Sunday, December 15, 2013

Juvenile substance abusers in India.. No more limited to street children

A few months back, 14-year-old Vikram Batra (name changed) started behaving oddly. Normally quite a talkative boy, Vikram, started keeping to himself. On returning home from school, he would head straight to his room and remain locked there for hours at a stretch. Two month’s back, his mother, Vibha, an IT professional, received a call from the counsellor at Vikram’s school, a renowned private institute in central Delhi.
The counsellor told her that Vikram had become unresponsive in class and was often lost in his own world. One day, when Vikram was out, Vibha searched his room and found three empty bottles of white solvent in his school bag, traces of which she had occasionally seen on Vikram’s lips. She called the counsellor and told her that the child was into substance abuse.
Substance abuse among Indian children is growing at a much faster rate than previously believed. And contrary to popular belief, the addicts are not just street children. A first-of-its kind study conducted by the National Commission for Protection of Child Rights (NCPCR), has found that one third of juvenile substance abusers live in homes and attend schools.
The average age of those using drugs like opium, pharmaceutical opiods and heroin is as low as 14.3 years, noted the study which covered more than 4,000 children and adolescent substance abusers across India.
This is the first such study conducted on a nation-wide basis. Earlier studies on substance abuse in children, conducted by private organisations, concentrated on regional figures. “There have been no  studies that have been conducted at the national level, and which tell us about the total number of children in India who are into substance use.
The recent nation-wide study conducted by us for NCPCR informs us about the pattern of substance use and profile of children using substances as well as the factors associated with it. A nation-wide study, if conducted, will also further help in understanding the problem of substance use among children in India,” said Dr Anju Dhawan, professor, National Drug Dependence Treatment Centre, AIIMS and principal investigator of the survey.
The NCPCR survey findings indicate the prevalence of a particular phenomena in a purposive sample of child substance users and do not represent prevalence of a phenomena in the entire child population. The survey covered around 4,000 substance-using children between 5-18 years across 26 states/3UTs. Nearly 69.8% respondents were from urban areas; 28% were currently studying in a regular school, 12.9% pursuing education through open school and rest were not studying. Girls comprised 4.2% of sample

The findings of the NCPCR study has come as a shock even to those working in the field of helping and rehabilitating substance abusers. Respondents were divided into three categories- children living on streets, children living at home and going to school and children living at home but not going to school and concentrated on the nature of substance used by these children.
“We were surprised to discover that the use of inhalants (as a means of intoxicant) was common to all three categories. Also, the fact that its use is prevalent in rural and tribal areas was something which we had not expected,” confessed Dr Dhawan.
Tobacco and alcohol were found to be the most common substances used by children, with 83.2% and 67.7% of respondents respectively admitting to having used it. 35.4% of respondents admitted to having used cannabis, while 34.7% said they used inhalants as a means of intoxicant. The use of tobacco and alcohol was found to be higher among children living at homes than those living on the street. Approximately 12% of those questioned admitted to having used injectable substances, a practice that was believed to be prevalent only among adults. The practice may make them vulnerable to HIV and Hepatitis B & C infections.
A 2007-2012 report by the union Ministry of Women and Child Development (MWCD) had also indicated to a rise in the number of children indulging in substance abuse. “More than 13% of those involved in drug and substance abuse in India, are below 20 years,” the report had noted. 
“A new trend has emerged in drug and substance abuse with children now using a cocktail of drugs through injections, and often sharing the same needle, which increases their vulnerability to HIV infection,” the MWCD report had said. According to the MWCD report, approximately 20 million children in India are getting addicted to smoking every year. Nearly 55,000 children are taking up smoking every day. The corresponding figure in the US is only 3,000. Between 1999 and 2003, the number of registered cases of smoking among children went up by 589 per cent.
Last year, the Delhi government had identified approximately 250 civic body and state government- run schools where students were vulnerable to substance abuse. “We had formed more than 100 teams to closely monitor these schools and interact with the students. So far, we have come across approximately 50 cases where school children were found to have used cigarettes and alcohols,” said Dr JP Kapoor, assistant director, health services, Delhi government and in-charge of school health programme, adding, none of the teams came across students using cannabis and more harmful narcotics.
Age does matterSubstance abuse in the young poses a different set of challenges when compared to addiction among the adults. Almost half of the children interviewed for the study did not admit to facing any problems owing to substance abuse or felt the need for help, making difficult the task of counsellors and doctors.
