Special Feature: International Day against Drug Abuse and Illicit Trafficking

UNODC Deep Dive Dialogues: Experts extend support to 'Listen First' campaign; say communication is key to address drug abuse

UNODC South Asia presents its latest e-feature, the "Deep Dive" Dialogues, an effort to foster an open dialogue between leading changemakers and to bring to you the best of insights on security, justice and health.

New Delhi, India/June 26, 2018:  On the occasion of the International Day against Drug Abuse and Illicit Trafficking, Ms. Mohini Daljeet Singh, CEO of the Max India Foundation, Professor Rakesh Chadda, Chief, National Drug Dependence and Treatment Centre at AIIMS, and Mr. Devendra Dutt, Law Enforcement Specialist, engaged in a candid conversation with UNODC's Samarth Pathak on drug abuse and its socio-economic impact in India and South Asia.

Calling for collective action against drug abuse and illicit trafficking, the three experts shared their perspectives on the issue from the business, health and law enforcement points of view. "Communication is the key to fight drug abuse," they concurred.

Watch the complete video here :  https://www.youtube.com/watch?v=RtInbxYCrbw&t=3s

Following are the key excerpts from the interaction:

Q: As we observe the international day against drug abuse and illicit trafficking, it is important to take stock of where we are and where we are headed. What is your opinion on the current state of drug abuse in India and the region, and our collective response to the same?  Are we on the right track?

Mohini Daljit Singh: Well, I would say that the present situation is really a dismal picture and it is only getting worse. According to one of the UNODC studies, I think one to three percent of the population in most states in India are on drugs. This is in comparison with Europe, which has around 0.1 to 0.2 percent. So that is how grave the situation is. Are we on the right track? Yes, at least we are addressing it, but perhaps not enough. We need to collaborate all the agencies and think of one aim first, rather than over the weightage of each of the agencies. We have to work together and not in silos; otherwise we are not going to get anything.

Rakesh Chadda: Definitely it is a serious problem. In our society, there are a lot of misconceptions about drug use. Often in the society, drug use is not even recognized as a disorder or an illness that needs treatment. It is often recognized as a habit. The patterns of drug use have been changing over a period. Strictly going by tobacco and alcohol,they are often not taken seriously though both have serious issues. In the case of illicit drugs, they are taken seriously and have harmful effects that appear very quickly. One of the bigger issues we have, as compared to the western population is, that even in the western population it is only one in six people who probably receive treatment. In India, we have a larger treatment gap and lesser facilities.

Devendra Dutt: I think the two experts have already summarized the situation and I quite agree with them.

Numbers apart, there is a situation in terms of families in which there is a problem of drug abuse, which is devastating.

We certainly need to do more than what we are doing as of now.

Q - What are some of the greatest  challenges in the fight against drug abuse in india? How can drug abuse and illicit trafficking be addressed comprehensively? What is the secret ingredient that we are missing? 

Mohini Daljit Singh: I would say that the biggest challenge is denial, you know, and it is something that is swept under the carpet. Firstly, within our families, the communication levels have gone down. Often, the family itself would not know the extent of the problem till the situation is quite bad, and even when they know they do not want to admit it. It's like a stigma. And if there is a woman involved, the stigma is much worse. So this is firstly a big challenge--I mean, how are we going to address the situation if we do not even agree that there is a situation. So that's number one.

You said the right word--'comprehensively'. So a response has to start at the very unit of the family, beginning from school wherever there is communication, wherever there is interaction between human beings. Personally, I believe that all these problems arise because of some kind of deprivation. There is a gap and there is this vacuum that people try to fill in with alcohol, tobacco, and illicit drugs.

For instance, street children, it has been found, take to drugs because of hunger, because of the cold, to get over these kinds of things. Then there is also the issue of security and wellbeing, as in love and affection. So I think communication is the key to addressing drug abuse.

Rakesh Chadda: There are a lot of misconceptions, so we need to create the awareness that drug abuse is an illness. This awareness has to be across the society. Often the problem starts in adolescence or early adulthood, so that is where we need to focus on--to create awareness among the school teachers, young adolescents, families and parents. School dropouts and street children are another group that are high risk segments.

