Today IN YOUR OPINION we focus on the all important topic of  DRUG DEPENDENCE IN SRI LANKA, where a cross section of experts in that particular field are interviewed by Anusha David.

 

It is estimated that there are currently about 45,000 regular users of heroin and about 600,000 users of cannabis in Sri Lanka. It is further estimated that between 1–2 % of heroin users are IDUs. In Sri Lanka the most disturbing and troubling aspect is not the number of users but the seemingly endless and easily accessible supply of all types of drugs to school children as well as adults and people from all walks of life.

Since the onset of the Yukthiya Anti Drug Operation in December 2023 approximately 149,000 persons have been arrested for drug-related offences. However it is the small fish who are being apprehended while the big fish swim away!!!

 

Due to the reports of increasing drug dependence and the ready availability of a wide variety of substances, Anusha David poses a series of questions on this all important topic of drug use, drug dependence and it’s trafficking into Sri Lanka.   

 

Jude Manesh Wevita - Attorney at Law

QUESTION
What can our legal system do to assist persons who are drug dependent as well as counter-drug trafficking?

A
The Poisons, Opium and Dangerous Drugs Ordinance is outdated and should be amended. Even the 2022 amendment has many problematic sections and has created delays in the legal process and overburdened the courts. The Government Analysts' Department, which tests seized materials suspected of being drugs, does not have enough personnel, hence reports are always delayed for months. Because of the Yukthiya operation the Department's workload has increased and now reports take 10 to 12 months or more.  After
months in remand and  until the reports are ready, many persons are often released with a fine because the drug in their possession is a miniscule quantity. This shows the persons being arrested are mostly users and not traffickers. It is important that arrests are conducted respecting due processes, and we must also respect the right to legal representation and the right to fair trial of arrested persons because that is a fundamental
right protected in our Constitution.

 

Ambika Satkunanathan – Human Rights Advocate, Former Commissioner Human Rights Commission of Sri Lanka, Board Member UN Voluntary Trust Fund for Victims of Torture

 

QUESTION

What must the government do to minimize drug dependence, prevent the increasing use of drugs and integrate cured / reformed dependentsdicts back into society enabling them to function as useful and productive citizens ?

 

A

The government should abandon the punitive approach and adopt an evidence, health and human rights -based strategy. Drug dependence is a health issue and evidence shows imprisoning or sending persons who use drugs/are drug dependent to compulsory drug treatment does not work. We need community-based, voluntary treatment and harm reduction, which evidence shows, work, along with other forms of support and awareness raising. While persons who traffic drugs in large quantities may have political and state patronage, with even some police officers being arrested for trafficking drugs or assisting drug traffickers, police are arresting persons without reasonable suspicion, violating their due process rights and subjecting them to ill-treatment. This will not stop drug trafficking. Instead, it places the rights of everyone at risk of being violated because a lawless environment is created when the police engage in illegal/extra-legal action. One of the ways in which Sri Lanka can increase the intelligence we receive from other countries to prevent drugs being trafficked into Sri Lanka is to abolish the death penalty because some countries don’t share intelligence if the arrested persons could be sentenced to death. 

 

 

 

Giada Girelli - Senior Analyst - Human Rights and Justice at Harm Reduction International".

 

 

QUESTION

What can we learn from other countries’ experiences confronting drug use? And what are the international standards Sri Lanka should follow to develop effective drug policies that keep people who use drugs as well as their communities safe and healthy while reducing crime?

 

 

A

Drug use is a complex problem, with health and social causes and consequences. Countries have addressed it primarily through criminalisation and repression. Hoping to achieve a “drug free world”, police and the military have been tasked with punishing and imprisoning people – mainly people who use drugs – at great expenses.

 

It is now clear that this approach does not work. The UN admits the drug market is “booming” and is more complex than ever. Millions of people have been incarcerated or forced to undergo non-medical treatment. Rather than reducing drug use, harsh drug laws have led to more poverty and unemployment, to families left without breadwinners, to HIV and other infectious diseases spreading. People in poverty have been the most affected by these policies.

