Kashmir facing severe opioid crisis

Srinagar, Nov 16: Kashmir is facing a severe opioid crisis with over 52,404 individuals struggling with opioid dependence, accounting for a staggering 2.23 percent of the population.
The alarming prevalence rate, coupled with the high number of Injection Drug Users (IDUs) estimated at 32,097, paints a grim picture of the region's battle against substance abuse.

According to official figures, over the past two years alone, the Drug De-addiction Center at SMHS Hospital has received more than 5000 new cases.
Between March 2021 and March 2023, the Drug De-addiction Center at SMHS Hospital registered a total of 5159 new cases in the Outpatient Department (OPD).
Among the new cases, the majority were heroin users, accounting for 36,870 individuals, which is approximately 79 percent of intravenous drug users.

As per the doctors at IMHANS-K, opioids are the most common psychoactive substance used in every district of Kashmir with heroin being the predominant opioid.
Fazle R Bhat, DM, Department of Psychiatry, Institute of Mental Health and Neuroscience (IMHANS) Kashmir told Greater Kashmir that opioid dependence poses a significant burden on the economy as the average monthly expenditure on consumption of heroin by a user is Rs 88,183.58.

He said that many different reasons for the rising substance abuse are decades of war and psychosocial trauma which worsen the mental health problems.
“A lot of people who have mental health problems use drugs or alcohol to deal with their problems. Unlike the rest of India, Kashmiris generally don't prefer alcohol. They found it easier to find comfort in opioids. Kashmir has the availability of pain drugs (codeine-containing cough syrups and tramadol). Since the early 2000s, all of these patients switched to strong painkillers like heroin, especially after 2016," Dr Bhat said.

Doctors at IMHANS said that regular visits to primary care providers, emergency departments, and outpatient clinics were frequently necessary for opioid users.
“The demand for healthcare services is propelled by concerns including pain management complications associated with opioid use, including fatal overdoses, Hepatitis C, and skin ulcers. Overdoses of opioids and complications associated with them are substantial causes of visits to emergency departments and hospitalisations. Hepatitis C is present in nearly 80 percent of intravenous drug users, posing a significant obstacle. Mental health issues like depression and suicidal attempts in this population are other challenges,” they said.

The doctors said that the measures for opioid use including supply reduction, demand reduction, and harm reduction methods are necessary to curb the drug menace.
“As part of the supply reduction strategy, drug traffickers and peddlers must be hardened. Demand reduction: public awareness campaigns that educate the public about the dangers of opioid use, the indicators of addiction, and the resources available to them via a variety of media channels,” they said.

Dr Yasir Hassan Rather, a professor at IMHANS, told Greater Kashmir that one more very pertinent yet ignored factor was the influence of social media.
“A decade back, social media was a new thing, used for chatting purposes but in these years it has become the most powerful tool of awareness, communication and influence. Film stars, social media influences, and Instagram reels that glamourise illicit drugs become contributing factors to creating the idea of consuming heroin. It’s a seed sown in the brains of youngsters and then the peer pressure and easy availability act like water and fertiliser for it,” he said.

Dr Rather said that in the past year due to the active involvement of the government, NCORD initiatives have helped to bring down the easy availability of heroin in Kashmir and it's getting reflected in the decrease of new cases seen in the OPDs.