The Hindu : New Delhi News : Need to control HIV epidemic among Injecting Drug Users

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Wednesday, Dec 13, 2006
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New Delhi

Need to control HIV epidemic among Injecting Drug Users

Staff Reporter

`There are over 3.3 million IDUs in South and South-East Asia using legal pharmaceutical substances easily available over the counter'

NEW DELHI: There are over 3.3 million Injecting Drug Users (IDUs) in South and South-East Asia and a significant number of them inject pharmaceutical products that are easily available in medical stores.

While across the world, IDUs predominantly use illegal products like heroin, in India an overwhelming majority of them use legal pharmaceutical substances easily available over the counter, HIV/AIDS experts said here on Monday.

Addressing the media after wrapping up a South Asian Regional Conference on HIV risk among IDUs organised by UNAIDS and NACO, Consultant Psychiatrist M. Suresh Kumar said: "Nearly 80 per cent of the drugs used by IDUs are easily available at chemist shops in India and the SAARC region at large. Mostly these people prefer to take a cocktail of pharmaceutical products."

"There are major health hazards associated with injecting of a cocktail of pharmaceutical products.

Not only are these products available over the counter, they are also freely accessible in the illicit drug market," he added.

Survey

According to an all-India survey conducted by the Union Government and United Nations Office on Drugs and Crime (UNODC) in 2004, of the 40,697 men in the age group of 12 to 60 years, over 0.1 per cent were IDUs.

As per UNAIDS, the estimated population of IDUs is 150,000 to 200,000 in India; 60,000 in Pakistan; 25,000 in Bangladesh and 20,000 in Nepal.

The experts also observed that since early 1990s a lot of drug users had switched from inhaling drugs to injecting them and that this transition was rising at a "rapid and alarming" rate, increasing the HIV risk among them.

"The reasons for this change is that injections are easier to obtain from anywhere compared to the hassles involved in procuring heroin. Also, injections are low-cost and can be administered anywhere," said Luke Samson, Executive Director of non-government organisation Sharan.

On whether the IDU population of India was confined just to the North-East region, WHO representative D. C. S. Reddy said they had identified other areas like Mumbai and Chennai where the prevalence of IDUs was "quite high".

Drug supply

The experts highlighted the need for a "pragmatic and feasible" regional response to control the emerging HIV epidemic among the IDUs in South Asia.

"It is difficult to stop the drug supply, even more difficult to stop the sale of spurious drugs. What we need to do is implement an opioid (synthetically-derived drugs from opium) substitution theory on a larger scale. Though abstinence is our goal, but it is not easy to ask IDUs to give up drug use completely," Dr. Kumar pointed out.

"We must offer IDUs an attractive treatment plan. We must aim at substituting injecting mode of transmission with a non-injecting route to bring down the HIV risk. This will stabilise the drug use and eventually the life of IDUs. A stabilised drug user is more likely to adopt the abstinence theory than a chaotic one."

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