 

What this experience tells us is that a change in approach is needed, one that focuses on supporting people who use drugs and their communities. This is what international standards also require.  People who use drugs should not be incarcerated. This would reduce the harms highlighted above, and free up resources for the government to invest in effective responses; including harm reduction policies and programmes (such as needle  exchange programmes, that reduce the spread of infectious diseases) and treatment for those who truly want it.

 

 

Hans Billimoria, Director, Grassroots Trust

 

QUESTION

Most (65%) drug users are in the age group 20-35 years. About 56% are single and 7% have never been to school. Drug users are proportionally distributed among all ethnic and religious groups in Sri Lanka (NDDCB 2003). How do we establish a drug free school scenario, and how do we establish a preventive method amongst young people starting at an early age?

 

A

Any sensible prevention intervention in schools must focus on the science of how drug use affects the developing brain, and parents must be included in the ecosystem of learning. 

 

Deterrent approaches using horrific images of emaciated drug users or telling stories of how heroin leads to loss of family and opportunity may instill fear, but rarely deals with the motivations for drug use. [This includes student peddlers of ICE touting its potency for keeping you awake, studying hard into the night to fulfil expectations.]  Neither does this approach take into consideration that students may feel a disconnect between them and the “addict” that got it all wrong.

 

A sensible approach in schools must address young people who, for example, view marijuana as harmless, based on the legalization of recreational marijuana for adults across the world; students who use ecstasy, MDMA and other party drugs, including those who google to find health related websites that provide you with step-by-step instructions on how to use drugs safely to mitigate concert/rave related overdoses; and schools must address the use of our licit drug, alcohol, all of which have detrimental effects on the developing brain as it prevents children and young people from putting the building blocks in place for analytical thought and problem solving. 

Ultimately, a scientific, evidence-based approach will help both parents and students navigate what can often be challenging circumstances, which traditionally have been associated with drug use. Let's have a drink. Let's smoke a cigarette. These are socially accepted responses to stress and disappointment. Think then of the growing list of illicit drugs student peddlers make available to their peers to help them overcome. This is why any sensible drug prevention approach must help both parents and students identify viable alternative coping mechanisms.

 

Gina and Aku Musajee - Parents

 

QUESTION

 

As parents to a bright and intelligent 17 year old, and being acquainted with others who have children of a similar age, what are the guidelines you adopt at home to ensure your child’s safety and security in an ever increasing drug scenario and what would be your advice to other parents of school going and impressionable children ?

 

 

A

 

We are Aku and Gina Musajee, parents of a 16 year old daughter who just completed her O Levels. At this impressionable age, it is indeed very tricky dealing with concerns arising from drugs that teens face today. 

 

I think the number one factor in looking out for your child is COMMUNICATION. Being able to talk about anything and everything, not only from the time the children are in their teens, but communicating realistically,  has to start from the time the children are little. 

 

Regarding drugs, we would discuss it quite openly from the time she was 7 or 8 years old for fear that she could unexpectedly be in a scenario where a stranger could offer her substances. 

 

Another tool I would advise parents to use are the examples around us. For instance, while watching a movie, if we saw someone doing illegal substances, we  would talk about how it can affect the young persons health and overall life’s decisions. This conversation would take place in front of our daughter without it being directed at her. She would intently listen and we know the message would indirectly sink in. 

 

A further  piece of advice we would give parents of teens is - when they talk about sensitive subjects when it comes to themselves or their friends, please DO NOT react with disbelief and a holier than thou attitude. By expressing these emotions, your child will surely loose the confidence to confide in you. Be neutral till you can process the information and address the situation in a calm and collected matter at a later time with your teen. 

 

 

Dr. Inosha Alwis (MBBS, MSc)
Lecturer, 
Department of Community Medicine,
Faculty of Medicine, 
University of Peradeniya.

 

 

 

Question:

 

What is the current epidemiology of drug abuse in Sri Lanka? How can we get to know the factual situation amidst the alarming narratives that are created ?  

