'Injecting drug use no longer confined to NE States'
Tentacles spread to hotspots in some States
Source: The Sangai Express / Agencies

New Delhi, November 01 2013 : "Injecting drug use is no longer confined to the North Eastern States of Manipur and Nagaland.

We have hotspots of drug use in States like Punjab, Orissa, Andhra Pradesh and Bihar", pointed out Lov Verma, Secretary, Department of AIDS Control, New Delhi.

Lov Verma was speaking at the opening day of the two-day National Dissemination Workshop held at New Delhi today.

The workshop is being organised by Emmanuel Hospital Association to share harm reduction initiatives and experiences among people who inject drugs (PWID) implemented by Project ORCHID in Manipur and Nagaland since October 2004 .

The Department of AIDS Control, Project ORCHID partner NGOs, representatives of State AIDS Control, UNAIDS, Emmanuel Hospital Association, Avahan India AIDS Initiative, Indian Drug Users' Forum, Indian Harm Reduction Network, North East Harm Reduction Network, HIV Alliance, and community representatives took part in the workshop.

The workshop coincides with the International Drug Users' Day which is observed every year on November 1 .

HIV among injecting drug users remains a great challenge in the North East, with Manipur still having the highest HIV prevalence among PWID.

There are similar challenges emerging in other States which need to be emphasised, added Verma.

Pointing out the difficulty in scaling up Opioid Substitution Therapy (OST), he urged community-based groups and networks in Manipur and Nagaland to put pressure on the State Governments so that the scale up process is hastened.

OST involves replacing a drug user's primary drug of use (opioid), for example heroin or spasmo proxyvon, with a medically safe drug in a safer mode of administration under medical supervision.

Currently there are 52 OST centres spread across 14 States in India.

The Government is setting a target of 300 centres by the end of this year.

Between Manipur and Nagaland there are presently 29 OST centres and around 3000 injecting drug users are availing services from these centres.

Emphasising the harm reduction strategy of Project ORCHID in North East, Ganesh Ramakrishnan, head of Avahan India AIDS Initiative, said that a concept like harm reduction was not understood well and accepted when ORCHID started working in North East.

However with strong focus on partners of drug users, including female drug users and their family, ORCHID was designed as a model intervention for injecting drug users, he added.

"There are a number of things that we can learn from Project ORCHID.

Orchid is not only a model for injecting drug use programme but also of partnership between various stakeholders including NGOs and the Government", Rama-krishnan said.

He also urged partners to sustain and scale up the programme and further maintained that it will be tragic if Project ORCHID is reduced to memory.

Zodingpui, a female injecting drug user from Churachandpur district in Manipur who took part in the workshop also stated that she has also benefited from the OST initiative in Manipur.

A Peer Educator in Shalom, one of the NGOs implementing OST in Manipur, Zodingpui started using drugs in 1983 during a college sports event.

Still under OST she had experienced a cycle of treatment and relapse in the past.

"Relapse is more common among female drug users.

Once the line is crossed (women using drugs) they are not accepted in the society even when she is not doing drugs any more.

Reintegration is easier in case of male drug user.

Due to this factor there is very low motivation among them to give up drugs", saidPuii, Director Shalom, Manipur.

Around 180 Female Injecting Drug Users (FIDU) are currently accessing harm reduction services from Shalom.

Representing the Indian Drug Users' Forum (IDUF), Abou Mere urged the Government to involve the community and not look at drug users as a problem.

He also urged the government and other stakeholders to look into the issue of drug overdose and Hepatitis-C, causes of unnecessary deaths every year.

Speaking at the workshop, TaufikBakkali, UNAIDS, said that community involvement and comprehensiveness of an intervention is what makes ORCHID's initiative different from others.

He however said that the workshop is also an opportunity to talk about what went wrong and how we can adapt better.

Swarup Sarkar, Special Advisor to UNITAID, who spoke at the workshop, said that globally budget for community-led organizations for HIV is very less for meaningful community involvement and added "Community organizations are yet to be seen as a regular essential mechanism integrated with development plans and processes.

As a result community-based groups and civil society organizations are struggling to survive in spite of their excellent work" .

We need to ask ourselves, are we doing enough in the North East, are we doing enough not to repeat what we have experienced in the North East - delayed response and increase in transmission, and are we doing enough to strengthen community organisations.

Our response is too slow and too little in other states, he added.

Emphasising community involvement in planning and implementation Dr Langkham, who heads the Project ORCHID initiatives in Manipur and Nagaland said, "I am not a drug user so all that I know I have learnt from the community and it is a joy to see them lead the programme today" .

Started in October 2004 the Project ORCHID harm reduction initiative focus on needle and syringe exchange for injecting drug users, condom promotion, service outreach in geographically difficult hill districts through outreach workers and secondary distributors, OST, nurse-led treatment of sexually transmitted infections, drug overdose management, and initiatives to prevent and manage crisis.

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