Social health approach against drug abuse

Muhammad Abdul Mazid | Published: February 01, 2019 21:31:41 | Updated: February 04, 2019 21:54:19

Initiatives are on to revamp the way the scourge of drug addiction and abuse is countered, with emphasis to move away from mere punitive action under the criminal justice system. Sections in the Narcotics and Dangerous Drugs Act need to be reviewed to correct the punitive approach. Mere enforcement of the law to counter the use and trafficking of illegal drugs and narcotics may not only be ineffective, but it also worsens the health of the individual besides increasing government expenditure. The use and trade of harmful drugs should be reviewed more from the social health aspect and monitored through the health sector rather than being handled by the criminal justice system. The use of drugs and addiction is a complex biological effect which is influenced by various factors such as genetic disposition, psychological and environmental factors.

Illegal drug traffickers, who were arrested, and users, who had left various drug rehabilitation centres, can return to the habit if there is no motivation and continuous support to help them fight the illegal business prospects and addiction. The social problems associated with drug abuse include unemployment, homelessness and poverty as its "key roots". These can drive people towards criminal behaviour, incarceration, transmission of HIV due to IV drug use and high-risk sexual behaviour. The cost associated with these issues is burdensome to the government. This is why it is necessary to approach drug abuse as a medical problem. In order for the process of recovery and re-integration into society to work for previous drug abusers, they require the support of their family, friends and community. All these interconnectedness is part of social health. While amending laws aimed at addressing drug trafficking and addiction differently, terms like "dangerous drugs" need to be redefined.

For the past two decades, Bangladesh has struggled to find an effective and sustainable solution to substance abuse, which has had deleterious effects on the country's development. Severe drug addiction has affected the productivity of a major portion of its workforce, especially the youth. Government measures to address the challenge primarily consist of cracking down on the distribution of illegal narcotics while neglecting the health of addicts. According to the Association for the Prevention of Drug Abuse (Manas), the current number of drug addicted people in Bangladesh is around 6,600,000, while the Department of Narcotics Control (DNC) reports that the number is around 5,000,000. However, the National Institute of Mental Health (NIMH), in a programme held last June, stated that more than 7,000,000 people suffer from drug addiction in Bangladesh.

The new approach requires "political will". The country's prisons are over-populated with drug-related offenders, some involving minors and non-violent offences. But the offenders, once imprisoned will suffer from social stigma and will be unable to find jobs and return to their communities when released. They should rather be treated as "patients". Healthcare agencies need to be empowered to detain addicts. Traders and  patients should be treated in the community and not in isolation so that the counselling given would be relevant. If they are confined to jail or rehabilitation centres, the counselling will prove ineffective. Treating addiction as a chronic illness is a more acceptable approach as it reduces the stigma. Drug addicts will then be more willing to seek treatment. The new approach should no way mean the legalisation of drugs and its trafficking. Rather, it will decriminalise the use of drugs. Qualified doctors, social scientists, psychologists, and not just administrators, should be consulted to find solutions to addiction problems.

According to a number of reports published by the International Narcotics Control Board (INCB), the phenomenon of drug abuse requires societies to dedicate resources to evidence-based prevention, education, and interventions, including treatment and rehabilitation. Although such activities can be resource-intensive, studies have shown that for every $1 spent in good prevention programmes can save governments up to $10 in subsequent costs. In Bangladesh, however, the rehabilitation process is in need of significant improvement. A number of experts have characterised the current resources for rehabilitation as inadequate and ineffective, and stated that reducing drug addiction across the country would require massive changes in several sectors. The Ministry of Home Affairs is currently playing the lead role in fighting drug addiction. Law enforcers and the Department of Narcotics Control (DNC) are jointly working under the ministry.

Dr Muhammad Abdul Mazid is former Secretary to the Government, former Chairman, NBR. mazid.muhammad@gmail.com

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