Answer: 

Correct epidemiological knowledge is crucial for tackling this issue. However, finding out the actual prevalence of drug abuse in Sri Lanka is a difficult task. The two main indicators we have - drug-related arrests and admissions to treatment facilities - are not valid reflections of the existing burden.

 

Unfortunately, research on this issue is also limited. The last national survey among adults was done 5 years ago. It showed cannabis to be the most commonly used illicit drug with nearly 300000 users (1.9% prevalence) and estimated 92000 users of heroin (0.6% prevalence). The last national survey among adolescents found that 2.8% use illicit drugs. These patterns have likely changed at present. Recent data on drug-related arrests show that the majority are males, between 25 – 29 years and are educated up to the Ordinary Level.

Given the rampant stigma and other agendas, we have to be very careful before believing news about drug abuse, especially on social media. The recent ‘ice’ epidemic in schools is a case in point. Though there was evidence of increasing use of methamphetamines, it was mainly among adults and not school students. There are a few sources to be guided by, like the surveillance by National Dangerous Drugs Control Board. But Sri Lanka needs to invest in more scientific research on this!

 

 

Prof. R.Surenthirakumaran MD)

Dean, Faculty of Medicine, University of Jaffna

Consultant Community Physician & Professor in Community Medicine,

Department of Community and Family Medicine,

Faculty of Medicine, University of Jaffna

 

QUESTION

 

As the Dean of the Faculty of Community Medicine in Jaffna, what can societies, families, and educational establishments, as well as the general public, do to create an awareness of the dangers of drug use and addiction, thus minimising drug addiction as well as preventing the increasing use of drugs?

 

A

Substance use is a global problem and is highly prevalent in many countries, including Sri Lanka, where there is a rising trend in the Jaffna district in the use of illicit drugs and alcohol. Various factors influence substance use among youth, such as family history, parental attitudes, poor supervision, associating with substance-using peers, and mental health issues. Conversely, factors like family engagement, support, disapproval of substance use, and school connectedness can prevent youngsters from initiating substance use.

To address this issue effectively, the following steps are recommended:

1. Parent Engagement and Support: Parents need to spend more time with their children, building strong relationships and understanding their needs and problems. Providing parents with support and resources to help them in this role is crucial.
2. Life Skills Programs for Children: Schools and community organizations should implement formal life skills programs to help children develop resilience and leadership skills to handle challenges and peer pressure.
3. Recreational and Cultural Activities: The state and community should arrange more recreational, skill development, cultural, and religious activities in schools and communities to build cultural cohesion and provide healthy outlets for youth.
4. Empowering Teachers and Counselors: Teachers and counselors should be empowered to identify and support students who are victims of sexual abuse, physical abuse, or neglect. Providing necessary care and assurance can help reduce mental distress and prevent substance use.
5. Early Identification of Substance Use: Schools should implement programs to identify students using substances early to prevent further spread among peers. Peer influence is a significant factor in substance use initiation.
6. Reform of Legal Framework: Current laws need to be revised to allow internationally recommended programs like harm reduction and early detection of substance abuse in students and youth.
7. Community-Oriented Rehabilitation Programs: Establish proper rehabilitation programs that are community-oriented, focusing on developing skills and providing opportunities for individuals to earn a livelihood and reintegrate into society.

By implementing these measures, societies, families, educational establishments, and the general public can work together to create awareness about the dangers of drug use, minimize addiction, and prevent the increasing use of drugs in the Jaffna district and beyond.

 

 

Dr. Anuradha Baminiwatta , Lecturer in  Psychiatry at the Faculty of Medicine, University of Kelaniya and a leading young Researcher in the field of mental health in Sri Lanka.

 

 

 

QUESTION

 

What is the role of psychiatry in addiction. Can you also identify any negative health effects that patients might have acquired during their addiction.

