Drug addiction in Bangladesh

Introduction

a) Background of the study:

Background of the study means what’s the importance of this study or why it is important

b) Scope of the study: Scope of the study is to consider as the area or the department where we are going to work according to our requirements.

c) Methodology: Methodology of the study signifies that from which sources we collected data for our requirements

i) Primary source:

• Field work

ii) Secondary source:

• Web sites

• Reference books:

d) Object of the study:

Objects of the study indicate what we want to archive by doing this group project report.

As we have done the group project, we have also some objects under the study. The objects are given below:

• To inform the people about Drug Addiction and its effect and cause.

• How we can control this problem.

• How to treat the addicted people.

• To concius the young generation.

e) Limitation

Here, the term limitation means what problem we faced in work place we faced some problems.

• Problem with find out the drug addicted people.

• The police did not cooperate with us.

What is a drug?

A drug is any chemical that produces a therapeutic or non-therapeutic effect in the body. Many prescription drugs that produce therapeutic effects may also cause non-therapeutic effects if taken in excess and/or without a specific prescription.

Drug addiction is considered a pathological state. The disorder of addiction involves the progression of acute drug use to the development of drug-seeking behavior, the vulnerability to relapse, and the decreased ability to respond to naturally rewarding stimuli.

About Primary Source

Primary source means the physical and face to face interaction information getting system for a report. For our report we went to Zia Uddan and collect our essential information or data about our report.

About the interview of drug addicted people

PERSON-1

Name: Mr. Mahatab (Hirhonci)

Photo

Age: 45-46

District: Sylhet

Occupation: Unemployed

Marital status: Married

Family: He told us about just his brother.

Physical condition: Suffering from many diseases.

Education level: N/A

First drug: Biri

First drug experience: Felt good

Present drugs: Bacchu biri, Wits( Ganza).

Cause of being drug addicted: Influenced by friends.

Area of getting drug: When he was 12/13 years of old.

Sources of Drugs: BNP Colony (Agargaon), Gulistan.

Amount of doses per day use: Depend on earning.

Earning process: Begging

Desire to come back: No

PERSON-2

Name: Mr. Shohid (Dead Body)

Photo

Age: 25-26

District: Noakhali

Occupation: Tokai

Marital status: Unmarried

Family: N/A

Physical condition: All time trembling, sometime getting fever and about to abnormal.

Education level: Up to class 5.

First drug: Biri and Wits(Ganza)

First drug experience: Felt bad

Present drugs: Bacchu biri, Wits( Ganza).

Cause of being drug addicted: For own interest.

Area of getting drug: When he was 9 years of old.

Sources of Drugs: Gulistan.

Amount of doses per day use: He takes 2/3 doses(Puria), Sometimes he takes Hirone when his income become high.

Earning process: Tokai

Desire to come back: He disre to come back but he has no money or who will take care of them.

PERSON-3

Name: Mr. Babul

Age: 27-28 Photo

District: Chandpur

Occupation: Normal work

Marital status: Unmarried

Family: N/A

Physical condition: All time trembling, sometime getting fever and about to abnormal.

Education level: Up to class 8.

First drug: Biri and Wits (Ganza)

First drug experience: Good

Present drugs: Bacchu biri, Wits ( Ganza).

Cause of being drug addicted: Failure in love.

Area of getting drug: When he was 18 years of old.

Sources of Drugs: Gulistan, Puran Dhaka.

Amount of doses per day use: He takes 2 doses (Puria – 50 Tk.),

Earning process: Tokai

Desire to come back: No interest about life.

PERSON-4

Name: Afjal Hossain

Age: 33

District: Bikrompur.

Occupation: Normal work

Marital status: Married

Family: 2 wives, 5 children.

Physical condition: Serious

Education level: Illiterate

First drug: Cigarette

First drug experience: Good

Present drugs: Anything.

Cause of being drug addicted: Family conflict.

Area of getting drug: When he was 25 years of old.

Sources of Drugs: Gabtoli, Mirpur.

Amount of doses per day use: How much he get.

Earning process: Cooli.

Desire to come back: No intesrest about life.

About secondary source

Secondary source means what we get for our report without face to face interaction like by the help of website, books, newspapers, magazines etc.

Some information about Drug Addiction

Due to the variety and continual chemical alterations made to drugs, some drugs are now more addictive and pose a greater health risk than others. This is in part due to the pharmacology of the substance, and how it affects the mood and behavior of the user. However, a drug addiction is often characterized by certain habits and behavior shown by the individual.

Characteristics of a Drug Addiction

1. Loss of control: The drug user is unable to predict what will happen when he uses the substance. One day he may be able to stop after one drink, or after one line of cocaine; the next day he may not be able to control his use at all.
2. Compulsive preoccupation: The drug addict spends a great deal of time thinking about the substance he consumes.

Continued use despite negative consequences: If drinking or drug use causes problems but the individual still continues to consume the substancet, the individual is tempting drug addiction or is already addicted. The person has lost voluntary control over the use of that substance.

Category of Drug:

Drugs are categorized into seven different types:

1. Cannabinoids (hashish and marijuana)
2. Depressants (such as Nembutol, Xanax, and Qualudes
3. Dissociative Anesthetics (such as PCP)
4. Hallucinogens (such as LSD and mescaline)
5. Stimulants (such as amphetamines and cocaine)
6. Other compounds (such as steroids and inhalants)
7. Opioids and Morphine derivatives (such as heroin, opium, and some prescription drugs, including Vicodin).

There are literally hundreds of commonly abused drugs readily available to users. The National Institute on Drug Abuse has compiled an extensive table identifying about 50 commonly abused drugs with useful information that includes:

• Category
• Examples of commercial and street names
• How administered (orally or by needle)
• Intoxication effects
• Potential Health consequences

The table is by no means all-inclusive of currently available narcotics and otherwise illicit drugs, and experts warn that additional ones become available every day.

Drug Addiction: The Symptoms

Drug addiction produces a drug personality with these symptoms:

• Mood swings
• Unreliable
• Dishonesty
• Unable to finish projects
• May begin stealing from family and friends
• depressed
• Unexpressed resentment and secret hatreds
• Lies to family, friends, and employers
• Withdraws from those who love him
• Isolates self
• May appear chronically

Due to the variety and continual chemical alterations made to drugs, some drugs are now more addictive and pose a greater health risk than others. This is in part due to the pharmacology of the substance, and how it affects the mood and behavior of the user. However, a drug addiction is often characterized by certain habits and behavior shown by the individual.

Characteristics of a Drug Addiction

3. Loss of control: The drug user is unable to predict what will happen when he uses the substance. One day he may be able to stop after one drink, or after one line of cocaine; the next day he may not be able to control his use at all.
4. Compulsive preoccupation: The drug addict spends a great deal of time thinking about the substance he consumes.

Continued use despite negative consequences: If drinking or drug use causes problems but the individual still continues to consume the substancet, the individual is tempting drug addiction or is already addicted. The person has lost voluntary control over the use of that substance.

Addiction reaches beyond alcohol and drugs. Many people suffer from all sorts of different addictions. Gambling, eating, shopping, sex, internet, work, video games, etc can all be just as addictive in many cases just as destructive to a person. Those behaviors may affect the person differently, but they can be just as devastating as substance dependence. The 12 step program, which was originally devised for overcoming alcoholism, has now been transformed into well over 200 different addiction support groups. Always remember too much of a good thing can hurt you.

What are the signs and symptoms of drug abuse?

With the extent and diversity of available substances, the signs and symptoms of drug abuse vary widely. For example, whereas the primary initial physical signs of LSD are hallucinations, the signs for opioids such as Vicodin are euphoria and drowsiness.

