February 19, 2017 2:16:14 am
It is 8:30 am, but already there is a small group of heroin addicts at the Opioid Substitution Therapy (OST) centre in the Civil Hospital compound here, waiting for it to open. The addicts are here to get their daily dose of Buprenorphine, meant to gradually wean them away from heroin. Addicts on the treatment need to take a shot of this substitute daily, which is why the OST centre remains open even on Sundays. The centre is open from 9 am to 3 pm in the winter, and among the early birds are daily wagers who can get their shot quickly and continue to their place of work. “I’m working with the forest department as a labourer. We are carrying out a plantation in a school of Patti. I’m supposed to reach at 9 am. But I’ll be late for duty. The centre should open at 8 am,” says one of the addicts, who registered himself at the OST three months back.
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Meanwhile, cleaners have opened the building, and after spending 5 minutes inside, locked it up again and left. A few more addicts have reached by now and are standing in two groups. At the first sight of staff nurse Baljinder Kaur and Auxiliary Nurse Midwifery Veerpal Kaur entering through the main gate of the Civil hospital, a relieved shout goes up from among the waiting men: “Madma aagyian (The madam have arrived).” Like children running to stand in rows for morning assembly at the ring of the bell, the addicts run towards the centre’s entry gate to be first in the queue. This scene, which plays out daily at the centre, is a reminder of the enormity of the challenge that awaits the next government which will be voted in on March 11. Except for Shiromani Akali Dal, which maintains there is no drug problem in the state, all others parties in the fray made promises to do something about the issue. AAP has said it will eliminate the drug supply chain in one month, while Congress has said it will eliminate both the supply chain and consumption in one month.
Whether one month is enough was always debatable, but it is at OST centres like the one here that makes the massive social and health costs of the problem immediately apparent. The OST in Patti opened in September 2013. A total of 917 addicts have been registered since its opening. Around 200 of these addicts have been coming to OST regularly; some 20 to 30 are irregular, and rest have not reported after their registration. According to the Centre’s records, only seven addicts became well enough to kick their heroin habit.
While the two nurses take a few minutes to mark their attendance at the office of the Senior Medical Officer of Patti hospital, the addicts, their mood much improved now, crack jokes as they wait. So close is the queue to the door that when Baljinder Kaur arrives at the centre that she hands over the key to the first man in the line to unlock the door. Now the queue moves inside, in front of the room where they will be given their medicine. Every addict has a registration number. With the number, the nurse consults a register to check the dosage prescribed for the addict by psychiatrist Dr Isha Dhawan, who runs the separate de-addiction centre at the hospital.
The medicine is a tablet, which the nurse first crushes in a steel mixer with her fingers. Next, she asks the addict to open his mouth, and places the powder under his tongue. The staff must maintain a record of the daily drug dose given to each patient at four places. First, it is recorded in the “client register”, then in the master register filled in at the same time as the patient is administered the dose. In the lean hours of the day, the staff fill in details in the OST sheet of every visiting addict. Then all the data is compiled and sent to Chandigarh at the end of the month.
Counselor Deepika Sharma helps Baljinder and Veerpal in the record-keeping. The entire exercise is carried out to ensure that the drug dosage is not misused. Patients must sign on the client register before getting their dose. “The dose takes time to melt in the mouth. So we ask the patient to sit for two minutes after placing it under their tongue. Otherwise, there are some addicts would take out some part of it when they leave the room,” says a nurse.
Addicts, who pay Rs 10 daily for this treatment, are known to sell small pinches of this crushed tablet, taken out from their mouth, for between Rs 100 to Rs 500, even though the tablet is powedered to prevent this resale. Apart from Baljinder and Veerpal Kaur, and the counsellor, the centre has a computer operator Charanjit Singh. Most of the addicts come between 9 to 11. There is no respite for the four in the first two hours. It’s only at noon that the queue thins out enough for a cup of tea, but even then, they can leave the room only one at a time.
“The room cannot be left empty. These tablets are gold for addicts. Also, some are experiencing withdrawal symptoms. So they want to get the medicine as soon as possible to get rid of the pain. They start shouting if they are asked to wait even for a minute. So we have cup of tea or our lunch one by one so that they don’t have to wait,” says a staff member.
Outside, some of the patients, their nerve restored after the medicine, are now watching Punjabi singer Gurdas Maan’s new song Punjab, in which he sings about the “chitta toofan”sweeping across Punjab. One of the addicts, himself a singer with a single that has been viewed well on YouTube, has downloaded the Mann song on his mobile. Two of his friends are also registered at the OST. “I don’t know why some people are criticizing Gurdas Maan. What has he said wrong in his song?” he says. Some have questioned the timing of the song’s release after the election, and others are taking Mann to task for “double standards”, as he has sung songs glorifying drugs and liqour previously. SAD supporters have accused Mann of defaming Punjab.
His friends also approve of the song. “We are all from good families. We don’t know what happened to us. Now, we are trying to shun drugs, but people would still consider us ‘Amali’ (addict),” says an addict. The addict, who has a job in the Forest Department, has no time to linger after his dose. “It is better to take this daily medicine than inject heroin daily. At least, now I do not create any trouble at home every morning like I used to by asking for money to get a heroin fix. I no longer have to think of thieving for heroin. Now, I have a job to go to,” he says as he rushes out.
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