The other thing is, controlling the availability and supply of the drugs. This comes in the legal framework, which enables stricter controls on trafficking, production, and ensuring that drugs are not diverted to the illegal market--these are some of the areas where we need to have specific efforts.

Devendra Dutt: Though we often talk about the deprived children or street children or drop-outs, today there are a large number of children from affluent societies vulnerable to drug abuse, particularly the adolescents. There has been a shift from the earlier family set up. Both the husband and wife are now generally working and they do not get the time to engage with their children. I recall a senior officer telling me that he was speaking to his child, where the child (who studies in one of Delhi's top schools) told him that there is a paan (betel leaf) shop which provides something to the students and they buy it from there.  So there are situations like this also happening. And it is not only the traditional drugs like marijuana or heroin, but also the new psycho-active substances that are easily available. These drugs don't smell, and are just swallowed and it gives you a high. These things are also becoming a big problem today. So while on one side you need to be providing treatment, raising awareness and counselling, at the same time the law enforcement also has to be playing its part.

Q: From the standpoint of health, how is the National Drug Dependence and Treatment Centre (NDDTC) addressing the critical needs of prevention, treatment and rehabilitation? What are some of the successful models of care and treatment that are currently in practice?

Rakesh Chadda: We have been working in multiple areas- prevention, creating awareness among communities, that is one area of our work. Then we have a big service centre at NDDTC, which itself is a 50 bedded facility. At our main hospital, we are attending to nearly 70 to 80 new cases and around 300 follow ups. We have three outreach clinics in the city of Delhi, basically in the areas which have a higher prevalence of substance abuse. The other important concept, which the NDDTC has introduced in the last few years and in which the Ministry of Health has taken the initiative, is the 'Drug Treatment Clinic'. Earlier, there used to be a 'Rehab Centre', where the patient stayed for months together, after which he went back to society. Now setting up a centre required more resources, and it was found that the patients who went back to the community often relapsed and again the same cycle was repeated. To address this, we came up with the concept of 'Drug Treatment Clinics', in which the patients are given the Opioid Substitution Therapy, in which Buprenorphine is being used. For this less resources are required - one doctor, one para-medical worker and one attendant. The Ministry of Health has opened 20 centres across the country, out of which 6-7 are in North-East, 2-3 in Punjab and others are located at various locations. So this is a new concept which NDDTC has come up with, in which lesser resources are required. We have simultaneously developed training programs for the doctors and facilitators. NDDTC is also involved in the National Epidemiology Survey , which is done in all States and Union Territories, covering more than 500,000 people. This survey has been going on for the one and a half years, and the findings should be available in the next 2-3 months.

Q- Mr. Dutt, please share some emerging trends in terms of illicit trafficking of drugs in the region? What has been the role of law enforcement in countering this crime?

Devendra Dutt: In so far as the role of law enforcement is concerned, it can be said that they are there to control the trafficking of drugs and their production. So basically it is the supply side which law enforcement takes care of. In India, we have the Narcotics Control Bureau, which is the apex agency for controlling narcotic drugs and psychotropic substances. They coordinate the efforts of all the central as well as state law enforcement agencies. NCB has encouraged all the state governments to set up special task forces for controlling drugs. NCB also organizes regular, periodical meetings to coordinate the efforts with regard to the trafficking trends and receive feedback. There is a reporting system, which they study and come out with analytical reports.

Coming to the trends, if I may say, a recent NCB report revealed a three-fold increase in drug seizures in the past 5 years. Now, seizures point towards the types of drugs that are coming in and the quantities, and the trends in smuggling and abuse. As you know, all the drugs that are coming to India are not coming to stay here, but part of it is also taken out. Regarding the type of drugs coming in, I think in 2017, nearly 2,100 kilograms of heroin and over 3 tonnes of opium were seized. The most important thing is that even cocaine has started coming in larger quantities, which did not happen ten years back. Last year, there was a seizure of 61 kilograms of cocaine, most of which was seized in New Delhi-around 30 kilograms. Mind you, what is seized is not the actual amount that is coming in. We can say that only 10 per cent gets seized while 90 per cent still goes out--so that shows the trend.

