Drug addiction is defined as out of control use of drugs despite their negative effects. In recent years Jammu and Kashmir in India has seen an exponential increase in the drug use. According to official data shared by the Central Government in Parliament, the number of people affected by drug abuse in Jammu and Kashmir has reached nearly 10 lakh, which is around 8% of the total population of Jammu and Kashmir. [1] [2] [3] [4] On 4 August 2023 the Standing Committee on Social Justice and Empowerment has conveyed to the Parliament of India that approximately 13.50 lakh drug users are estimated to be in Jammu and Kashmir, with the majority falling within the age range of 18 to 75 years. [5]
According to the United Nations Office on Drugs and Crime, Jammu and Kashmir has 60000 drug addicts. In last three years there has been an increase of 1500% in the use of drugs. [6] In March 2023, Ministry of Social Justice and Empowerment stated that approximately one million individuals in the Union territory were grappling with substance abuse. The ministry also revealed that over 50% of these individuals were specifically addicted to opioids. [7] As per a survey carried out by the Jammu and Kashmir administration last year, over 52,000 individuals in Kashmir acknowledged their heroin usage. The survey findings revealed that, on average, a user spent approximately 88,000 rupees ($1,063.54; £860) per month to sustain their drug habit. [8]
According to the doctors at the Institute of Mental Health and Neurosciences Srinagar (IMHANS), there has been a transition observed in drug usage patterns. Specifically, there is a shift away from using medicinal opioids like Codeine, SP, Tramadol, and Tapentadol, towards the more potent and dangerous hardcore drugs, predominantly intravenous (IV) heroin. [9] According to Dr. Yasir Rather, approximately 70% of drug users test positive for HCV at IMHANS. [10]
In 2023, a study conducted by IMHANS revealed that the prevalence of Hepatitis C among drug abusers in Kashmir is 72 percent. The institute received 150 drug addiction cases per day. It also found that over 33 thousand syringes are being used daily for heroin injections. [10]
On 12 June 2023, Dr. Farooq Abdullah, the National Conference President and Member of Parliament from Srinagar, said that the drug addiction or substance abuse have become significant threats to the youth of Jammu and Kashmir. Expressing his worries about the alarming increase in drug addiction cases among the youth, Dr. Farooq called drug abuse a widespread issue in the region. He urged everyone to reflect on this problem. [11]
According to IMHANS, on an average a heroin addict in Kashmir spends about 90,000 rupees on every month. [12]
According to the survey report, treatment and specialist interventions were in short supply. The Drug de-addiction centres have been flooded in recent years. [6] Most of the patients that are admitted in these centres are Heroin addicts. In Kashmir, there are limited private institutions, and the region has just two public drug rehabilitation centers situated in Srinagar - one being IMHANS, and the other operated by the police. Additionally, the government has established Addiction Treatment Facility Centres (ATFCs) in every district. However, ATFCs differ from drug rehabilitation centers as they do not provide admission facilities. Instead, they function as small clinics with one doctor, a counselor, and a nurse, dedicated to treating patients dealing with addiction issues. [13] Based on official statistics, the Institute of Mental Health and Neurosciences (IMHANS) in Srinagar, a distinguished rehabilitation center, witnesses an average of 150 fresh drug addiction cases every day. Out of these, approximately 70 cases are returning patients seeking follow-up care, while the rest are entirely new cases. It's worth noting that around 15 of these daily cases, constituting 10 percent of the total, are teenagers. [14]
On the basis of a study of 189 out-patients dealing with drug abuse, all of whom were registered at the Hospital for Psychiatric Diseases in Srinagar, the most commonly abused substance among them was cannabis, followed by heroin. It was observed that cannabis users had the longest duration of drug use but exhibited the lowest rate of drug dependence (29.9%) and the lowest rate of multiple drug abuse (6.1%). On the other hand, heroin users had the highest rate of drug dependence (88.8%) and the highest rate of multiple drug abuse (83.4%). [15] Doctors express concern over the prevalence of heroin users, stating that the level of addiction it induces is alarming. According to Dr. Rather, when compared to cannabis or medicinal opioids, heroin's addictive nature surpasses them significantly. Users attempting to quit heroin often endure severe withdrawal symptoms, including physical pain, aches, and restlessness. [16]
According to the Standing Committee on Social Justice and Empowerment, in the age group of 10 to 17 years, an estimated 1,68,700 children in Jammu and Kashmir are involved in drug use. The substances being used by these children include Cannabis, Opioids, Sedatives, Cocaine, Amphetamine-Type Stimulants (ATS), inhalants, and Hallucinogens [17]
Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the dried latex of the Papaver somniferum plant; it is mainly used as a recreational drug for its euphoric effects. Medical-grade diamorphine is used as a pure hydrochloride salt. Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents. Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Heroin is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy.
Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin, and amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and medical consequences that can be caused.
Self-medication, sometime called do-it-yourself (DIY) medicine, is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions, for example headaches or fatigue.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Drugs and prostitution have been documented to have a direct correlation.
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.
A methadone clinic is a medical facility where medications for opioid use disorder (MOUD) are dispensed-—historically and most commonly methadone, although buprenorphine is also increasingly prescribed. Medically assisted drug therapy treatment is indicated in patients who are opioid-dependent or have a history of opioid dependence. Methadone is a schedule II (USA) opioid analgesic, that is also prescribed for pain management. It is a long-acting opioid that can delay the opioid withdrawal symptoms that patients experience from taking short-acting opioids, like heroin, and allow time for withdrawal management. In the United States, by law, patients must receive methadone under the supervision of a physician, and dispensed through the Opioid Treatment Program (OTP) certified by the Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Administration.
The drug policy in the United States is the activity of the federal government relating to the regulation of drugs. Starting in the early 1900s, the United States government began enforcing drug policies. These policies criminalized drugs such as opium, morphine, heroin, and cocaine outside of medical use. The drug policies put into place are enforced by the Food and Drug Administration and the Drug Enforcement Administration. Classification of Drugs are defined and enforced using the Controlled Substance Act, which lists different drugs into their respective substances based on its potential of abuse and potential for medical use. Four different categories of drugs are Alcohol, Cannabis, Opioids, and Stimulants.
The drug policy of Sweden is based on zero tolerance focusing on prevention, treatment, and control, aiming to reduce both the supply of and demand for illegal drugs. The general drug policy is supported by all major Swedish political parties with the exceptions of the Left Party – which advocates for the decriminalization of private consumption – and 5 of the 7 major parties' youth wings.
Polysubstance dependence refers to a type of substance use disorder in which an individual uses at least three different classes of substances indiscriminately and does not have a favorite substance that qualifies for dependence on its own. Although any combination of three substances can be used, studies have shown that alcohol is commonly used with another substance. One study on polysubstance use categorized participants who used multiple substances according to their substance of preference. The results of a longitudinal study on substance use led the researchers to observe that excessively using or relying on one substance increased the probability of excessively using or relying on another substance.
The drug policy of Portugal, informally called the "drug strategy", was put in place in 2000, and came into effect in July 2001. Its purpose was to reduce the number of new HIV/AIDS cases in the country, as it was estimated around half of new cases came from injection drug use.
Heroin-assisted treatment (HAT), or diamorphine-assisted treatment, refers to a type of Medication-Assisted Treatment (MAT) where semi-synthetic heroin is prescribed to opiate addicts who do not benefit from, or cannot tolerate, treatment with one of the established drugs used in opiate replacement therapy such as methadone or buprenorphine. For this group of patients, heroin-assisted treatment has proven superior in improving their social and health situation. Heroin-assisted treatment is fully a part of the national health system in Switzerland, Germany, the Netherlands, Canada, and Denmark. Additional trials are being carried out in the United Kingdom, Norway, and Belgium.
An opiate is an alkaloid substance derived from opium. It differs from the similar term opioid in that the latter is used to designate all substances, both natural and synthetic, that bind to opioid receptors in the brain. Opiates are alkaloid compounds naturally found in the opium poppy plant Papaver somniferum. The psychoactive compounds found in the opium plant include morphine, codeine, and thebaine. Opiates have long been used for a variety of medical conditions, with evidence of opiate trade and use for pain relief as early as the eighth century AD. Most opiates are considered drugs with moderate to high abuse potential and are listed on various "Substance-Control Schedules" under the Uniform Controlled Substances Act of the United States of America.
Most of the illegal drugs in Pakistan come from neighbouring Afghanistan.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.
Discrimination against drug addicts is a form of discrimination against people who suffer from a drug addiction.
Tim Ryan is an American activist, drug abuse interventionist, author and speaker. He is the Founder and Executive director of “A Man in Recovery” foundation. According to the National Safety Council, Ryan is notable for his position in favor of Drug policy reform and as a proponent of legislative change in American drug policy. His work was the subject of the A&E series “Dope Man” in July 2017. Ryan is also the author of the 2017 memoir From Dope to Hope: A Man in Recovery.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.