The State’s drug crisis has acquired another dimension following a steady increase in the number of female addicts. Vikas Vasudeva reports on the toll substance abuse has taken on the lives and families of these women and the infrastructural support needed to help them

She got hooked on drugs seven years ago. Her school-going, teenage daughter had introduced her to a drug. “Within three days,” says Jasmeet, 42, “I had become an addict.”

Jasmeet works as a domestic help in Jalandhar. She has been a regular visitor at a drug de-addiction centre in Kapurthala since 2014. Along with her, her husband and their only daughter are also undergoing treatment for heroin addiction. Cases of whole families being compulsive consumers of drugs are not uncommon in today’s Punjab.

Describing her descent into drug addiction, Jasmeet says, “After working all day, I would feel anxious and exhausted. One day my daughter came to me and said she had a medicine that would make me relax. I agreed to try it. She then injected the medicine, which turned out to be heroin. Initially I felt a heaviness in my head. But in a few hours I felt quite relaxed. I took the drug for two days. On the fourth day, when I skipped a dose, it felt as if my body was crumbling.”

As the daily dose of the drug — a fraction of a gram — helped Jasmeet to keep up her energy levels, she found it to be a support in helping her cope with her workload. At the time, she was earning ₹6,000-7,000 a month.

“I liked the drug as it made me feel agile while working,” recalls Jasmeet. Sourcing it was not a problem either as my daughter would get it from her friends. Later, I got myself introduced to drug suppliers and began to buy it directly from them. Over the years, the destructive side of the drug addiction started. I began to spend my entire earnings on drugs. As my dependence on heroin increased, I started selling my personal belongings to pay for it. The first thing I sold was my gold earrings.”

She adds, as she waits with her husband at the clinic centre: “My husband is a truck driver. He would be away from home for months at a time. So I had a free run. And he too was addicted to heroin. All three of us in the family had fallen prey to the drug. It was when my husband and I started selling jewellery that we started having quarrels, which also led our secrets [our drug habits] spilling into the open.”

“Most of the addicts at the centre have similar tales of how they got hooked on drugs — they all blame their friends.” | Photo Credit: AKHILESH KUMAR

Despite four years of methadone maintenance treatment [a comprehensive treatment programme using methadone], Jasmeet has so far been unable to kick the habit as her rehabilitation has been disrupted by relapses. Their daughter had visited the same clinic for her routine dose earlier in the day as she had to take care of her 18-month-old baby.

“I came to know that my daughter was also addicted to heroin the day she fainted. We took her to the hospital, where it became clear that she had been on drugs. My husband was in jail at the time on charges of drug trafficking. My daughter and I nearly starved to death before a worker from a local non-governmental organisation came to our rescue and took us for treatment,” Jasmeet remembers.

Says her husband, Amandeep, 45: “I spent nearly three years in jail before I was acquitted of the charges. It was a really bad phase in our lives. We kept quarrelling whenever I was at home. We neglected our daughter. We were on the verge of getting divorced. Altogether I wasted nearly ₹4 lakh, first on drugs and then on court fees. We sold almost all our belongings, except for a small house that we somehow managed to retain. It is not as if the local police are unaware of what is going on but no one is bothered.” He emphasises the point that the availability of drugs needs to be curtailed if the drug epidemic in the State is to be ended.

The road to ruin

The latest front to have emerged in Punjab’s war on drugs is the growing number of women addicts. However, data on the number of women addicts are not available — or on the number of de-addiction centres for women. Punjab has 31 government-run de-addiction centres but only one exclusively for women. This is in Kapurthala, which it came up in July last year.

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Around three years ago, Tara, 25, from Jalandhar, began having heroin in the company of her friends for “enjoyment and relaxation”. What followed was a descent into addiction and misery that eventually led her to becoming a drug peddler.

“Tara was brought to our centre for treatment about seven months ago by the police,” says Dr. Sandeep Bhola, who is in charge of the Kapurthala centre. “They had arrested her in connection with a drug smuggling case. She was not interested in treatment. But two weeks later she came back with her family and signed up here. She is well educated and was working as a teacher in a government school. But her colleagues and friends got her hooked on heroin.”

