By Raj Gonsalkorale

Drug use disorders, a pressing issue globally, have particularly strained Sri Lanka’s public health and security systems, affecting its youth and communities. Sri Lanka has witnessed a troubling rise in drug-related issues, with a 13% increase in arrests for drug offenses during the 2022 economic crisis, totalling 152,979 individuals. The infiltration of narcotic drugs like cannabis, heroin, cocaine, and prescription medications has significantly impacted adolescents and young adults, including school-aged children. Despite these alarming statistics, there has been a notable shortage of effective prevention and treatment programs, leading to high relapse rates due to the chronic, relapsing nature of drug use disorders. UNODC – United Nations Office on Drugs & Crime https://www.unodc.org/southasia//frontpage/2024/July/sri-lanka_-unodc-rolls-out-groundbreaking-drug-use-prevention-strategies-and-capacity-building-of-stakeholders.html#:~:text =Sri %20Lanka%20has% 20 witnessed %20a,economic%20crisis%2C%20totaling%20152%2C979%20individuals.

The handbook of drug abuse information in Sri Lanka 2024 released by the National Dangerous Drugs Control Board of Sri Lanka (NDDCB) states that a total of 162,088 persons were arrested for drug abuse related offences, 46,939 persons were imprisoned and 2039 persons received rehabilitation treatment in numerous state and non-state institutions. Based on these numbers, it appears that out of the total arrested, 28.9% were imprisoned, and 1.25% were sent to rehabilitation centres.

In a research study done in 2021 by Nuwan Darshana, Champa Wijesinghe, and Vijitha De Silva for the department of Community Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka, the study found that among a randomly selected sample of 189 male heroin addicts in five selected rehabilitation centres in Sri Lanka, with followed up for six months with two follow-up interviews at 3 months and 6 months after discharge from the respective rehabilitation centre the relapse the results at the end of three months, the relapse rate was 48.7% while after six months it was 59.6%. The easy availability and accessibility of heroin within the living community was identified as the main reason for relapse in as many as 82.6% of heroin users who had relapsed. A majority (66.1%,) of those who relapsed did so within the first six weeks weeks) after discharge. https://www.researchgate.net/publication/354331421_Relapse_rate_following_institutionalized_rehabilitation_of_male_heroin_addicts_A_Sri_Lankan_experience. The study calls for the attention of policy makers who are responsible for planning and implementing follow-up programmes for drug addicts, including heroin addicts, especially during the initial period after discharge from rehabilitation centres to minimize the number of relapses

An anecdotal reason could be that rehabilitated addicts return to the same environment and conditions that made them addicts, without an opportunity to earn a living using the skills they may have learnt during rehabilitation and being stigmatised and shunned by the society around them. This would naturally leave them with no hope for their well-being and future and leading them back to the mental world of addiction as their only solace. Perhaps the rehabilitated addicts could be monitored after release and assisted to use the skills acquired to make a living, and appropriate institutions like religious institutions and humanitarian institutions included in a program to destigmatise addiction. This view is expressed in a study titled Drug Control, Detention and Treatment of People Who Use Drugs in Sri Lanka” by Ambika Satkunanathan (https://www.hri.global/files/2021/08/03/HRI_Report_-_Sri_Lanka_Drug_Control.pdf) who says there is also little post-release support or after-care to support effective reintegration into society. This is evidenced in the narratives of the interviewees who have been to more than one rehabilitation centre. They report facing stigma, which hinders social and reintegration and livelihood opportunities, as well as harassment by the police. The need for community support, particularly to secure a livelihood, was reiterated by all interviewees. Those who had received treatment for drug dependency pointed out that stigma and harassment are key reasons that lead to relapse”

While addressing challenges associated with rehabilitation is a major issue, and the government as well as several non-government entities are engaged in it and intend expanding and transforming rehabilitation approaches and services, perhaps even what is more critical is how a significant dent can be made on the supply side as well as the demand side of the supply/demand equation.

The supply side

It is well known that in Sri Lanka and of course in other countries, the major players in the drug trade are a few powerful individuals strongly suspected as being the elite amongst the corrupt, and not the minions who hit the headlines, and that they are entirely responsible for the supply chain relating to drug addiction.