Focus Adolescent Services has developed a useful chart of warning signs for teen substance abuse based on changes and trends rather than just physical symptoms:

Physical
Fatigue, repeated health complaints, red and glazed eyes, and a lasting cough

Emotional
Personality change, sudden mood changes, low self-esteem, irritability, irresponsible behavior, poor judgment, depression, general lack of interest

Family
Starting arguments, breaking rules, withdrawing from the family

School
Decreased interest, negative attitude, drop in grades, many absences, truancy, discipline problems

Social Problems
New anti-social friends, problems with the law, changes to less conventional styles in dress and music

What causes drug addiction?

People use drugs for many reasons, such as:

• curiosity or experimentation
• peer pressure or desire to be part of a group
• a sense of relaxation and pleasurable euphoria
• Numbing effect that helps to ease physical or emotional pain.

It is not likely that anyone begins using a drug with the intention of becoming addicted. However, the very qualities that lead to use are in themselves addictive. In addition, addiction results in painful withdrawal symptoms when stopped suddenly, providing another incentive to continue using.

The medical causes of drug addiction are not fully known. Researchers can only state with assurance that the repeated use of addictive drugs can bring about dramatic changes in both the structure and the function of the brain in destructive ways that can result in compulsive drug use.

The most recent scientific research speculates that some people may be more prone to drug addiction than others and that there may be genes that predispose certain people to addiction. However, an even more important factor in the cause of addiction may be social circumstances, which include:

• low self-esteem
• emotional distress
• patterns of use in the addict's family or subculture
• peer pressure
• advertising or media influence
• easy access.

Drugs causing addiction

Drugs causing addiction include both illegal drugs as well as prescription or over the counter.

• Stimulants:
• Amphetamine and Methamphetamine
• Caffeine
• Cocaine
• Nicotine

• Sedatives and Hypnotics:
• Alcohol
• Barbiturates
• Benzodiazepines, particularly alprazolam, clonazepam, temazepam, and nimetazepam
• Methaqualone and the related quinazolinone sedative-hypnotics

• Opiate and Opioid analgesics
• Morphine and Codeine, the two naturally-occurring opiate analgesics
• Semi-synthetic opiates, such as Heroin (Diacetylmorphine), Oxycodone, and Hydromorphone
• Fully synthetic opiods, such as Fentanyl and its analogs, Meperidine/Pethidine, and Methadone

These substances (sometimes called "downers") typically facilitate relaxation and pain-relief.

• Steroidal medications

Addictive drugs also include a large number of substrates that are currently considered to have no medical value and are not available over the counter or by prescription.

Addictive potency

The addictive potency of drugs varies from substance to substance, and from individual to individual

Drugs such as codeine or alcohol, for instance, typically require many more exposures to addict their users than drugs such as heroin or cocaine. Likewise, a person who is psychologically or genetically predisposed to addiction is much more likely to suffer from it.

Although dependency on hallucinogens like LSD ("acid") and psilocybin (key hallucinogen in "magic mushrooms") is listed as Substance-Related Disorder in the DSM-IV, most psychologists do not classify them as addictive drugs.

Prevalence

The most common drug addictions are to legal substances such as:

• Alcohol
• Nicotine in the form of tobacco, particularly cigarettes
• Caffeine in the form of pills, tea, coffee, and caffeinated sodas

The biological basis of drug addiction

Researchers have conducted numerous investigations using animal models and functional brain imaging on humans in order to define the mechanisms underlying drug addiction in the brain. This intriguing topic incorporates several areas of the brain and synaptic changes, or neuroplasticity, which occurs in these areas. Acute effects

Acute (or recreational) drug use causes the release and prolonged action of dopamine and serotonin within the reward circuit. Different types of drug produce these effects by different methods. DA appears to harbor the largest effect and its action is characterized. DA binds to the D1 receptor, triggering a signaling cascade with in the cell. CAMP-dependent protein kinase (PKA) phosphorylates CAMP response element binding protein (CREB), a transcription factor, which induces the synthesis of certain genes including CFos. ^[4]

Reward circuit

When examining the biological basis of drug addition, one must first understand the pathways in which drugs act and how drugs can alter those pathways. The reward circuit, also referred to as the mesolimbic system, is characterizing by the interaction of several areas of the brain.

• The ventral tegmental area (VTA) consists of dopaminergic neurons which respond to glutamate. These cells respond when stimuli indicative of a reward are present. The VTA supports learning and sensitization development and releases dopamine (DA) into the forebrain.^[5] These neurons also project and release DA into the nucleus accubems ^[6], through the mesolimbic pathway. Virtually all drugs causing drug addiction increases the dopamine release in the mesolimbic pathway ^[7], in addition to their specific effects.
• The nucleus accumbens (NAc) consists mainly of medium-spiny projection neurons (MSNs), which are glutamatergic neurons. ^[8] The NAc is associated with acquiring and eliciting conditioned behaviors and involved in the increased sensitivity to drugs as addiction progresses. ^[9].
• The prefrontal cortex, more specifically the anterior cingulate and orbitofrontal cortices^[10], is important for the integration of information which contributes to whether a behavior will be elicited. It appears to be the area in which motivation originates and the salience of stimuli is determined. ^[11]
• The basolateral amygdala projects into the NAc and is thought to be important for motivation as well. ^[12]
• More evidence is pointing towards the role of the hippocampus in drug addiction because of its importance in learning and memory. Much of this evidence stems from investigations manipulating cells in the hippocampus alters dopamine levels in NAc and firing rates of VTA dopaminergic cells.

Stress response

In addition to the reward circuit, it is hypothesized that stress mechanisms also play a role in addiction. Koob and Kreek have hypothesized that during drug use corticotrophin-releasing factor (CRF) activates the hypothalamic-pituitary-adrenal axis (HPA) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with drug addiction. They have found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid (CSF). In rat models, the separate use of CRF antagonists and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed a dysregulation in other hormones associated with the HPA axis, including enkephalin which is an endogenous opioid peptides that regulates pain. It also appears that the µ-opioid receptor system, which enkephalin acts on, is influential in the reward system and can regulate the expression of stress hormones.

Behavior

Understanding how learning and behavior work in the reward circuit can help understand the action of addictive drugs. Drug addiction is characterized by strong, drug seeking behaviors in which the addict persistently craves and seeks out drugs, despite the knowledge of harmful consequences. Addictive drugs produce a reward, which is the euphoric feeling resulting from sustained DA concentrations in the synaptic cleft of neurons in the brain. Operant conditioning is exhibited in drug addicts as well as laboratory mice, rats, and primates; they are able to associate an action or behavior, in this case seeking out the drug, with a reward, which is the effect of the drug. ^[17] Evidence shows that this behavior is most likely a result of the synaptic changes which have occurred due to repeated drug exposure. ^[18], ^[19], ^[20] The drug seeking behavior is induced by glutamatergic projections from the prefrontal cortex to the NAc. This idea is supported with data from experiments showing the drug seeking behavior can be prevented following the inhibition of AMPA glutamate receptors and glutamate release in the NAc.

Allostasis

The concept of allostasis is the process of achieving stability through changes in behavior as well as physiological features. Allostasis appears to adjust as a person progresses into drug addiction and enters a new allostatic state, defined as divergence from normal levels of change which persist in a chronic state. Addiction to drugs can cause damage to your brain and body as you enter the pathological state; the cost stemming from damage is known as allostatic load. The dysregulation of allostasis gradually occurs as the reward from the drug decreases and the ability to overcome the depressed state following drug use begins to decrease as well. The resulting allostatic load creates a constant state of depression relative to normal allostatic changes. What pushes this decrease is the propensity of drug users to take the drug before the brain and body have returned to original allostatic levels, producing a constant state of stress. Therefore, environmental stressors may induce stronger drug seeking behaviors than in the presence of no environmental stressors.

