Multiple dimensions of drug abuse Part-I: Social dimensions

 Substance use disorder is a multi-dimensional problem that can be tackled effectively by adopting multi-pronged strategies at different levels with active involvement of all stakeholders

Drug abuse, that is more appropriately termed as ‘Substance-Use-Disorder’ owing its derivation to the rising trend of abuse of multiple substances and volatile solvents apart from opioids and prescription drugs, is more of a bio-psycho-social disease or disorder than a self-inflicted affliction, with definite socio-politico-economic and medico-legal dimensions. Etiological or causative factors of this disease, that has of late assumed shape of a dreadful monster ready to swallow and engulf our budding youth and developing nation, too are a lot more complex and diverse than just emotional distress or pleasure-seeking yearning of abusers and so are its confounding and risk elevating factors. Therefore, this scourge needs to be viewed through all relevant prisms and perspectives and all its associated dimensions need to be studied well leading to a multi-pronged, multi-faceted and multi-dimensional strategy to tackle the menace effectively and decisively. Any half-hearted, superficial or unidimensional approach will simply be a waste of time, resources and energy yielding very little or no benefits in terms of curbing this menace. 

Since the problem is deep-rooted, its solution too demands an in-depth exploration and excavation for its conclusive extermination from the depths of our society. This article series seeks to discuss some of the multiple dimensions governing this malaise and multipronged strategies needed to effectively control the same. While first and second parts of this series will discuss psycho-social and religious dimensions; third part will dwell upon medico-legal and biological dimensions; fourth part will shed light upon geo-political and economic dimensions and finally fifth and last part of this series will deliberate upon administrative and regulatory dimensions of this menace. Focus will be on the problem as well as its solution. 

Social Dimensions 

The theme chosen by United Nations for this year’s International Day Against Drug Abuse and Illicit Trafficking on June 26^th was, “People first: Stop stigmatization and discrimination” that emphasized upon the need to treat victims of drug abuse with empathy while showing no sympathy for those indulging in illicit peddling and trafficking of drugs. It calls for an end to isolation, discrimination and dehumanization of drug abuse victims and giving them the much-needed opportunities for treatment, rehabilitation, livelihood generation and reintegration back into their respective communities since they too have their own human rights. United Nations Office on Drugs and Crime (UNODC) duly recognizes the importance of taking a people-centric approach with a focus on human rights, compassion, and evidence-based practices. 

While sharing and caring, mutual respect, longing and love, coherence and compassion have conventionally been the hallmarks of human relations, social relationships nowadays appear to be undergoing a rapid transition from a close-knit, coherent and intertwined social fabric to an isolated, fragmented and self-centric style of living. Mutual relations are perpetually getting overwhelmed by the rampant use of social media and electronic gadgets leaving little scope for frequent physical interactions, sharing, caring and complementary exchanges. Of late it appears that the intensity, intimacy and depth of bonding among relations is gradually dwindling due to a whole lot of inherent and overarching factors. All this is pushing our younger generation towards the edges and forcing them to explore new ways of social engagement, entertainment and living. Consequently, they are finding temporary and deceptive solace in drugs and substances of abuse and thereby ruining their entire life and future. They are falling prey to the peddlers and getting enslaved by the short-lived euphoria of drugs. 

Need of the hour is to help drug abuse victims break the shackles of slavery and set themselves free from this dangerous entrapment. We need to give victims of drug abuse their freedom to think, plan and decide for themselves within the supportive framework of a loving and caring family and community. Being judgmental about them sows the seeds of discord and hostility among them. One should neither look down upon them nor expect them to change themselves overnight. Accepting people as they are with all their flaws, shortcomings, limitations as well as powers and strengths is the key to a sustainable relationship. As a result of our fraying social fabric our youth are getting more and more isolated and feeling lonely with very limited opportunities of recreation and relaxation. We need to revert back to social engineering through community-based, peer-led interventions and change our age-old social practices, dogmas and stereotypes. We need to treat drug abuse as a disease and accordingly help the victims overcome its sphere of influence through appropriate social, medical, educational, administrative and regulatory interventions. 