The other important thing is that in our neighbourhood in Afghanistan, in the year 2017, there has been a record production of opium-that is around 9000 metric tonnes, which is a very high percentage over the previous years. Now most of that 9000 metric tonnes of opium, if not all, is most likely to be converted into heroin, and if it is to be converted into heroin, it needs to be moving out. Now even if we say that most of the heroin that Afghanistan makes does not come to India-seizures will reflect perhaps that only 8 to 10 per cent has been passing through our territory-it will still be a significant amount. You may like to know that Afghan heroin moves broadly in three routes - one the northern route, the other is the Balkan route and where India falls is the Southern route. Now, the Southern route naturally has become active. The recent seizure in Delhi was about 29 kilograms, where heroin was produced in Jalalabad and moved to Pakistan. From there it moved to Jammu and Kashmir, then came to Delhi and from there it was likely to go to South East Asia and onward. All this falls in the Southern Route. Normally we think that drugs enter India via Punjab and Rajasthan, but now we are seeing that it is coming in via Jammu and Kashmir as well for obvious reasons.

Though the quantity was small, it pointed towards the drug trafficking trends and what we may expect in the future. From Jammu and Kashmir, the drug cache comes to Delhi, from where it is likely to go to South East Asia. Though the quantity was small, it points to the way drug trafficking trends may come in the future and the supply route. I will just conclude by saying that the Southern route also includes the maritime route, that is, ports such as Gwadar, Chabahar and Pakistani ports etc. are becoming more advanced, and are is likely to be used more in the future. We need to pay attention to it.

Q - Ms Singh, what is the business case to address drug use and related health issues like HIV AIDS and Hepatitis C in India under the CSR mandate. How has Max India taken up this challenge?

Mohini Daljeet Singh: Of course, there is a business case for addressing drug abuse, because that is completely related with health-- right from spreading awareness and trying to detect it early, and then counselling and then going in for treatment and rehabilitation. I agree with Dr Chadda that rehabilitation centres cannot really be residential ones, those do not work, but we just do not have the clinics. We do not have enough of those. So, there is a lot to do, and, with these, we will have outcomes of better health, we will have a reduction in HIV/AIDS and so many other diseases. This is something that definitely needs to be done.

Corporate Social Responsibility is a framework, which can address all these problems. CSR is now a major player in the social development of the country now. It has indeed proved to be an effective tool.

As far as we are concerned at Max India, I will just outline a few of the major things that we have done so far. One is that we are supporting a drug rehab centre, which is like a clinic, established by the Indian Army at Baramullah in Jammu and Kashmir. Drug abuse is rampant in Jammu and Kashmir--as it is the youth there does not have much to do and a lot of them are into drugs. So, we were requested by the Indian Army if we could support this. We have done it over two and a half years, with fantastic results. There is another NGO involved from Delhi, who send the counsellors and engage with us in training some local people from Baramullah. It has turned out to be a good and proactive initiative.

Also, last year we were very happy to come on board with UNODC for drug control in Punjab. Max India Foundation is actively involved in Punjab. We have two hospitals there - one in Mohali and one in Bathinda. We also have our only production unit in Raelmajra in Nawanshahar district, wherein we had adopted a village 10 years back. So this is a continuation of our work and we are happy to come on board with UNODC. 

With this, there will be more awareness and together we are working on the training of trainers and counsellors and the actual execution through this special task force that has been established by the Government of Punjab.

Besides illicit drugs, we have been working very hard on tobacco control since the past three years. We have a campaign in Delhi where we are supporting to train the police in the Cigarettes and Other Tobacco Products Act (COTPA). You must have noticed in the newspapers that how much the fines have gone up in Delhi. For that you must thank us, because we have been behind them, we have invested a lot in it. We are now making forays into the armed forces and other places.

