Addicted to substitute drugs: the unexpected turn in the opioid crisis for India

Balkar Singh, a 35 year old farmer in Jalandhar, Punjab, takes his buprenorphine-naloxone tablet every day at 8 am. Taken sublingually, the prescription pill delivers 2 mg of synthetic opium, ensuring that Singh—whose name has been changed to protect his privacy—doesn’t feel like injecting himself with heroin, the opioid he was addicted to for more than four years.Singh hasn’t taken heroin for five years. He gets his buprenorphine free from the nearest state run outpatient opioid assisted treatment clinic. Punjab has 529 such clinics, as well as 36 addiction treatment centres and 19 rehab centres, to tackle opioid abuse.In 2022, 21% of the 681 deaths in India1 from drug overdose happened in Punjab. The north western state also has some of the highest rates of opioid use and dependency in India. Whereas the national average is 2.06%, in Punjab 9.69% of the population use opioids while the number of people…
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