Sri Lanka is now on a war footing against drug abuse. President Maithripala Sirisena has vowed to eradicate the menace with stringent laws. He has also pledged to prevent young newcomers to the drug scene from becoming hard core drug addicts with education and rehabilitation programs, with the support of the Forces, the Police and the community.
The danger of becoming addicted to narcotics, especially in the area of health is still not understood by youth who are the first target of the drug mafia. Emeritus Prof. of Forensic Medicine and Toxicology University of Colombo, Senior Prof. of Forensic Medicine at General Sir John Kotelawala Defence University and former Chairman of the National Dangerous Drugs Control Board, (nddcb) Prof. Ravindra Fernando, shared his hands on experiences as a researcher in this field with the Sunday Observer.
Excerpts…
Q. President Maithripala Sirisena has pledged to eradicate the drug menace from Sri Lanka by 2020. He also expressed confidence that the Antinarcotics program he launched last year will bear fruit by mid 2019, with a positive change in society. As one who has spearheaded the anti narcotics war over many years, is this a realistic goal?
A. Sri Lanka’s goal always has been to eradicate the drug menace by 2020. All stakeholders must work hard to achieve this goal.
Q. Dangerous drug abuse involves many medical, legal, social, cultural and economic health implications. You have been a researcher in this field for a long time. Tell us your views?
A. Drug abuse is a state characterised by behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects (psychic dependence) and sometimes to avoid the discomfort of its absence (physical dependence).
The most common reason to abuse drugs is to ‘get high’. Adolescents can become involved in experimentation with drugs. Fortunately, only a small percentage of people who experiment with drugs become drug abusers.
The desire to ‘get high’ could be for many reasons. Pressures of coping with school, work, or family tensions and underlying disease such as, depression can lead to addiction.
Harmful health effects of drug abuse are well-known. The effects depend on the drug. For example, cocaine causes loss of appetite, violent behaviour, hallucinations and paranoid psychosis. It increases the temperature, heart rate and the blood pressure.
Cocaine abuse leads to perforated nasal septum, keratitis of the eyes, dental erosions, fits, heart muscle disease, coronary artery disease, liver disease, brain hemorrhages and sudden death due to heart failure.
Illicit cultivation, production, distribution and possession of drugs are crimes. Drug trade is involved with money laundering. Drug trafficking leads to all types of crime, violence, gun use and even terrorism.
Q. Where is the highest incidence of drugs found in Sri Lanka?
A. The highest incidence of drug abuse is found in Colombo and other major cities.
Q. What are the leading drugs commonly used in Sri Lanka?
A. The NDDCB estimates that there are about 200,000 cannabis (ganja) addicts and about 50,000 heroin addicts in Sri Lanka. As drug addiction is a process that happens secretly, it is difficult to estimate the exact number of addicts. However, some institutions and individuals believe that the actual number is much more.
Q. What are the ages of the users in general?
A. Usually the affected age group is 18 to 25.
Q. What are the health implications of those who abuse drugs?
A. I mentioned the harmful effects of cocaine earlier. Heroin causes a sense of detachment from emotional/physical distress, drowsiness, lack of concentration, respiratory depression and even death.
Addiction to heroin causes serious withdrawal symptoms when heroin is not present in blood. Addicts experience anxiety, restlessness, sweating, yawning, runny nose, watering of the eyes, diarrhoea, incontinence of urine, abdominal pains, muscle cramps, hallucinations and delusions.
In Sri Lanka heroin is inhaled. This is much less harmful than intravenous injection. Intravenous drug addicts are more prone to get infections. They die prematurely from acute heroin overdose, inhalation of vomit, acute ulcerative endocarditis, broncho-pneumonia and hepatitis. They are more likely to meet with accidents and commit suicide.
Cannabis causes impaired performance, sleepiness, confusion and hallucinations. Cannabis affects brain development. Regular cannabis use, particularly, when started in adolescence, is associated with addiction, lasting cognitive impairment (such as lower IQ), poor educational outcome, diminished life satisfaction and achievement, and increased risk of psychotic disorders.