Neuroplasticity

Neuroplasticity is the putative mechanism behind learning and memory. It involves physical changes in the synapses between two communicating neurons, characterized by increased gene expression, altered cell signaling, and the formation of new synapses between the communicating neurons. When addictive drugs are present in the system, they appear to hijack this mechanism in the reward system so that motivation is geared towards procuring the drug rather than natural rewards. ^[23] Depending on the history of drug use, nucleus accumbens (NAc) excitatory synapses experience two types of neuroplasticity, or bidirectional plasticity, long-term potentiation (LTP) and long-term depression (LTD). Using mice as a model, Kourrich, ‘’et al’’, displayed that chronic exposure to cocaine increases the strength of synapses in NAc after a 10-14 day withdrawal period, while strengthened synapses did not appear within a 24 hour withdrawal period after repeated cocaine exposure. A single dose of cocaine did not display any attributes of a strengthened synapse. When drug experienced mice were challenged with one dose of cocaine, synaptic depression occurred. Therefore, it seems the history of cocaine exposure along with withdrawal times affects the direction of glutamatergic plasticity in the NAc.

Once a person has transitioned from drug use to addiction, behavior becomes completely geared towards seeking the drug, even though addicts report the euphoria is not as intense as it once was. Despite the differing actions of drugs during acute use, the final pathway of addiction is the same. Another aspect of drug addiction is a decreased response to normal biological stimuli, such as food, sex, and social interaction. Through functional brain imaging of patients addicted to cocaine, scientists have been able to visualize increased metabolic activity in the anterior cingulate and orbitofrontal cortex (areas of the prefrontal cortex) in the brain of these subjects. The hyperactivity of these areas of the brain in addicted subjects are involved in the more intense motivation to find the drug rather than seeking natural rewards, as well as an addict’s decreased ability to overcome this urge. Brain imaging has also shown cocaine-addicted subjects to have decreased activity, as compared to non-addicts, in their prefrontal cortex when presented with stimuli associated with natural rewards. The transition from recreational drug use to addiction occurs in gradual stages and is produced by the effect of the drug of choice on the neuroplasticity of the neurons found in the reward circuit. During events preceding addiction, cravings are produced by the release of DA in the prefrontal cortex. As a person transitions from drug use to addiction, the release of dopamine (DA) in the NAc becomes unnecessary to produce cravings; rather, DA transmission decreases while increased metabolic activity in the orbitofrontal cortex contributes to cravings. Before a person becomes addicted and exhibits drug-seeking behavior, there is a time period in which the neuroplasticity is reversible. Addiction occurs when drug-seeking behavior is exhibited and the vulnerability to relapse persists, despite prolonged withdrawal; these behavioral attributes are the result of neuroplastic changes which are brought about by repeated exposure to drugs and are relatively permanent.

The exact mechanism behind a drug molecule’s effect on synaptic plasticity is still unclear. However, neuroplasticity in glutamatergic projections seems to be a major result of repeated drug exposure. There are several ways in which glutamate transmission is altered. One way is by increasing presynaptic release of glutamate and the other is increased response to glutamate. ^[26], ^[27]. The two main glutamate receptors involved are NMDAR and AMPAR. The expression of these receptors on the cell surface increases with repeated drug use. This type of synaptic plasticity results in LTP, which strengthens connections between two neurons; onset of this occurs quickly and the result is constant. In addition to glutamatergic neurons, dopaminergic neurons present in the VTA respond to glutamate and may be recruited earliest during neural adaptations caused by repeated drug exposure. As shown by Kourrich, et al, history of drug exposure and the time of withdrawal from last exposure appear to play an important role in the direction of plasticity in the neurons of the reward system.

An aspect of neuron development that may also play a part in drug-induced neuroplasticity is the presence of axon guidance molecules such as semaphorins and ephrins. After repeated cocaine treatment, altered expression (increase or decrease dependent on the type of molecule) of mRNA coding for axon guidance molecules occurred in rats. This may contribute to the alterations in the reward circuit characteristic of drug addiction.

Neurogenesis

Drug addiction also raises the issue of potential harmful effects on the development of new neurons in adults. Eisch and Harburg raise three new concepts they have extrapolated from the numerous recent studies on drug addiction. First, neurogenesis decreases as a result of repeated exposure to additive drugs. A list of studies show that chronic use of opiates, psychostimulants, nicotine, and alcohol decrease neurogenesis in mice and rats. Second, this apparent decrease in neurogenesis seems to be independent of HPA axis activation. Other environmental factors other than drug exposure such as age, stress and exercise, can also have an effect of neurogenesis by regulating the hypothalamic-pituitary-adrenal (HPA) axis. Mounting evidence suggests this for 3 reasons: small doses of opiates and psychostimulants increase coricosterone concentration in serum but with no effect of neurogenesis; although decreased neurogenesis is similar between self-administered and forced drug intake, activation of HPA axis is greater in self-administration subjects; and even after the inhibition of opiate induced increase of corticosterone, a decrease in neurogenesis occurred. These, of course, need to be investigated further. Last, addictive drugs appear to only affect proliferation in the subgranular zone (SGZ), rather than other areas associated with neurogenesis. The studies of drug use and neurogenesis may have implications on stem cell biology.

Psychological drug tolerance

The reward system is partly responsible for the psychological part of drug tolerance;

The CREB protein, a transcription factor activated by cyclic adenosine monophosphate (cAMP) immediately after a high, triggers genes that produce proteins such as dynorphin, which cuts off dopamine release and temporarily inhibits the reward circuit. In chronic drug users, a sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for an additional "fix".

Sensitization

Sensitization is the increasy in sensitivity to a drug after prolonged use. The proteins delta FosB and regulator of G-protein Signaling 9-2 (RGS 9-2) arethought to be involved:

A transcription factor, known as delta FosB, is thought to activate genes that, counter to the effects of CREB, actually increase the user's sensitivity to the effects of the substance. Delta FosB slowly builds up with each exposure to the drug and remains activated for weeks after the last exposure—long after the effects of CREB have faded. The hypersensitivity that it causes is thought to be responsible for the intense cravings associated with drug addiction, and is often extended to even the peripheral cues of drug use, such as related behaviors or the sight of drug paraphernalia. There is some evidence that delta FosB even causes structural changes within the nucleus accumbens, which presumably helps to perpetuate the cravings, and may be responsible for the high incidence of relapse that occur in treated drug addicts.

Regulator of G-protein Signaling 9-2 (RGS 9-2) has recently been the subject of several animal knockout studies. Animals lacking RGS 9-2 appear to have increased sensitivity to dopamine receptor agonists such as cocaine and amphetamines; over-expression of RGS 9-2 causes a lack of responsiveness to these same agonists. RGS 9-2 is believed to catalyze inactivation of the G-protein coupled D2 receptor by enhancing the rate of GTP hydrolysis of the G alpha subunit which transmits signals into the interior of the cell.

Individual mechanisms of effect

The basic mechanisms by which different substances activate the reward system are as described above, but vary slightly among drug classes.

Depressants

Depressants such as alcohol and benzodiazepines work by increasing the affinity of the GABA receptor for its ligand; GABA. Narcotics such as morphine and methadone, work by mimicking endorphins—chemicals produced naturally by the body which have effects similar to dopamine—or by disabling the neurons that normally inhibit the release of dopamine in the reward system. These substances (sometimes called "downers") typically facilitate relaxation and pain-relief.

