Drug addiction, a consequence of social ills rather than individual flaws
The spread of multiple drug use has aggravated the overall problem, personal and social dysfunction, impairment of health, crime and other violent behaviours
Abdul Kader Mohiuddin
Addiction is a maladaptive pattern of drug abuse including alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics and anxiolytics, stimulants, tobacco and others that persist despite negative consequences. An article of New England Journal of Medicine says addiction is a disease of the brain whereas another leading journal specifies: Genetics contributes significantly to vulnerability to this disorder. Neurological changes observed in long-term substance abusers are nearly identical to those seen in people struggling with obesity, porn aficionados, gamblers, internet addicts, compulsive shoppers and simply those involved in intense romantic relationships. As with many other brain diseases, addiction has embedded behavioural and social-context aspects that are important parts of the disorder itself.
Globally, 50% of deaths of liver cirrhosis, 30% of deaths of oral and pharyngeal cancers, 22% of deaths of interpersonal violence, 22% of deaths of suicide, 15% of deaths of traffic injuries, 12% of deaths of tuberculosis, and 12% of deaths of liver cancer were attributed to alcohol consumption, according to Journal of Family Medicine and Primary Care, 2019. The WHO estimated that there are 2 billion alcohol users, 1.3 billion tobacco users, and 185 million illicit-drug users worldwide. Currently, 80% of tobacco users live in low- and middle-income countries. Smoking and alcohol abuse collectively made India a home of worlds 27% of tuberculosis patients in 2017. Nearly 6,000 people die from alcohol-related diseases every year in Australia, where 30% fatal car crashes are drunk and drive cases. The prevalence of alcohol use disorder is highest in Europe (7.5%) and the lowest among East Mediterranean Regions which includes Afghanistan, Bahrain, and Egypt. In the US, the largest national economy of the world, 75% of high-school students have reportedly used illegal drugs, drunk alcohol or smoked tobacco, and opioids claim 40,000 death each year from overdose.
Bangladesh is situated in the crucial point between the golden triangle (Myanmar, Thailand and Laos) and the golden crescent (Pakistan, Afghanistan and Iran) in terms of geographical location. Bangladesh with its easy land, sea, and air access is becoming a major transit point. Traffickers who supply drugs in the markets of Northern America, Africa, and Europe are routing their shipments through Dhaka, Chittagong, Comilla, Khulna and other routes in Bangladesh. It ultimately contributes to the number of drug abusers as well. The Bangladesh Bureau of Statistics, 2013 found that 2034 years was the age of initiation for most (47.3%) intoxicating substance abusers and 33% of abusers started between 1519 years old. A study conducted in the outpatient department of National Institute of Mental Health in Dhaka, revealed that 7.66% of respondents suffered from a substance-related disorder. A similar study conducted in a private psychiatric clinic in Dhaka showed that around 30% of admitted psychiatric patients were suffering from substance-related disorder. Meanwhile, a separate study conducted by ICDDR, B shows that in the capital, around 80% of the users are male and 20% are female.
Despite prohibition, alcohol is available across the country and is produced locally. Locally produced alcoholic beverages are made from sorghum, maize, millet, rice, cider, fruit wine or fortified wine (tari, bangla mod, haria, choani, ek chuani, do chuani, mohua, etc.). Data from the HIV behavioural surveillance survey conducted in 2016 among people who inject drugs (PWID) in Dhaka city showed that 53.1% of PWID shared needles and syringes in the last week compared to 60% in 20062007. This clearly shows that the needle/syringe sharing practices have not changed among this segment of population over the past decade despite the ongoing Needle and Syringe Programme (NSP).
It is estimated that there were about 4.6 million regular users of Yaba (several combinations of N-methylamphetamine and caffeine sold within BDT 300 to BDT 2000, as red or pink pills) in Bangladesh on or before 2012, which is around 10-15 million, according to Association of Prohibiting Drug Abuse (MANAS) chief Dr. Arup Ratan Chaudhury. Around 80% of drug abusers are young people aged between 16 and 35, said the Department of Narcotic Control report, 2016 by the Home Ministry. A BBC report April, 2019 says that Bangladeshi authorities seized 53 million Yaba tablets nationally in 2018. The total value of this illicit business is estimated to be worth upwards of $1 billion a year. Over half of the public vehicle drivers take drugs regularly and it could be the main reason for accidents in the country.
The spread of multiple drug use has aggravated the overall problem, personal and social days function, impairment of health, crime and other violent behaviour. Youth are the most falling victims to drug abuse, which eventually lowers their standards of education and attendance at schools and colleges. They abuse drugs due to social isolation, frustration, depression, curiosity and mostly, refusal by loved ones. Major risk factors responsible for drug abuse are family disorganization, parental neglect, parent-child conflict, loss of spouse strife, indiscipline, isolation, lack of emotional support, rejection of love, complex relationship status, over-protection, unemployment, repeated failure and personality mal-adjustment and easy availability of controlled drugs without prescriptions. According to Addiction Management Integrated Care (AMIC), some 250 female addicts took treatment at AMIC during the period of 2015 to 2018. A nearly half of them taken Yaba mainly due to family unrest. More than 40% unemployed youth are addicted. And among addicted, more than 40% are female, close to 50% are educated and 60% are sex offenders.
It is high time for the leaders to wake up and save the endangered society as more new addicts join the ranks of the hardcore ones. The Drugs and Narcotics Department was created two decades ago, especially to counter the production and availability of addictive drugs. They have done tremendous jobs in recent years, no doubt, but a lot more is expected to eradicate the jeopardy. Preventive education against drug abuse is essential. Implementation of laws by the enforcing agency is needed to curb drug trafficking. There is evidence that willpower can be crucial in beating addiction. If we fail to control of this it will destroy the whole nation someday, for sure.
The writer is Secretary Treasurer, Dr. M. Nasirullah Memorial Trust, Dhaka. E-mail [email protected]
