Tihar’s battle against drugs stumbles on follow-up

Tihar’s battle against drugs stumbles on follow-up
Comment E-mail Print Share
First Published: Tue, Jun 16 2009. 01 15 AM IST

Anti-drug effort: Shankar Kumar Jha (top, centre) with other inmates at the deaddiction centre inside Tihar jail; (above) Vinay, who mentors his fellow inmates to stay away from drugs, outside the cen
Anti-drug effort: Shankar Kumar Jha (top, centre) with other inmates at the deaddiction centre inside Tihar jail; (above) Vinay, who mentors his fellow inmates to stay away from drugs, outside the cen
Updated: Tue, Jun 16 2009. 02 02 PM IST
New Delhi: When he was 20 years old, Shankar Kumar Jha ran away from his village near Ghaziabad, heading for New Delhi and looking for work. In the city, at a tent-rental agency, he found a job as well as a drug habit, both of which would occupy him for the next three years.
“It was a couple of others in the tent agency who first asked me if I wanted to try smack,” Jha says, using the colloquial English term for heroin. “At first, I did say no. But then, they asked again and again, and I finally thought I’d try it.”
Anti-drug effort: Shankar Kumar Jha (top, centre) with other inmates at the deaddiction centre inside Tihar jail; (above) Vinay, who mentors his fellow inmates to stay away from drugs, outside the centre. Harikrishna Katragadda / Mint
Shooting up with just smack proved expensive; on the street, a single dose of (mostly adulterated) heroin can cost between Rs50 and Rs100. So, Jha began to mix it with over-the-counter medications: Avil, an antihistamine, and Norphin, a painkiller. He also began to finance his habit by picking pockets, for which he was sent twice to Tihar jail.
Jha was arrested for the third time earlier this year, but this time it was for something he says he didn’t do. “It was around 2am, and I was walking home after work. Somewhere near where I was walking, a bicycle had been stolen, and since I was the only one on the road at the time, the owner pinned the blame on me and had me arrested,” he says. “The police didn’t believe that I was out on the street at that time for innocent reasons.”
In late May, when Jha returned to prison, Tihar was ready for him.
Jha is part of the disproportionately high population of drug addicts among Tihar’s incoming prisoners. Internal records show as many as 10% of new inmates have a recent history of drug abuse. In a jail with a prisoner count of close to 12,000, that can be a problem; deprived of their drug, roughly 1,200 of them suffer severe withdrawal symptoms. And intravenous users with needle-contracted diseases such as AIDS or hepatitis risk infecting fellow prisoners.
Since November, however, addicted prisoners have been dispatched to Tihar’s own de-addiction centre, a pilot project that has worked with at least 1,500 inmates thus far. “Earlier, we only did symptomatic treatment of their withdrawal, and there was some counselling available,” says N.K. Girdhar, Tihar’s resident medical officer. “But we knew all along that we needed to intervene even more to be really effective.”
Tihar’s tussle with addicted prisoners stretches back to 1993, when Kiran Bedi arrived for a two-year stint as inspector general of prisons. “My first night there, Tihar was like a zoo—the prisoners were howling and growling because of the withdrawal,” Bedi says. Drugs seeped into the prison despite security measures. “We had to ban smoking because prisoners were hiding drugs in cigarettes, and we had to segregate addicts from other prisoners.”
The current director general of prisons, Brijesh Gupta, has continued in Bedi’s flinty, uncompromising vein; when a dozen guards were found selling tobacco to prisoners, Gupta dismissed them instantly. “Tihar is a jail for the poor, not for the rich,” Gupta says. “Few people care if the poor are infected with HIV or not. But they’ll spread it to their spouses, their other partners, their children—and then it’s trouble.”
The idea to set up the new deaddiction centre, according to Gupta, emerged after he attended a conference in Vienna organized by the United Nations Office on Drugs and Crime (UNODC). “There was so much concern about this aspect of prisons,” Gupta says. “So, we sent some people to Iran to study a model in use there.”
But, Girdhar acknowledges, running the deaddiction project—and the opiate substitution treatment (OST) at its core, the first of its kind in a South Asian prison—came with a set of unique challenges.
One-fifth of Tihar’s addicts have been intravenous users, and opiate substitution replaces unsafe injections of illegal opiates (such as heroin) with strictly regimented tablets of legal ones. Methadone, the legal opiate used in Iran, is banned in India, so Girdhar adopted a compound called Buprenorphine. “That made diversion a problem,” he says. “A patient (Girdhar never calls them “prisoners”) would pretend to take the tablet, keep it in his mouth, and then sell it elsewhere in the prison.”
Inmates now receive their daily dose of Buprenorphine in an elaborate early morning ceremony. In a long room, three inmates file in, supervised by one doctor, one paramedic, one member of the jail staff and one closed-circuit camera. Patients rinse their mouths, and the paramedic then places the tablet at the back of their tongues. “The tablet dissolves in 5-7 minutes, but we wait 20 minutes to be doubly sure,” Girdhar says. Then the patients rinse again to make sure there is no residue left.
Most of the intravenous users under Girdhar’s care are petty thieves rather than terrorists or murderers, and their tenure at Tihar is correspondingly short, often just a few months. “So the other problem is follow-up, because after they’re released, they won’t have the tablets, and they’ll go right back to smack and sharing needles,” Girdhar says. “We’ve taken it upon ourselves to follow up for at least five years. UNODC provides the tablets free, and we tell patients to go to one of three treatment centres in Delhi that are run by AIIMS (All India Institute of Medical Sciences).”
That isn’t easy either. As Girdhar says: “Will a guy go from Bawana (in north-west Delhi) all the way to his centre in Ghaziabad?” Even inmates such as Manoj Kumar and Raj Kumar, who praise the programme for finally allowing them to think about something other than their next fix, doubt their ability to stick with the follow-ups for five years.
“I’m a day labourer, after all, and I have to go where there is work,” Raj Kumar, a heroin addict on the mend, says. “What if I have to go somewhere like Gurgaon for work? Or if I need to go back to my village?” Then, a little dubiously: “I suppose I’ll just have to resist the urge to take any other drug, and that will be difficult. But I do understand that the doctors can’t give us a week’s worth of tablets just like that—I’m sure many people would simply sell them off or overdose on them.”
Raj Kumar stays with 19 other OST patients in a clean, sunlit ward with a bathroom at one end and a television set at the other; 13 more patients live in a ward next door. Just outside the entrance to the deaddiction centre is a small, neat park, intended as much to beautify as to set the centre apart from the rest of the prison. “Now, for addicts who come to Tihar, we make sure they spend their entire time in the centre, whether it is one year or two years or whatever,” Girdhar says.
Girdhar insists that the advantages of the deaddiction centre go beyond the physiological benefits to the people who are weaned off drugs. “One of these guys, for instance, would have been spending Rs500-800 on smack, and his income would be only Rs200,” he says. “So, he’s obviously making up the balance from theft or some such crime. If he doesn’t need the smack, hopefully he also won’t need the crime.”
Comment E-mail Print Share
First Published: Tue, Jun 16 2009. 01 15 AM IST
More Topics: Tihar | Drugs | Girdhar | AIDS | Medication |