Drug problems are still widespread in Punjab

The lost generation of the Punjab

Substance abuse is widespread in the Indian state of Punjab. In the past, opium was mainly smoked and chewed. Today more and more addicts are injecting synthetic drugs and heroin intravenously. The corrupt state deliberately looks the other way.

Sita has been a domestic servant since her husband died six months ago. Although she cleans and washes from early in the morning until late in the evening, with 1200 rupees a month (20 francs) she is nowhere near enough to support her four children. “We only eat rice and lentils, and as little of it as possible,” says the 40-year-old. Her family of five lives in a tiny room in the Maqpoolpura slum in Amritsar in the north-west Indian state of Punjab. Apart from a tattered mattress, some cooking utensils and an ancient television, Sita has nothing. Before the death of her husband, she spent a lot of money on his treatment and not only had to sell her jewelry, but also got into debt.

Desperate widows

A picture of the deceased hangs on the wall above the mattress. With a dashing quiff and a brightly colored tie, he looks down at his family with a smile. But appearances are deceptive. Sita and the children had little reason to laugh in recent years. The 45-year-old day laborer was addicted to drugs and spent a large part of his income on intoxicants. He was also often aggressive. "Drugs destroy families," says Sita and can no longer hold back tears. «But what should I have done? It wasn't until after getting married that I realized he was addicted. He kept promising to stop, but never made it. "

Sita is not an isolated incident. "Most men in Maqboolpura are addicted to drugs," the young widow notes, dejectedly. She would like to talk to her neighbors about her worries. But the subject of drug addiction is taboo in the neighborhood because it would be an insult to husbands, she says. This morning we hear many similarly sad life stories in Maqboolpura. Fifty-year-old Gita and her sister-in-law Sunita, who is ten years her junior, both lost their husbands last month. The two brothers likely died from an overdose. To keep up appearances, however, the family blames high blood pressure. Gita and Sunita fare better than Sita, who is on her own, which can be very tough for a woman in conservative Indian society. The sisters-in-law live in a large family and are currently supported by their relatives. But they too do not know how to feed their children in the future.

The majority of the 30,000 or so residents of Maqboolpura work as day laborers, factory workers or domestic workers. Almost all families here live below the poverty line. Many children do not go to school or leave it after a few years in order to earn some money. According to social worker Ajit Singh, the situation is dire. The young people had no prospects and could easily get on the wrong track. Many would start taking drugs as teenagers and often also dealing with them in order to finance their addiction. The crime rate in the neighborhood is high, and mafia gangs are gaining increasing influence.

More harmful substances

“Maqboolpura is more affected than other areas, but drug addiction is a serious problem everywhere in Punjab,” explains Ranvinder Singh Sandhu, a retired sociology professor from Amritsar who has dealt intensively with the subject. Like everyone else he spoke to, he emphasized that drug addiction was not a new phenomenon. Alcohol and opiates have been consumed excessively in Punjab for decades. In recent years, drug use has increased significantly and more and more dangerous drugs are being consumed, he says. While opium was traditionally mainly smoked and chewed, synthetic drugs and prescription drugs are now increasingly injected intravenously.

Addiction occurs in all walks of life, but poor families are hardest hit. The majority of addicts are young men from disadvantaged castes. Sandhu suspects that half of the Punjab population today uses intoxicants. How many of them do this occasionally and how many are really addicted is difficult to say, however.

The psychiatrist P. D. Garg, who runs a rehab clinic at the Guru Nanak Hospital in Amritsar, is also convinced that the proportion of addicts has risen sharply in recent years. In addition, more and more men were smoking, sniffing and injecting heroin, which is more harmful to the body and has a higher potential for dependence than opium. Today heroin addicts in particular come to his clinic, the doctor notes.

The drugs people use depend on their social status. In Maqboolpura it is mainly cheap synthetic drugs that are consumed, while more affluent areas tend to consume heroin. According to Garg, both addictive substances are increasingly being injected intravenously. Half of the junkies who injected the drugs are now HIV-positive. His rehab clinic has 50 beds and is the only such institution in Punjab. Most of the 21 district hospitals have some beds for drug addicts, but there are no other specialized clinics. In theory, Garg's rehab clinic is government funded. The government made the building available and pays the wages of the nursing staff. However, patients have to pay for medication and therapy themselves. According to the chief physician, this is problematic because treatment is out of the question for many. Garg says that he urgently needs more financial support so that he can also help less well-off patients.

In his clinic, patients are given buprenorphine as a substitute, which has a similar effect to methadone, which is widely used in the West, but is significantly cheaper. The patients remain inpatients for around ten days. After that, they will continue to receive buprenorphine on an outpatient basis for at least one year and receive psychological support. A ten-day stay costs 3,000 rupees (50 francs). The families in Maqboolpura could never afford such treatment. Quite apart from that, they have no idea about possible treatments. Nobody we speak to this morning has ever heard of a rehab clinic.

35-year-old businessman Sandeep Sharma is currently in rehab at Guru Nanak Hospital. He started sniffing heroin as a schoolboy many years ago. At first he felt better with drugs, he says, but gradually the addiction became a problem. His sunken face and dark circles under the eyes speak for themselves. Sandeep is sweating profusely and his hands are shaking as he talks to us in the barren hospital room. His mother is sitting next to his bunk. Doctor Garg only accepts patients who come with relatives. Social control is very important, says the doctor. This is the only way to ensure that the addicts in the clinic do not continue to use drugs.

