Alarmed over the rising number of injecting drug users, the government has decided to increase the number of Opioid Substitution Therapy (OST) centres in the country from the present 52 to 300 by the end of this year.
Of the existing OST centres spread across 14 States, Manipur and Nagaland alone have 29 where around 3,000 injecting drug users are availing themselves of the services. OST involves replacing a drug user’s primary drug of use (opioid), for example heroin or spasmoproxivon, with a medically safe drug in a safer mode of administration under medical supervision.
“Injecting drug use is no longer confined to the Northeast States of Manipur and Nagaland. We have hotspots of drug use in Punjab, Orissa, Andhra Pradesh and Bihar,” said Lov Verma, Secretary, Department of AIDS Control, speaking at the two-day national dissemination workshop here.
The two-day workshop is being organised by Emmanuel Hospital Association to share harm reduction initiatives and experiences among People Who Inject Drugs (PWID) implemented by Project ORCHID in Manipur and Nagaland since October 2004.
HIV among injecting drug users remains a great challenge in the Northeast, with Manipur still having the highest HIV prevalence among PWID. “There are similar challenges emerging in other States which need to be emphasised,” added Mr. Verma. Pointing out the difficulty in scaling up OST he urged community-based groups and networks in Manipur and Nagaland to put pressure on the State governments so that the scale-up process is hastened.
Zodingpui, a female injecting drug user from Churachandpur district in Manipur who took part in the workshop, has benefited from the OST initiative in Manipur.
A Peer Educator in Shalom, one of the NGOs implementing OST in Manipur, Zodingpui started doing drugs in 1983 during a college sports event. Still under OST, she had experienced a cycle of treatment and relapse in the past.
Relapse is more common among female drug users. “Once the line is crossed [for women using drugs], they are not accepted in the society even when she is not doing drugs any more. Reintegration is easier in case of male drug user. Due to this factor, there is very low motivation among them to give up drugs,” Puii, Director Shalom, Manipur. Around 180 Female Injecting Drug Users are currently accessing harm reduction services from Shalom.
Representing the Indian Drug Users’ Forum, Abou Mere urged the government and other stakeholders to look into the issue of drug overdose and Hepatitis-C, causes of unnecessary deaths every year.
Started in October 2004, the Project ORCHID harm reduction initiative focuses on needle and syringe exchange for injecting drug users, condom promotion, service outreach in geographically difficult hill districts through outreach workers and secondary distributors, OST, nurse-led treatment of sexually transmitted infections, drug overdose management, and preventing and managing crisis.
