AMRITSAR, India — On a recent sweltering summer day, 27-year-old Gaurav Sharma tossed and turned on a small bed in the corner of a well-lit room. He buried his face in the pillow to try and forget the aches in his legs. A plaque hanging on the wall behind him spoke to his anguished state: “Drug addicts are not bad people who need to be made good, they are sick people who need to be made well.”
Sharma had not had any heroin for 24 hours. The withdrawal symptoms had begun.
“When it is really bad, it feels like I’m drowning and can’t breathe,” he said.
Drug use has become an epidemic here in the city and throughout the northern Indian state of Punjab, with officials estimating that more than 50 percent of people between 18 and 35 are using illegal drugs, including heroin and prescription opiates. More than two-thirds of the state’s rural households have at least one drug addict.
The drug problem took center stage during the April national elections as two of the state’s biggest political parties, the incumbent Shiromani Akali Dal (SAD) and the Congress, publically traded charges of ignoring the problem and courting drug traffickers. In Punjab, many political workers were allegedly bribing voters with drugs. But after a bruising vote where the ruling SAD party lost a number of its supporters, it has since jumped into action, launching a massive crackdown on drug dealers and complicit politicians that could signal a major shift in policy for the state.
Because most drug abusers deny use, the number of addicts in Punjab is hard to quantify. But government officials report that the prevalence of illicit substance use is greater than 10 times worldwide use, which was nearly 5 percent in 2010. The rampant drug abuse in Punjab stems partly from the once affluent state’s struggling economy and rising unemployment, as well as the easy availability of drugs smuggled into the country from Afghanistan and Pakistan.
For Sharma, the problem started three years ago, when some friends in his neighborhood of Sundernagar started snorting heroin. He tried it with them, thinking he’d keep his use recreational. Before he knew it, he was addicted.
Within a year, Sharma was using heroin seven to eight times a day, heating up the powder on an aluminum foil and inhaling the smoke at home and at work. When his employer found out, he lost his job, making it harder for him to afford the 3000 rupees ($50) it cost to buy his fix—a gram a day. Within two years, Sharma was spending the majority of his time obtaining the drug and recovering from its effects.
“I would travel more than a 100 kilometers if required in the middle of the night, just to get the drug and take care of my craving,” Sharma said. He is now in his second attempt at rehab.
Sharma was fortunate to get into a private treatment center, called the Amrit Foundation Clinic, where he will receive detoxification treatment for five days. In all of Punjab, which has a population of nearly 28 million, there are just 10 government and 63 private drug counseling and rehabilitation centers—much less than the number of treatment options many doctors say are required.
In Maqboolpura, a severely affected neighborhood in Amritsar, so many families have lost male members to drug addiction that they call it a “village of widows.”
Across the state, local politicians and police are regularly accused of being complicit in the drug trade.
“Whenever we catch a drug peddler, we get a phone call from the political bosses to let him go,” said a local retired police officer speaking on the condition of anonymity to avoid trouble with the ruling government.
But there are signs this might be changing in Punjab as a result of the elections. Within just two weeks after the election, the state government arrested more than 3,000 people on drug charges and dismissed 25 police officers for suspected links with drug racketeers. At least one state minister has been forced to resign due to his son’s involvement with the illegal drug trade.
Critics on the other hand, such as the Congress party, still feel that the efforts are insufficient and the arrests misdirected at drug addicts rather than peddlers, sparing higher-ups in the ruling party who have also been implicated.
Meanwhile, after five days of rehab, Sharma was ready to go home to his wife and parents.
“The hardest part of the treatment is now, when he is away from direct supervision,” said Jaswinder Singh, an anesthesiologist at the clinic. Singh said that relapse rates were disturbingly high, with nearly half of his patients returning to drug use once they left the clinic.
Sharma knows this all too well. The last time he was in treatment was in February more than a year ago, and he started using again within two weeks of returning home.
“It is very hard but I have suffered enough, this time I am determined to quit,” he said.
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Editor's note: This post is part of a regular series called "A Doctor's Notes" that originates with Harman Boparai's reporting in India last summer for the GlobalPost Special Report, "Step by Step: The Path to Ending Child Mortality."