The Government of India is tackling the issue of drugs through its two pronged strategy viz. supply reduction and demand reduction. Supply reduction falls under the purview of the enforcement agencies.
The demand reduction strategy is in the domain of social sector. Ministry of Social Justice & Empowerment in the Government of India is responsible for implementation of demand reduction activities in the country.
The main strategy is to empower the society and the community to deal with the problem of drug abuse. The approach is to recognise drug abuse as a psycho-socio medical problem, which can be best handled through community based interventions of three different levels.
Primary Prevention :
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Keeping healthy by encouraging drug abstinence and alcohol moderation.
Secondary Prevention :
Facilitating the process of behaviour change of high-risk individuals by themselves; early identification of troubled people; counselling and early assistance.
Tertiary Prevention :
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Treatment, rehabilitation and reintegration of recovering addicts into the mainstream.
For the purpose of drug demand reduction, the Ministry of Social Justice & Empowerment has been implementing the Scheme of Prevention of Alcoholism and Substance (Drug) Abuse since 1985-86. The Scheme was revised thrice in 1994, 1999 and 2008, and at present provides financial support to NGOs and other eligible organisations mainly for the following objectives :
(a) To create awareness and educate people about the ill-effects of alcoholism and substance abuse on the individual, the family, the workplace and society at large;(b) To provide for the whole range of community based services for the identification, motivation, counselling, de-addiction, after care and rehabilitation for Whole Person Recovery (WPR) of addicts;
(c) To alleviate the consequences of drug and alcohol dependence amongst the individual, the family and society at large;
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(d) To facilitate research, training, documentation and collection of relevant information to strengthen the above mentioned objectives.
Strategic Focus:
Keeping the aforesaid approach in view, the Drug Demand Reduction strategy of the Govt, of India has three broad focus areas:
• Awareness through preventive education.
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• Counselling, treatment and rehabilitation.
• Capacity building of service providers.
Awareness and Preventive Education:
Building awareness and educating people about ill effects of drug abuse through preventive education efforts through various audiovisual aids and Information Education & Communication (IEC) materials:
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Counselling, Treatment and Rehabilitation:
Dealing with the addicts involves a multi-faceted approach including programmes of motivational counselling, treatment, follow- up and social-reintegration of recovered addicts. Treatment of drug dependence involves a prolonged and complex process consisting of:
Identification/ Intervention:
Once the client comes to the treatment centre and the team gathers the case history from the client as well as the secondary sources, based on this information, chemical dependency and other related problems are diagnosed and treatment is planned specific to the client.
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Detoxification:
Detoxification is the medical management process to remove the toxicity from the body and ensure recovery from its effects.
Rehabilitation:
Rehabilitation provides help to enable addicts to get out of his/her dependency on drugs and make positive changes in his life-style.
After Care:
This includes the package of services provided to the addict after successful discharge from the programme designed to permit the client’s effective re-integration into the society by leading a drug free life.
Service Delivery Mechanism
A comprehensive service delivery mechanism has been set up by the Ministry of Social Justice and Empowerment, Government of India
1. A nation-wide network of about 350 NGOs running more than 400 Integrated Rehabilitation and Treatment (IRCA) centers, with the financial assistance of the Ministry.
2. Works on premises of effective handling of the psycho-social & medical problem through community based intervention.
3. Average bed capacity of de-addiction centers is about 6000 for in-patient treatment.
4. Services for open community treatment.
5. Number of addicts benefiting from these services varying between 1,00,000 to over 1,20,000 annually.
Capacity Building:
Imparting drug abuse prevention/rehabilitation training to volunteers with a view to building up a skilled cadre of service providers is another important area of intervention by the Government of India through the Ministry of Social Justice and Empowerment. The salient features of this area are as follows:
1. National Institute of Social Defence (NISD) through its National Centre of Drug abuse Prevention (NC-DAP) impart training for raising competency level of service providers.
To provide motivational counseling, treatment and rehabilitation. A brief overview is presented below
2. Emphasis is given on training in local language compatible with socio-cultural milieu of the place. .
3. 11 Regional Resource & Training Centres (RRTC) have been set up in NGOs of proven capability to work as extended arms of NISD.
4. Separate modules have been worked out for training in Basics of DAP, Counseling Issues & Processes, Relapse Prevention, BCC, Prevention of HIV/AIDS among IDUs, etc.
5. 9882 service providers trained through 316 training programmes varying from two days to three months duration (from April 2005 to March, 2010).
6. “Minimum Standard of Care” – as a benchmark of quality in- service delivery has been adopted.
7. An online Drug Abuse Monitoring System (DAMS) to ensure regular flow of information of profile of treatment seeking drug users has been set up.
Monitoring & Research:
1. For continuously fine-tuning the intervention strategies, the need to undertake research and monitoring the pattern, trend and extent of drug abuse is important. A number of initiatives have been taken in this regard including:
2. National Survey on the Extent, Pattern and Trends of Drug Abuse (2004).
9882 persons trained through 316 courses between April 2005 to March 2010
Outreach and Advocacy:
For reaching out effectively to remote areas and effective implementation of programmes, schemes, training activities, monitoring and evaluation, the 11 NGOs have been designated as Regional Resource and Training Centres (RRTCs).
RRTCs strengthen NGOs and CBOs by:
• Imparting Training
• Providing technical support and backstopping
• Facilitating implementation of Drug Abuse Monitoring Systems
• Advocacy and sensitization programmes.
• Counseling and convergence of stakeholders.
• Intersectoral convergence and networking.
Networking and Collaboration:
In order to synergize the concerns and resources by effective convergence and augmenting drug abuse prevention activities effort are afoot to dovetail the drug issues in other programmes of Government, International organisation and NGOs. Some of the important initiatives in this regard include:
1. Workplace Prevention Programmes leading to the formation of a group of stakeholders known as Association of Resource Managers against Alcohol and Drug Abuse (ARMADA).
2. Reaching out to rural areas in collaboration with Government agencies including Nehru Yuva Kendra, Department of Field Publicity, Police and armed forces etc.
3. Federation for Indian NGOs in Drug Abuse Prevention (FINGODAP) with over 400 member NGOs.
4. Drug Abuse Monitoring System (DAMS).
5. Rapid Assessment Survey (RAS).
6. Further, for designing evidence based intervention strategy, a number of focused thematic studies have been undertaken in areas such as:
Drug Abuse among women
Burden on women due to drug abuse by family members Drug Abuse among rural population Drug Abuse among prison population Availability and consumption of Drugs in border areas.