“Unlike adults, they do not want to come forward for treatment because they don’t even realise that they are in trouble,” explained Dr Rajesh Kumar, executive director of the Society for Promotion of Youth and Masses, which runs a de-addiction centre for children in Delhi.
How the young addicts ensure they get their daily dose of drugs is even more disturbing - from lying to parents to get money, to selling off their belongings, pilfering and borrow money from friends. Indulging in sex in exchange for either narcotics or money is also not uncommon. 20% of respondents living on streets admitted to using this method for supporting their addiction.
Many become members of criminal gangs. “A significant number of juvenile offenders are substance abusers. Once they become addicts, you can make them do anything in return for narcotics. Narcotics may cost upto Rs. 1,000- Rs. 1,500 per day. Neither can they earn so much money, nor can they borrow it from someone. Those belonging to the lower socio-economic groups are left with no option but to turn to theft and robbery,” said Sanjay Gupta, director, Chetna, a Delhi-based NGO which works with street children.
What causes them to fall...According to the NCPCR study, peer pressure is the primary reason behind children giving in to substance abuse. Eight out of every ten children interviewed for the study admitted to being close friends with those who are into substance abuse.
The easy availability of substances that can be used as intoxicants, such as relief ointments, glue, paint, gasoline and cleaning fluids at stationary and chemist shops, adds to the problem, says Gupta. “These are toxic gateway substances that are often abused by children. Delhi sees a daily sale of these substances worth approximately `50 lakh, claimed Gupta.
“On numerous occasions, we have approached the authorities to ban over-the-counter sale of such substances, but failed in our efforts. Also, there seems to be zero implementation of a government order banning sale of tobacco, cigarettes and alcohol within 1 km radius of all schools,” he added. Lack of sensitisation programmes and few de-addiction centres makes it difficult to check the problem. Then there are the oft-sited reasons, urban living, rise of nuclear families and the resultant lack of attention given to children.
Bharti Ali, co- director, HAQ centre for child rights, said, “According to the central model rules of Juvenile Justice Act, juvenile delinquents suspected to be suffering from addiction should be kept in separate dormitories or wards or hospitals. But there is only one government-aided de-addiction centre for children in the country. Also, substance abuse is rampant among inmates of government-run child care institutions. And this is a problem which often goes unreported.”
Meanwhile, children like Vikram continue to live under the shadow of substance abuse. If detected in time, help is still possible for some of them. Vikram is at present undergoing detoxification at a private facility.
Vibha, a single mother, has left her job to ensure that Vikram is able to rise above his addiction. The treatment may take six months to two years. Depending on Vikram’s performance, Vibha will decide whether to continue his education at a regular school or to enrol him in an open school.
Case study
** From pampered teen to habitual drug user
(Reshma Tamir, 16, Mumbai)
The Tamirs were a picture-perfect family until two years ago. The parents were wealthy investment bankers with a plush home in south Mumbai’s exclusive Peddar Road area. The family went on vacations abroad every year and the parents plied their only child, Reshma, with gifts.
But underneath the surface, the parents had been disconnected and unhappy for years and, in 2011, got a divorce.
With their long working hours, Reshma ended up in her father’s custody, with her paternal grandparents the main care-givers. Reshma’s mother moved back to her parents’ home in Cuffe Parade; her father travels abroad much of the time for work.
Still, she tried to make the most of her new situation, says Sujata Ganega, who has been her counsellor for three months.
Then she attended a party at a friend’s house and tasted alcohol for the first time.
“She had seen her parents drink a peg after work every day to relax, so she thought it was normal to consume alcohol,” says Ganega, executive director at Support, a charitable trust offering residential rehabilitation to drug-using children.
As Reshma became a regular drinker, she was introduced by her friends to different types of alcohol, cigarettes and eventually cannabis. “Her friends reinforced her impression of these substances by telling her it was ‘cool’ to be doing these things,” says Ganega.
Her grandparents, meanwhile, gave in to all her demands for additional ‘pocket money’ because they did not want to add to the trauma and loss that she had recently suffered. She was allowed frequent stayovers at friends’ home and her curfew deadline was extended until later and later at night.
“It was her uncle who first raised an alarm,” says Ganega, “asking why she was always going to stay at friends’ homes and never invited anyone home herself.”
