Write articles for 'GatewayforIndia' Drug/alcohol addiction in India – Disturbing trends By- Dr. A. Gupta Drug addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by neurochemical and molecular changes in the brain. Drug abusers gradually spend more and more time and energy obtaining and using the drug. Once they are addicted, the drug abusers' primary purpose in life becomes seeking and using drugs. Drug addiction is becoming a major health problem in India with some estimates indicating that as many as 15 million people in India could become addicts by the end of 2004. Link between drug abuse and crime is well established but recently the association between drug addiction and HIV/AIDS has been a prime concern for health authorities in India. A significant recent shift in drug use patterns in India is the move from smoking to injecting drug use. Heroin, buprenorphine (tidigesic/tamgesic) and dextropropoxyphene (spasmo-proxyvan) are the most commonly injected drugs in India. In a study of Indian opioid addicts, researchers found 8.3% of injectible drug users were HIV-positive.  The drug problem and its consequences have been particularly alarming in the north-eastern states. In some states of north-east 80% of all injectible drug users were HIV positive. Trafficking from Myanmar brings in high quality heroin, which is usually injected by abusers. The problem has now reached the higher echelons of society, along with the lower strata, and includes children, and students in urban areas. Daily wage earners/laborers, rag pickers, truck drivers, medical workers and youths are all equally susceptible to the menace of addiction. Heroin in urban areas and opium in rural areas have emerged as the two most commonly used drugs. Increasing trend of drug and alcohol, addiction in large cities, especially the metropolitan cities is alarming. A recent report on India by the UN Drug Control program cites that in Delhi, 44.7% of treatment seekers were heroin addicts while alcohol accounted for 26.4%. Mumbai is considered as the country’s major drug trafficking center. States like Tamil Nadu, Kerala and Andhra Pradesh are centers for cannabis related drugs while in northern states of U.P, Bihar and M.P, poppy (from which opium is derived) is cultivated in some areas. Narcotics Drug and Psychotropic Substances Act was passed by the parliament in 1985 and Narcotics Control Bureau was set up in 1986 to counter drug abuse and illicit drug trafficking. Traditionally opium and cannabis derivatives, LSD, Mandrax, cocaine, barbiturates etc. have been used by drug addicts. But recently use of ‘synthetics’ that include stimulants like amphetamine and its derivatives, methcathinone, varnish, paint and glue as drugs for addiction has also increased. These substances are readily available everywhere and are not covered by law. Health problems arising due to drug/alcohol addiction depend on the type of drug that is being abused and duration of abuse. Here we will take examples of alcohol, Heroin and Amphetamine: 1) Alcohol abuse can result in psychological dependence, liver disease, (hepatitis, cirrhosis), chronic pancreatitis, gastritis and gastric ulceration, cardiovascular problems (e.g. hypertension) and neurological problems. A strong association exists between alcohol use and cancers of the esophagus, pharynx, and mouth, whereas a more controversial association links alcohol with liver, breast, and colorectal cancers. A person is generally considered to be dependent on alcohol when they have experienced three or more of the following symptoms during a year: a strong urge to drink, difficulty controlling drinking, physical withdrawal symptoms, such as sweating, shaking, agitation and nausea when they try to reduce drinking, a growing tolerance to alcohol (needing larger quantities to get the same effect), gradual neglect of other activities Persistent drinking even though it is obviously causing harm. 2) Heroin can cause – Addiction, depressed respiration, clouded mental functioning, death due to overdose, nausea and vomiting, spontaneous abortion in pregnant woman. Intravenous use can cause Infectious diseases (e.g., HIV/AIDS and hepatitis B and C), collapsed veins, bacterial infections, arthritis and other rheumatologic problems.   3) Long-term heavy use of amphetamines may lead to malnutrition, skin disorders, ulcers and diseases resulting from vitamin deficiencies. Regular use may contribute to lack of sleep and weight loss. Intravenous users are at risk for serious, life-threatening diseases such as AIDS, lung and heart disease and other cardiovascular diseases. Frequent use of large amounts of amphetamines may eventually result in mental illness, suicide and violent death. Amphetamine-induced psychosis is a paranoid state that may develop after ingestion or the injection of large doses of amphetamines. People resort to drug/alcohol abuse for many reasons. Some of the reasons are - -          Seeking pleasure, relaxation and adventure -          Psychological disturbance (depression, social maladjustment, parental neglect etc.) -          Medical problems (to overcome severe and/or chronic pain) -          Religious/social reasons -          Children and youths trying to imitate their icons ( e.g. movie and sports stars, rock artists) Besides these physical and health problems drug addiction is a major social problem with increase incidence of crime in drug/alcohol addicts. Drug addiction causes immense financial and psychological problems for the addict and his/her family. So what can be done to counter this menace? ·          Improvement in the existing laws is needed to plug the loopholes that would help in decreasing drug pedaling. ·          Better implementation of the law by enforcement agencies. ·          Active judiciary that would quickly dispose drug offence related cases and aggressively punish the guilty. ·          Better rehabilitation programs for the addicts and easy access to rehabilitation centers. At present only a limited number of rehabilitation center and rehabilitation programs are available for drug/alcohol addicts in India. ·          Increase the public awareness regarding the hazards of drug/alcohol addiction by using mass media like television, newspapers, magazines, radio etc. e.g. You can learn a lot about heroin abuse and recovery by reading up on the subject in books, magazines, and on the Internet. ·          Public figures and icons should aggressively participate the anti drug campaign. ·          Social, psychological and economic support to the family of the addicts. A concerted effort by the government, judiciary, social organization and responsible members of society is needed to control this menace.