Max India Foundation does regular health camps in Delhi NCR and other places. Anti-Tobacco campaigns are a part of this- we have flip-books, we have doctors and we go to the slums - even if we are doing a health check camp, while people are waiting, my people speak to them about drugs also. Interestingly, when it started and when we did immunization camps for children, I would tell my team that look these are kids, should you really be talking to them about tobacco? But I was shocked to learn that those kids were telling us the brands and they were very well into it. So it is really worthwhile and I am happy to say that we are able to contribute out little bit.

Q: UNODC and Max India, like you mentioned, are already working in Punjab. What is the situation in Punjab and in the light of that how important are collaborations?

Mohini Daljeet Singh: From what I hear, Punjab is three times as bad as any other state in India. So I think we have touched a raw nerve and this was very much needed. I am very happy to come on board and I am sure that together, with the expertise of UNODC and whatever help we can give-in terms of our physical presence there as well as CSR funds-I am very hopeful that we should be able to make a dent. The Punjab Government is also very enthusiastic and they have set up a task force. I look forward to much more engagement, particularly, cohesive and coordinated action. Now it is time for action.

Q: On this occasion, what would be your appeal to the people, especially the youth and the women and the children of the region? How can the people help governments and their own communities in countering the problem of drugs and also promoting the SDGs?

Rakesh Chadda: What happens in the beginning of drug use is curiosity or peer pressure, which leads to first experience, and the person who refuses is considered as weak. So we have to encourage children and adolescents to say no to drugs, and to understand that to say no is not a sign of weakness but a mark of strength. That is what we need to tell the younger generation.

Talking about this year's theme, "Listen First," I think that is very important. Our society is becoming more and more engrossed to the electronic devices. This habit has to be stopped and families need to engage in face to face, one to one communication with each other. Through face to face communication, one can understand expressions to understand if the other person is going through stress, peer pressure or anxiety, and engage with an emotional touch. We have to work in all these areas.

Devendra Dutt: The World Health Organisation has identified video games as a mental health disease that has to be treated accordingly. It is a major health issue that is causing a lot of disorders. Now we talk of globalisation and how technology has made life easier, whether it is in business, trade or communications or travel, among others. At the same time, there is a darker side of globalisation, in the sense that technology is being abused by the criminals, whether it is for terrorism or transnational organised crime or drug trafficking in a major way-through the internet or darknet, they promote the sales of their drugs. We talked about the importance of face to face communication, but now it is becoming Facebook communication, due to which one has more virtual friends than real friends.  I can only say that if the problem is to be won, it has to be done as it is happening in the Football World Cup, which is currently going on. If we have to go to the other side and score a goal, then all of us need to be moving together as a team. To defend our goal in this case, we would require a strong response from the health side, while as a law enforcement representative, I would be the attacker on the forward side to push away the drug traffickers. So my message would be that let's work together like a team and defeat the drug problem.

Mohini Daljeet Singh: I think we have to begin at the grassroot level, at the ground and then upwards. The first thing, which all of us have mentioned at some point, is communication. There was a time when the family met for dinner and everybody would sit together and talk-that is not happening anymore. The UNODC has talked about Listen First-I believe that is very important. You have to feel the pulse of a child, of a family member, when they are little, then as they are growing up, then adolescence, when you start feeling lonely and lost. There is also a lot of peer pressure, at all strata of society-whether it is the underprivileged, whether it is the very privileged, whether it is the stars. Many times, very famous actors, who have a huge fan following, are really the loneliest people, because there is no one to really speak or talk to them. So the first thing is to communicate. Let us talk, let us listen. How many of us listen to our children? We have to stop everything, hear their voices. It all starts from communication.

Personally I feel that if we watch out, if we listen, whether it is at home, whether it is at the workplace, whether it is anywhere else, in society, with neighbours, we can see the problems. As Dr. Chadda said, it is a mental health issue, it is a disease. It is not just a fad or someone being silly, it may lead to suicide.   

So I agree with you when you have appealed for Listen First-please let's listen, let's communicate, let's talk, let's drop our own selves. We have become so self-centred, let's look outwards.