Hacked by the Needle

SOON, I know, the doctors will cut off my legs,” says Naobi as he smiles wryly, sipping tea at a roadside stall in downtown Imphal,“but I can’t help it.” Bandaged over festering ulcers, Naobi’s swollen legs will be amputated to prevent gangrene setting in. For years, this father of two has got his psychotropic high by injecting himself a painkiller capsule’s powder mixed with water. This mixture, of the capsule Spasmo Proxyvon, doesn’t dissolve but collects beneath the point where it’s injected, blocking the flow of blood in the veins and making the body part useless.

Living off his wife’s earning, Naobi, 31, must give up the addiction to avoid a terrible end. “Unless the mind thinks of stopping, I can’t stop using the drug,” he says. Every year, on an average 20 drug abusers see their limbs surgically removed in Manipur. As many as 5,700 people in the state today run the risk of amputation, according to a calculation by Premjeet, an advisor on drugs and HIV to the state government. This number – fully 15 percent of the total drug abusers in a state of 2.3 million — is alarming. The menace was underscored two weeks ago when police in neighbouring Nagaland seized an illegal supply of 600 capsules. This is a small yet significant amount as the drug’s sale has been banned in northeast India for nearly six years.

Manufactured by pharmaceutical giant Wockhardt, Spasmo Proxyvon is commonly prescribed for stomach cramps. Doctors say it has a “weak, opium-like” effect. In the northeast, the capsule is increasingly preferred by addicts who inject drugs such as heroin into their bodies, legs, hands, even genitals. Each shot is made from four to six capsules. Unlike heroin, the effect of each shot lasts three minutes, making an addict take a dozen shots a day. As multiple shots at the same spot burst a vein, addicts use different veins, bringing abscesses to their limbs over a period.

Located close to Myanmar, Thailand and Laos — key global centres of illegal narcotic production and supply — Manipur saw drug addiction zoom in the 1970s. Over the next 20 years, heroin dominated its narcotic landscape. At the start of this century, addicts began turning to Spasmo Proxyvon due to the strict enforcement against heroin. That the drug was cheaply priced helped: eight capsules cost just Rs 13. Hard up for money, the addicts get a reasonably good high spending Rs 150 a day on Spasmo Proxyvon compared with Rs 400 a day on heroin.

“The capsules were available at any pharmacy,” says Ashita Mittal, a senior program officer with the UN Office on Drugs and Crime, explaining the quick shift to the drug. “Besides, there was a lower risk of conflict with the law.” Imphal resident Abungcha is an ex-heroin addict hooked to Spasmo Proxyvon.“I know many whose legs and arms were cut off… some even died,” he says. But Abungcha doesn’t even want to look at his“one-time favourite” heroin. Three years ago, the middle finger of his right hand was excised.Father of seven-year-old twins, Abungcha is dependent on his wife who sells second-hand clothes for a living.

A New York-based research periodical, the Harm Reduction Journal of the Albert Einstein College of Medicine, studied the problem of injected drug addiction in northeast India last year. It found that most addicts turn to the drug around the age of 20 years. Peer pressure and plain curiosity are ample motivations. Of the 200 addicts interviewed for the study, nearly 170 were initiated by a friend while 140 had initiated at least one another person.

The spread of Spasmo Proxyvon addiction has also aided HIV transmission. HIV was first reported in Manipur in 1989 following a spurt in needle-sharing by heroin abusers. Today, over 2,800 people in Manipur suffer from AIDS. A whopping 28,000 have been diagnosed HIV+. This figure is more than one percent of India’s 2.5 million HIV+ sufferers. Spasmo Proxyvon addicts pass the needle around to save money, not caring if HIV+ addicts have used them. “Injecting was a gang activity,” recalls Taza, who took to abusing the painkiller in Mizoram when he left home to wean off heroin at his uncle’s place. Six years later, in 2002, Taza found he was HIV+. Now enrolled at a rehabilitation centre near Delhi’s Qutub Minar, Taza says, “I really don’t know what to do.” Adds former addict Dio Siam, also from Manipur, now working with the rehabilitation centre: “Taking drugs is seen as an assertion of masculinity. The young have only two options: take up drugs on join the militants.”

Alarmed at the spread of the painkiller addiction, Assamese secessionist group ULFA banned the use of the drug two years ago and threatened to kill traffickers. The militia’s diktat underlined the failure of the Manipur government to enforce its own ban on the drug in 2002. The government’s apathy is visible on its website: it lists dog bite a medical concern but ignores the abuse of Spasmo Proxyvon.“One in six abusers is on the verge of getting his limbs cut off,” says Manipur government’s advisor, Premjeet. “Yet, the government has no exclusive programme to control the epidemic.”

THE ALL Manipur Anti-Drug Association is a vigilante pressure group that runs raid-and-seizure campaigns against illicit drugs and other intoxicants. It wrote to Wockhardt in August 2006 asking the company to stop supplying Spasmo Proxyvon to Manipur. It also threatened a boycott of Wockhardt’s other drugs if the company failed to do so. The NGO claimed the capsule was being illegally manufactured in Assam and trafficked into Manipur. When contacted, Wockhardt refused to confirm or deny the allegations.“Spasmo Proxyvon is a drug approved by the Drugs Controller General of India (DCGI),” Wockhardt’s Product Manager Divya Mishra told TEHELKA. “I have nothing more to say.”

India’s top drugs official, DCGI Surinder Singh, who oversees pharmaceutical licensing and monitoring, refused to comment and did not respond to a faxed questionnaire. His deputy D. Roy, who oversees north India, said the northeast was the domain of the government’s anti-narcotic wing.“I’ve heard of the arrests and the trafficking from the media but received no official complaint,” Roy told TEHELKA. Roy, whose jurisdiction includes Delhi, says there is no abuse of the painkiller in India’s capital. But come to Delhi the drug certainly has. One of the inmates at the rehabilitation centre is Sunita, who is trying to build her life anew after 12 years of Spasmo Proxyvon abuse. She was addicted to the drug by her husband, who forced her to take it orally believing it to be an aphrodisiac. “It made me dull and sleepy,” Sunita recalls. “Then my husband could do anything with my body.”

Soon, Sunita developed psychosomatic addiction to the painkiller, taking up to 10 a day, fearing an upset stomach if she abstained. Her husband is now dead; her house sold. Also holed out at the rehabilitation centre is Muan, 20, who ran away from Manipur to Delhi to beat the drug habit, only to find it was easier to buy in Delhi. “I don’t have the confidence to stay out on my own,” says Muan. “I just can’t stop thinking about it.”

With inputs from Anjulika Thingnam in Manipur