While Punjab is waging an all-out war against drugs, it faces a Herculean task in curbing substance abuse by women, who have often been overlooked in the discourse. Against this backdrop, a recent video showing a young, inebriated woman by a roadside bench in Kapurthala has caught the glare of public eye. The married 22-year-old, addicted to heroin, had been undergoing treatment at the State’s only government-run women’s de-addiction centre in Kapurthala.
In the video, which went viral on social media, the young woman is heard saying she gets her chitta (heroin) from the nearby Mehtabgarh village, where drug peddlers can frequently be found roaming about. The police swung into action and had her re-admitted to the de-addiction centre. Sandeep Bhola, Deputy Medical Commissioner and consultant psychiatrist at the centre, told The Hindu that the woman was receiving treatment. He said the lack of outreach staff was proving to be a major obstacle in treating women addicts.
In another such case, in a video that went viral on social media last month, a young woman, allegedly under the influence of narcotic substances, is seen standing immobile on a road, swaying and attempting to move, in the Maqboolpura locality of Amritsar. Commissioner of Police (Amritsar), Arun Pal Singh, said that Maqboolpura is a “hot spot” for drugs and the police regularly take up operations against peddlers.
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“We have waged a war against drugs. The number of registered cases and recoveries in the past few months has been much more than in previous periods. But yes, there’s a problem till such time there’s an addict and the market. We are soon launching an awareness drive and will work on rehabilitation of drug addicts as well,” Mr. Singh said. He added that the girl in the video was later admitted to a de-addiction centre by the local Aam Aadmi Party (AAP) MLA, Jeevan Jyot Kaur.
Data on women substance users is scanty and the number of de-addiction centres for women are woefully short. Punjab has 32 government-run de-addiction centres but the only centre run exclusively for women in Kapurthala was opened in 2017. Even this facility, situated inside a district hospital, shows signs of the government’s indifference, sources said.
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According to the Punjab Opioid Dependence Survey (PODS) conducted in 2014-15, approximately 2.3 lakh persons in the State are dependent on opioids, and approximately 8.6 lakhs are users. The PODS showed that 1% of the opioid-using population is women, which adds up to about 8,000-10,000 women. The survey led to the setting up of the Kapurthala facility for women.
“Unfortunately, there were not many women availing the service when the centre was started in 2017. There are several reasons for this, including social stigma. In 2019, a pilot project titled ‘Comprehensive Health and Rights-based Response for Women who Use Drugs’, sponsored by the Global Fund and coordinated by the India HIV-AIDS Alliance was rolled out in Kapurthala. This pilot project ran successfully with the help of outreach staff and we were able to achieve the desired targets. We had three outreach workers who were from the drug-using community itself. They were local residents and were well aware of many drug addicts in the surrounding areas, and hence they proved to be of great help in bringing female patients to the de-addiction centre,” Dr. Bhola said.
Outreach workers help in extending services to drug users — bringing them to the hospital, securing their medical check-ups, connecting them to the de-addiction centre, if required. Dr. Bhola said the results were encouraging. “As many as 241 female patients were registered with us, but we hit a roadblock when funding for the project ended in 2020. Since 2020, the number of female patients has dropped to 35. Ideally, the State government should have adopted and taken over the project but despite requests, nothing concrete has come out. We urge the government to retain the outreach staff members. The patients have faith in them. They are a key link to bringing patients from their home to the centre and taking them back,” he said.
“The incident involving the 22-year-old girl is a typical example of the ‘missing link’ problem arising from the absence of outreach workers. They would bring this girl to the centre but when the project was discontinued in 2020, the girl stopped visiting the centre and the result is for all of us to see,” he said.
“According to the ‘Magnitude of Substance Use in India-2019’ [report], there are around 40 lakh drug users in Punjab, which includes alcohol, cannabis etc. Different national and international surveys suggest that 2% to 5% of this population could be females. If we go by these estimates, there could around 80,000 women drug users in Punjab,” Dr. Bhola said.
The exclusion of women from the discourse around substance use and substance use disorder (SUD) impacts a range of aspects — from epidemiology to treatment-related services. There’s evidence to suggest that the issues pertaining to women using psychoactive substances are quite different from those of men and it’s imperative that these concerns should be addressed separately within the broader rubric of SUD, say experts.