Sunday Reading

New Delhi, 14 July 2010

Prescription Drugs

ABUSE DANGEROUSLY ‘HIGH’

By Suraj Saraf

The trend of prescription drugs’ abuse is menacingly increasing in India for getting a high. It is estimated to have grown three times during the past five years. In fact, a recent report by the UN Office on Drugs and Crime (UNODC) pegs India as the largest consumer of heroine in South Asia.

“Easy availability of pharmaceutical drugs like Spasmo, Proxyvon, Tramadol and Ketamine make them the most abused drugs in the North East. Addicts take as many as 24 injections a day, says Dr. Chawand Lung Muana, project officer of an NGO working on HIV and AIDS cases in Mizoram. Such drugs are readily available at any chemist shop and are legally prescribed even by premier health institutes for pain management, especially for pregnant women and women during menstruation.

“Globally, the number of people using amphetamine type stimulants, estimated at around 30 to 40 million, is soon likely to exceed the number of opiod and cocaine users combined. There is also evidence of increasing abuse of prescription drugs”, warns the UNODC report. Opiods, in particular, have a side effect of euphoria. It is similar to the pleasure felt when one has been successful or after intense physical excitement, but it requires no such effort to attain. As people who are in pain have typically suffered an unpleasant experience that caused the pain -- be it an accident or over-exertion -- the pleasurable effects of these painkillers may turn out to be a delightful surprise. Seeking repeated experiences of pleasure through the addictive behavior or substance is one of the hallmarks of addiction.

According to the UN organization the non-medical use of prescription drugs is an increasing problem in many countries. In some countries, this is second only to cannabis. This is most notably in North America, but there are reports of significant treatment demand in Europe, Africa, South Asia and Latin America. Addressing the non-medical use of prescription drugs needs to carefully take into consideration the need to ensure the availability of these substances (that do have a recognised and much needed medical use), while preventing diversion and misuse. The UNODC is developing a ‘discussion paper’ to assist Member States in addressing the issue of the non-medical use of prescription drugs, focusing on recommendations for policy and practice.

The purpose is to provide the same kind of advice that exists with regard to prevention of the use and the treatment and care of the dependence of illicit drugs. The sources of prescription drugs are different, but the need for prevention and treatment with a view to promoting health is the same. Government authorities, parents, medical doctors, pharmacists, pharmaceutical companies have all important roles to play, notes the UNODC.

In India the easy availability and least legal check makes prescription drugs, especially for pain management the latest hit among drug users even though manufacturers’ label on painkillers contain chemicals, which if taken for long lead to addiction. The addiction to legally pharma drugs has further compounded the number of HIV cases in the country. Among 20 to 30 per cent of such addicts in the North East are already HIV positive and health functionaries are concerned that they are instrumental in spreading the scourge, which is already a major problem.  

An assessment is that the growing dependency over pharma drugs for getting a high has also trapped people in one of the most affluent states such as Punjab. Here experts emphasise the case of Maqboolpura, near Amritsar which has come to be known as a land of widows because majority of male members there had succumbed to excessive pharma drugs’ abuse.

“Prescription drugs for pain management are used without legal prescription. There is an indispensable angle of crime associated with drug usage. It is the prevalence of criminal organizations and drugs mafias that is driving the market for such drugs,” is an assessment of Cristibe Albertio, UNO Drug and Crime South Asia representative.

The big question is what steps should be done to bring a halt to such kind of drug abuse? According to Dr Muana the need of the hour is that adequate primary interventions such as sensitizing the youth and empowering them through counseling and advocacy should be in place. The young minds must be alerted about the need to restrain from misusing such drugs or else they could get trapped as addicts.  

Three classes of drugs viz certain pain killers, which contain codeine of morphine, sedatives or tranquilizers can get you hooked if taken without a medical prescription or if taken over a period of time. What is common and well-know is that even the most common cough syrups are misused as they give a ‘high’.

Clearly, drug abuse of any sort is not an individual problem. It is a social problem and must be viewed as such. This is so primarily because an addiction can create curiosity among the non-users thereby multiplying the numbers of users. A collective onus is required to curb the menace from the roots.

Both the Health and Family Welfare and the Chemicals and Fertilizers Ministries need to take collaborative measures to check this rapidly growing abuse of pharmaceuticals drugs for getting a high, suggests Prasada Rao of UNAIDS.

Another suggestion to curb the menace comes from Dr. Jitendra Nagpal, senior consultant, psychiatrist, Vidyasagar Institute of Mental Health and Neurosciences. He recommends that both doctors and chemists can play an important role—the doctors by studying the patient profile carefully and the chemists by not giving the drug without a proper prescription.

Another expert, Dr. CM Gulati, is of the view that “we are aware of cases where people take medicines for psychotropic effects. There may be some legitimate cases where a chronically sick patient suffering from a long-term illness gets hooked on to a particular drug, or where patients recovering from serious bone injuries, get relief from a pain killer which may be an opioid”.  

“Chronic use of these drugs can result in tolerance which means that higher doses are required to achieve the same initial effect,” notes Rani Dandeka Bhatia, psychiatrist, St Stephen’s Hospital.

Doctors say that those abusing the drugs usually are between the age group of 15 to 35. Often they may pop a pill to alleviate anxiety but it becomes a case of addiction if taken for three to four weeks. The danger increases when one starts taking higher doses. Indeed, the non-medical use of drugs is on the increase and it is time for the authorities to check this abuse. ---INFA 

(Copyright, India News and Feature Alliance)