COVID-19 lockdown has pushed the Himachal Pradesh government’s agenda against the increasing drug abuse to the backburner for the time being and those who feel the pinch of this situation the most are none other than substance users themselves.

While the lockdown has checked the illegal supply chain, the substance users (mostly opioid users), who fell in the trap in past, and had withdrawal or relapse during lockdown since 24 March, are facing tough times want of easy access to medical, counselling or rehabilitation facility.

Field reports said over 60 private rehabilitation centres for drug addicts in HP are reportedly getting calls from families of substance users in withdrawal/relapse on daily basis, but they are unable to take fresh admissions in view of COVID-19 scare, the ‘social distancing’ norm and unavailability of focused drug-deaddiction counselling, medication and treatment in government hospitals in the event of the lockdown.

More so, out of the two Integrated Rehabilitation Centre for Addicts under Social Justice and Empowerment Department, the one in Kullu has retained six persons for treatment to be extra careful in COVID-19 crisis, and the other one in Shimla is almost shut.

“We get so many calls from people who are in withdrawal or relapse every day. We simply refuse. We can’t take the risk and admit people for drug deaddiction at this moment due to COVID-19 crisis and are just concentrating on the ones already in our Centre for overall safety. We really don’t know how to address this issue in COVID-19 lockdown,” said Vishal, who runs a Rehabilitation Centre for Addicts in Shimla district.

“The government should come out with guidelines on the issue of drug de-addiction in lockdown, lest it also turns out to be a big problem later,” said a volunteer with a Rehabilitation Centre in Kullu, Panki Sood said.

Most private rehabilitation centres in Himachal Pradesh are usually dependent on government set up for medication for de-addiction. “We are finding it difficult to refer to government hospital even for those admitted in our rehab centre in the curfew, then how can we accommodate others?” said a volunteer with one such Centre.

The latest survey on substance use in India (2018-19) shows that Himachal Pradesh ranks 7th in the country in cannabis users (3.20 per cent against the national average of 2.8 per cent), 11th in opioids (5.66 per cent users against the national average of 2.06 per cent) and tenth in sedative users (2.07 per cent against the national average of 1.08 per cent).

An alarming statistics is that HP has a high prevalence of inhalant users (fourth in the country) at 3.38 per cent against the national average of 0.70 per cent. Most of these users are adolescents.

Chief Executive Officer of the State Mental Health Authority, Dr Sanjay Pathak, however, said the withdrawal symptoms in opioid users is painful and annoying, while that in cannabis users is not that problematic. “It is a medical emergency and such patients are to be taken to the emergency of a hospital immediately.”

The state government’s exercise to start OPD (Out Patient Department) services for addiction treatment in some chosen health institutions, including Community Health Centres (CHCs), last year after training at Gunjan organisation, Dharamshala, which is Regional Resource and Training Centre (RRTC) of Union Ministry of Social Justice and Empowerment too has not done very well on the ground so far.

Noted psychiatrist with National Drug Dependence Treatment Centre NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, Dr Atul Ambekar said, “COVID-19 and the lockdown is an extraordinary situation and we have to deal with it. We can’t do overcrowding in deaddiction centres at the moment. They should be handled in OPDs in bigger hospitals.”