NGOs demand 'clean up' of Drug Dependence Treatment

[Guest guest]

19th

September 2008

New

Delhi

Mr. K M Acharya

Secretary

Ministry of Social

Justice and Empowerment (MoSJE)

Government of India

And,

Mr. Naresh Dayal

Secretary

Ministry of Health

and Family Welfare (MoHFW)

Government of India

Dear Mr. Acharya

and Mr. Dayal,

We

write to you as NGOs working with people using drugs to express grave concern at

the deplorable state of drug dependence

treatment in the country. The issue merits urgent attention from

your Ministries, both of which manage some aspects of drug dependence.

Violation of rights in the name of “therapy”

Across

the country, drug users report neglect and mistreatment in

“de-addiction” centres. Physical isolation, chaining, thrashing and

violence, forced labour, denial of meals, interception of communication and

other inhuman behaviour are commonly practiced in the name of “de-addiction”

In recent months, shocking incidents have come to light from Punjab,

notably Chandigarh[1],

Jalandhar[2],

and Ludhiana.[3]

Patients admitted for “drug treatment”

are routinely tortured, and in some cases, beaten to death.

Most of these centres function without official approval, in contravention of

legal provisions for the establishment, and management of drug treatment

centres, that is, Sections 71 and 78 of the Narcotics Drugs and Psychotropic

Substances Act, 1985. A similar situation was witnessed in the North East, where drug users were caged,

chained and tonsured to give up drugs. These practices, including the gravest

violations of fundamental rights, are seldom reported; even rarely investigated

and addressed. India’s

robust constitutional and legal framework is clearly failing drug users.

Lack of standards for delivery of treatment

While

these incidents may be seen as extreme, drug treatment services in India

are severely deficient. There are no standards for clinical care; “de-addiction”

centres follow outmoded,

non-scientific methods to make “addicts” “drug free”.

To illustrate, detoxification centres in Manipur administer Lobain (a

combination of dextropropoxyphene with ibuprofen)

even though its use has been discontinued in Europe

on account of adverse effects. Centres supported by MoSJE merely provide

psycho-social interventions such as yoga, spirituality or group counseling. While

such activities may aid recovery, they cannot replace pharmacotherapy as the

primary method of managing drug dependence. Despite advances in addiction medicine,

the Government continues to ignore evidence based Buprenorphine and Methadone

for managing opiod dependence. While countries across the world including China, Malaysia,

Vietnam and Thailand are successfully rolling out opiod

substitution therapy, drug treatment in India, is clearly, off the mark.

Drug Dependence Treatment – nobody’s responsibility

The

abject neglect of drug treatment delivery is not surprising; in most states

confusion prevails over whether drug dependence is a subject matter of social

welfare or the health department. Worse still, the criminalization of drug

consumption, makes it a law enforcement priority. Despite the involvement of many

government agencies such as NISD, NCB, MoHFW, drug treatment is nobody’s responsibility.

This is apparent from the absence of data

on the extent of drug dependence, which is the very basis for planning,

budgeting and implementing treatment programmes. Neither does the Government

monitor services, provide follow up and assess relapse. This lack of

accountability reflects in the State’s failure to respond to drug

users’ health and rights.

Universally,

drug dependence has come to be accepted as a matter of health, requiring a multi disciplinary approach.

The newly developed “Principles of

Drug Dependence Treatment” by the World Health Organisation

and the United Nations Office on Drugs and Crime[4]

articulate common, minimum standards for managing drug dependence. The

document provides a benchmark for the MoSJE and MoHFW to review their

programmes and undertake much needed reforms.

Towards this end, we

urge the MoSJE and MoHFW to convene a

joint meeting with NGOs, medical and health providers, drug policy experts and above

all, people using drugs to discuss these concerns. As civil

society, we assure you of our support in developing human rights compliant and

evidence based interventions for drug dependence.

Yours truly,

Luke Samson

Executive

Director

SHARAN –

Society for Service to Urban Poverty

F6/8A, Vasant

Vihar, New Delhi

110057

Phone:011-26154483

Anand Grover

Project Director

Lawyers

Collective HIV/AIDS Unit

63/2, Masjid Road,

Jungpura, New Delhi

110014 Phone: 011-24377101/02

Tripti Tandon

Lawyers Collective HIV/AIDS Unit

www.lawyerscillective.org

[1]

http://www.thehindu.com/2008/08/25/stories/2008082555340800.htm

[2]

http://www.tribuneindia.com/2007/20070512/jal.htm#1

[3]

http://www.tribuneindia.com/2007/20070120/ldh1.htm#1

[4]

http://www.who.int/substance_abuse/publications/principles_drug_dependence_treatment.pdf