Commonly abused drugs in States: Alcohol, tobacco, cough syrup containing codeine, cap spasamo-proxyvon (SO) - relipen, lobain, etc. SP is abused in oral and IV-injecting form, volatile solvents etc.

Causes of drug abuse:

1. Peer pressure group, 2. Experimentation, 3. Drug culture - traditional use of bhang, charas, ganja, pan, cigarettes etc, during local festivals, birth day celebrations, marriages, religious celebrations (like Christmas) etc. 4. Unemployment, frustration and others 5. Lotrogenic, 6. Insurgency: George Fernandes accused the centre in the early 1980s of sending/supplying intoxicated substances in the North East states as a means to reduce and control insurgency.

Anti-drug, anti-liquor and anti-HIV activities: Government agencies, NGOs, social, religious, youths, women (anti-liquor crusaders - Meira Paibis etc), community leaders, elected representatives and all sections of people have joined the campaign. Care support and rehabilitation : Nursing care, medical care, infection control practices, educating the affected persons, family members and the community as a whole, provision-nutrition, supplement for breast feeding of HIV+ babies, detoxification, pre-test and post-test, rehabilitation for orphans, widows for schooling, vocational training, support and linkage with the social welfare, etc for livelihood.

The first Reported Survey in Manipur carried out by the Regional Institute of Medical Sciences (previously known as Regional Medical College, Imphal) in 1984 quotes that there were 6 percent addicts in 1972 which rose to 23% in 1982 (it is confined to their Study group). Further there were 300/1305 (229/1000) outpatient addicts as against the National level of 6/1000. This specific study of 40 high schools in Churachandpur district, Manipur showed that there were 67% addicts among the students their ages varying from 10 to 15 years. 28% addicts in the same district among the students of two colleges, their ages varying from 15 - 25 years. Moreover 60 per 1000 government employees were found to be addicts. The State rate is the highest in the country. This trend was also recorded in Pakistan from negligible numbers in 1980 to 2 lakhs in 1982. Many precious budding lives have been sacrificed to the alter of this silent killer. Besides this, Manipur State has also surpassed the National Record in the field of liquor having sold out, consumed 98,432 liters in 1979 - 80 and in 1985 there were 60 licensed Foreign Liquor Shops, 38 being bagged by Imphal alone. Illicit distillation, liquor brewing has been high and alarming (Manipuri's Twin Vices - Indian Express, March 4, 1985) Delhi.

First Reported Survey of Drug Abuse in Ukhrul District: A glance of the Tangkhul Mayar Ngala Long-TMNL (Tangkhul Youth Council, Ukhrul) survey shows the number of addicts: 15 addicts in 1982-83, 242 in 1987, 3137 in 1992-93 and 3500 to 4000 in 1996-97. This clearly shows the trend of the alarming situation with special reference to drug abuse - and prohibition. In connection with drug abuse another ugly head in the form HIV/AIDS infection had played the worst. As on 30th Sept 2005, 1,28,176 blood samples were screened in Manipur out of which 20,744 were found to be HIV sero positive. In respect of district wise Ukhrul district has 1909 screened, 809 HIV+ with 43% sero-positive rate followed by Churachandpur district with 33% and Imphal by 21%.

Anti-Drug, Anti-Liquor and Anti-HIV/AIDS campaign in the North East States:

The NE States have been campaigning on war-footing to prevent, control and manage these dreaded diseases and the NGOs, social activists, communities, church leaders, Government department, agencies and others have been taking up several activities and measures in this respect. In course of such activities certain undesirable activities, elements have also been encountered.

The Sangai Express Imphal, dated 17th October 2005 under the caption “Anti-Drug Campaign" highlights this issue. Anti-drug and liquor campaign spearheaded by the powerful Young Mizo Association has reportedly claimed five lives since December 2004 and public outcry after the death of the last victim has been intensified. The protest from the human rights activists has also fallen on deaf ears. YMA activists continue to take law in their own hands and five people have been lynched, a plethora of people tonsured by the mob, a number of houses destroyed and many people were evicted.

Total prohibition was imposed in Mizoram on 20th February 1997 by then CM at the instance of the powerful church. Besides YMA activities, Mizo underground group called Mizo Tlangva (MTV) indulged in such activities leading to the death of one person and a number of abductions. There were hue and cry from several sections of the people and according to The Sangai Express Imphal, 18th October 2005 under the caption the 'Central YMA sorry for its action, the president deeply felt sorry for “some flaws” in the ongoing drug/alcohol war but denied the allegations that YMA has killed 4 persons in its crusade against drugs and liquor and challenged the accusers of producing the relevant documents to prove their claims.

The Morung Express Dimapur, dated 16th October 2005 gave the latest data of addicts for Dimapur district, Nagaland as follows; total number of drug users-10682, Number of IDUs 2958, Number of Street vulnerable children -934, number of sex workers/sexual partners of truckers - 216. Though this relates to Dimapur district only yet it gives some picture of drug abuse scenario in Nagaland. In a dramatic turn of events the total prohibition act is brewing up conflicts with liquor sellers resorting to violence as a counter mea-sure against women welfare Society, Jalukie, Nagaland which is spearheading implementation of the act. Liquor sellers have formed a union -Paupai Zausak Nkwa (PZN) which was condemned at an emergency meeting of churches and NGOs held on 14th October, 2005 at Jalukie for the formation and activities of PZN.