Her son has changed a lot in recent years, says Sandeep's mother. He got moody and stole money from her. Because nobody talks about addiction, she did not understand what was going on with him for a long time. "For the first time we are getting professional help, and I am optimistic that my son will make it this time," says the 50-year-old housewife. Like many others, in desperation, she first turned to one of the private rehab centers that have mushroomed in Punjab in recent years. Sandeep said they would have paid 15,000 rupees (CHF 250) a month there. It was of no use whatsoever. The addicts were treated and beaten like criminals in the center. They were given pain medication, otherwise they would not have had any medical care, let alone psychological care. Most of the patients relapsed afterwards. Unprofessional clinics are a big problem, confirms Doctor Garg. Because the state is doing nothing, many have sought help from quacks who use questionable methods and trample on the dignity of patients.

Social stigma

The main problem is the social stigma associated with addiction in India, explains sociologist Sandhu. Widespread drug addiction is a social problem, but society dismisses it as an individual or family problem. Addicts would be seen as guilty, not victims. Affected families tried to hide drug addiction. Unaffected people didn't care. The state, on the other hand, is deliberately looking the other way, criticizes the drug expert.

The medical officer in Amritsar, Yash Mitra, vehemently denies the latter. The regional government takes the problem very seriously, claims the district's senior medical officer. But he cannot tell us approximately how many drug addicts there are in Amritsar, nor how many beds are available in state hospitals for such patients. A survey will soon be carried out to determine the exact number of addicts, he explains evasively. After that, everyone would be sent to rehab.

But how does he intend to handle this without the appropriate clinics? Withdrawal does not necessarily have to take place as an inpatient, but can also be done at home if it is monitored by medical staff, says Mitra. Of course, there is also a lack of doctors and trained nurses in the Punjab. Drug addiction is psychiatric in India, and there are now just a dozen psychiatrists for every 30 million people in the entire state, according to Garg.

An alarming report in an Indian news magazine and a statement by Rahul Gandhi, the hopefuls of the ruling Congress party, recently drew public attention to the issue. Gandhi claimed that 70 percent of young people in Punjab were addicted to drugs (he misinterpreted the results of a study by Professor Sandhu that said 70 percent of addicts in the state were between 15 and 35 years old). In the heated debate that followed, the central government and the opposition government of Punjab blamed each other for the situation. After a short time, however, political interest in the topic died out again. Neither the central state nor the regional governments have ever seriously tried to find a solution to the problem, says the sociologist Sandhu with resignation.

Amritsar is just under 30 kilometers from the Pakistani border. Opium and heroin are smuggled in large quantities from Afghanistan via Pakistan to India and can be obtained here at ridiculous prices. The archenemy Pakistan is responsible for the drug problem in Punjab, says the police chief of the border district Taran Taran, Kamaljit Singh Dhillon. The Pakistani secret service used to distribute weapons to young people in order to split the Punjab. Today he tries to undermine morale with drugs.

The police officer claims that all drugs come from the neighboring country. However, experts like Professor Sandhu point out that many of the intoxicants consumed in Punjab came from India itself. In the neighboring state of Rajasthan, for example, opium is legally grown for medical purposes, which is also smuggled into the Punjab, among other things. Synthetic drugs and prescription drugs, on the other hand, are easy to get in local pharmacies.

"The sale of pharmaceuticals is theoretically regulated, but the regulations are hardly enforced," explains a journalist in Amritsar, who does not want to be named. “Nobody does anything because a lot of money is made selling drugs, as well as alcohol, and corrupt politicians, officials and police are involved in the business. The smuggling of heroin across the Pakistani border is even more lucrative and is certainly not being combated. "

Trade is flourishing

The police officer Kamaljit Singh Dhillon vehemently denies this. In the past six months, his men arrested 461 people and confiscated around 20 kilograms of heroin and over 200,000 pills, he explains. But this was obviously just a drop in the bucket, and the drug trade continues to flourish. Ajit Singh also blames corruption for the lax behavior of the state apparatus. Whichever party is in power in Punjab, none of them do anything against the lucrative drug business, says the social worker. "Even worse, political parties even distribute synthetic drugs themselves in the election campaign to catch votes, and large landowners have always given their workers opium so that they can toil harder and longer."

In addition to the availability of cheap intoxicants and corruption, the sociologist Sandhu primarily blames poverty and unemployment for the widespread drug use in Punjab. In many other Indian constituent states, of course, the same conditions are met. So why is the Punjab so badly affected? The state is more prone to drug abuse than others for cultural reasons, explains Sandhu. In many regions of India, drinking alcohol in public is forbidden or frowned upon. In Punjab, on the other hand, it is widely accepted, and even expected of a "real man". Chauvinism and peer pressure ensure that many men here drink excessively from a young age, explains the sociologist. The inhibition threshold for the consumption of other addictive substances is correspondingly much lower than elsewhere.

Social worker Singh complains that drug addiction has struck the Punjab like a cancer. It is high time that society dealt with the problem. Only with information campaigns and tough crackdown on dealers could the wheel be turned around.