Zehru Nissa

 During past three years, 10,000 patients have sought help from Government Medical College Srinagar, for getting rid of drug addiction. According to Zehru Nissa, there is a constant rise in patients with psychiatric issues, resulting from substance abuse. In Kashmir, cannabis tops the list of substance abuse, followed by opium and related products. The reality is that there is absence of planned and concrete measures to plug supply of drugs, to create sensitisation and awareness among masses and to set right manpower shortage.



Alarming Rise:

“In past three years, as per data of Government Medical College (GMC) Srinagar, over 10,000 patients have sought help from doctors to get rid of drug addiction. Although these patients belong to all parts of Kashmir, a majority of them are from Srinagar, according to the doctors. The GMC runs the only de-addiction facility in hospital-setting in entire Kashmir. “The numbers may not reflect what we are witnessing here in this hospital. We are seeing a constant rise in patients with psychiatric issues resulting from substance abuse,” said Dr Arshid Hussain, professor of psychiatry at the hospital. However, more than the numbers, Dr Hussain is worried about the intensity of mental health problems found in these patients. “Earlier, we would see a patient in two or three days who needed hospitalization and who also needed de-addiction,” he said. Now, it has become a daily affair.” Many of these patients remain admitted for weeks, sometimes even months. On August 4, at least 10 patients were admitted to psychiatric diseases hospital with serious mental health issues which doctors link to substance abuse. Aged between 16 and 20 years, these patients gave a look of misery. Unable to take care of themselves, their close relatives sat beside them, devastated. However, some of them were alone. “Sometimes, the family is tired of the members who are chronic substance abusers and exhibit serious psychiatric problems,” a doctor at the hospital said. “They drop them at the hospital and abandon them.” In Kashmir, cannabis tops the list of substances abused followed by opium and related products and solvents. Doctors report growing incidence of opium abuse from the areas that lines along Srinagar-Jammu highway. “It seems that opium is quite accessible along the highways and it is devastating our young generation,” said a young doctor at de-addiction center. Even though there is a facility for opium de-addiction in form of opioid substitution therapy (OST), being one and only such center in Kashmir comes with its limitations. The OST requires daily visits of patients to the center which becomes a hurdle for people hailing from far off places. At the peripheral level, doctors said, there were no facilities to address the problem. “Almost all patients from different district are referred to the GMC for admission,” said Dr Majid Siraj, a psychiatrist working in Pulwama. However, at GMC too, things are not good”.


Apathy of the government:

“For long, doctors at this hospital have been voicing their demand for a multi-pronged strategy to address issue of substance abuse. But each time they have been let down. Last year, after a number of people sought intervention of Chief Minister’s grievance cell, it was announced that a framework would be put in place to define role of stakeholders in tackling the problem of substance abuse. Subsequently, in November the then coordinator of CM’s grievance cell, Tasaduq Mufti, had told Greater Kashmir that Kashmir’s first substance abuse strategy document was on cards. “We will be ready to roll it (strategy document) out in a few weeks hopefully. We hope that it will give us a clear picture of responsibilities and role of each department,” Mufti had said. However, on the ground, there has been no improvement in past nine months. Given the magnitude of the problem the government had repeatedly claimed of starting de-addiction facilities at district level. However, since the health department has not been able to start even district mental health program, de-centralised de-addiction centers remains a far-fetched dream. For past one decade various proposals, including sanctioning 12 posts of faculty for 40 bedded de-addiction center at SMHS Hospital, submitted by department of psychiatry for strengthening of infrastructure for mental health and de-addiction have been repeatedly ignored by the state government. The gross shortage of nurses has also been a serious shortcoming for delivery of care at the two facilities run by the department. As per nursing council norms, there must be at least one nurse for five beds. However, the department runs with a handful of nurses. At 100-bedded psychiatry hospital, which has been rated as “institute of excellence”, there are only eight nurses posted. Head of psychiatry department Dr Mohammad Maqbool Dar minced no words while admitting about shortage of manpower. “Often, it seems the system might collapse if our staff refuses to stick to tough duty hours and job profile even for a day,” he said. “Our doctors, paramedics and nurses are always multitasking. That’s how we are still running,” he added, grimly. Although the issue of substance abuse is being discussed at every forum, by government and civil society, absence of planned and concrete measures to plug supply of drugs, create sensitisation and awareness among masses and high risk groups, upgrade facilities for patient care and address problem of manpower shortage is resulting in this problem “slowly devastating Kashmir’s younger generation”, said another senior psychiatrist.


[Courtesy: daily Greater Kashmir, Srinagar, Kashmir, August 08, 2018].

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