Transition from joint to nuclear families and social seclusion practices have led to shattered community linkages. Supportive families are essential for raising socially, mentally and physically healthy and well-adjusted children and preventing later adolescent problems. Factors such as lack of security, trust and warmth in parent-child relationships, lack of structure in family life, inappropriate disciplining practices and insufficient limit-setting can render children at greater risk of isolation, problematic behaviours and subsequent substance abuse and mental health disorders. Therefore, family skills training programmes have been found to be effective in preventing many of these risky behaviours, including substance abuse. There is need to adopt innovative approaches to keep the drug threat at bay. Parents and other family members of the victims in particular have a very significant role to play in identifying potential abusers, developing a supportive and caring environment within the family, counseling and educating the abusers about the ill-effects of drug abuse, helping the abusers to return back to their normal life and get rid of the substances of abuse, while at the same time rehabilitating them and boosting their morale and confidence to start afresh as a normal human being capable of standing on their own feet and living an independent life. Parents need to be cautious about the pocket money given to and spent by their wards because abundant pocket money and easy availability of drugs in their vicinity could make their children potential candidates for drug abuse. Bad company and emotional insecurity or instability could only make the things worse for them. They need to be alert about the changing habits, attitudes, behaviours and routines of their children and occasionally snoop into their rooms to make sure there is nothing like razors, aluminium foils, insulin syringes, cigarettes lying around in their cupboards and bags. 

Other than parents, young adults spend most of their time with their teachers thus making them one of the important stakeholders in curbing the menace of drug abuse. Teachers can be of great help in detecting, identifying, counselling, hand-holding, supporting, encouraging, rehabilitating, remedying, mainstreaming and managing the young drug abusers attending their classes. Regular awareness and counselling programmes through outdoor camps, open air theatres, dramas, painting competitions, video displays, street plays etc need to be conducted by every school and college across the region against drug abuse in order to acquaint the students with the dangers and consequences of such addiction. Awareness about ill effects of drug abuse must be incorporated into the curriculum at all levels of education. Teachers too need to be acquainted well with the signs and symptoms of potential substance use disorder and in the event of any sudden or gradual changes in the performance, responsiveness, attitudes and behaviours of their students they can report the same to their seniors, parents or counsellors and arrange a counselling session for them. Teachers need to keep the students engaged in creative and recreational activities like sports, cultural and community-based group activities so that their energies and curiosities get channelized in the right direction. Moral and value-based education needs to be made an inevitable component of the curriculum so that the students do not go haywire. Modern day teacher has to be a friend, a philosopher, a guide, a counsellor, a mentor and sometimes a ‘caregiver’ too. ‘Care’ translates into interventions that are in the best educational, emotional and psychological interests of the students. As suggested by Deiro (1996), “Students value adults who value them”. Thus, students who are living in seemingly intolerable situations but have a pro-social adult outside their home environs who cares about them will adjust their behaviour to carefully safeguard that relationship. 

At the community level, constitution of block and district level monitoring and vigilance committees with active participation of police, traffic police, medical health officers, school and college teachers, principals, religious preachers, housing societies, Mohalla committees, drug control and excise officials can go a long way in not only creating awareness and preventing abuse but also in identifying magnitude of the problem in each locality and motivating the abusers towards return, reintegration and rehabilitation. Social engineering is of crucial importance in preventing drug addiction. Perpetual sermons through religious preachers during weekly religious congregations, mass prayers and gatherings can have a durable impact in discouraging drug abuse. In Islam use of alcohol as well as all kinds of intoxicants has been clearly prohibited in Holy Quran, Surah Al-Ma’idah [5:90-102], wherein substance abuse has been declared an act of Satan that takes a person away from success, freedom and welfare in life. Therefore, prohibition of drug abuse by all religions needs to be propagated and disseminated constantly to curb the menace. Religious beliefs have a strong influence upon individuals and therefore religious sermons by the respective heads can be highly effective in controlling the problem. Mohalla committees need to identify drug abusers in their own localities, counsel them and their parents, offer them all kinds of monetary, psychological and logistic support in rescuing the victims from the clutches of drug abuse and subsequently treating, reintegrating and rehabilitating them back into the mainstream. Constant monitoring, vigil and intervention at the locality level can prove to be highly effective in overcoming this scourge (To be continued). 

(Based on the excerpts from a talk delivered by the author on June 26: International Day Against Drug Abuse and Illicit Trafficking  at National Institute of Technology (NIT), Srinagar, organized by CAUSE and DSW, NIT, Srinagar. Author teaches at the Department of Pharmaceutical Sciences, University of Kashmir and holds the additional charge of Director, Centre for Career Planning and Counselling of the University)