The last three decades of conflict have seen decadence as political instability plagues the society in J&K. People are upfront against manifold problems. The conflict has had huge human costs. Life has lost its value and we are surviving mechanically. This low cost conflict has consumed our generations and still there is no hope of any resolution. Kashmir conflict has become so convoluted that the politicians now fancy China acting as a savior. Economic development is absent, political situation is vague and socially we are a rout. Where to start? How to start? Every idea of ameliorating and salvaging from this chaotic situation vaporizes as volatile camphor-a good feeling that just doesn’t last long. I sound cynical but over the years it got ingrained in us.
Health is wealth, a state of mental well being. An acute craving for this ‘feeling good’ can become an addictive habit for which we seek various ways and means. Technically addiction is of two types viz; behavioral addiction and substance addiction. The former is an inability to stop indulging in activities such as excessive eating, working, gambling etc. resulting in various lifestyle diseases, stressful life and even economic instability. While substance addiction is an inability to stop consuming a drug, a chemical, or any substance which can cause both psychological and physical harm besides pushing the user towards criminality. The substances include the psychotropic drugs, opioids like codeine, tobacco and alcohol.
However, there is a difference between addiction and misuse which results from the incorrect, excessive or non-therapeutic use of body and mind altering substances such as painkillers. People who misuse such substances may or may not become addicts either due to the side effects of such usage or by discontinuing the same. However, addicted persons will continue such misuse inspite of the harmful effects.
These psychotropic substances produce an intense sensation by the release of dopamine in the neuron cells of the brain whereby a person feels euphoria stimulating pleasure experiences. Hallucinations and this feel good sensation acts as mood enhancer, makes a person more talkative, and gives a false feeling of confidence relieving stress or anxiety. Sometimes curiosity induces many a people to try these substances. Performance enhancers boost sports persons’ efficiency temporarily but can become addictive. The euphoria is but a momentary reflex of the brain that grips the user and addicts him/her to prolonged usage of the substance. Once addicted a chronic user becomes an abuser.
Substance abuse is said to have a two way relationship with ‘mental health’. Mental health issues such as loneliness, guilt, stress, anxiety and depression can push a person towards addiction. However, even prolonged use of therapeutic drugs can also cause addiction unless a person is discouraged by their side effects such as dizziness, vomiting or hangover from alcohol. Such an excessive use can cause psychosis. Other way round the continuous usage of these substances can lead to similar mental health issues.
Symptomatically a person who has become habitual seeks such substances uncontrollably. He/she becomes neglectful and loses interest in all kinds of activities; they are often irritable in relationships, become fearless, paranoid, secretive and have personality issues. Chronic addiction causes violent behavior and has damaging effects on health, loss of appetite to irregular coital activity. Parents should watch out for all these traits; strange friends and phone calls at odd hours.
The substances have a disastrous effect on the health of a person. Medicos opine that snorting which means taking in the cocaine through the nose can damage the nasal cartilage. Opiates can induce constipation which may result into chronic bowel gangrene and prove potentially fatal if a person does not receive treatment. Smoking met amphetamine causes severe form of dental decay known as ‘meth mouth’.
Tobacco use is also addiction and can cause a wide range of cancers. Injecting substances like cocaine and heroin can cause allergic reactions, skin and muscle damage. Various diseases like HIV and Hepatitis-C get transmitted by the use of non-sterilized or reused syringes. The brain system gets completely rewired and often co-ordination and balance is impaired leading to falls or accidents.
The sustained and addictive use of substances also spikes the blood pressure and heart rate, strains the heart and blood vessels increasing risk of heart attack and even death. In case of pregnancy in a female it can lead to congenital anomalies or even death of the fetus. An overdose by taking one or mixing substances such as opioids/painkillers, alcohol and cocaine together to get a more intense feeling of euphoria can result in seizures, cerebral hemorrhage and respiratory failure, lung trauma, bleeding from the nose, coma and death.
It has been observed that the opiate and heroin abusers who use injections to get a longer intense rush are more prone to suicide because as the effect wanes out the user has heightened dependency on the substance and becomes drug tolerant/resistant.
It is significant to note here that the body builders take mass increasing steroids and face high risk of addiction if not properly managed under expert dietician’s advice. Doctors who prescribe painkillers and anesthetic/tranquilizing drugs should make it a point to issue minimal such prescriptions. In Kashmir we have a habit of self medication which should be desisted from.
There is a two pronged strategy to treat the substance abusers viz; counseling and behavioral therapy by mental health experts and psychiatrists and substance specific medication to prevent the users from a relapse. A relapse means returning back to consuming drugs. Significantly there is no specific medication for drug de-addiction nor are any medical devices available to treat or gauge withdrawal symptoms a person undergoes as he/she forgoes the habit. Sometimes even withdrawal symptoms can be fatal. The patients need very personalized care and strict management.
In our parts talking about mental health, stress related issues or depression is a taboo which is a reflection of our cultural lag. Drug addiction is also just like any other illness. It is a brain disease and needs to be understood in a correct perspective rather than superstitiously which has been our traditional approach. The disease becomes serious and cannot be ignored.
Its treatment happens in phases: when the patient has to quit-a different set of medication is provided to help him control the craving and minimize the withdrawals; if the patient is having excessive withdrawal symptoms the family is psycho-educated for the same and also proper medication is given to control it. Drug rehabilitation centers also provide some kind of respite, they admit the patients for months altogether; the government hospitals have proper and adequate facilities both OPD/IPD services available that can be availed by such patients.
There has to be more awareness of psychotropic and narcotic drugs, their harmful consequences and how they can be overcome. De-addiction therapy necessarily involves the family of the addicts. They are the first line of support for their re-socialization. Necessarily, drug addiction involves criminal activity like theft, peddling, prostitution, etc. But these addicts need compassion and empathy from all members of the society more than any punishment; above all social acceptance and encouragement to become productive useful members again rather than shun and shame them which will result in their severe relapse and make their recovery impossible.
A deviant or a drug addict may have the will to revert back. The families need to rectify them rather than disowning them. They may emerge from the crisis with help but disowning makes them forever guilty and lonely even if surrounded by well wishers.
Drugs are a hideous mask to cover a demented personality, depression or behavioral deviancy, therefore needs to be talked about unrestricted and appropriate guidance can be sought from the specialist doctors. Counseling is a pre-requisite for any medical therapy.
It is a common proverb, ‘Curiosity killed the cat”. Therefore, overcome the instinct and desist from trying drugs even if in small quantity. The dose will grow and shorten your life. Refuse this kind of recreation which is but a momentary distraction.
Don’t be perfectionists because nobody is perfect. Children need to grow according to their times and parents need to evolve with them. But that surely doesn’t mean that values need to be compromised. No luxuries or gadgets can compensate for parental care and affection. The void remains there all through the life. Therefore, spend more time with your children, hold their hands; involve yourself in family activities to shrink that space created by loneliness and seclusion. Strong values and family bonds go a long way in deterring a person from using these destructive substances. Once an addict is not always an addict, they recover as they overcome the dependency. Addicts who have recovered can contribute significantly by counseling other addicts and their families.
Educate children and friends about the ill effects of their usage. Our social structure is in shambles, let’s start talking about it and doing our bit. Bit by bit we will put the ruins together. (An awareness IMPACT INITIATIVE by SPARK-The Peace Builders)
Shefan Jahan is an Advocate
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