Stimulants

Stimulants such as amphetamines, nicotine, and cocaine, increase dopamine signaling in the reward system either by directly stimulating its release, or by blocking its absorption (see "reuptake"). These substances (sometimes called "uppers") typically cause heightened alertness and energy. They cause a pleasant feeling in the head known as a high. This high wears off leaving the user feeling depressed. This makes them want more of the drug or the addiction.

What are the effects of drug abuse?

In addition to these lifestyle changes, drug abuse can have serious short- and long-term medical effects, among which are:

• dangerously increased heart rate and blood pressure
• hepatitis or AIDS through shared needles
• violent, erratic, or paranoid behavior and hallucinations
• clinical depression
• sleeplessness and tremors
• liver, lung, and kidney impairment
• sudden death (from misuse of inhalants, or from heart attack or stroke).

Most of the most serious medical effects result if and when a drug abuser becomes addicted to a drug or drugs. The sequence of events often is as follows:

• S/he experiments with a popular addictive drug.
• S/he enjoys the euphoria and repeats the use again and again.
• S/he may try to stop using the drug.
• S/he can't stop; the brain demands the drug.

The drug use is compulsive; s/he is addicted

Drug addiction in children

Knowing that your child is abusing drugs may not be as easy as it is made out to be. As parents we are always on the look out for a our children’s welfare. We watch over them and worry about them but, even then, we may not be the first to know if our child is seeking excitement and comfort in chemical substances.

Statistics show that parents that unambiguously communicate their desire that their children stay well clear of drugs are 50% less likely to have children that do drugs. Communication cannot be underestimated. Communication, however, is not just telling our kids how we feel about drugs it is creating a climate where they feel comfortable to give us their own UNCENSORED view.

The first thing that a parent feels when a child is discovered to be taking drugs is overwhelming guilt and some anger. The anger is aimed at the fact that the loved one has placed themselves in danger and this is unbearably painful for a parent. The guilt comes from a feeling that they should have known, that there was something that they could have done to stop this from happening.

When your child takes drugs it is time to take off the blinkers. All of them. The only way out is going to be through a great deal of painful but liberating honesty and overzealous feelings of guilt don’t help. Guilt trips for parent or child are not appropriate. You need to practice forgiveness and compassion like you have never done previously. You will also need professional help. Don’t be afraid, good help should strip you naked and give you nowhere to hide, you and your child. This is good. Your family will never be the same again. It will be stronger and more robust. This is the potential.

When parents are the addict

When a parent takes drugs the child feels that their childhood has been taken from them. They begin to take on the role of parent to their childlike mother or father. This means that they end up surrendering all their own questions and issues about life to the overwhelming parental dilemma.

More often than not the child of the drug addict feels painfully responsible. He or she can never relax into their own lives. They must always be vigilant lest the sky fall. They give up their own feelings on a deep profound level believing that they must be strong for a parent that is invariably a poisonous mixture of need and anger.

Children of alcoholics and drug addicts can have their young lives irreparably damaged if they do not seek help from neutral outside agencies. It is important that these people are not extended family members who end up treating the child like the responsible adult. Support groups and relevant professionals have the power to give the children of addicts their childhood back. This is crucial.

The addiction of one member of the couple

It is tough to love someone who is lovable one moment and a monster the next. It is tough not to feel somehow responsible for their pain. It is tough not to give up your own life in support of a lost cause.

Honesty is the only defense in the domestic situation that involves the drug addict partner. Being a strong partner can not only save yourself and your partner but more importantly it will provide a redemptive role model for children in the family.

When one parent is disintegrating it is all the more important that children be able to look to the other parent for support. The addict creates a quasi reality that threatens to suck in every member of the family. The addict has lost contact with reality and is being ruled only by his or her need for the substance of addiction

If the sober partner finds it too difficult to confront the drug addict he or she should be strong enough to recognize that and seek help from professionals outside of the little hell that is fast being created by the addictive behavior.

Drug addiction and abuse has the power to destroy a family forever. The best defense is to take it 100% seriously. This means admitting that the problem will not go away if you all conspire to ignore it. The best defense is to look the interloper straight in the eye and act to save every member of the family. Immediately. Do not wait for a catastrophe. Do not worry that you are over reacting. Trust your gut on this and get help.

When somebody becomes addicted to drugs, the answers to quitting aren’t always as simple as we’d like them to be. It isn’t a case of the user simply been self-indulgent. Nor is it a case of “if they wanted to quit, they would do”. It isn’t so simple because of the changes which occur in the brain, and the body of the addicted person.

Physical addiction can be explained in more simple terms and can be cracked relatively simply by a good drugs detox program. When somebody has abused drugs, the drugs store themselves in the fat tissues of the body and release themselves into the person’s blood stream even years afterwards. This sustains a level of addiction and initiates cravings. Drugs detox will remove the physical craving by speeding up the process by which the toxins are removed from the body.

Although all drugs have different effects on the mind, the types of drugs people become addicted to all have one thing in common: they have changed the persons mind. Drugs are taken because they release feel-good chemicals in the brain. These are the same chemicals which are released naturally as good things happen in our lives. They are known as reward censors. Drugs generally become addictive because the reward censors reward the user greatly every time a drug is consumed. The drug becomes the users greatest pleasure source, if not eventually only pleasure source. The drugs, in effect, trick the mind into rewarding itself for every drug it takes.

A great deal of brain re-wiring occurs when somebody becomes addicted; therefore the reversal process has to undergo the same rewiring. It takes time, and it takes effort and it is never easy. Do some research and reading, learn and become primed in the ways you can become rehabilitated before undertaking a program and you will help yourself greatly.

Drug Addiction and Society

The addiction to drugs arises more from psychological problem lurking in the back ground of the person. The impression that addiction is a disease caused due to
pleasure seeking attitude of individuals has been considered as one side of a coin. There are other factors like genetic and biochemical predisposition which have to be taken into account. Hence we find that even if more people are exposed to the same environment only some are affected to it. We find a lot of psychological impact before and after the intake of addictive substances.

The drug addiction may begin from a young age when you are of an impressionable age and try to do it as a compulsion or out of thrill. These drug addict teens who have started early in life are easy to tackle by nipping the bud of the problem at the outset. But the people who have been into addiction for a long time, it has become difficult to handle as the physical and emotional dependence is more. In addition the habit clouds their mind from reacting to counseling and treatment.

The role of society in handling these issues is important. A lot of rehabilitation centre are working for the cause of these people. They consider social and philosophical factors as the prime reason for addiction and try to improve them by providing social status and changing their beliefs. This is the general way of treating them. But if we consider them individually it might give us an insight into the circumstances which has led them to embrace this habit.

Tips to Understand the Psychology of a Drug Addict

1. You can seek the psychiatric help at a very young age when you find some behavior problems or changes in a person.

2. We usually feel that our child or relatives may never come across such tendencies. Learn to accept the fact that anyone may be affected and always raise an eye brow in suspicion if you find anything abnormal in attitude of the near and dear ones.

3. Our first reaction is an outburst. Hence try to remain calm as blaming, mal handling and shouting will aggravate the situation.

4. Take the help of rehabilitation centre as many sessions may be required to come out with positive results.

The most important fact is that emotional support goes a long way in the treatment as we find addicts unable to give up the habit even after they have recovered.

Recovery methods

Methods of recovery from addiction to drugs vary widely according to the types of drugs involved, amount of drugs used, duration of the drug addiction, medical complications and the social needs of the individual. Treatment is just as important for the addicted individual as for the significant others in the addicted individuals sphere of contact.

Determining the best type of recovery program for an addicted person depends on a number of factors, including: personality, drug(s) of addiction, concept of spirituality or religion, mental or physical illness, and local availability and afford ability of programs.

