International Drug Day on 26 June reminds me of the past that shaped my present, and the present that is so different from my past.
It reminds me of my youthful days as a drug addict wandering the streets of Kathmandu. In the mid-1990s, I was about 20 and had been using drugs for four years. My first drug was something that was available in the local pharmacy for just Rs 20: the then famous cough syrup, Phensydyle. Many people my age in the 1990s probably tried Phensydyle. For me it represented the beginning of a long and treacherous journey, the life of a junkie.
The rest of the world believed that it was me and only me who was to be blamed for what I became. Since the rest of the world believed this, I believed it too. However, at the back of my head was always the conviction that it wasn't just my fault.
For four years I did Phensydyle and similar codeine-based syrups. When new policies went into effect to control these drugs, the law enforcement agencies tightened their grip on narcotic drugs. Phensydyle and Heroin were the ones worst hit. Phensydyle was sold in 200ml bottles, and therefore too bulky to sneak through the southern border.
The supply may have been cut off, but the demand hadn't reduced. The demand shifted to other drugs, namely Tidigesic: bupremorphine injections were available once again in the local pharmacy for as little as Rs 12 for a 2ml ampoule. One dose could cost as little as Rs 6 and was enough for a whole day. A clean syringe cost Rs 5.
Ironically, government crackdowns resulted in an introduction of more lethal drugs into the market. The result was that HIV prevalence among injecting drug users in Kathmandu rose from zero in 1994 to 70 per cent in 1998. That figure includes me.
We had the tools, we had the knowledge and yet we failed to prevent HIV infections among injecting drug users during this period. We lacked the political will to admit that there was a problem and, therefore, to do something about it. Brave outreach workers entered the netherworld to distribute clean syringes, but were often harassed by the law enforcement agencies. The Ministry of Health approved needle exchange as an effective means to ward off HIV, but the more powerful Home Ministry still believed that distributing needles would encourage drug use. When the drug was cheaper than a syringe, who cares about using a clean syringe? It was as simple as that.
To see the Home Ministry's mistake, consider how an abuser would think: one doesn't buy a new lighter to light a new cigarette. So, should I keep the syringe in case I need it later? Well, no, because I could easily get caught carrying a syringe.
The Home Ministry thus systematically fuelled the epidemic.
The government succeeded in wiping out the 200ml Phensydyle, but they couldn't do the same to the 2ml Tidigisic that is still being smuggled across the southern border.
Today I am out of drugs and leading a healthy life. Ten years of HIV and 19 years of drugs has taught me many important lessons. One that I think is important to share on Internatiional Drug Day is this: don't ban glue sniffing, since sniffers will end up injecting.
Lethal dose - FROM ISSUE #457 (26 JUNE 2009 - 02 JULY 2009)