 

A

 

Drug addiction is understood, through a medical lens, as a disorder. Therefore, psychiatrists play important roles in both preventing and treating drug addiction. When people start using substances, initially they may have control over this behaviour. However, with repeated use, the brain functions change, and the person loses control over their substance use, leading to physical symptoms and intense cravings in the absence of the drug. Moreover, we are seeing a rise in the number of patients presenting with serious mental disorders like schizophrenia that are either caused or aggravated by drugs, particularly cannabis and methamphetamine. We use both psychological and drug therapies to help these clients manage withdrawal symptoms and to remain abstinent.

 

Negative health effects of drug addiction span not only physical and mental issues, but social problems including domestic violence and crime. Although as psychiatrists we work in the best interest of the patient, sometimes we have to make the difficult decision of recommending compulsory rehabilitation for risky individuals, since we have a duty to the society as well. However, the benefits of current rehabilitation programmes in Sri Lanka are highly questionable. Thus, psychiatrists need to collaborate further with other authorities in preventing rather than treating drug misuse. 

 

 

Pradeep Kumara Koholanegedara - Assistant Director of Preventive Education and Training, National Dangerous Drug Control Board

 

QUESTION

What are the consequences of youth substance abuse and what are the drug use trends among Sri Lanka’s youth ?  What causes them to experiment with drugs which in turn leads to addiction in most cases ?

 

A

 

 Substance Abuse Prevention

The simple meaning of drug prevention consists of three steps. The first step is to prevent a child or young person from trying drugs as soon as possible. Secondly, if a person experiments with drugs due to the positive image of the drug, the first use of the drug should be delayed as much as possible. The third step here is to prevent someone who is already using drugs from becoming addicted to drugs.

 

Drug prevention in a country is controlled by two methods. First reduce the supply . Cannabis, heroin, methamphetamine, LSD and other banned substances are considered illegal drugs. The second strategy is demand reduction measures.

 

In preventive education, the children of Sri Lanka are currently gaining a very high level of knowledge through school, family and youth-based universal prevention programs, but the weakness of policy implementation has added a significant burden.

 

Thousands of school-based, family-based, youth-based, media-based, community-based and workplace-based prevention interventions have been implemented in Sri Lanka by the public, private and non-governmental sectors. Beyond that, resorting to extremely high-cost and zero-result activities such as crime, imprisonment, rehabilitation centers, and treatment programs are unsustainable for a country like Sri Lanka.

 

 

Anmol Rajwani is  a 17 year old student in the math and commerce stream,  who enjoys enjoy art, dancing, and reading.

 

 

QUESTION

Generally,  youth seem to be the main target of this drug menace and its abuse. Curiosity, peer

pressure, and availability of drugs such as cigarettes and alcohol are the immediate causes of drug

abuse amongst the youth. In the company of bad associates, friends are pressured to indulge in the

use of drugs especially amongst  seniors. “Curiosity,” it is said, “kills the cat.” The youth of today are very inquisitive and curious. They seem to want to test the efficacy of whatever they see and hear of. This curiosity at times becomes fatal even to the point of death.

As a school prefect how do you handle such problems both in your personal life and outside, what would your advice be to young adults such as yourself as to how they should handle themselves, steer clear of temptation, focus on their studies and grow up to become responsible and productive members of society,

 

A

 

As a teenager, it’s hard to ignore the harsh reality that many of my peers are caught in the grip of drug addiction. It’s an issue that affects us all on a personal level.

 

In Sri Lanka, the drug crisis is severe, with around 45,000 heroin users and 600,000 cannabis users. Easy access, curiosity, and peer pressure often lead to addiction. This issue became personal for me when a close friend, lured by "ice," deteriorated rapidly despite our efforts to help him and tragically lost his life. His story highlights the urgent need to address drug addiction more effectively and support those facing similar struggles.

 

Drug addiction among students is influenced by the glamorization of drug use, social pressures, and the desire to escape academic stress. This normalization of drug use and stigma around addiction discourages individuals from seeking help, leading to serious health issues and strain on healthcare systems. Effective prevention, support systems, and collective efforts from students, educators, and communities are essential to address the root causes, enhance treatment programs, and create supportive environments for a healthier, drug-free future.