Many different ideas circulate regarding what is considered a "successful" outcome in the recovery from addiction. It has widely been established that abstinence from addictive substances is generally accepted as a "successful" outcome.

Residential

Residential drug treatment can be broadly divided into two camps: 12 step programs or Therapeutic Communities. 12 step programs have the advantage of coming with an instant social support network though some find the spiritual context not to their taste. In the UK drug treatment is generally moving towards a more integrated approach with rehabs offering a variety of approaches. These other programs may use Cognitive-Behavioral Therapy an approach that looks at the relationship between thoughts feelings and behaviors, recognizing that a change in any of these areas can affect the whole. CBT sees addiction as a behavior rather than a disease and subsequently curable, or rather, unlearnable. CBT programs recognize that for some individuals controlled use is a more realistic possibility.

12 Step program

One of many recovery methods is the 12 step recovery program, with prominent examples including Alcoholics Anonymous and Narcotics Anonymous. They are commonly known and used for a variety of addictions for the individual addicted and the family of the individual. Substance-abuse rehabilitation (or "rehab") centers frequently offer a residential treatment program for the seriously addicted in order to isolate the patient from drugs and interactions with other users and dealers. Outpatient clinics usually offer a combination of individual counseling and group counseling. Frequently a physician or psychiatrist will assist with prescriptions to assist with the side effects of the addiction (the most common side effect that the medications can help is anxiety).

Anti-addictive drugs

Other forms of treatment involve replacement drugs such as methadone. Although methadone is itself addictive, opioid dependency is often so strong that a way to stabilize levels of opioid needed and a way to gradually reduce the levels of opioid needed are required.

Ibogaine is an (unpleasant) psychoactive drug that specifically interrupts the addictive response, and is currently being studied for its effects upon cocaine, heroin, nicotine, and SSRI addicts. Alternative medicine clinics offering ibogaine treatment have appeared along the U.S. border.

Alternative therapies

Alternative therapies, such as acupuncture, may be used to help alleviate symptoms as well. However, In 1997, the following statement was adopted as policy of the American Medical Association (AMA) after a report on a number of alternative therapies including acupuncture:

There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.

How is drug addiction treated?

Treatment for people who abuse drugs but are not yet addicted to them most often consists of behavioral therapies, such as:

psychotherapy,

counseling,

support groups, or

family therapy.

Drug addiction is also a treatable disorder, but treating drug-addicted people often requires a combination of behavioral therapies and medications. The primary medically assisted withdrawal method for narcotic addiction is to switch the patient to a comparable drug that produces milder withdrawal symptoms, and then gradually taper off the substitute medication.

Medications for treating drug addiction

Medications such as methadone or LAAM (levo-alpha-acetyl-methadol) are effective in suppressing the withdrawal symptoms and drug craving associated with narcotic addiction, thus reducing illicit drug use and improving the chances of the individual remaining in treatment.

Once a patient goes through withdrawal, there is still considerable risk of relapse. A great deal of research is being done to find medications that can block drug craving and treat other factors that cause a return to drugs.

There are currently no medications approved by the Food and Drug Administration (FDA) for treating addiction to the following drugs:

• cocaine
• LSD
• PCP
• marijuana
• methamphetamine and other stimulants
• inhalants
• anabolic steroids.

There are medications, however, for treating the adverse health effects of these drugs, such as seizures or psychotic reactions, and for overdoses from opiates.

Finding an appropriate treatment program

The National Institute on Drug Abuse stresses that while the ultimate goal of all drug abuse treatment is to enable the abuser or addict to achieve lasting abstinence, there are important immediate goals as well:

• to reduce drug use,
• improve the patient's ability to function, and
• minimize the medical and social complications of drug abuse.

As listed in the searchable Substance Abuse Treatment Facility Locator (see resources below), there are 11,000 addiction treatment programs in the U.S. including:

• In-patient residential treatment centers
• In-patient hospital programs, and
• Outpatient treatment centers.

Inpatient and outpatient facilities have comparable success rates. The choice of institutional treatment program can be dictated by any of a number of factors, such as:

• severity of dependence
• availability of facilities
• insurance coverage or financial aid
• need for detoxification, methadone, or long-term treatment
• factors such as age, pregnancy, young children, or need for other medical treatment
• need for treatment in language other than English

Among the different types of treatment programs are:

• Outpatient drug-free treatment programs, which do not include medications and encompass a wide variety of programs for abusers who visit a clinic at regular intervals. Most of the programs involve individual or group counseling.
• Therapeutic communities (TCs), which are highly structured programs in which patients stay at a residence, typically for 6 to 12 months. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal activities, and seriously impaired social functioning.
• Short-term residential programs, often referred to as chemical dependency units, involve a 3- to 6-week inpatient treatment phase followed by extended outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous.
• Long-term residential programs involve a stay for detoxification, short-term (a few days to a few weeks), or longer term treatment (a few months to a year or more). These facilities provide a structured environment, often based on the 12-step approach, and include drug education and different types of therapy (group, individual, and sometimes family or couples therapy).
• Methadone maintenance programs for heroin addicts, which are usually more successful at retaining clients with opiate dependence than are therapeutic communities ? which in turn are more successful than outpatient programs that provide only psychotherapy and counseling.

The NIDC has concluded that, in general, the more treatment given, the better the results. Specifically:

• Patients who stay in treatment longer than three months usually have better outcomes than those who stay less time.
• Patients who go through medically assisted withdrawal to minimize discomfort but do not receive any further treatment, perform about the same in terms of their drug use as those who were never treated.
• Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by drug-dependent people.
• Researchers also have found that drug abusers who have been through treatment are more likely to have jobs.

Some Diagram on cause and effect of Drug addiction

SPEAKING ABOUT THE RATE OF DRUG ADDICTION, HAS IT INCREASED, DECREASED, OR STAYED UNCHANGED?

SPEAKING ABOUT DRUG ADDICTS, WOULD YOU SAY THEY ARE THEMSELVES TO BLAME, OR DO THEY TAKE DRUGS FOR EXTERNAL REASONS?

WOULD YOU REGARD DRUG ADDICTION AS A DISEASE OR A CRIME?

OPEN-ENDED QUESTION: WHY DO YOU THINK PEOPLE BEGIN TO TAKE DRUGS?

Idleness

· "From idleness, they don't work – we used to work a lot, and didn't even know about drugs"; "they don't want to work, they have no troubles"; "it seems to me they have nothing to do, that is why they get involved."

Curiosity, sensation-seeking

· "They want to try a forbidden fruit"; "mainly from curiosity and interest"; "they want something new"; "sensation-seeking."

Social and economic problems

Low living standards, rootless in life

· "Poverty"; "because of the very low living standard"; "lack of money"; "their life is bad."

Unemployment

· "No work"; "there are no jobs for the youth"; "it is difficult to find a job."

Lack of state attention to problems of teen-agers and youth

· "There were circles of interests before, and now the outdoors is the place of interests"; "lack of sports and cultural leisure"; "lack of attention by the state to the problems of the youth"; "there are no public organizations working with the youth"; "the children don't know where to go."

Psychological problems, disorientation of people

Depression, despair

· "From despair"; "they are disappointed and don't see sense in life"; "depression, uncertainty in the future"; "lack of hope"; "lack of prospects."

Escaping reality, problems

· "It is easier to get away from the problems of reality, to forget about everything"; "they try to hide from reality."

Dissatisfaction with life, impossibility to realize oneself

· "They can't find their business, have no aims in life, no belief in themselves"; "they cannot find themselves in life"; "if parents are not able to find their places in life, what can be said about the children?"

