Bangladesh does not have any national guideline for the treatment of drug addicted people as a result most of the private rehabilitation centres as well as the government treatment facilities provide treatment to the drug addicted people largely based on their experiences.
For the first time, the Department of Narcotics Control has been formulating a national guideline titled “National Guidelines for the Management of Substance Use Disorders (SUD)” for the treatment of drug addicted people across the country.
“It is the first milestone for the science-based treatment for the drug users in the country and it will help improve overall quality of the treatment of the drug users,” said Dr. Rahanul Islam, psychiatrist at the Department of Narcotics Control (DNC).
There is an increasing tendency of substance use in Bangladesh and the problem is more concerning especially among adolescents. Different studies said that more or less 2.5 million people in Bangladesh are addicted to drugs. Among them, 80% are adolescents and young people of 15–30 years.
The government facilities for rehabilitation are not sufficient as a result more and more private rehabilitation centres are being set up across the country. Every year, the government is providing financial assistance to the private rehab centre to improve the quality of the treatment.
Dr. Rahanul Islam, who is involved in the preparation of the guidelines, said that so far they have been providing treatment to drug addicted people following the international guideline DSM-5 which is basically used for the treatment for people with mental diseases because the World Health Organisation (WHO) considers drug addiction as a mental disease.
But every country formulates their own national guidelines for treatment considering the socio-economic and cultural contexts.
“Bangladesh did not have it. We have just completed the guidelines. We will print them and distribute them among the psychiatrists, psychologists and medical officers as well as people involved in the treatment of drug users,” said Dr. Rahanul Islam.
He said that following the guidelines, they will make an operational guideline for the treatment of the drug addicted people. Some more manuals will be created with details.
“The guidelines include the process of handing the suicide-prone drug addicts and managing violent patients. These directives are already included in the guidelines,” said Dr. Rahanul.
“Until a drug addicts becomes violent, no one admits drug addicts to a drug rehab, and sometimes many accidents happen managing such violent patients,” the physician added.
The guidelines also include standard protocols for the treatment of the special populations, for example, women drug users, children drug users, Hijra community drug users and drug users’ among street children and injectable drug users need different approaches.
Many people, who were drug addicts in the past, have set up rehabilitation centres across the country and provide treatment based on their experiences and non-scientific methods. The new guidelines will help them to follow procedures which will ultimately improve the quality of the treatments.
“Private drug rehabilitation centres are now under some kind of supervision. However, how will you supervise the private rehab centres when there is no national guideline or standard?” said Dr. Rahanul Islam.
“Undoubtedly, this guidelines will pave a way for effective supervision,” said Dr. Rahanul Islam.
However, Dr Helal Uddin Ahmed, associate professor at National Institute of Mental Health and Hospital said that it is not right that there is no guideline for the treatment of the drug addicted people.
“Our psychiatrists provide treatment to the drug addicted people following the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders.” said Dr. Helal Uddin Ahmed. “It is an internationally recognised guideline.”
Dr. Mekhala Sarkar, associate professor at the National Institute of Mental Health and Hospital said that a national guideline is very important for Bangladesh as 3.4% people area someway or other drug addicted in the country.
“We think this is the tip of the iceberg and the number of drug addicted people is slowly increasing,” said Dr. Mekhala Sarkar.
She said that many new rehabs have been being set up in the country in this context.
“Now many recovery addicts provide treatment in their rehabs based on their experiences,” she added.
“If we do not have any guideline, there are scopes that the drug addicted people can get maltreatment and the treatment will suffer from effective management. So, definitely, a national guideline is very important,” she opined.
Drug addiction situation
The government research found that the drug addiction has already reached an alarming situation in Bangladesh and as the days are passing, this is turning into a grave situation. In 2017, the Department of Narcotics Control (DNC) conducted a research titled “Baseline Study in Drug Addiction in Bangladesh”. The study was conducted in the 8 major cities of Dhaka, Chattogram, Khulna, Rajshahi, Rangpur, Sylhet, Barishal and Mymensingh.
“Drug users are basically young with their average age at 28.7 years. Every 7 out of 10 drug users are less than 30 years old. About 70% drug users possess SSC or above education level of education,” the research reads.
The research found that a slightly half of drug users are either students or unemployed while the remaining are with employment basically in business and services. Household income of drug users shows that they basically belong to the middle class.
Most frequently used drug is yaba followed by cannabis, phensidyl and heroin. A total of 94% respondents reported that they use yaba, 88% said they use cannabis and 52.5% use Phensedyl.
The research found that they are using drugs for quite a long time with the average being 7.2 years. Although they are mostly from middle class families, they spend about Tk 713 per day on an average on drugs.
