Addiction 101 (Part 2)

“I admire addicts. In a world where everybody is waiting for some blind, random disaster or some sudden disease, the addict has the comfort of knowing what will most likely wait for him down the road. He's taken some control over his ultimate fate, and his addiction keeps the cause of his death from being a total surprise.” ― CHUCK PALAHNIUK, Choke

Sample this. You are a just a normal person: you have families to talk to, jobs to go to, kids to look after; and at times, you have to take major decisions to grow or proceed in life. However, none of these matters until you get a day’s shot. Even death becomes secondary when the most important thing, and which you have to get it any cost, is just the one and only shot of your chemical of choice. How would you approach when the nightmare extends to the morning day in and day out? Occasionally you have the money and the burden is comparatively lighter, but that is not enough unless you get the substance from one of the notorious areas in the town where the users, sex workers and policemen lurk around to rob you. Somehow, the day passed in your favour, nevertheless the last thing on your mind is to worry about the next day again. To quote a popular saying, you use to live and you live to use—‘abuse’ seems a better word than ‘use’. How will you tolerate that kind of life?

(Addiction 101 Part 1 http://kapilarambam.blogspot.in/2015/03/addiction-101_8.html)

It starts with a single shot. Just one single shot. As in life where the good is scarce and the bad aplenty as well as it takes ten steps to be good, just one to be bad—drugs are the supreme example of this relativity. They get better as much as they are worse. In a circle of users, it is common to find that prescription drugs are infantile when they compare it with heroin, so are the amphetamines when equated with marijuana, so on and so forth. In almost all the addiction cases, the abuse of a whole lifetime starts only with casual use. Which thief would want to admit s/he is a thief? Which user would want to be labelled an addict? In a way, it is quite a human nature. Every sane person wants the feel-good factors, the comfort, the satisfaction and all. Drugs, sans any morality or ethics, make people experience the feel-good factors, fly them to their deepest areas of comfort and offer all the contentment. When they can reduce the grief and grime of everyday life, it is no surprise to see addiction is a global phenomenon.

First Shot: In the Neighbourhood

The reasons for drug abuse are as varied as the number of users. It might make you laugh but some people want to change their lives and use drugs as the means to their ends. The environment also plays a crucial role. From families to friends, it does make a gigantic impact. Scientific studies have shown that genetics also has a push-button as evident from the traits a user inherits from their parents. In other cases, people want to go well with others and if not, escapism seems to unburden harsh living experiences. Alternatively, some people are just too rebellious and experimental. In some places it is just a perfect getaway from the world of ennui and nothingness, where the only tales of interest are those of social decadence and political impotency.

For us, in a land flooded with social unrest, political conflicts and economic backwardness, the cocktail of the consequences of this bleak reality is a disaster. If we talk about my hometown, in Manipur, there is the added pressure of being located near the infamous Golden Triangle of Burma, Thailand and Laos, that is a haven for international heroin production and distribution. Our town is just three hours away from the Burmese border and it is an open secret that we are a main transit point of the smuggling chain that stretches out to the entire major black markets in western Asia, Europe and beyond. If just one percent of the total volume that sinks in along the Manipur route is sufficient to wipe out a generation. According to the United Nations Office on Drugs and Crime (UNODC) in Dec 2014, opium poppy cultivation in the Golden Triangle has tripled since 2006. Especially in Burma and Laos, cultivation rose to 63,800 hectares from 61,200 hectares in 2013. It also mentions that Burma is the main grower, with an estimated production of 762 tons of opium and 76 tons of heroin after refinement, coming from the Shan state.

Of course, there are some corners where the idea of addiction as a social disease is looked down. Moral weakness is the main reason, according to them, why there is rampant drug abuse cutting across border, gender and occupation. Again, their solution of dumping the ideas of the users that they should make rooms for changing their behaviours.

In the most beastly condition, like in Churachandpur, users are chained, tied and locked up, to help them get rid of drugs. It might sound like the conduct of a neighbourhood vigilante team—but no, it happens in the so-called rehab centres with rules of their own world. In this second largest town of Manipur, you can see in busy market areas where peddlers sell capsules and tablets in toffee bottles in broad daylight in main market complexes while heroin is a little more discreet. For that matter, in the valley capital town, Imphal, every kid knows that the notorious BOC (or North AOC) area is the centre point, with abundant flow of sex and drugs in the locality.

Second Shot: Comfortably Clean

Drug-related institutions use two kinds of treatment for addiction: 1. Detoxification (or simply detox) and counselling, and 2. Substitution therapy.

