Sri Lanka – The next Narcoland?

Heroin addicts are the most maltreated patients in our society. Heroin causes many altered brains and affects the mesolimbic dopaminergic pathway (Reward Pathway) of the brain

After 10 years of addiction, heroin addicts become like vegetables. Many become freaks. This could be prevented by early treatment and medical detoxification

Heroin residue that remains in the fatty tissues of the body for over six years will trigger relapses even up to six years

Not having any medicines has caused heroin dependents to end up as retarded deranged and violent people. Heroin has brought about destruction to Education

It is morally unacceptable to let more than 550,000 heroin dependents undergo unimaginable pain and suffering by not allowing them to get available medicines and preventing doctors from treating them

Harmful use of heroin is a psychiatric condition according to the WHO (International Classification of Diseases ICD – 10) and the American Psychiatric Association (Diagnosis and Statistical Manual of mental illnesses). World Drug Report of UN (UNODC) recommends METHADONE, LAAM, Buprenorphine and Naltrexone for the treatment of Heroin addicts.
Heroin addicts are the most maltreated patients in our society. Heroin causes many altered brains and affects the mesolimbic dopaminergic pathway (Reward Pathway) of the brain. During the first few weeks, half a pack is sufficient to give pleasure. After two years he will need four packs to give that same pleasure. It is then consumed to prevent the painful withdrawal symptoms (yawning, muscle pain, tearing, dilated pupils, goose bumps, loose motions and insomnia) When medicines are given, the amount of medicine used during the first 10 days can be used to treat during the next 15 days. Medicines can be tailed off gradually. Medicines are necessary to prevent the damage done to the Brain by heroin. Medical detoxification is made possible by (1) Methadone and 12 other symptomatic treatments. (2) Medicine and excess liquids are given to remove the heroin residues along with urine.  (3) Medicines are given to remove heroin residue with faeces. (4) Three litres of medicated fluids are given orally and they are kept in steam baths for 1½ hours and heroin residue is removed in sweat and urine.

Methadone the first pharmacological treatment for heroin addiction was pioneered 50 years ago in the United States by Rockefeller University’s Mary Jeanne Kreek and her colleagues. Methadone is effective for 24 hours. It prevents the use of illicit Heroin. It is cost-effective methadone prevents HIV, Herpes and Hepatitis C.  They can work and earn while taking treatment. Methadone reduces suicides and retains them in treatment programmes.  Methadone prevents imprisonment. Many countries keep heroin addicts in Methadone programmes thereby preventing drug cartels raking in trillions of dollars.

 
Iceberg

Wele Suda, Makandure Madush and hundreds of attached names form the exposed tip of the iceberg the Hummock, which is only 1/10th of the iceberg and it is only an Eyewash. The Bummock which is 9/10th of the iceberg is submerged. In many countries where there is heroin this 9/10 from the destructive drug cartels. These gentlemen know the best attires in the world, the best weapons and money laundering. They are ruthless, versatile, Elegant and invisible. They have many real estates and many mansions. They own many commercial chains, fleets of vehicles and mini armies. Justice, Taxation, Torture, Human rights poverty and starvation are not in their vocabulary. Getting rid of an opponent is as easy as lighting a cigarette. In 2001 Afghanistan produced 5,800 tons of Heroin. The farm gate value of one kilo of heroin was 850 Sterling Pounds. And, the UK street value of one kilo of  heroin was 75,700 Sterling Pounds. The final selling price is 168 times the purchasing value. No business can ever come close to the drug trade.
The blunder of the 30-year war was over in 2009. The next blunder was to continue to destroy our own self by letting heroin to spread by not allowing doctors to treat heroin addicts.  This caused much more destruction than the war itself. When the war was over there were 150,000 heroin addicts. It has increased to 550,000 heroin addicts by 2023. There were less than 1,000 heroin addicts in 1983. During the war, LTTE spread heroin to most areas in the island. By the year 2000 there were 45,000 regular users of heroin [REID and CONSTGAN 2002] price of heroin was Rs. 100 per pack in 2009. The price of heroin was kept low to propagate heroin as much as possible. It was alleged that Prabakaran had said attacking Colombo was completed using Heroin. After the war, police began to raid Heroin strongholds and dens. The balloon effect that was created kept on increasing the price of heroin. In 2000 an addict had to spend Rs. 150/- per day. To get heroin in 2014 he had to spend Rs. 3,000 for a day. That was about 90,000 for a month and the families of heroin addicts became paupers overnight. Robberies, burglaries pickpocketing, kidnapping, RTAs, prostitution, camouflaged businesses, homicides suicides and destruction at workplaces increased ten fold. Heroin addicts began to seek treatment from doctors because, with the amount of money an addict had to spend on a day, he could take treatment for two weeks. When doctors did not have medicines over 40,000 heroin addicts became peddlers. Each peddler introduced heroin to 10 – 15 people in his area. Peddlers come to Colombo, buy a bundle (Each bundle has 20 packs) go back to their hometown and distribute to new users after taking their share. These peddlers increased the number of heroin addicts 10 times.  This would never have happened if doctors continued to treat heroin addicts. The number of heroin addicts would never have increased by more than 200,000. Now there are 550,000 heroin addicts in the country.

