Wake up folks and smell the cocaine! Come sundown, at least 20 persons not yet 18 years old somewhere, someplace in Bihar have got their virgin ‘fix’ out of a hypodermic needle. That’s a ballpark figure thrown out by Jojo Bimal, a chap with an NGO working with IDUs or intravenous drug users in Bihar. We’re just talking about the not yet adults, so the overall number of people shoving a package of hallucinations up their veins for the first time by this evening is significantly higher.

Jojo’s organisation (or the one that he’s working for) offers technical support for IDU in partnership with Bihar State Aids Society, and is mainly concerned with the prevention and management of HIV and AIDS, through ‘targeted interventions’. Hridaya, one such resource centre under India HIV Aids Alliance covers 2,302 IDUs (20 of whom are women) in 12 such targeted interventions.

“Let’s get this clear, we’re working with people, mainly addicts who inject drugs using needles. The other drug users, those who use ganja, cannabis, charas, ecstacy, heroin by smoking or sniffing but who aren’t injecting are not IDUs. Then there are the other addicts who sniff glue or abuse medical formulations. Many of those young people who first start off sniffing Xerox fluid or smoking ganja may slowly become addicts, and then travel up to more ‘potent drugs’ ending up as needle users,” explains Jojo, who travels throughout Bihar interacting with IDUs under the BSACS TI programmes.

According to a NACO-Hridaya report released earlier in the year, 95 percent of IDU in Bihar said that their first ‘legal drug’ was tobacco (average age at first use 16 years), 77 percent said that their first illegal non-injecting drug was cannabis (age of first use 19 years), and first illicitinjecting drug was Buprenophine (47%) and Pentazocine (45%), first used around 26 years of age. The last two are opioids, or medications that relieve pain available under different brand names and formulations. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus. They also have ‘mind altering’ side effects which for some may lead to ‘psychedelic’ highs .

Most of us think that people who inject drugs use cocaine or some other exotic derivatives. The truth is very different. “People in Bihar inject sedatives like avil, spasmoproxyvon, fortrivin, calmpose, and diazepam,” says Jojo, who also mentioned that abuse of these substances increased in certain areas of Bihar when the illegal cocaine  supply from across the UP border began dwindling.

How do people get their first fix? The report indicates that about 75 percent of the IDUs received their first injection from someone else: an experienced friend, spouse, sex partner or client. Would you believe that 19 percent of the injectors received their first fix from health workers? Evidently, these people received these injections to relieve pain, but got hooked on the ‘ceiling side-effects’. Only 5 percent of the respondents in the NACO -Hridaya report injected themselves the first time.

“Recreational drug use and addiction are two separate things,” said a young college goer, tries to justify his use of non-injected drug. Recreational drug use is occasional, just for fun. When you start hitting up regularly, then dependency on drugs increases, that’s when you’re really in deep shit. the small amounts no longer work, you need bigger and stronger doses, and that’s when you go over to the valley of no return.”

The college boy, like several of his pals, abuses medical substances as well as smokes ganja and has even ‘snorted cocaine’ by his own admission. Why? Partly because of peer pressure, but mostly when he’s ‘pissed off by his parents and the world in general’, he says. He says he doesn’t have a ‘habit’. Yet. But like several young people in your city, it all started when he was in the eighth grade, aged 14, with that first cigarette bought from the friendly neighbourhood ‘paan wala’!

  Dateline Bihar, Frank Krishner, India HIV Aids alliance, International network of People who use drugs (INPUD)