Sumit has been using heroin intravenously for over a decade. He is also a ‘client’ of Voluntary Health Association of Meghalaya (VHAM) and beneficiary of its Needle Syringe Exchange Programme that ensures that addicts do not fall prey to HIV virus during sharing needles.
But unavailability of the contraband and inability to get help from VHAM turned this lockdown into a nightmare for the 30-year-old man.
“The stuff (heroin) was not at all available in the city. And those who were selling were charging four times more than the usual price. Owing to the lockdown nobody could move around and procuring syringes became a problem. I would take it from friends,” Sumit told the reporter on phone.
The initial days of total lockdown was a dark phase that became difficult for Sumit to explain to a stranger on phone. “You cannot imagine how painful the withdrawals were. I would get suicidal.” That he was grappling for the right words to describe the agony was evident from his intermittent silences.
Sumit was not the only person addicted to heroin who suffered during the lockdown. According to VHAM Executive Director Eudora Warjri, with the complete shutdown of the organisation’s functioning and restrictions on movement, reaching out to the clients, as VHAM calls the addicts undergoing treatment at its centres, became a challenging task.
“There were several cases of withdrawals, and in heroin withdrawal, the pain is excruciating for the person concerned and the situation is difficult for the family,” Warjri said.
Tenzing, who has been using heroin intravenously for around two decades, also recollected his experience. With the price of heroin shooting up to Rs 1,500-2,000 from Rs 300, it became difficult for many to purchase it. Tenzing, for instance, had to struggle for a shot. “Some of my friends managed to go to Ri Bhoi during the lockdown and could not return,” said the 34-year-old man.
VHAM runs another programme called Opioid Substitution Therapy (OST) under which buprenorphine tablet is prescribed. Warjri said even this tablet can lead to withdrawals if the medication regimen is hindered.
A 28-year-old recovering addict under OST who was unwilling to give his name experienced severe body pain, insomnia and loss of appetite during the lockdown when he was unable to get the daily doses. As the situation stabilised and VHAM’s outreach members resumed field work, the young man and several others undergoing OST heaved a sigh of relief.
The youth, who works as a daily wage earner, said many of his friends using heroin told him after the lockdown that they want to quit. When heroin is impossible to procure, OST comes as a respite.
“In the first phase of the lockdown, 101 new heroin users contacted us for OST as they were desperate to get some help to reduce the pain. Since they are not yet registered with us, we have to ensure on-the-doorstep delivery of the medicine,” she added.
Arbor Thangkhiew, a member of the VHAM outreach team, said there were reports that heroin addicts who could not procure fresh needles would share a syringe and “there is always the risk of contracting other diseases like HIV+”.
When asked whether cases of HIV+ have gone up during the lockdown, Thangkhiew said it would be difficult to give statistics currently and the impact could be gauged only after the pandemic is over.
After the initial phase of the lockdown, VHAM resumed its programmes and started home delivery of the medicine and syringes. Members would visit different localities and with the help of the respective Dorbar Shnong, would reach out to heroin users in need. “For women clients, it was strictly home delivery,” Warjri said.
As the VHAM office in Police Bazar was closed, it tried to reach out to clients through the OST centre at Civil Hospital. Many could not come as their localities were strict about moving out.
The office opened in May and currently they are running 2-3 days a week, improving reach-out post lockdown substantially. But one glitch remains. “Counselling is an important part of our programmes as psycho-social support to heroin users or a recovering person is necessary. But with the health protocols in place and lack of space, we are being unable to hold one-on-one interactions or group discussions,” said Warjri.
Pre-lockdown, a GD session would have had at least 15 clients but with the physical distancing norm in place, not more than seven are allowed.
“This counselling is not enough,” she added.
Both Warjri and Thangkhiew agreed that female addicts face a bigger problem because “first, many of them do not know about the programmes, and second, they face stronger social taboo”.
The teething problems for VHAM owing to the lockdown have eased but the challenge to keep all its clients on board and safe during the pandemic still remains.