The use of methadone to treat heroin addicts has increased annually in all the countries where there is heroin. Use of methadone in USA 20,000 kg/year.   1 kg – 200,000 methadone 5 mg tablets.    UK  - 1,833 kg per year.   Australia 100 kg per year. Australia has 74,000 heroin dependents in a population of 25.8 million. In Sri Lanka from 2014 there was a mere 0.135 kg per year. There are more than 550,000 heroin addicts in a population of 22 million. There is not a single medicine to treat heroin addicts from May 2021.Only the drug lords benefitted by not having any medicine in the country. Methadone is available in Maldives, India, Pakistan, Nepal, Bangladesh etc. Prisons are overcrowded with twice the number of inmates of which 70% are for drug-related offences. It is alleged that former Minister of Justice. Mr. Ali Sabry said that 553,000 people in Sri Lanka are addicted. Present Minister of Justice Dr. Wijeyadasa Rajapakshe has said there are 500,000 methamphetamine (ice) addicts mainly school children in the country. If the Doctors continued to treat heroin addicts, then the drug cartels could not have raked massive amount of money and that would have prevented ice (methamphetamine) spreading in Sri Lanka. There will be startling revelations if laboratory urine testing for Heroin and other narcotics are done in people between 15 years to 55 years.

After 10 years of addiction, heroin addicts become like vegetables. Many become freaks. This could be prevented by early treatment and medical detoxification. It may be possible to get rid of the tip of the iceberg the Hummock. But, not the core of the Bummock. The doctors will never be able to solve this problem. The effect could be minimised only by the doctors. There is not much in Sri Lanka that drugs are not behind.

Rehabilitation

There are 550,000 heroin addicts in the country. Rehabilitation could be done only in 3,500 heroin addicts per year. Heroin residue that remains in the fatty tissues of the body for over six years will trigger relapses even up to six years. When taking treatment there is no suffering, they can work, save money and have a happy family life. Rehabilitation causes pain and suffering due to withdrawal symptoms. Heroin dependents dislike going to centres. Many going to centres lose their employment.
Treating heroin addicts is branded as an inferior disrespectful and repugnant branch of the medical profession. All the doctors purchased the monthly quotas of methadone and other medicines approved by the Director General of Health Services (DGHS) from the MSD. In 1993 WHO/HCDIP funded by an Italian cooperation conducted a training programme for 15 doctors. Treatment given by the doctors saved the lives of heroin addicts and their families. These doctors were insulted, Humiliated ridiculed threatened and were not respected. By 2009 there were only eight doctors. Until 2008 there were adequate amounts of medicines to treat heroin addicts. Methadone was out of stock at the MSD in 2009, 2010, 2014 and 2017. From May 2021 there was not a single methadone tablet or any other indicated medicines available to treat heroin addicts. The only thing heroin addicts could do was to buy heroin to get over withdrawal symptoms. Not having any medicines has caused heroin dependents to end up as retarded deranged and violent people. Heroin has brought about destruction to Education. The happiness index has reached as low as 4.44 in Sri Lanka. This is the only country in the world that has a very high density of heroin addicts but does not have a single medicine to treat them.
Heroin addicts are more prone to have many other diseases. Bronchial Asthma, Bronchiectasis, Tuberculosis (TB) lung abscesses and pneumonia. Heart failure, liver degeneration kidney failure are some of them. How could one treat any of these without treating the root cause which is heroin addiction? The dog did not do its duty and let the ass do it, and made a mockery out of it. 

We can be inconsiderate about the unaccounted billions that were drained out of the country in acquiring and smuggling heroin into the country. Much significant damage to the country was done by over 150 times more billions that were raked in by the drug lords inside the country from the drug addicts. This monstrous mad money that went into the wrong hands did much destruction to the country, and paved the way to the beginning of methamphetamine (ice) addiction in the country.  This would not have happened if the doctors continued to treat heroin addicts and 40,000 peddlers came for treatment without spreading heroin to others. It is morally unacceptable to let more than 550,000 heroin dependents undergo unimaginable pain and suffering by not allowing them to get available medicines and preventing doctors from treating them. Krokodil serves as an excellent illustration of the havoc that bad drug policies can wreak on communities. The unfounded fear created about medicines is due to total ignorance because not a single METHADONE addict was produced during the past 35 years after doctors treated heroin addicts.