as a personal failure or a character flaw not a disease. Comedian Russell Brand in an obit to Winehouse wrote: "We need to review the way society treats addicts, not as criminals but as sick people in need of care. "
Addiction is a chronic disorder characterised by persistent drug-seeking and drug-taking behaviours. It is in the genes and is passed on from addicts to their children. So if your father or mother is/was an addict, you have up to 60 per cent chance of becoming one. Scientists in China recently identified 400 genes which could possibly be responsible for addictive behaviours. However, in India awareness about addiction's disease aspect continues to be abysmally low.
In May, a doctor at a de-addiction centre in Delhi's Shahbad Dairy area allegedly beat an inmate, Manjit Rana, to death. In the North-East, where addiction is rampant, three patients have so far been reported dead this year at Bethsaida de-addiction centre in Churachandpur, Manipur. In 2008, a centre in Mohali near Chandigarh was shut down after an inmate was found dead under mysterious circumstances.
The lucky few who manage to recover or run away have problems resuming normal life. "Their families continue to be suspicious of them and no one wants to give them employment, " says the Al Anon member.
In desperation, some reformed addicts start running illegal, ill-equipped de-addiction centres as a business. Last year, one such group of 'reformed' addicts from Uttarakhand took up a few rooms on rent in the Kullu Valley - a hotbed of drug abuse - and started a so-called de-addiction centre. It was actually a perfect cover for drug peddling. Rural teen addicts who were sent here by hopeful parents came back home in a worse shape. The centre was eventually closed down by the authorities.
"These kids would regularly get beaten up. In fact, a room was kept aside for such beatings, " says Ramesh Upadhyay, a community volunteer who works in the area and also runs an adventure sports company.
What makes things worse for addicts is that many - up to 40 per cent of them estimates a psychiatrist - also suffer from chronic mental illnesses, like bipolar disorder, schizophrenia and anxiety. Therapy for these is as important as de-addiction. At CAIM Bangalore, addicts get treated for various physical disorders as well.
"We try to address the reasons behind a patient's addiction. It could be because of an illness, a dysfunctional family or childhood problems. All these issues need to be addressed. You can't be a hapless victim of your genes, " says Jayant Shah, founder of Chemical Addiction Information and Monitoring (CAIM).
Shah used to be an alcoholic and he established CAIM in 1982 after he recovered from his addiction. Here, patients are never kept under lock and key. They are, instead, divided into various open groups, given shelter and a second-hand car to move about the town. As a reformed alcoholic says, "I could beat addiction because I was treated just like a patient, not as a criminal. We need as much love and attention as someone suffering from heart disease or diabetes. Please don't isolate us. "
JUST LIKE DEV. D
Smoking up' has become a part of young adult vocabulary in metros and the recent crop of edgy, realistic and youth-centric Bollywood films have done their bit to make drug use look cool. Dev. D, Aisha, Dum Maro Dum and Shaitan had scenes where protagonists are shown unapologetically and casually doing drugs. In Aisha, Sonam Kapoor and her friends smoke up on the banks of the Ganga as they sing around a bonfire. In Dev. D, Abhay Deol goes into a drug-alcohol spiral after his girlfriend marries another man. And Shaitan shows a group of rich kids snorting thin lines of white powder and making cracks about 'joint account'.
"A culture of sense-organ-excitation has set in, largely thanks to consumerism. People have the money to buy such drugs. Everyone's spending but not responsibly, " says Jayant Shah, who runs a de-addiction and rehab centre in Bangalore.
A bit of this screen cool can easily rub off on the audience, which is mostly in the age group of 20-35 or even younger. The official statistics are alarming. According to a paper published in the Indian Journal of Psychiatry, it is estimated that about 50 per cent of boys would have tried at least one substance that can be abused by the time they reach the ninth grade. A UNDP report says that in Punjab 73. 5 per cent of the youth population is addicted to drugs.
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