The World Health Organization has stated that drug addiction should be treated as a disease rather than a crime, and yet in Nepal, all rehabilitation centers have been kept under the responsibility of the Home Ministry instead of the Health Ministry. If we are to break the societal stigma surrounding drug addiction, rehabilitation, and reintegration into society, perhaps this is where we should begin.

The above was emphasized by both Dr. Toshima Karki (Member of Parliament and former State Minister of Health) and Sher Bahadur Tamang (former Minister of Health and Population) at an event organized by the Federation of Drug Demand Reduction on the occasion of International Day Against Drug Abuse and Illicit Trafficking on 26^th June.

Led by the slogan “People first: stop stigma and discrimination, strengthen prevention,” the event aimed to raise awareness about drug abuse, reduce the stigma associated with addiction, and underline the importance of prevention. The presentations and speeches delivered during the event shed light on the challenges posed by drug addiction in Nepal and called for collective efforts to address this pressing issue.

Photo credit: Sanjeeb Khadka

Deepak Kumar Upreti, a former drug addict who has been clean for 17 years after a 27-year battle with addiction, delivered a heartfelt welcome speech. He stressed the need for schools to incorporate education about the dangers of drug addiction into their curriculum. Upreti shared his personal regret that his addiction prevented him from building a successful career, highlighting the significant impact drug addiction can have on an individual’s life.

A presentation was given which shed light on the historical context of drug addiction in Nepal. The influx of drugs such as cocaine, methamphetamine, and heroin began with the arrival of hippies in the 1960s and 70s. Prior to this, marijuana was the primary drug used in the country, with it being the only drug produced within the country as well. Nepal’s geographical location as a transit point and its open borders with loose airport security made it a hub for the drug trade. According to a statistic by the Ministry of Home Affairs, currently, over 130 thousand people in Nepal use hard drugs. Hard drugs are often injected into the body, and a concerning 72.6% of hard drug users in Nepal are below the age of 30. Brown sugar and methamphetamine are prevalent substances among drug users in Nepal. The presentation stated that the progressive, compulsive nature of addiction makes it extremely difficult to quit, however emphasizing that while it is incurable, it is treatable.

Addressing the challenges faced in combating drug addiction, the difficulties in opening rehab centers due to conservative attitudes in communities were also discussed. Additionally, there is a lack of support from the local government, hindering efforts to establish and maintain effective rehabilitation facilities. There are hurdles faced in organizing awareness events, as the home ministry and Chief District Officer (CDO) were claimed to have been discouraging such initiatives.

In the event, SSP Siddhi Pratap Shah from Nepal Police addressed the audience, revealing an interesting statistic: only 10% of those caught in drug-related offenses are brought to trial, while the rest are sent to rehab centers upon recommendation from their families. Shah emphasized the importance of both supply cutoff and demand reduction in combating drug proliferation. He mentioned that there are currently 700 programs in place to educate and raise awareness about the demand side of drug addiction. Dr. Toshima Karki highlighted the need to identify the root causes of drug addiction. She questioned why rehab centers in Nepal fall under the jurisdiction of the home ministry rather than the health ministry, despite the World Health Organization (WHO) recognizing drug use as a disease rather than a crime. Dr. Karki stressed the importance of addressing addiction as a public health issue and finding comprehensive solutions that focus on prevention, treatment, and support.

To better understand the workings of a rehabilitation center in Nepal, Aawaaj reached out to one in Godawari. For the past ten years, Muktidaya Sewa Healing House has been at the forefront of advocating for drug users’ rights and monitoring rehabilitation centers in Lalitpur. The organization has shed light on the human rights violations prevalent in rehab centers, such as forced treatment and coercion. Relentless efforts have drastically reduced these practices, which were once rampant. The motto “treatment, not torture” has become a powerful campaign slogan, emphasizing the importance of dignity and respect for individuals seeking rehabilitation.

Sanjeeb Khadka, a former drug user himself, has been a driving force in Muktidaya Sewa Healing House’s mission. After having gone through the recovery process and being clean for seven to eight years, Khadka, Treasurer at the rehab center, developed a deep interest in opioid substitution therapy (OST) and reduction programs. Recognizing the need for youth representation and voices in the field of drug rehabilitation, he aimed to break the long-standing oligopoly of the same individuals running the centers for decades. He understood that the changing drug patterns and societal dynamics required fresh perspectives and youth involvement to effectively address the issue.

Photo credit: Sanjeeb Khadka

Through advocacy, the stigma surrounding rehabilitation has been reduced over the years. However, societal conservatism still poses challenges in addressing the issue comprehensively. Families often fear the societal judgment they may face when a member is admitted to a rehab center, hindering their willingness to pursue treatment options. Despite growing awareness about the benefits of rehabilitation, translating this knowledge into practical action remains a significant hurdle.

The rehabilitation programs at Muktidaya Sewa typically span six months, but many participants choose to stay for a year or even longer. The programs incorporate experience-sharing sessions, the Narcotics Anonymous 12-Step Program, and spiritual elements. These approaches aim to boost self-esteem, instill a sense of purpose, and foster personal growth. Additionally, various activities like exercise, cleaning, classes, family meetings, and group therapy provide a comprehensive support system. Over 10 years, the center has treated anywhere from 1500 to 2000 people, and each year somewhere between 50 to 100 people are treated.

There are several challenges in the mission to combat drug addiction effectively. The conservative attitudes prevalent in the community hinder the establishment of rehab centers in local areas. These issues highlight the need for collaboration between stakeholders, including NGOs, to overcome these challenges collectively. Right now, the majority of rehabilitation centers in Nepal are run by former drug addicts who have recovered and decided to help others break free.

The event organized by the Federation of Drug Demand Reduction served as a platform to address the challenges posed by drug abuse in Nepal. The presentations and speeches delivered underscored the urgent need to stop the stigma and discrimination surrounding addiction, strengthen prevention efforts, and provide the necessary support for those seeking treatment. By working together, addressing the root causes, and involving multiple stakeholders, Nepal can take significant strides toward combating drug abuse and creating a society that prioritizes the well-being and recovery of its people.