The Morung Express Dimapur, dated 16th October 2005, highlights the 3rd School watch Club Annual event 2005 organized by El Shaddai Resource Centre, Ukhrul (Manipur) under the theme “Beyond Edge-Hope” at Viewland Baptist Church Ukhrul to create awareness and positive attitude towards HIV/AIDS and drug abusers.

The Sangai Express Imphal, dated 17th October 2005 - Three SP addicts were shot in the legs by KYKL underground cadres at Kakching Turen Wangma and warned them not to use the tablet.

The Sangai Express Imphal, dated 16th October 2005 - Police embark on anti-AIDS mission. A.K Parashar, DGP, Manipur has said that preventive measures for HIV/AIDS infected patients would be taken up seriously. It may be mentioned here that such activities/measures have been carried out for the para and military forces. Assam Rifles had even advised its personnel even to carry condom to prevent HIV/AIDS for safer sex which was condemned by the Imphal valley underground groups terming it as encouragement and sexual abuse.

Drug abuse scenario in the North East States:

According to the Ministry of Social Welfare GoI, 1992 which covered survey of 33 cities and towns in India, the country has 2.25 million drug users with 70 thousand of heroin users, Manipur has around 40 thousand drug users with 20,000 IDUs, Nagaland 1500 IDUs and Mizoram 18,000 drug users with 2000 IDUs (Source: HIV/AIDS and You by Dr. Khomdon Singh, 2004).

The Outlook Magazine August 2005, states that about 75% of Phensedyl cough syrup manufactured in India were found to be smuggled in the North Eastern States and then to neighboring country Myanmar.

Medical ethics, patients, patients rights versus abuse and violations against drug addicts,

AIDS patients with special reference to the North East India:

The North Eastern States have been besieged with three health violated and related problems, namely

1. Drug addicts and HIV infected persons,

2. Insurgency leading to the death of innocent people in the cross-firing, in the course of paramilitary security forces operations besides the casualties on both sides of the paramilitary and civilians on one hand and on the other hand Undergrounds and militants,

3. Ethnic violence eg: the Naga-Kuki clashes, the Kuki-Zomi clashes in Manipur leading to the death of hundreds of innocent victims, thousands homeless and hundreds disabled and orphaned.

The North Eastern States have some peculiar picture, isolated situations different from the rest of the country in respect of topography, communication (road and communication, postal and telecommunication, social, economy, culture and tradition and health violated aspects etc, e.g. Manipur with a population of 23.89 lakhs (2001 census) has around 40000 addicts out of which 15,000-20,000 are IDUs.

The underground organizations have tried to stop the drugs abuse and HIV infection in Manipur through non-violence in the form of warnings, etc. However these strategies and methodologies stop upto certain extend the continuing drug abuse and trafficking situation in the State and as a last means they started killing the pedlars which was reported from Imphal and other districts of Manipur. Many addicts, HIV patients, substance abusers alcohol drinkers, have been physically abused, assaulted.

The State also kept the addicts and HIV patients in different jails of the State with inadequate medical facilities in the past as the State has no sufficient fund to meet the demands and expenses.

Very few Human Rights activities, health activists/professionals, NGOs, social workers, church leaders and other could raise their fingers against such injustice, denial and violation of rights of the addicts/HIV patients. The society also seems to give social sanction for such unscientific methods, styles and so-called reformations by remaining passive against such injustices.

Issues and Suggestions:

1. Experience and utilization of previous training

Trained and experienced persons/Mas/staff and others may be posted as far as practicable. This will help the staff working in the DDACs to update their knowledge and skill and less financial expenditure for fresh training of the concerned persons working in the field of substance use disorder/drug abuse and HIV/AIDS. In this connection six Mas, two other staff from Ukhrul district, Manipur were trained at AIIMS, Delhi. Unfortunately only 1 Medical Officer (the author himself is posted at DDAC Ukhrul). The posting of the trained Mas and staff in other districts of Manipur is more or less the same.

2. Difficulties encountered in Clinical Care.

Regular refresher course/updating on clinical care - counseling, detoxification, treatment and management is required. Hardly exclusive training on drug-abuse has been conducted though few topics are covered in HIV/AIDS program. Posting of minimal staff is required. At the DDAC Ukhrul there is no counselor, pharmacists, watchman etc.

3. Suggestions for additional topics for training -Abuse of SP injecting form/oral form, cough syrup containing codeine.

Abuse of solvents - dendrite, correcting fluids, paint thinner etc.
Drug abuse and medical, social, legal and religious ethics.
Drug abuse and Human Rights.
Drug Policy (e.g. On the line of State AIDS policy Manipur 1996).
Social Welfare Departments and other departments/agencies.
Rehabilitation facilities for orphans, widows and widowers and affected/infected persons.
Special employment generating project (ego 3% reserved on all India Civil Services for Handicap Persons).
Government actions/legal actions/concerned departments/agencies for actions against drug pedlars traffickers, ganja/poppy plant cultivators etc.
Awareness activity of the affected/infected persons, families and the communities.
Supply and demand.
Joint International actions against drug abuse/substance use disorders.

(Courtesy: The Sangai Express)