By Dr Rajiv Gupta
Any combination of biological, psychological, social, cultural or environmental factors can trigger substance abuse. Biological factors include having a family history of drug use or psychiatric conditions, externalising traits, personality disorders, while psychological factors like childhood physical and sexual abuse, neglect by parents and coexisting mental health issues can contribute towards drug use. Smoking, especially hookah, has socio cultural approval in the state and has special place in social functions along with alcohol.
Environmental factors need a special mention as Haryana shares borders with six states and one Union Territory. Himachal Pradesh and Uttarakhand are known for illegal cannabis cultivation and Uttar Pradesh has a culturally permissive attitude towards cannabis use. Punjab has already touched the rock bottom and in Rajasthan opium cultivation is legal in certain. Metropolitan culture of Delhi and Chandigarh has promoted easy accessibility of illicit party designer drugs, stimulants and hallucinogens. This puts Haryana in centre of various drug routes and is trapped from all sides by states with high availability of illegal substances and porous boundaries allow easy access and inroads to the supply chain.
In the past two decades, there has been a shift in Haryana from traditional agrarian economy to a more industry-based economy. This has led to two important changes -- prosperity due to enhanced per capita income of the state, which is among the highest in the country; and at the same time, massive unemployment among the youth. With increased purchasing capacity and easy availability, illegal substances have often been used as a companion to boredom and idleness. Furthermore, with the turn of this century, significant changes have been seen in socio-cultural milieu, especially with nuclearisation of families which has led to limited availability of social support. Rapid ruralurban transition has also left new generation with a sense of confusion. All these sociocultural-economic changes have made people more vulnerable to not only substance abuse but also to Internet and behavioural addictions which will become a huge challenge in coming years.
Tackling the burgeoning problem of substance abuse requires a multipronged approach with principles of primary, secondary and tertiary prevention. One way is to reduce the number of people initiating substance use. School and college curricula must contain topics about substance abuse in order to generate a healthy discussion. Regular awareness programmes in community can lead to greater understanding of the problem in the society and help people take decision to refrain from substance use and abuse. Secondly, there is need for enhanced efforts by the narcotics cell and drug enforcement agencies to check the illegal supply of drugs. Despite bans, certain drugs are easily available in the market and sold openly. Thirdly, we need to have better facilities to treat people with substance abuse disorders.
Haryana's initiative to upgrade existing de-addiction centre in department of psychiatry, Rohtak to an apex state drug dependence centre (SDDTC) is one step in the right direction. However, with the number of people needing treatment for substance abuse disorders in lakhs, many more specialist centres need to be open at district levels. We need to learn lessons from the opioid menace in Punjab and must take precautionary measures before the problem spirals out of hand. Unfortunately, at present, we are deficient in both demand reduction and supply reduction measures and we need coordinated efforts with all stakeholders, including various government agencies and NGOs in order to address the problem of drug abuse effectively.