Asininity, mindlessness

· "From the lack of mind"; "I think that is only fatuity"; "asininity - they don't understand how difficult it is to get rid of that habit later"; "the youth has no mind, they understand nothing."

Influence of friends

· "From communication with bad friends"; "to be like everybody"; "for a crowd– they don't want to show themselves as white crows."

Richness, «easy money»

· "They don't know how to spend their money"; "the richer the family, the more chances a child has to become a drug addict"; "those who have no money don't buy drugs"; "from the good life"; "parents give too much money to their children."

OPEN-ENDED QUESTION: WHAT DRUGS, IN YOUR OPINION, ARE WIDESPREAD NOW IN ASIA?

General Opinion

(% of those surveyed in South Asia)

India Bangladesh Opium drugs 44 39 Heroin 35 34 Opium 4 3 Cop-rose 3 1 Papaveraceous straw 1 1 Hanka 1 0 Derivatives of cannabis 34 26 Anasha 11 7 Marihuana 9 9 Hashish 7 4 Dagga 4 3 "Indian grass" 3 3 Stimulants 10 12 Cocaine 9 8 Composite drugs 1 4 Sedatives (tablets – "wheels") 1 1 Hallucinogens (LSD) 1 4 Other 1 2 All drugs 2 1 No response, wrong responses 44 50

Recommendation

After doing our report we come to recommend that drug addicted people should not be neglected. It is a social problem as well as economical problem. So, we should take care of it not to spread it out.

1 case study

A Case Study at Comilla Town

A. Background

Drug abuse directly influences the economic and social aspects of a country. In Bangladesh it is a growing national concern. There are millions of drug-addicted people in Bangladesh and most of them are young, between the ages of 18 and 30. And they are from all strata of the society. A recent epidemiological survey carried out in the three divisions of Bangladesh shows that the country is going to be transformed into a potential user of drugs with the rapid increase in the number of addicts. For the safety of our people and the society from this deadly game, we have to control illicit drug transportation immediately. Under the circumstances, Research And Social Survey Unit of Democracywatch has taken an initiative to find out the severity of drug addiction and drug trafficking in Bangladesh. In this view we took Comilla town as the case study site, one of the major vulnerable areas of drug addiction and drug trafficking points in Bangladesh.

Bangladesh is situated in the central point between the ‘golden triangle’ (Mayanmar, Thailand and Laos) and the ‘golden crescent’ (Pakistan, Afghanistan and Iran) in terms of geographical location. And it is also surrounded by the major drug producing countries of Asia, many of which are strengthening their narcotics legislation and stepping up enforcement measures. Bangladesh with its easy land, sea and air access is becoming a major transit point. Traffickers who supply drugs in the markets of Northern America, Africa, and Europe are routing their shipments through Dhaka, Chittagong, Comilla, Khulna, and other routes in Bangladesh. It is believed that with the increasing quantity of the wares more and more people are likely to get involved in drug business. In this way it ultimately contributes to the number of drug abusers as well.

Our country is a land surrounded by India from three corners. The northern and eastern sides are surrounded with hills and mountains. And the western corner is mainly plain land. The hilly regions are suitable for illicit drug trafficking. The traffickers can easily hide themselves in these hilly forests and transfer the drugs safely. In our country there are many border-crossing points from where every day millions of money are being exchanged for drugs. The border crossing points with neighboring countries are shown in Table A:

Table A

The Main Border Crossing Points In Bangladesh That Are Highly Used For Smuggling

Regions	Country	Border crossing points
Western	India	Benapol, Dorshona, Dogachi, Parsha, Hilly, Birol, Balubari, Banglabandha.
Eastern	India and Mayanmar	Latu, Ahamadabad, Akhaura, Koshba, Amratoly, Razapur, Braymmapara, Bibirbazar, Chaddagram, Suagazi, Mirja nagar, Ramghar, Barkal, Ukhia, Teknaf
Northern	India	Tinbigha Corridor, Patgram, Mogholhat, Ailatoly, Tamabil
In Comilla (Eastern region)	India and Mayanmar	Amratoly, Razapur, Braymmapara, Bibirbazar, Chaddagram, Suagazi

(Source: Graphosman’s New Atlas)

NB: Table mentioned border crossing points as well as some nearest border area

From Table-A, it is clear that Comilla is one of the most popular drug trafficking points in our country. A few days back, Democracywatch had some campaign programs, especially on anti-drug issues in Comilla town. As a follow-up of the program the Research and Social survey unit recently conducted this research in January 2001. The research focused mainly on the youth in Comilla town.

Objectives of the study

· to identify the family-related and social reasons for being addicted;

· to identify the key role players in drug business in Comilla;

· to find out the economic loss of the drug abusers and their families;

· to find out the ways and alternatives in coming back from addiction to normality;

B. Drug addiction and type of drugs

I. What is drug addiction?

The word addiction means getting habituated with something. In case of drugs when a human body gets dependent on some stimulating things, and after a certain period it creates a habit which means that the body has become dependent on the stimulant which is addiction. World Health Organization (WHO) defines it: Drug is a chemical substance of synthetic, semi synthetic or natural origin intended for diagnostic, therapeutic or palliative use or for modifying physiological functions of man and animal.

A drug abuser can undergo different stages of tasting apart from normal lifestyle. Drug abuse can decay normal human senses through deep feelings. It creates different types of excitement both in the body and mind. Finally, it makes a person passionate to drugs. In the long run the user has to increase the dose day by day.

Addiction has some stages.

a) Initial stage

b) Pre-mature stage

c) Mature stage and

d) Dangerous stage

a) Initial stage (starting): This is the first stage of drug addiction. At first, a person starts to take drug without concerning his body. At the early stage he takes it just normally, and gets the ordinary happiness, which makes him feel better. Sometimes, he wants to touch heavenly excitement and dreams himself as a floating constituent in the sky. This is the first stage of drug abusing. Amateurs are in this group. They take drug once or twice a week with their friends or seniors in their locality, who are already addicted. He collects it and processes it to take.

b) Pre-mature stage (the real test of drug): In this stage, drugs become a habit, and the abuser wants more. Feeling better s/he tries to increase the dosage drugs. It is taken at least 4-5 times a week. This is the primary stage for abusers in becoming addicted. At the initial stage they can easily manage or collect the money for purchasing. They collect money from their family, and sometimes from other sources. They take drugs with their friends. After a few days they need to take more and become dependent on it both mentally and physically. The sudden need for excess money, involvs them in criminal acts like hijacking, and they feel thrilled to do it.

c) Mature stage: After the pre-mature stage abusers become seriously addicted. They have to take it every day, after a certain period. In maximum of cases it is taken from evening to night time. For that, they are busy all day long in collecting the expenditure of drug. They need much more money for it and sometimes they turn against the law. Many discontinue their education after failing to concentrate on any kind of discipline. They forget social protocol, always remain bad tempered and feel they are always in the right. They do not want to hear any advice and count themselves as very aware and competent. Sometimes they feel frustrated and even lose the will to live.

d) Decaying stage: After mature stage most of the abusers stay on the verge of decaying. It means gradually their lives crumble. They can realize, how imbalanced they are. They lose taste for food. At this stage they become fully dependent on drug, gradually after a few hours they have to take it, otherwise their body system stops. In that situation the abuser loses human characteristics and behaves like a monster. They have no sense to evaluate good or bad, to enjoy anything, they lose interest in normal male/female yeamings. And finally one day they fully surrender to drugs, which leads them to their graves.

II. Types of drugs found in Bangladesh

There are three types of drugs available in use in Bangladesh.

