“Due to the consumption of heroin, I’m Hepatitis C Virus positive and if I wouldn’t stop I would die sooner.”
A young boy seems restless standing in a queue from past hour. He tries to merge with other people so that he can be the first to reach the cabin and seek appointment. He’s youthful but his face looks tired, gaunt and older. The eyes are pale and dark circles have layered round his eyes. His black hair has turned grey.
He stands last on the row and tries to convince others so he can jump the queue. Eventually, after many requests he’s behind few people and has made his way to reach quickly to the doctor’s cabin. There’re old women in front of him sitting on a bench as he has passes many people. He volunteers his space with a man and runs to the garden anxiously and ignites a cigarette.
“I need to see the doctor,” he talks to himself while smoking. “This pain is irresistible.”
He comes back and sees his space being taken. While the person tries to set a conversation, he starts an altercation. To avoid the heated conversation, the person gives him his space. The young man is the second one to enter the doctor’s cabin.
Shoaib Hilal greets the doctor guiding him for months. They both talk like good friends. “So how’s your life going? Do you go to work now?” asks the doctor.
But Shoaib doesn’t answer his question and seems frustrated. He has severe pain in his liver and requests him to increase his medical dose.
The doctor asks him to report his dairy on the nearby counter and denies to increase the dose and explains him that his liver is not in a condition to take high dose medicine. Shoaib shortly leaves the cabin.
In his twenties, Shoaib is a school dropout and has been heroin addict from past three years.
“I started from sniff on a chocolate paper and ended up injecting,” he says. “The reason for taking drugs came from a heart break and separation from my girlfriend.”
For the time, he thought of enjoying drugs and escaping the trauma but it eventually led him to self-destruction. “But these doctors have saved my life,” he says. “They are angels.”
In Srinagar, Dr. Yasir Rather is among well-known psychiatrists, who daily sees around 60 drug addiction and depression patients.
Heading the Institute of Mental Health and Neurosciences Kashmir (IMHANS), Dr. Yasir believes the turmoil has changed the mental state of society.
“The pervasive use of drugs is a reflection of the strife,” he says. “This has made people with mental issues like depression, anxiety and PTSD vulnerable to addiction.”
Calling drug addiction as a mental disease, the medico says the substance abuse has many implications—affecting mostly family dynamics, social life and overall the society.
“The youngsters mostly consume drugs from the peer-pressures of their internal conflict,” Dr Yasir continues. “Most often the addictions develop from a person’s family problems, childhood trauma, sexual abuse, physical abuse, bullying and some common factors of society. The easy availability and the illicit trafficking of hard core substances are equally increasing the addiction.”
From a biological point of view, the doctor says, as a person starts using drugs it changes the neurochemistry of the brain and the person slowly becomes dependent. “In medical term,” he says, “we call it substance use disorder.”
From the records of 2016 and 2017, 490 patients were registered in the OPD of the IMHANS, most of whom were the witness of the civilian killings and uprisings in Kashmir. But from April 2018 to March 2019, the number of such patients saw a sudden increase to 51200 patients.
The 2016 records say four or five in every hundred drug addicts used heroin and came to the rehabilitation centres for treatment. But in the corresponding period April 2018 to March 2019, 80 per cent of the patients at the medical facility were using heroin.
The research led by Dr. Yasir found 50 per cent of the patients as minors and educated. So how do they counsel such juvenile addicts?
“The first thing we develop an emotional bond with a patient, and be empathetic,” Dr. Yasir says.
“The development of this emotion among these patients brings them close in the counselling sessions. We try to build a reputation with the patients who have lost their self-esteem due to the negligence of society. This helps us to counsel them in our different sessions which undergo several stages.”
The procedure includes detoxification where the addict’s parents are also involved. The patients are integrated with their parents before the treatment. Later the parents are being psycho-educated in the rehabilitation centres and admitted along with the patients. The families later play a role in pushing their wards to take part in counsel sessions and follow-ups.
According to the National Institute on Drug Abuse, between 40 and 60 per cent of people recovering from drug addiction relapse. These recurrence rates are similar to those of other chronic diseases, including Type 1 diabetes and hypertension.
“Relapse is the part and parcel of this illness,” Dr. Yasir says. “Among 100 patients, 60 percent patients relapse back to the drugs. We never get disheartened. Our doors are always open for our patients.”
The drugs like heroin has got many complications like Hepatitis C, Hepatitis B, and in some cases HIV Aids which have been recorded in many of the patients who come have come to the medical facility in Srinagar’s Rainawari for treatment.
Meanwhile, recalling his days of addiction, Shoaib says he used to sniff three grams of heroin per day and had lost around Rs 9 lakh along with a motor vehicle in buying the substance.
The craving for heroin blinded Shoaib to the extent that he became a robber and stole from his own family. “I didn’t even spare my mother’s gold ornaments and sometimes when I ran short of money, I robbed from my grandfather,” he recalls.
“Once when my family got anxious with my activities, they complained to police who brought me to rehabilitation centre in handcuffs but each time I managed to run. This is so dangerous that kills your power to think and one only thinks of heroin.”
To make a youth addict, the dealers first sell at low prices and within the increase of consumption they increased the price, Shoaib says. “The one who becomes addict buys at any cost. Even if one gram of heroin costs Rs 10 thousand, the addict will buy it because its cravenness doesn’t let you rest at peace.”
One day, Shoaib says, he put a knife on his father’s neck for money to buy heroin and when his kin stopped giving him money, he became a supplier and began to sell heroin in his locality.
“The reason of quitting this heroin addiction wasn’t a pressure but from medical reasons,” he says. “Due to the consumption of heroin, I’m Hepatitis C Virus positive and if I wouldn’t stop I would die sooner.”