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CHANDIGARH: At a time when the nexus between terrorists and drug smugglers in Pakistan has come under a harsh spotlight after the Pathankot airbase attack, a new study by AIIMS has found that opioids worth Rs 7,500 crore are consumed in Punjab every year. Of these, heroin's share is a massive Rs 6,500 crore.This is a startling revelation given that almost all the heroin that comes to Punjab is through the Pakistan border, pumped in by smugglers allegedly aided by ISI. It is this smuggler network that the terrorists who attacked the Pathankot airbase are believed to have used.Security agencies have so far insisted that Pakistani heroin is not consumed in Punjab; it merely passes through to bigger cities like Delhi. But this study - a first of its kind survey by the National Drug Dependence Treatment Centre (NDDTC) at AIIMS - busts the myth. It says that in a population of around 2.77 crore people, there are more than 1.23 lakh heroin-dependent people.Based on the previous studies, Punjab's opioid dependents are four times more than the global average.In effect, not only are the drug smugglers being used to push jihadis into India, they are also creating an army of heroin addicts in Punjab. The study has found that 0.84% (around 2.3 lakh) of the entire state's population is opioid dependent. It takes into account both opium derivatives as well as artificial substances that have the same effect as opiates on the nervous system.Previous studies conducted in select districts of Punjab had shown widespread use of synthetic or pharmaceutical opioid drugs The survey reveals that opioid-dependent people are spending approximately Rs 20 crore daily on these drugs. On an average a heroin-dependent individual spends about Rs 1,400 per day. The study - 'Punjab opioid dependence survey: Estimation of the size of opioid dependent population in Punjab' - was presented to Punjab health minister Surjit Kumar Jyani on January 6. "I have my doubts about the figure of Rs 20 crore per day. At the same time, the government is seeing this as a warning sign. We will aim for a drug-free state," he said.While around 2.3 lakh people are opioid-dependent in Punjab, around 8.6 lakhs are estimated to be opioid users. Heroin-dependents are the highest at 1,23,414. For the survey, NDDTC collaborated with Delhi based non-profit organisation Society for Promotion of Youth and Masses.The study was conducted between February and April 2015. Data was collected from 3,620 opioid dependents from 10 districts. Among the men aged between 18 and 35 years, four in 100 are opioid dependent, while 15 in 100 could be opioid users."We must also note that this survey estimates a much higher number of injecting drug users in Punjab (around 75,000) as compared to the existing estimate (under 20,000). Thus there is a clear threat of explosive epidemic of HIV among injecting drug users in Punjab," said the lead investigator and the principal author of the survey, Dr Atul Ambekar.In this survey, interviews were conducted mostly at the drug-dependence treatment and rehabilitation centres at the government civil hospitals of Punjab. Each respondent interviewed was asked to send three more people whom he knew and who were also opioid dependent. The respondents thus came voluntarily to participate in the survey and were interviewed in government hospitals.Previous studies in 2008 and 2012 (UNAIDS and United Nations Office on Drugs and Crime studies respectively) for Punjab indicated that pharmaceutical injectables were the drugs of choice. The current study shows that heroin is commonest."Our data shows that 80% of opioid dependent people in Punjab have tried to quit taking drugs but only 35% have received help. This may indicate either inadequate availability of services or reluctance / low-acceptance among the people to access available services," added Ambekar.