1. Opium

a) Heroin

b) Phensidyl

c) Tidijesic

d) Pethidine

2. Cannabis

a) Ganja

b) Chorosh

c) Bhang

3. Sleeping pill

a) Tranquilizer

b) Seduxene (Diazapam)

In Comilla: Specifically in Comilla we found many drugs, which are in use by the abusers. These are:Wine, Ganja, Heroin,Chorosh, Opium, Phensidyl, Pethidine. Sleeping pills are randomly being used since they can be easily bought from any nearby medicine shop/pharmacy and in most cases without doctor’s prescription. These are: Enoctine, Seduxene, Phenergan, Stemetil, Laxatine

Table B

Main Drugs Smuggling Traffic Roots In Comilla

Drugs	Source / where from	Rout up to Comilla
Heroin	India, Mayanmar, South-East Asia	Benapol, Rajshahi to Comilla, and Cox-bazar to Chittagong to Comilla.
Phensidyl	India	Every border crossing point in Bangladesh. In Comilla it comes mainly in Bibir bazaar, Amratoli, Matinagar, Fakir bazaar, Boura bazaar, and some other places Choddagram, Laksam, Cosba.
Ganja	India, Mayanmar, Naogoan, and other district in Bangladesh.	Every border crossing point in Comilla The main root is Rajshahi – Dhaka—Comilla. Teknaf, Chittagong – Comilla By bus and Train.
Wine	India, Mayanmar, Europe, also from growth triangle.	The main route for trafficking wine is Chittagong And Cox’s-Bazar by ships and some other border crossing places in Eastern and Western side. Some times they use Mongla port also.
Chorash	India and locality	Mainly in to border crossing point.
Opium	South East Asia and Growth triangle.	Chittagong, Mongla sea roots, and other land roots are used.
Pethidine	As a pain relief medicine it’s come from everywhere.

III. Comilla: An in-depth observation

The Laksham, Bibirbazar and the Chaddagram are the most vulnerable points for illicit drug trafficking and the nearest places from Comilla town. According to various sources, every day millions of taka is spent in the drug business in Comilla. It is one of the main transit points through India for trafficking drugs. According to the local people, there are 8,000-10,000 people who are directly or indirectly engaged in drug business from the top level to the grass root level. The sellers sell drugs in every road and lane in the town area. The retailers told that one ‘puria’ of heroin costs lower than half a bottle ‘phensidyl’, sometimes it costs nearly equal to ‘ganja’. During the fieldwork, the addicted persons informed the investigators that one ‘puria’ ‘heroin’ gives much longer period of addiction than five-bottle ‘phensidyls’ and ‘ganja’. So, comparatively, low-income groups of people are becoming addicted to ‘heroin’ than the high-income people. They also told that in Comilla town the total number of drug abusers is around one lakh. Around 40-50 per cent of the youth are already addicted to drugs. People from all corners of the society, especially many of the students, unemployed young people, sportsmen, medical representatives, businessmen, transport workers, rickshaw pullers, physicians and other professionals are found to be addicted. The interviewers talked to some physicians in Comilla. From the conversation, a lot of astonishing information have come out. 60-70 per cent (especially young doctors) are fully addicted to ‘phensidyl’ and ‘ganja’; some are also on ‘heroin’. Among the medical students about 80 per cent are regular user of ‘ganja’, ‘phensidyl’ and ‘heroin’.

C. Methodology

Qualitative approaches were used to conduct the study. At first thirty drugs business and spots were identified in Comilla town. During the spot visit, around 20 young addicted were identified. Of them three cases were studied. Two focus group discussions were also made with the young addicted persons, one in the selling spot and another in a neutral place. A sample size of thirty-five addicted persons were given a structured questionnaire to quantify some aspect of drugs in Comilla. The questionnaire consisted of thirty-eight questions related to drugs, addiction and the demographic profile. Most of the questions were open-ended. The fieldwork continued for 20 days.

D. Some Findings from survey

1. Opinion on how the respondents were drug abused

· Encouragement from friends

· Frustration from family matters

· To get immediate relief from tension

2. Reasons for being addicted to drugs

· Easy access to drugs

· Unemployment problem/economic insolvency

· Surrounding atmosphere

· Estranged in love

· Mental stress due to family problem

3. Sources of money for buying drugs

· From own income

· From pocket money

· Loan from friends, family members

· Collect money by criminal activities like hijacking, extortion etc.

4. Where from respondents collect drugs/the nearest drug spots

· Specific sellers in the locality

· Drug smugglers in town

· Houses near border area

· Drug smugglers in border crossing points

· From police, BDR

5. Persons involved in drug business/smuggling: Respondents opinion

· Some elites in society

· Some political leaders/so-called student leaders

· A syndicate of smugglers

· Some members of the police/BDR

6. Causes why respondents change drugs one after another

· A tendency to increase the dose because the same dose doesn’t create the desired effect.

· Impatience in body and insomnia in not having drug after a certain time.

· A psychological and physical dependence on the effects of the drugs.

· to feel better

· Easy access to other drugs

· Lower cost

· Adventure in tasting different drugs

· Desire to have an extreme taste of addiction

7. Negative effects due to drug abusing: Respondents view

· Physical impatience

· Insomnia

· Sense of perception doesn’t work

· Increased head-ache

· Feeling dizziness until taking drugs

· Hallucination syndromes

· Decreased working capability and stability

· Sexual problem

· Abnormal behavior

· Loose humanity and every kind of assessment

· Lack of discipline in daily life

8. Suggestions of respondents to get rid of drug addiction

· Personal will is the main way to get rid of addiction

· Creating more employment opportunities

· Ensuring proper treatment and rehabilitation measures

· Healthy drug free working environment

· To involve in any creative work

· To avoid mixing with bad company

· Enactment of articles on anti-drug issues in the text books and newspapers

· Media campaign against drugs

9. Changes in social behavior according to the respondents

· Increased hijacking

· Increased extortion

· Increased stealing, robbery

· Deteriorated law and order situation and respect ness to elder

· Increased personal and family expenditure

· Lost of interest in education

· Change in morality

10. Comment on the role of Police/BDR

· Some members of the police and BDR are involved in this business who take some percentage of the sale money. Sometimes they even escort them while crossing the town safely

11. Comment on the role of Narcotics Control Department

· They pretend to be ignorant, sometimes their performance is poor

· Some of them are involved in the drug business

12. Comments on the role of NGOs

· In some areas different NGO’s are conducting anti-drug awareness program/campaign.

13. Respondents’ overall comments

· Easy access to drugs is one of the major problems in becoming addicted

· Persons from all Occupations: doctors, teachers, students, service-holders, businessmen etc. are involved more or less in drug business

· In Comilla town there are at least 5-8 per cent of the total population who are engaged in drug business directly or indirectly

· Roles of the department of narcotics control, police, BDR are not up to the satisfactory level.

E. Focus Group Discussion

Focus group 1:

I. Personal Profile

Total number of discussants is 12. Their average age is around 26 years. All of them passed the HSC and some have university degrees. Almost all participants are sportsmen. One of them is a badminton player of the national team. Many of the sportsmen have side businesses. Average monthly income of the group is Tk 5,000 per month.

II. Principle findings

All from this group were engaged in games and sports during their school lives and were free from addiction. After passing higher secondary examination their friends influenced them to taste it and gradually they get addicted. Previously they were all upper division players, later as they lacked strength due to addiction, they couldn’t concentrate well on their sports. As a result, their performance fell which finally made them frustrated. Slowly and steadily their sports career came to an end. This group takes various drugs but according to them ‘Phensidyl’ tops the list, then comes ‘heroin’ and ‘alcohol’.