Describing her ordeal, Dr. Bhola observes that the desire to show that she belonged to an “upmarket and open” culture drew her to drugs. “Once she got addicted, she entered the drugs business herself in a bid to earn more money and fund her addiction.”

Dr. Bhola points out that while the problem of drug abuse among women is on the rise, not many seek help. Two factors hold them back: social stigma, and the lack of exclusive treatment centres for women. “Establishing exclusive treatment facilities for women and large-scale awareness, besides a crackdown on availability are necessary to address the problem,” he says.

Sangeeta, 28, who works as a daily wager with food service units in Kapurthala, echoes his sentiments: “My friends lured me into it. Initially, they offered me heroin for free. Once I was addicted, they began to demand money. I ended up spending my entire day’s wage of ₹400-500 on drugs.” She is currently under treatment.

Dr. Sandeep Bhola, psychiatrist at the 'Navjeevan Kendra' a drug de-addiction centre treating men and women at Civil Hospital in Kapurthala. Photo: Akhilesh Kumar | Photo Credit: AKHILESH KUMAR

“I started taking heroin, inhaling it through foil. Later, I began injecting it. In about four days I was addicted. My day started with a dose of heroin as it helped me to keep working without feeling tired. When I was left with no money, I would have sex with peddlers in exchange for the drug,” says Sangeeta, whose husband is also a truck driver.

Under treatment at the Kapurthala centre since 2016, she remembers her past with horror: “It was a terrible time that I want to completely forget. I didn’t even have money to feed my four children. No savings, nothing left for their health and education.”

Shaminder, a counsellor at the clinic, says that drug abuse among women is increasing: “Until a few years ago there were hardly any female patients. But in the last couple of years their numbers have been rising. The women who visit us are from across a wide cross-section of society — rich, poor, educated, uneducated. But it is mostly the lower- and the middle-class patients who take regular treatment from us. There is a high percentage of female sex workers among our patients. The upper middle class prefer to visit private de-addiction centres as the social stigma associated with a woman drug addict is the biggest source of anxiety for them and their families.”

At the Kapurthala centre, over 60 female patients have undergone treatment since 2012. While 35 were treated through the outpatient department (OPD), the remainder got admitted at the indoor patient facility.

“These patients have been treated for substance (drug) abuse and dependence. Most of them are here for a month or two and discharged after treatment,” says Shaminder. The centre has a 15-bed facility where, at present, three indoor patients have been admitted while 10 are undergoing treatment through the OPD.

Lured by ‘friends’

Most of the addicts at the centre have similar tales of how they got hooked on drugs — they all blame their friends. Rajni, 35, from Kapurthala, had been on heroin for nearly five years, until 2017, when she decided to seek treatment. “My friends introduced me to heroin,” she says. “My husband died 10 years ago. I had four school-going children to look after. I was finding it difficult to manage. One day my friend offered me heroin to ‘relax’ and that was it. I took to it. I used to earn ₹200-300 a day cleaning utensils in houses. I began to spend everything I earned on drugs.”

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Rajni is at the centre along with Rimpi, her teenage niece, who is also under treatment for heroin addiction. She says her addiction to drugs caused her niece also to fall into the same trap. “When I ran out of money, I started offering my place to peddlers. They would come to my home and use it as a safe haven to do drugs. Then I started to have sex with them in exchange for heroin. While I remained ‘high’, my children and niece suffered. Things got so bad that it didn’t even register that my children hadn’t been fed for three to four days. My neighbours found them crying and extended help,” she says.

Rimpi says her drug habit completely ruined her family life. “My addiction to heroin was the reason my husband and I got separated. Raising my two-year-old as a single mother has been very difficult.”