It is a multimillion-rupee industry that reportedly funds among others, individuals within some political parties, in customs, the Police, the judiciary, in schools, in the pharmaceutical industry and even within the Buddhist institution to keep the industry going as a very profitable one. The human cost associated with this industry, preventable in most cases, is unimaginable although obviously it does not evoke any sympathy, empathy or consideration in the warped minds of the big fish.

No doubt, many readers will agree that only sprats have been apprehended and punished while Sharks have roamed free continuing their despicable business with some even functioning as major benefactors of some politicians, and individuals in religious and social institutions. It is an injustice to humanity to allow these big fish to roam free. They need to be apprehended and made to pay the price for their crimes with very serious punishment, including depriving them of their civic rights considering the damage they have inflicted on society. Punishing them alone is not sufficient as key players in the supply chain, including from entities mentioned above, have to be brought to book and strong deterrent punishment meted out to them as well. It would be foolish to exclude such players in the supply chain as they are all complicit in making the supply chain work and without them, both the supply aspect as well as the demand aspect of the industry will cease to function.

Whatever strategies that one decides and choose to implement to eradicate drug trafficking and consumption, it has to be considered from the prism of a supply chain as the supply component of it has a direct relevancy to creating a demand for drugs, and both aspects have many contributory players who are engaged in making the chain work and provide growth and profitability to the industry. Creating a demand and increasing that demand is key to those who supply the drugs. The unfortunate victims are school children, the youth of the country. It is reported that while the situation in 2003 was that most (65%) of drug users were in the age group 20-35 years, this group now includes children over 15 years as well. Today The small fish involved in the chain close to the consumers, are just that, small fish. They are traders, individuals and entities of varying magnitudes, but taking some of them out of the chain will not serve as an effective deterrent as there will be others ready and waiting to take the place of the small fish removed from the chain.

Although the government and its law enforcement agencies and the judiciary are responsible for apprehending and punishing the drug barons and their henchmen, if a serious dent is to be made on the supply side of the drug industry, this itself will not address the demand side of the problem, drug consumption that results in addiction.

In this context, the writer wishes to draw the attention of all relevant authorities to a question that is in the minds of many, and which generates much speculation amongst the public. This is about the fate of the substances that are detected and confiscated amidst much publicity. There is a lack of information about what happens thereafter to what is confiscated. Speculation results, including that some of what is confiscated finds its way back to the illicit trade thanks to corrupt elements within the law enforcement and justice institutions. Such speculation is harmful to the efforts being made to eradicate the drug trade and consumption and addiction, by all well-meaning individuals in all authorities. It is understood that disposal of confiscated substances is based on court orders and that most substances are held in storage thereafter until they are taken for deep sea disposal. It would be beneficial for the public to be made aware of the process and periodic notices to be published about what and how much has been so disposed.

The demand side

While rehabilitating drug addicts is a humanitarian activity, preventing them from becoming addicts is even a greater humanitarian activity. Prevention is always better than cure and the focus of the government and the society in general must be more on prevention than cure, through awareness campaigns, education, skills development and more generally reframing education centres as knowledge and skills development centres. While the writer does not have confirmed information, it is understood that the funds allocated for rehabilitation is significantly more than the funds allocated for prevention activities mentioned earlier, although the results relating to rehabilitation, on account of several factors, is far from effective in preventing readdiction. The study referred to earlier in this article as well as anecdotal information on this confirms that reoffending has not abated despite the good efforts of many who are associated with rehabilitation.

In this regard, and in order to refocus attention of policy makers towards heightened prevention activities related to substance consumption and addiction,  the activities proposed and conducted, perhaps not to the extent wished for by the National Dangerous Drugs Control Board (NDDCB), should be supported and the primary focus of attention on the drug addiction issue shifted to (a) Eliminating the elite amongst the illicit drug industry including those who are complicit with this elite, and (b) preventative measures that reduce demand for drugs. Citing the NDDCB, their Prevention Education and Training Unit (PET Unit) is promoting drug prevention activities Island wide. This Unit maintains a balanced and comprehensive approach to the drugs problem addressing demand which supported by evidence-based responses focusing on prevention, social integration, and sustainable livelihoods. The Unit is building cooperation with the institutional bodies of the drug control system, International and National agencies and the scientific community to drive work that is evidenced-based. They conduct preventative services in the following areas. More details on each of these are available via https://www.nddcb.gov.lk/preventive-education-and-training-unit.php and readers are encouraged to access this information.