During our conversation they had 5-6 sticks of ‘ganja’. At present the rate of addiction is so severe that drugs are controlling the health and mind of the addicts. Among them, those who are heroin addicts have been taking it for the last 8-12 months. It happened due to the rise in the price of ‘Phensidyl’ and the rise in the number of addicts.

On an average they take drugs at least twice a day, which cost them approximately Tk. 200.

Reasons for getting addicted to drugs:

Wide availability

To get relief from frustration.

To forget the pain of separation from both broken affairs and marriages and also to some extent from family problems (esp. broken family children).

Available drugs: Heroin b) Phensidyl c) Ganja d) Alcohol e) Beer f) Sleeping Pills

Feelings and reactions of drug: The body relaxes and the mind feels fresh after taking drugs. If an addict cannot take it, peevish temperament occurs and he doesn’t wish to work or even talk. S/he feels fever, headache, itches in his body and sometimes vomiting also occurs.

Most of the married persons of this group are frustrated and unhappy in their conjugal life.

They stated that the sports tradition of Comilla is at stake only due to the increasing rate of addiction.

Their suggestion to control narcotics: To control the prevailing unpleasant situation the government and the mass of people should come forward. In this aspect the availability of drugs should be curtailed. In Comilla there are more than hundreds of places where drugs can be taken. Moreover, in streets the hawkers sell drugs even in front of the police.

Focus group 2:

I. Personal Profile

The number of participants is 20. Average age of this group is 30. Everyone is related to the health profession i.e. doctors and medical promotion officers etc. Almost every one of them is economically solvent. Their Average income is Tk. 15000.

II. Principle findings

They have been abusing drugs since their student life. Some of them increased their dose after starting their professional career. They all take drugs in-group. They are mainly addicted to ‘phensidyl’ and ‘ganja’. On an average they take five bottles ‘phensedyl’ during the day. Without taking drugs they can’t concentrate on their work. Even some of them take ‘phensedyl’ in their own chambers, and every evening they move to certain spots to take drugs in-group.

Reasons for becoming addicted:

1. The wide availability of drugs is one of the main reason for their addiction

2. The price is lower than other areas in Bangladesh

3. As there is no access to entertainment, they treat drugs as a tool of entertainment.

According to them at least 50 per cent of the doctors and MRO’s in Comilla are addicted to drugs.

They spend Tk. 150-200 daily for drugs on an average.

According to them, merchants, and politicians in Comilla town are involved in drug business through people of low-income groups and administration. The houses near ‘Shashan gacha’ and the station road are the largest drugs selling spot.

They stated that teachers, lawyers and police are also more or less addicted to drugs.

F. Case Study

Study 1:

Personal Profile: The victim of this case is a young chap named Khaled. Though he is 20 years of age, he looks like a man of 40 years. He continued up to class eight and afterwards was involved in a clothing business. His monthly income is around Tk. 3000. His father also earns. Total family member is 7.

Main findings: He has been useing drugs for 10 years. He started to use drugs since he was a schoolboy. Firstly, his friends introduced him to drugs as a means of enjoyment. Gradually he became addicted. He started with ‘ganja’. He sometimes changes his drugs to meet his satisfaction level. He changes drugs one after another from ‘ganja’, ‘phensidyl’, and ‘wine’ to ‘heroin’. Now he is fully addicted to ‘heroin’, and has to take it four times in a day. Without having it he can’t do anything. He has to take at least two ‘puria’s of ‘heroin’ every morning. A psychological and physical dependence has grown in his body. He spends Tk. 80-100 everyday for drugs. Sometimes, for collecting money, he turns to hijacking. He collects drugs from local spots or from particular persons. These drugs come mainly from India through Bibir Bazar border area.

According to him, in Comilla, the most used drug is ‘heroin’. Though he is aware of the negative impacts of drugs, he can not avoid it because of the ‘withdrawal symptoms’ He opined that in Comilla most of the abusers are unemployed, young, students, and doctors. He even knew about some girls/ladies who take drugs. He thought that in Comilla approximately 50-60 per cent of the people are drug users. Some social hazards viz. hijacking, stealing etc. are happening due to drug addiction. He told us that the police are collaborating with the drug dealers by taking bribes.

Study 2:

Personal Profile: He is Masum (21), looks healthy, studying at graduate level. His monthly pocket money is approximately Tk. 1000. His father is the only earning member of the family consisting of seven members.

Main findings: He has been drug abused for the last 2 years. He started drugs as enjoyment through friends. He started with ‘ganja’. He changes his drugs for more satisfaction. Now he is fully addicted to ‘heroin’, and has to take it at least twice a day. Without having it he can’t do anything. He has to take at least a puria heroin every morning. He spends Tk. 80-100 everyday for drug purposes. For the excess money, sometimes he takes loan from friends or steals his own household materials. He collects drugs from the local spots or a particular person.

Study 3

Personal Profile: His name is Iqbal Hossain, age 23. He passed the HSC, presently unemployed. He has no sources of income but gets Tk. 1500-2000 monthly as pocket money from family. His family member is 11 and all of them are educated.

Main findings: He has been abusing drugs for 2 years. He turned to drugs because of his personal problem. He fell in love with his cousin and they got married without the consent of their families. This made him frustrated. He started with ‘phensidyl’ and now ends with ‘heroin’, takes it twice a day. He collects drugs from the local spots and/or from a particular person.

He told us that police are helping the drug sellers, and if the police and the BDR maintain their duties and responsibilities, no drugs can reach Comilla town.

G. Recommendations

During the fieldwork it has been found that many people, especially the youths are eager to get rid of drugs. But unfortunately they can hardly find any way out. The departments of narcotics control, police, BDR etc. either do not work or/and even some how are related to drug smuggling/business. According to the discussion with the concerned people such as drug abusers, guardians, teachers, policemen and related persons in the drug business, it is clear that behavioural modification of the abusers is not enough to check the spread of drug taking and drug trafficking in Comilla. The concerned people gave the following suggestions in order to free Comilla of drugs:

· Concerned administration should be reshuffled. Culprits, those who are hidden in the police, BDR and narcotics control department, must be punished. At the same time, rewards may be declared for good performance. It is obvious that, drugs business in Comilla would fall rapidly if border-crossing areas can be checked properly.

· Leaders of social institutions like schools, colleges, clubs etc. should come forward to build resistance against drugs.

· The NGOs can play a great role in Comilla, especially in the awareness and rehabilitation processes. It is observed by many of the addicts that, the rehabilitation procedures and costs introduced by the narcotics department are high and cumbersome. But only a few NGOs are active.

· The addicts, while talking with the investigators sought treatment to wipe out the negative effects of drugs.

H. Conclusion

When a disease breaks out like en epidemic in all segments of the society, it indicates a social change. In Comilla this symptom has been observed. It is not only the youth, drug addiction has also grabbed the social leaders. Even the teachers and physicians who are supposed to guide the society are more or less getting addicted. Law enforcing agencies and other concerned authorities are in most cases either refraining from their job or associated with the drug business. Undoubtedly it is an awesome situation.

We believe that the pictures in other cities and towns are more or less the same. This survey focused mainly on the youth and middle class members of Comilla town. In the last few years, we have observed a massive use of drugs in several towns of the country, almost all of users were poor. So the condition is severe everywhere in Comilla. The situation is the worst in the transit regions like Comilla.

Every disease has a cure. We must come out of this monopolistic deadly game. Some ‘entry barriers’ and ‘exit points’ are given in the recommendation chapter. But that is not enough. A more intensive research, action program, and social movement are needed. It is also needed to strengthen family and social values and religious ethics in order to maintain a stable and drug-free society.

We believe that there is a lot to do to stop this social malaise now before another dangerous symptom appears which is AIDS.

References