Health: To treat people dependent on alcohol and opioid drugs, BNCA and UNODC launched a programme called ‘pharmacological treatment options for opioid and alcohol use disorders’ in Thimphu yesterday.

At least five drug overdose cases come to Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu every month.

Records with JDWNRH show that the hospital got 27 cases of drug overdose in the last six months. However, only two of the cases resulted in death that occurred due to consumption of Chendu (aconite), root of a medicinal plant which can cause death if consumed in large quantities.

Emergency department’s GDMO Dr Sona Pradhan said that the hospital does not have records to determine how many overdose cases were due to overconsumption of pharmaceutical drugs.

Unresponsive behaviour from people after abusing cannabis, over consumption of paracetamol in suicide attempts, abusing other pharmaceuticals drugs such as Spasmo Proxyvon and Relipen are reported as overdose in the hospital records.

According to the annual health bulletin 2014, 129 people died from alcohol liver diseases of the 2,631admitted to the hospitals across the country in 2013.  In 2012, 140 people died from alcohol liver diseases  and 169 died in 2011.

The bulletin says that 774 cases of mental and behavioural disorder due to alcohol were reported in 2013.

According to Bhutan Narcotics Control Agency (BNCA), over 500 cases of drug and alcohol use disorder were rehabilitated since 2009.

For the pilot phase of the programme, the treatment therapy will be conducted on 50 people with opioid use disorder and another 50 with alcohol use disorder. Opioid is opium like compound that binds to one or more of the three opioid receptors of human body. It is a pharmaceutical drug that is abused. A person who is addicted to the drug is called an opioid dependent.

The treatment will use a harm reduction approach through an opioid substitution treatment (OST) for opioid drug users. Buprenorphine tablets will be provided as substitution for opioid.

For the alcohol use disorder treatment, clients will be given alcohol withdrawal management service or detoxification based on standardised protocols, management of basic health problems associated with dependent drinking pattern, basic education on alcohol use disorder, psychological support and counseling service.

Making alcohol dependents ‘abstain from alcohol’ is the main goal of the programme. Dependents are treated with disulfiram, a deterrent drug (tablet) that will help them stay away from alcohol.

BNCA’s director general Phuntsho Wangdi said that the launch marks the beginning of hope and opportunities for many helpless citizens, particularly young people who are ensnared in the clutches of addiction.

“It is a day when hopes will be rekindled, lives saved, opportunities recreated and smiles brought back into the lives of many individuals and families who are affected by the scourge of addiction,” he said.

He added that while the law enforcement agencies continue to keep vigilance, rehabs and drop-in centres in the country keep treating and rehabilitating people with substance use disorder.

A crack down by law enforcement agencies found 1,300 drug cases in last one and a half year.

Health minister Tandin Wangchuk said alcohol use is more common in Bhutan than marijuana and pharmaceutical drug use.

Although the presence of injecting drug users is low, the increasing number of youth abusing pharmaceutical drugs orally could lead from oral to injection, he said. “We should not be complacent.”

He added that till date the approach taken to address opioid and alcohol dependent disorder has had some success. To cater for more severe cases of addiction, pharmacological intervention is necessary.

Bhutan has not done any study to determine the drug and alcohol dependent population since 2009.

UNODC experts presented and conducted demo details of a survey ‘computer assisted personal interviewing’ that will map accurate prevalence of drug and alcohol use in Bhutan.

The programme was launched as part of the Drug Free Campaign 2015 that Her Majesty Gyalyum Tshering Pem Wangchuck launched on June 26 to commemorate the 60th Birth Anniversary of His Majesty The Fourth Druk Gyalpo.

Nirmala Pokhrel