Heroin abuse is reaching epidemic levels in Bangladesh
With a population of 150 million, Bangladesh faces many unique challenges resulting from a number of factors. Perhaps the single biggest contributing factor to the addiction crisis in Bangladesh is its geographical location. Bangladesh sits between the Golden Triangle (Thailand, Myanmar, Laos) and the Golden Crescent (Iran, Pakistan, Afghanistan). Given its proximity to these illicit drug producing regions of the world, it’s no surprise that opium and heroin abuse is reaching epidemic levels in Bangladesh.
High levels of poverty mean that for those living on the streets or in substandard housing, drug abuse is a way of coping with the difficulties they face on a day-to-day basis. Peer pressure and mental illness are also factors that contribute to the rise of substance abuse. In fact, the majority of drug users are unemployed or students according to the Journal of Health, Population and Nutrition (JHPN). With limited resources available to combat addiction and ill-equipped treatment services with undertrained staff, there is no doubt a long and winding road ahead for public and private sector service providers to control addiction, certainly for those that are living below the poverty line.
A report by the World Health Organization (WHO) suggests that most of the drug users in Bangladesh are predominantly men aged between 18 and 30. Although estimates vary widely, it is thought that approximately 5 million people in Bangladesh are dependent on drugs – mostly young people. This is a growing trend that is alarming and shows no signs of improvement at this time. In addition to heroin (the deadliest drug abused in Bangladesh), recent years have seen a spike in use of cough syrup (codeine) and Yaba (methamphetamine). Both are highly addictive and dangerous but they have become the drugs of choice and are at this time quite ‘fashionable’ as is the case throughout most of Asia.
De-addiction services in Bangladesh
Given the extent of drug abuse in Bangladesh, there are still very few options for treatment and rehabilitation throughout the country. Public Sector services are limited, and within the private sector there are few facilities that offer a high standard of care provision. For most Bangladeshis, treatment for drug abuse is out of reach due to costs and access. In recent years, drug abuse and addiction has grown to be of great concern and has affected society, families, and Bangladesh as a whole. This has led to an increase in treatment centres and rehabilitation programmes for drug abuse. There are now an estimated 300 private rehab centres in Bangladesh, of which 54 have a licence from the government.
Despite the relatively small number of services on offer in Bangladesh for de-addiction treatment, credit should be given to the services that do exist who face the mammoth task of getting to grips with drug abuse amongst the younger generation. While there are hospitals that offer drug detoxification and outpatient de-addiction services, full-time inpatient (residential) services are much harder to find.
Government rehabilitation services
As problems of mental illness and substance abuse have become more widespread in Bangladesh, more effort has been made on techniques and efforts towards de-addiction and recovery from mental illness. Amir Hossain, Additional Director General of the Department of Narcotics Control thinks “Better treatment services are required for drug addiction treatment and rehabilitation. There is no alternative except capacity building of drug addiction treatment professionals.” Bangladesh still has a long way to go in their development of infrastructure of treatment services to combat drug abuse and rehabilitate drug addicts.
Treatment facilities operated by the government are available at Tejgaon in Dhaka (250 beds), Uposohor in Rajshahi (5 beds), Moilapota in Khulna (5 beds), and Pachlaish in Chittagong (5 beds). The Central Drug Addiction Treatment and Rehabilitation Centres operate under the supervision of the Department of Narcotics Control (DNI). They are poorly equipped and provide only limited healthcare services to drug users.
Case Study: The Central Drug Addiction Treatment and Rehabilitation Centre, Tejgaon, Dhaka
This 250 bed treatment facility has no emergency medical units but treats patients daily, but limitations in the level of services provided mean that long-term care provision is unavailable for its patients. A lack of resources means the centre is unable to provide comprehensive treatment, limited psychological therapy, and social care. Of the 250 beds, 100 are provided for detoxification purposes, the remaining 150 beds are designated for rehabilitation.
The centre’s resident psychiatrist, Akhter-uz-Zaman, says that ‘Everyday, patients come to our centre for treatment, but we lack one medical officer, one rehabilitation officer and one consultant.’ He also added that due to the lack of facilities ‘we suggest patients do their check-ups at a government hospital’. The limitations presented mean that once patients are discharged from care, they begin to use again in most cases.