Detox is the precursor to rehab, just like cottons swabs are there for fixing heroin with insulin syringes. It is a plain method of cleaning the body before making it anew so that things can start on a fresh note, literally. Once done methodically, it wipes out the traces of every toxin that a user has accumulated with the use of their substance of choices. Detox is not the end but just a means to recovery while reducing the rooms for relapse. It should be under a strict medical supervision but telling this to a user is tantamount to asking the government to be sincere. The necessity is not only for sincerity but an informed way to go through withdrawal symptoms, the madness of urge and other effects of going clean. Besides, users with their trademark habit of self-destruction need to follow a reasonable process too. Detox hardly takes long—just two to four days as the case might require, so it is worth the try. It is well established that as a drawback, once a user relapses after detox, things get worse with heightened tolerance to their chemical of choice that again implies more dependence than ever. It is actually madness, a detox process is madness—a user should do best under a professional care. If it fails at first, a user can try and try again to reach the goal of a life without dependence.

Another time-tested solution for healing addiction is oral substitution therapy (OST). Over the decades these two have been proven to be effective in treating addiction. OST is more of a process than a quick-fix solution: in which a user is administered with psychoactive substances (In most countries, buprenorphine and methadone are widely used in OST). These substances have identical features of heroin and morphine yet work synchronously to ease withdrawal symptoms and block the craving for one’s chemical of choice. OST is multipurpose in the sense that it discourages the use of drugs as well keeps a user away from the many troubles—ranging from those of HIV and Hepatitis to instinctive habits. In the same way, it shrinks the chance for relapse while stretching out the well-being of the users and their near and dear ones. Addiction isn’t about substance, Susan Cheever the American author wrote: you are not addicted to the substance, you are addicted to the alteration of mood that the substance brings.

In 2005, under the aegis of the UNODC, the Manipur-based Social Awareness Service Organisation started the OST with buprenorphine. Again in 2012, the UNODC collaborated with the National Drug Dependence Treatment Centre (All India Institute of Medical Sciences, New Delhi) kick-started the Methadone Maintenance Therapy (MMT) programme at the Regional Institute of Medical Sciences (RIMS) in Imphal, Manipur.

Third Shot: No Social Users But Society’s Favours

On one hand, addiction is a serious public health problem: it affects both the users and their families that extend to a society. In our hometown, it is a common saying that drugs will kill half of our generation, while guns the other half in the prevailing milieu. Then there are other issues of crimes, society’s breakdown, economic stagnation, arrested development and so on. At the same time, a society is solely responsible for the problems in the first place. To cite an example, nobody in Delhi would question the union of India but for us, who belong to the peripheral provinces, it is the question of our daily existence. Similarly, cocaine is not available in Manipur so there is no abuse—this perhaps answers the issues of supply and demand indirectly.

Addiction is prevalent even in developed countries. There are numerous reports and statistics churning out from countries like the United States and England. The US-based Drug Policy Alliance (DPA), which states their policies are based on science, compassion, health and human rights, mentions that ‘the US spends more than $50 billion a year on the “war on drugs” with the goal of creating a “drug-free society”—yet there has never been a “drug-free society” in the history of civilization.’ On the same level, the London-based Express, in one of the news blurbs, headlined that ‘the UK is the “addiction capital of Europe”, with increasing drug and alcohol abuse leading to the breakdown of society.’

Last Shot of the Day: Addiction affects everyone, starting from the individual to the society. It makes no discrimination of the rich and the poor, man and woman, believers and atheists. Despite the rampant destruction only an addict will understand another fellow’s problem, except in rare cases when family and friends understand the problems. Nobody is born an addict; neither anybody is born with the power to tolerate the temptation of drugs. It’s all in finding the right solution. To conclude, William S Burroughs puts it succinctly: ‘Whether you sniff it, smoke it, eat it or shove it up your ass,’ he wrote, ‘the result is the same: addiction.’

Through the Grapevine

IDU declining in Manipur
Source: Hueiyen News Service/E-pao
Imphal, March 19 2015: The percentage of Injecting Drug Users (IDU) in Manipur has declined by 12.89%, said MACS Joint Director, M Abhiram at the district level sensitization and advocacy programme on HIV/AIDS held by DC, Imphal East in coordination with DAPCU, Imphal East and West and MACS NGO partners at Panchayat Bhawan, DC Office Complex, Imphal East.

Read Hueiyen Lanpao’s The Role of Society in Preventing Drug Abuse

Analysis: The Drug Problem – An Ongoing Political Challenge in Burma, by Zin Linn (The Asian Correspondent)

Books

The Politics of Heroin in Southeast Asia by Alfred W. McCoy
The Truth about Addiction and Recovery by Stanton Peele

Fiction

A Million Little Pieces by James Frey
Shantaram by Gregory David Roberts
Junky by William S Burroughs

Websites

United Nations Office on Drugs and Crime (UNODC), www.unodc.org
Alcohol & Drug Demand Reduction and Preventive Policies, Ministry of Social Justice and Empowerment, Govt of India, http://socialjustice.nic.in/aldd.php

Related Pieces on this Blog