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Drug rehabs - Rising Drug Use in India

11/19/2006

Drug Rehabilitation

In a recent press article from The Indian Express it is reported that the HIV problem afflicting much of the Western world is making itself felt in India, as well. The large number of Indians suffering from HIV due to intravenous drug use has led UNAIDS) The Joint United Nations Programme on HIV/AIDS) to suggest the use of methadone to combat the problem.

Methadone, originally developed by German scientists in the 1940's as an opiate-based painkiller, has long been one of the primary treatments in "replacement" therapy for heroin addicts. The alleged benefits of substituting methadone for heroin include modified behavior (the addict becomes more engaged in their lives and less apathetic), reduced criminality and reduced risk of needle infection.

Less well known are the risks involved in methadone use. Most people do not realize that methadone is addictive itself and recent years have seen a marked increase in street sales and abuse of methadone. Individuals who abuse methadone risk becoming addicted to it, and methadone addicts often report that it is more difficult to withdraw from than heroin itself. Withdrawal can involve excruciating muscle and bone pain, severe respiratory problems, nausea and vomiting, tachycardia, intestinal spasms, involuntary kicking and twitching movements as well as anxiety and depression, combined with suicidal thoughts. Withdrawal involves a longer length of time than does heroin withdrawal, according to addict reports.

Overdosing on methadone poses an additional risk. According to a report by the National Drug Intelligence Center, the Drug Abuse Warning Network reported that methadone was involved in 10,725 emergency department visits in 2001, a 37% increase from the previous year.

It is difficult to estimate the extent of methadone abuse in the United States because most data sources that quantify drug abuse combine methadone with other narcotics. Information provided by the Treatment Episode Data Set does reveal that the number of individuals who were treated for abuse of "other opiates" (a category that includes methadone) increased dramatically from 28,235 in 2000 to 36,265 in 2001. These individuals were predominantly Caucasian and were nearly evenly split between males and females. They also represented a variety of age groups. The NDIC also states that methadone abuse among high school students is a concern. Nearly 1% of high school seniors in the U.S. abused the drug at least once in their lifetime, according to the University of Michigan's Monitoring the Future Survey.

Some of the problems associated with the use of methadone as a heroin alternative include the situation where addicts are sometimes given a week's or even a month’s worth at a time and then selling much of it on the black market. School children have been found in possession of prescription methadone in Great Britain. In 1996, more than twice as many people died in the UK from methadone-related causes than died from taking heroin.

In Canada, a report by Correctional Service of Canada states that withdrawal from heroin is a two-stage process: withdrawal from heroin (to methadone), and when stabilized on methadone, withdrawal from it. It is this part (withdrawal from methadone) that has proven problematic, per the report. In addition, while heroin relapse rates exceed 90%, relapse rates from methadone are only very slightly less, at 85%.

Methadone has been accused of acting only as a palliative to the problem of heroin addiction and simply prolongs drug addiction within an individual. Prescription of a substitute for heroin offers no incentive to abstain from using drugs and many addicts simply use it as a free “top up” to their existing illicit drug consumption.

In a country as poor as India, to believe that free prescription methadone will not be considered a valuable commodity on the black market is foolish. There is no reason to believe that methadone abuse will not occur in the same pattern seen in the other countries currently using it as a treatment for heroin dependency. It is only substituting one strong, dependency-creating drug for another. Although efforts may be made to control its distribution and use, these efforts are not perfect and addicts are adept at finding ways to abuse the system. It's inevitable.

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