India to roll out oral substitution therapy to reduce risk of HIV transmission

NEW DELHI: A single pill taken every day for nine months will now help the country’s intravenous drug users (IDUs) kick the habit.

India has finally decided to roll out the ambitious Oral Substitution Therapy (OST) from September, to reduce the risk of HIV transmission among the country’s highly vulnerable IDU community.

The National AIDS Control Board, headed by health secretary Naresh Dayal, has sanctioned Rs 136 crore for the OST programme, which hopes to cover 40,000 IDUs by 2012.

Under the programme, substance abusers will keep an oral pill of Bupernorphin under their tongue for five minutes every day in front of a supervising doctor. This will cut their desire for addiction.

Kounteya Sinha, for Times of India.

Speaking to TOI, director general of National AIDS Control Organization (NACO) K Sujatha Rao said that the first phase would see India enroll 10,000 IDUs by March 2009 from Manipur, Nagaland, Mizoram, Chandigarh and Delhi.

These places may account for 90% of the country’s IDUs. Orissa, Mumbai, Punjab and Kolkata too are becoming hotbeds for IDUs. NACO estimates that India is home to 2 lakh IDUs.

Nearly 25% of them are suffering from HIV due to sharing of contaminated needles. OST programmes in China and Australia have proved to be a roaring success and it was found that Bupernorphin helped addicts get over hard substances like heroin and cocaine.

Rao had recently visited China, which had upscaled its OST programme to 30,000 IDUs in a year, to study how to formulate, plan and implement the programme in India.

According to Rao, surveys conducted by AIIMS had found the relapse rate after detoxification to be as high as 92% among addicts. “The OST policy has finally been cleared. By August, we will finish procuring the stock of Bupernorphin required to run the OST programme. By March 2009, we will reach out to 10,000 IDUs. Four expert teams are being formed to evaluate the 33 agencies who will implement the OST. The list of IDUs and the eligibility are being finalized — he should have support from family, ought to have gone through detox and failed,” Rao said.

According to her, 20% of the IDUs were suffering from such advanced addiction that their brain’s motor functions had stopped responding. “They can even commit murder if not put on OST. However, once they get the medication, they are as normal as you and me. China’s crime rate dipped after they introduced the OST programme. Till now, India followed a conservative 15-day detox programme for addicts. However, it has failed miserably,” Rao said.

India is a busy transit route for drug traffickers moving heroin from the Golden Triangle of Laos, Myanmar and Thailand and also from Afghanistan. Inevitably, that has led to a rise in substance addiction in India.

“Denying this would be disastrous — especially because drug addicts are at a higher risk of contracting HIV through sharing needles,” an official said.

NACO has already been worried over the increasing number of IDUs as these addicts infect their partners with HIV by having unprotected sex. Needles are the predominant way that HIV is spread. Also, addicts often stop caring about sharing needles and are simply concerned about their next fix.

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