Helping them kick the habit

Reena,40,hesitates before she rolls up the sleeves of her red sweater. Dotted around her arms,on bulging veins,are haphazard puncture marks. Reena was a heroine addict,a habit that lasted for 18 years — she spent most of her 20s and 30s intoxicated. She now works at the Sharan Society Clinic as a peer educator,educating users on the dangers of drug abuse. She recalls the dark period of her life,a time spent inhaling drugs with her husband. During that period,she abandoned her young daughter,who was raised by Reena’s parents.

The Sharan Society Clinic,a targeted intervention site for injecting drug users,is tucked behind the Jahangirpuri Metro station. The 20-member staff arrives promptly at 9.30 am,pack their bags with syringes and take off to Azadpur Mandi,Adarsh Nagar,Jahangir Puri and Sabzi Mandi. As former addicts,they can easily spot a user under a bridge or lying on a push-cart. The peer educators approach users cautiously from then on. It’s a well-rehearsed speech,with “do not share needles” being the main thrust of the conversation. To convince a user to abandon the habit is no easy task,but the centre has 905 registered clients.

The aim of this clinic is prevention of HIV among injecting drug users. A majority of the drug users in the area are getting high on a “new cocktail,” says Alok,the clinic’s project manger. As the price of heroine has risen from Rs 50 rupees for a vial to Rs 100,drug users are injecting pharmaceutical drugs as a substitute. “The pharmacist has become the new peddler,” says Alok.

The outreach workers’ main duty is to inform users about the dangers of sharing needles. “Although the drug is damaging,the occurrence of HIV/AIDS among users is on the increase,” says Alok. One of Reena’s main responsibilities is to distribute clean needles for older needles.

Alok opens the doors to the clinic at 9.30 am. The red doors with paint peeling off it,sees a queue form from 7am. Men with three-day-old stubbles and women in dusty sarees stand outside. “The cold of the night is easier than the shakes you get in the morning,” says Ajay,a drug-user. The cocktail,depending on frequency of use,has a minimum effect period of three hours. After those three hours,the urge to shoot up again increases.

The clinic is both a detox centre and a medical station. One doctor,on part-time basis,checks patients for abscess as blocked veins can lead to death. In the other yellow crumbly room,users enter,their bodies weak and their heads hanging. The room offers Direct Observation Treatment (DOT). Two field workers sit behind a wooden table,one notes the users’ names and the other crushes medicine with a pestle. The medicine is then emptied into the mouths of the users. “The process has to be monitored,because unmonitored oral consumption can also lead to addiction in the long run,” says Alok.

The aim of DOT is to wean of the user from injecting drugs to swallowing drugs. The medicines are given based on the frequency of usage,but the potency of the pill is much lower than what the addicts take. “The other challenge is to ensure that users do not get addicted to the pill,” says Alok. The team keeps a vigilant check on the number of people who come in and look for those who have not returned. “Searching for those who have not returned is also a challenge since these people sleep just about anywhere,” says Darshan,another outreach worker.

The nights get particularly weary for addicts. “Users do not think ahead. They think of their next fix. They don’t save money for shelter,” says Alok. Delhi’s unforgiving winters have claimed the lives of several users. A fortnight ago,Asif,a regular at the clinic,relapsed and died under a Metro bridge.

The Society operates other such centres in areas of high drug usage: Yamuna Bazaar and Nabi Kareem near Paharganj. The work done by the centre is free of charge and funds for operation are provided by Delhi State Aids Control Society.