By OUR STAFF REPORTER
RISHIKESH 1 Jun: People who use drugs (harmful and dependence pattern) constitute a major proportion of society. According to the national drug use survey, 2019, alcohol is the most common psychoactive substance used by Indians with the prevalence of 18.8% in Uttarakhand, which is higher than the national prevalence of 14.6% (16 crore persons). This translates to a big chunk of population who is at risk.
Medical Officer of the All India Institute of Medical Sciences, Rishikesh, Psychiatry Department Dr Neha Dhiman has revealed that, soon after the lockdown was announced on 24 March, many wondered how people using psychoactive drugs would cope with the difficulty. Did it provide an opportunity to quit the substance or prove hazardous to them? The exact answers to the questions are not yet known because researches are still studying the effect of the lockdown on drug users and psychiatric patients.
Dr Basu Aniruddh, Assistant Professor, Department of Psychiatry, adds that people who use illicit drugs are at higher risk of harm during the coronavirus pandemic due to various factors like presence of co-morbidities such as compromised liver functions due to alcohol abuse or compromised lung functions due to excessive smoking, predisposing them to severe complications from COVID-19. They also have poor nutritional status and thus compromised immune functions.
Difficulty in procuring medicines during the lockdown, such as anti-craving drugs or replacement therapies particularly for opioid drug users or opioid substitution therapy, who are required to visit hospital daily for getting the doses, has impacted users’ lives. Resorting to dangerous local made preparations that can be physically harmful, or users sharing drugs, puts them at additional risk.
Severe withdrawal that can be life-threatening in case drugs are not available like respiratory depression from opioids is one issue. Although alcohol withdrawal is generally mild to moderate and can be managed at home, but in case the person becomes disoriented, fails to recognise family members and is trembling badly, this can prove fatal if proper treatment is not given.
Under such circumstances, non-availability of regular OPD services and follow ups becomes a serious issue. Although, when sick, they can approach the emergency department for acute deterioration in their condition but those living in far off places are having difficulty coming to AIIMS, so they have to approach nearby hospitals or even quacks.
Currently, the focus is shifting to telemedicine services but in a country where the majority of patients live in rural areas and have poor literacy rate, this may be challenging.
According to Dr Basu, AIIMS has a functional helpline number by which they are attending to patients, particularly those who need follow up, but without physical examination, it becomes really difficult to assess the situation and treat sick patients.
Since the corona virus is new and there is no data on interaction between it and drug abuse, it is hard to say what would be the consequences of the virus on drug abusers.
AIIMS doctors advise that, in case of emergency and acute deterioration of condition, visit the hospital. The warning signs for alcoholics in severe withdrawals are failure to recognise relatives, being disoriented and tremulous. Opioid withdrawal causes excessive sweating, lachrymation, bodyaches, diarrhea/ vomiting, breathing fast and irregularly.
In case of mild withdrawals in nicotine addiction (irritability, mood changes, cravings) increase water intake and use nicotine gums/lozenges available over the counter.
If a patient is member of groups like Alcoholic Anonymous or Opioid Anonymous, continue being in touch with the group over social media.
In case they are facing issues of anxiety, low mood, sleep disturbances, contact AIIMS through telemedicine number- 18001804278, 7454989545, 9621539863 available from 9 a.m. to 6 p.m. Patient can make a phone call, WhatsApp call or WhatsApp video.
Professor Ravi Kant, Director, AIIMS Rishikesh, has appealed to the public to take all precautionary measures against COVID-19 and maintain social distancing. He also advised people to avail AIIMS telemedicine facilities in case of health problems and visit the hospital only if need arises.