Suspicious when she had no clear answers to his question, the uncle confiscated her phone and read hermessages.There, to his horror, he found mentions of cannabis.
Confronted, Reshma confessed that she had become a regular user of alcohol, brown sugar, cannabis and tobacco, in whatever form was available.
“There is little balance in parenting and child-care among the middle classes these days,” says Ganega. “The guilt of working long hours and being emotionally unavailable makes parents and guardians give in to potentially dangerous demands, makes them reluctant to use the word ‘no’.” This is one of the main reasons why a rising number of children in the middle classes are resorting to addictive substances.
Even after an addiction is revealed, parents react in damaging ways, adds clinical psychologist Pallavi Bhurkay. “They either try to hush up the matter for fear of what others will say, or they start playing a blame game, eager to disown responsibility for what has happened.”
— Inputs from Anubhuti Matta
** He took to stealing to buy his daily dose
(Prashant, 13, Delhi)
Prashant was seven years old when he first sniffed an inhalant. In the years to come, he consumed a range of substances including cannabis and injectable drugs. “There was a time when the powder was not enough for me. I had to use injection to get a high,” he recalls nonchalantly, sitting in the campus of SPYM centre for children in Delhi where he is being counselled for de-addiction.
Prashant, now 13 years, says it all began when he puffed a cigarette to emulate one of his seniors in school. Gradually, he moved on to serious substances. Pocket money- Rs. 10 per day- was too less to buy him his daily dose.
He started stealing metal articles and selling them off to make money. “Burnt bronze would get me Rs. 350 per kilogram; brass was Rs. 250 per kilogram. I also stole batteries from cars and motorcycles. Last year, I accompanied a gang of thieves. But I was not the leader...just a member” he recalls.
After every such heist, Prashant and his gang would  celebrate their success by trying the latest drugs in the market, he says. With his little hands, he enacts the process of preparing the powder, rolling it into a pipe, inhaling, holding it till it reaches the lungs and then slowly releasing it. “Smack used to make us feel hungry and weak. We had to eat bread and butter immediately after that,” he says. Prashant’s family of six resides in a slum cluster in the Dwarka area. His father works in an export company and is the only earning member in the family. When Prashant dropped out of school after class III, he says a tiff with a class mate was the reason behind it, it was hardly an issue in the family.
His parents had no idea that he was into substance abuse. If they did, they never discussed it with him.Sixmonths ago, one of the gang members tipped off police about him which lead to his arrest. He was produced in front of the Juvenile Justice Board which referred him to the centre for de-addiction.
“His detoxification is over. Now, we are giving him behaviourial therapy and making him participate in group activities,” says Dr Rajesh Kumar of SPYM centre.
— Inputs from Danish Raza
** In a different world for nine years
(Dipendra Kumar, 26, Uttarakhand)
Karnprayag resident Dipendra Kumar had lost himself in cannabis consumption for more than eight years before he could gather courage to quit after being huddled into a rehabilitation centre in Dehradun by his parents for more than six months. Kumar, 26, now runs a grocery shop.
He took to cannabis smoking when he was 13 years old, a student of class VIII at a local government school.
“I began taking Charas (cannabis) out of the desire to do something unconventional and feel the ecstasy. I travelled 30 kilometers at a stretch to Rudranath with friends to have my first puff of the cannabis ‘chillum’. Initially it was for fun, but soon I started enjoying cannabis chillums and was hooked to it. Later I released that it was addiction. I would finish 14-15 chillums a day” says Dipendra.
Son of a retired army personnel and one of four siblings in the family, Dipendra had no family history of addiction, barring his father’s occasional alcohol consumption. “I was in a world of my own for nearly nine years. I was not aware of the places of my movements. I used to leave home late in the night and stay at local crematorium. Walking as far as 80 kilometers for no reasons and enjoying the company of others cannabis addicts had become part of my daily routine” says Kumar. However, Dipendra is a happy man today as he has given up cannabis addiction completely. “My father and brothers tied me with ropes and took me to a rehabilitation centre in Dehradun. I stayed there for six months and underwent a de-addiction course with constant monitoring by the counsellor. He proved to be a God-man for me. Good counsellors and the will power to cure oneself are the only ways to cure your addiction” says Kumar. 
— Inputs from Prithviraj Singh

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