Shaminder, who has been at the de-addiction centre since 2013, says she has seen addicts from across the community, all ages, occupations, and class categories. Sharing details about Manpreet, a college student, she says, “This young girl, from a financially well-off family, came to us for treatment in 2014. She had been on heroin for more than four years. Her boyfriend had introduced her to heroin on the pretext that it would improve her concentration and keep her relaxed while preparing for her examinations. After she broke up with him, she began to source drugs from female sex workers. She told us that on several occasions she had had sex with different men in exchange for drugs. She dropped out of college and stayed at home for more than a year. All through this her parents remained clueless about her drug habit. Accessing heroin was never a problem for her as she had developed an efficient system of suppliers. Whenever she needed a ‘dose’, she would ‘give a missed call’ to the agent’s cell phone number, and would have it delivered home. She had identified a spot near the main gate of her house where the agent would hide the package and take the money left for him there.”

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Adds Shaminder: “Manpreet had two names, one for use in public life, and another one by which she was well known among drug dealers.” “Everyone in Kapurthala’s drug circle knew her. After treatment, she is doing fine now. She told me recently that she is getting married soon and trying to move on with her life.”

Alarming levels of dependence

A recent study, titled “Epidemiology of substance use and dependence in the state of Punjab, India: Results of a household survey on a statewide representative sample” — by the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, and published in March 2018 in the Asian Journal of Psychiatry — says that in Punjab, almost 4.1 million people have been found to have used a substance (licit or illicit) at least once in their lifetime. Among the lifetime users, four million were men and around 0.1 million women. The number of people dependent on a substance in their lifetime was 3.2 million (3.1 million men and 0.1 million women). Licit substances consist of alcohol and tobacco, while illicit substances include opioids, cannabinoids, inhalants, stimulants, and sedatives.

Opioids (heroin, smack, crude opium, poppy husk) were by far the most commonly used illicit drugs in the State. In the study, there were around 2,02,817 males and 10,658 females who displayed “lifetime dependence” on opioids as per World Health Organisation criteria. Interestingly, while 1,56,942 males were “currently dependent” on opioids, the corresponding figure for females remained the same (at 10,658), which experts find alarming.

“It is alarming because while the number of men who are ‘currently dependent’ on opioids is substantially less when compared to the number for ‘lifetime dependence’, in the case of women, the figures for the two categories are the same. That ‘current dependence’ among men is less when compared to ‘lifetime dependence’ suggesting that a large number of those who use and become dependent on opioids eventually break out of the drug habit. That is why a smaller proportion is currently dependent. With women, on the other hand, those using opioids become dependent on them, and will not or cannot stop using them. They continue using it in a dependent pattern, which is deeply worrying,” says Dr. Subodh B.N. from the Department of Psychiatry at the PGIMER.

He points out most women do not come forward for treatment fearing social stigma, which means that the actual number of women addicts is likely to be higher. “Exclusive treatment centres for women will definitely help,” he says.

For Nimmi, 32, it was not easy to overcome her fears and step out of her house for treatment. “The fear of being judged by society is what initially kept me from seeking treatment. It took almost a year of persuasion by my sister-in-law before I could get myself to visit the de-addiction centre,” she says. Since 2015, she has been regularly making the 30 km trip from her village to Kapurthala for treatment.

“Taking treatment meant that everyone would get to know that I am a drug addict,” she says. “It is not easy to live a normal life once you are addicted. In my village, most people know each other. While few are there to support you, there are too many who taunt for you for being an addict. My entire life has been ruined. My husband and I are separated. He is an alcoholic. I have three children. My third child is only 11 months old. To live with an alcoholic husband and such a young baby was also getting to be very difficult. I can’t feed the child because I have relapsed several times during the treatment. For a mother, not being able to breast feed is painful.”

Nimmi is now wiser for her decision to seek help: “What is most important is that once you get addicted to drugs, you admit that fact to yourself. If you continue to remain in denial, then by the time the consequences begin to hit you, it is often too late.” “Treatment for women and also children should be made available in exclusive centres across the State. Only then will Punjab stand a chance of winning a battle that it has been waging for so long.”

The names of the patients have been changed to protect their identities