KATHMANDU, July 29
Substance abuse - especially the consumption of alcohol and drugs - has been on the rise in Nepal since/after the COVID-19 pandemic, say health experts, pharmacists and rehabilitation centre operators. The loneliness, joblessness, pain and other problems induced by the pandemic have led to the addiction, of which many people are struggling to come out of. Substance abuse entails a pattern of the abuse of different kinds of drugs including sleeping pills that are mostly used to treat sleep disorders, and tranquillisers - medicines used to calm and soothe, or alcohol among others.
Shielding pain, and loss
Nirmala Basnet (name changed on request), 35, used to work as an officer in a private company when COVID-19 pandemic hit the country. She lost her mother to the pandemic and it had a tremendous impact in her life.
"The pain of losing my mother was unbearable," recalled Basnet who was "an occasional party drinker" till then. But to "get rid of the pain" she started "drinking alcohol on a daily basis". This habit apparently affected Basnet's sleeping pattern, ultimately making it difficult for her to sleep at all. She then consulted a doctor who advised her to take a 6-mg sleeping tablet every day. She followed the doctor's advice for a couple of days but started overdosing on the sleeping pill - she started consuming pills three times a day "to get proper sleep". After some months Basnet realised she had become too dependent on the pills and thus chose to get treatment at Relife Wellness Nepal, Maharajgunj. Now she is undergoing treatment there and says she "feels better".
Rohit Maharjan (name changed on request), 30, also resorted to sleeping pills to deal with the "unbearable pain" following his divorce from his wife of five years. He shared COVID-19 pandemic led the couple to the divorce: "As my wife and I were together all the time during the lockdown, we started to have fights regularly, and we opted for a divorce."
"The separation from my wife, court trials, and related changes increased my pain and tension and thus I started consuming sleeping pills to get proper sleep," shared Maharjan who is also undergoing treatment at the same centre as Basnet.
Pooja Sapkota, Founder of Relife Wellness Centre, pointed to joblessness as one of the causes of people resorting to substance abuse. She shared a case of a 32-year-old Nepali man who returned home from Malaysia where he worked as a security guard after losing his job due to the COVID-19 pandemic. As he had spent all his earnings to buy a house in Kathmandu, he had no money to provide for his family who was entirely dependent upon him. As such he developed an addiction for marijuana and alcohol, shared Sapkota.
Another patient undergoing treatment at the centre is 30-year-old Sujit Khadka (name changed on request) who suffered financial loss after he was forced to shut down his family-run tea plant during the pandemic. To escape from this harsh reality, "I began drinking alcohol" but later realised "I was getting paranoid as I had become addicted to it".
The Internet addiction also seems to be one of the reasons forcing people towards substance abuse. Ram Prasad Shrestha (name changed on request), 30, is one such example who was attracted to online games during the free time people had due to COVID-19 lockdowns. Shrestha claimed to have lost "Rs 14 lakhs gambling online". During the process, he also got addicted to alcohol.
Is COVID-19 to blame?
The aforementioned cases indicate how people got into substance abuse during the COVID-19 pandemic. "There is no doubt the COVID-19 pandemic has led to an increase in the number of substance abusers in the country," said Sapkota. She pointed out a variety of reasons for this: "Many people lost their jobs, relationships, loved ones, and sleep patterns during the stressful times of COVID-19. To deal with the pain, they resorted to abuse of alcohol, marijuana, painkillers, and sleeping pills."
Bipin Thapa, Clinical Psychologist and Substance Counsellor of Aasara Sudhar Kendra - a rehabilitation centre run by Nepal Police Wives Association - added, "A lot of tragic incidents were happening during COVID-19 pandemic - problems of mental health, financial crisis, domestic violence increased. These factors triggered people to alcohol consumption and substance abuse."
He also pointed out the risk of Internet addiction: "During COVID-19 pandemic people's addiction to mobile phones and Internet increased extremely as everyone was isolated and technology became a friend of almost every person. But such addiction is dangerous as it is the major cause of loneliness in people. When loneliness increases, people start to take drugs for pleasure."
Bal Kumar Giri, Founder of United Vision Foundation, a rehabilitation centre for substance abusers at Tokha, echoed a similar view. "It was a phase of tragedy for people during COVID-19 pandemic. They found various drugs as one of the easiest and fastest ways to escape the tragic experiences. This led to an increase in substance abuse," he said while revealing that his rehabilitation centre mostly has patients addicted to marijuana, alcohol and painkillers.
The easy access of public to all kinds of drugs and the government's lack of proper monitoring of the medicine sector during COVID-19 added to this.
Pharmacies were selling medicines, including tranquillisersto people without doctor's prescription, Sapkota pointed out.
The trend continues even today. A pharmacist from a pharmacy located in Kapan who wished to remain anonymous, claimed that substance abusers mostly visit the pharmacy to buy tranquillisers.
"Mostly teenagers, labourers, and helpers of public vehicles visit my store without doctor's prescription," the owner shared as he also revealed they mostly seek the cheapest pills available.
"They usually visit the pharmacy at the dusk or dawn with complaints of headache, and some even reveal they are 'craving' drugs and ask me to provide them with the same," he informed.