Q. What are the economic, social, legal implications when a person gets hooked on narcotics?
A. Drug abuse is common among poor families, while a drug abuser in a family makes them poorer. Drug abuse impairs family life, results in unproductive employment and reduces the quality of life. Impaired performance at work can lead to poor productivity and reduced income. Absence from work and intoxication at work can lead to disciplinary problems, accidents at work and excess medical claims. It is very unfortunate that young drug addicts face premature death.
Q. The NDDCB besides eradicating the drugs menace, also provides treatment and rehabilitation to drug dependents at Treatment and Rehabilitation centres. Where are these located?
A. The NDDCB has centres at Shanthi Mawatha, Thalangama, Unawatuna in the Galle District, Handessa in Peradeniya and in Urapola, Nittambuwa. There is a Treatment and Rehabilitation Centre in Kandakadu, Singhapura, managed by the Bureau of Commissioner General Rehabilitation.
There are several centres run by NGOs and private individuals. The centres run by the NDDCB provide basic but clean and hygienic accommodation, a balanced diet, in-door and out-door recreational facilities by a group of friendly and trained staff.
The treatment program consists of medical attention, counselling, behavioural therapy and vocational training. The treatment needs of each person are assessed individually. An addict has to stay about three months at the centre for residential treatment. After the residential period he is required to enrol into the relapse prevention program. Parents/guardians are required to assist his recovery process and help to cope with uncomfortable feelings.
Wherever possible, the residential program incorporates activities and experiences consistent with normal lifestyles. Daily activities include individual and group counselling sessions, educational programs, care and maintenance of the centre, work projects such as landscaping, creative pursuits such as pottery, welding work, carpentry and drama, stress management activities like muscle relaxation, meditation and recreation. Television and newspapers are available for residents.
Q. Will it result in a person being cured? Once rehabilitated does it mean that person is completely cured of his/her drug habit? Or can he/she go back to it if not given the motivation?
A. After a period of stay the addict is ‘cured’ but there is always a risk of relapse or starting the drug habit again when discharged from the Centre.
Q. Is there feedback and follow up of the rehabilitated person after he has completed his program?
A. Yes, they are followed up.
Q. The President has entrusted the Armed Forces and the Police with eradicating the narcotics menace. He has also said it was equally important to educate and rehabilitate students and youth who are the main target of the drug mafia. Several educational programs have already been launched in schools and higher educational institutes to this end. Do you think students who are still developing emotionally and physically should be exposed to all this information?
A. It is always better to be informed of the harmful effects of drugs.
Q. Are tobacco and alcohol also considered narcotics?
A. They are also addictive substances as we all know.
Q.What about beer? Wine?
A. Yes, definitely. They contain alcohol and people can get addicted to them.
Q. We also have reports of Kerala ganja and a betel chew that is illegally imported from countries like India and Pakistan where they are banned. What are the health implications of these two items which I hear are used mostly by young to middle aged persons to quench their hunger on long distance drives?
A. Betel chewing with tobacco and areca nut is harmful.
Q. What are the gaps you see that urgently need to be filled in improving services on behalf of rehabilitating the drug addict? Are there enough psychiatrists? Psychologists? Trained front line staff? Counsellors?
A. We need more rehabilitation centres with trained staff.
Q. Do you think criminalising drug offenders is the answer to the problem? I understand they have already called for applications for the post of hangman and there have been several takers. Is executing or hanging them the answer?
A. I do not think the death penalty will solve the issue. Sri Lanka carried out its last execution in 1976. There is no evidence that the death penalty has a deterrent effect against crime. Death penalty is not the solution for drug-related offences.
Q. Your message to young people who are tempted to take drugs in whatever form?
A. Do not experiment with drugs. Do not take drugs whatever the pressures and worries. They are harmful.