 School based prevention

Drug prevention programmes for school students with the aim of reducing the risks of alcohol, tobacco and drug abuse by addressing the major social and psychological factors that promote the initiation of substance use and other risky behaviours.

  TOT for Teachers

Training programme series with the aim of providing schoolteachers with skill-based, theoretical and practical knowledge of drug prevention.

  Vocational Training Centres and Tertiary Education Institutions

Students in tertiary educational institutes have been identified to be a vulnerable group for abusing drugs.

  Preventive Education for University Students

A skills-based programme to promote positive health and personal development for university students

  TOT for Youth

A series of training of trainer’s workshop for selected youth leaders.

Family based prevention

Family skill development programs and educational programs to prevent drug use in families.

  Larger Workplaces

Drug awareness programmes in larger workplace island wide.

  Government Officers

Awareness and training programmes for grama niladhari, samurdhi niladhari, development officers, and other field officers who employed in government sector Island wide.

  Programmes for Law Enforcement Officers

A programme series for three forces, Sri Lanka Police, Sri Lanka Custom and other law enforcement officials

Community Programmes

Drug education for grass root level community groups.

 Exhibitions

Drug Prevention Exhibitions. In these exhibitions, posters, banners, and leaflets containing drug prevention messages and information are distributed among public.

The Outreach Unit of the NDDCB is entrusted with the responsibility of extending the Board’s services (prevention, treatment and rehabilitation) to drug-dependent persons and their families, high-risk groups in the community and the general public by conducting community programmes, mobile awareness, and establishment and maintaining a communication network between Divisional Secretaries, Grama Niladaries, field Officers, community leaders and civil society organizations to develop programmes on discouraging the abuse of drugs. While the efforts of the NDDCB and many others engaged in all aspects relating to arresting the supply and consumption of these harmful substances and the many rehabilitation efforts being taken must be lauded, no agency should present a picture to the public where, in their own minds, they see that reality they face is not what it is as presented to them. If this happens, they will lose confidence in the efforts being made, and more to the point, efforts that are said to be taken to arrest this menace.

In order to make sure that what is planned and what is actioned are one and the same, it is suggested that the NDDCB carries out regular monitoring & evaluation of its activities and preferably, on a periodic basis this task is assigned to independent entities in order to be more impartially informed of gaps that exist between executed action and planned action.

In this regard it is also suggested that the NDDCB develop a strategic plan for say five years identifying its key goals and objectives and the strategies and action plans to be adopted to achieve these. Such an action plan has to identify the costs associated with the activities and the approved expenditure for each action. Considering that the Western province, in particular the Colombo and Gampaha districts, have the highest number of drug consumers (around 70% as per reports), and the largest number of arrests for drug and substance related offences, it would be natural and logical for the strategic plan to give greater focus and priority to these areas, and in the allocation of funds for related activities. In planning its activities and in the allocation of funds, NDDCB should give priority to strategies that are related to prevention rather than cure including rehabilitation work and engage the services of the non-government sector for such work. Even in preventive work, the NDDCB should enlist the services of institutions that should play a pivotal role in prevention and train and carry out awareness sessions through Train the Trainer programs in such institutions rather than themselves engaging in such activities at an operational level. NDDCB’s monitoring and evaluation role will be more impartial and productive if they were to assess the results of operations carried out by the entities tasked to work on prevention under the guidance of the NDDCB.

Arresting the harmful substance supply, its use, its prevention and cure is a huge effort that is not just a government or non-government entity responsibility, but an overall societal responsibility and the ownership of the effort has to be shared by all. Drug addiction is neither incurable nor hopeless: A pioneer in rehabilitation work, Venerable Kuppiawatte Bhodhananda Thero, the founder Mithuru Mithuro movement, very rightly says Why do people turn to drugs? It is out of ignorance and craving. Many people tend to stigmatize and marginalize drug addicts and say that it is impossible to reform them. This is mere prejudice, because every individual has the potential to develop himself and achieve the highest of human values. Reformed addicts can lead successful and happy lives and contribute positively to society.” –  https://mithurumithuro.lk/ven-k-bhodhananda-thero/