Similar is the experience of a pharmacist in Maharajgunj who shared on condition of anonymity: "It is mostly students who visit my store to buy drugs. When we refuse to sell them, they argue with us, even offer us extra money."
However, the owner claimed he doesn't sell drugs without prescription though he has "witnessed pharmacies that have a good bonding with addicts and provide them with such drugs".
The owner of a pharmacy in Sukhedhara meanwhile, revealed that such addicts mostly come in a group when buying drugs. "They have tried to give me money in advance so that I can provide them with drugs on a regular basis. When I refuse their proposal, they visit my store regularly asking for different drugs in bulk."
Consuming drugs has also led to an increased abuse of tranquillisers, as per Thapa.
"To enhance the high of marijuana, drug users these days tend to use tranquillisers too," she said as she warned, "The Nepali youth are misusing medicines meant for the treatment of people with mental health problems. We have even found drug addicts trying to scam counsellors and doctors - they (substance abusers) visit doctors and counsellors pretending to be mentally ill, with problems of anxiety, depression, and sleep disorders. Some have managed to fool the doctors and get related prescription so that it becomes easier for them to get tranquillisers and other drugs from pharmacies."
Sapkota also said that there could be an increase in number of abusers visiting rehabilitation centres post COVID-19 as the pandemic brought family members together. This led them to know one another so well that they were able to identify if someone in the family was addicted to drugs. "At the same time people have become more open-minded, which has caused them to realise how crucial mental health is. Therefore, people are coming for counselling without any hesitation."
Thapa meanwhile shared an interesting fact: "Although drug users have mostly been males from the very beginning, the interesting fact is that nowadays the number of female drug users has increased as many females visit us for counselling."
The risks and way forward
Substance abuse is a serious issue in Nepal, as per Thapa, who shared, "Such abusers suffer from mental health problems like chronic anxiety, psychosis, schizophrenia, and other conditions. Its physical effects on people include being infected with hepatitis, and HIV, infertility, among others. The daily life of people is also seriously affected as it damages people emotionally and make them numb. In severe cases, the abusers might need to be sent to mental asylum or they may lose their lives to overdose of drugs."
To address these problems, Thapa pointed out the need for awareness against abuse. "It is necessary to make students and family aware about the ills of drug abuse," he said and added that "interaction programmes and campaigns amongst substance counsellor, counselling psychologist, clinical psychologist, psychiatrist and ordinary people can be organised to prevent drug abuse".
He also emphasised on the need for more research on substance abuse and addiction as "very less is done in terms of research in Nepal in regards to such issues".
Despite the existence of a separate department responsible for the monitoring illegal sale of drugs by pharmacies, it is not effective, which is one of the major reasons for increased drug abuse in Nepal, Thapa added.
What about people who are already into substance abuse? Of course taking the help of professionals is the right thing to do. But the sad thing as pointed out by Thapa is that the government does not have any rehabilitation centres in Nepal.
The Ministry of Home Affairs' five-year Master Plan on Prevention and Control of Narcotic Drugs 2078 (BS) has given some hopes.
Home Secretary Tek Narayan Pandey shared, "The master plan includes activities to be carried out for prevention and control of narcotics and its trafficking from 2022 to 2028."
The master plan will probably incorporate youth support, awareness and counselling programmes, as per Thapa who also appreciated rehabilitation centres for providing free counselling to the public.
But as such facilities are mostly urban-centric, it is not easy to address the problems of the rural population. Thapa opined, "The condition in rural areas of Nepal is critical in the sense there are no rehabilitation centres, hospital detoxification unit, or other facilities related to substance abuse. Thus, the cases of depression, violence, drugs trafficking and other social problems are seen more in rural areas of Nepal."
Addiction in figures
KATHMANDU:
Nepal Drug User Survey 2076 of the Ministry of Home Affairs shows that substance abuse grew by 5.06 per cent between 2069 BS (2012-13) to 2076 BS (2019-20) in Nepal. There were 91,534 substance abusers in 2069 BS, which rose to 1,20,424 in 2076 BS. Cannabis users are on the top - they make 84.7 per cent of the share followed by tranquilliser abusers, which is 73.1 per cent. The cannabis users may also use tranquillisers and vice-versa. However, the ministry doesn't have the latest information on the status of substance abusers in the country, whose numbers as per the data available at various drugs rehabilitation centres are on the rise following the COVID-19 pandemic since 2020.For instance, at Relife Wellness Nepal, Maharajgunj eight patients were admitted to the rehabilitation centre between January to April (2022), which has increased to 20, as per Pooja Sapkota, Founder of Relife Wellness Centre.
Aasara Sudhar Kendra, Ranibari admitted 223 new cases of substance abuse in 2019- 2020 before the COVID-19 pandemic. The following year, it took in 325 new admissions - this comprised 183 jobless patients and 62 students.
According to Nepal Police, 21 per cent of the cases registered in 2078 BS (2020-2021) were related to drug issues. (HNS)
A version of this article appears in the print on July 30, 2022, of The Himalayan Times.
