The Ministry of Health’s National STD / AIDS Control Programme and the National Dangerous Drugs Control Board commenced a national, island-wide survey to assess the patterns of drug users.
The rapid assessment is to inform risk reduction interventions for ‘persons who use drugs’ (PWUD) and ‘people who inject drugs’ (PWID) and in turn lead to the revisiting of existing policies and services in place for them.
The Board estimated that there were approximately 45,000 heroin users and 200,000 cannabis users in the country with the Districts of Colombo, Gampaha, Galle and Kandy showing a high prevalence of drug use. Furthermore, concurrent estimates done by the Board acknowledge the growing presence of intravenous drug use and the higher risk of human immunodeficiency virus (HIV) infections amongst PWUDs and PWIDs.
According to the Board, cases of drug overdoses and new hepatitis C (HCV) infections amongst drug users including in the setting of prisons that have been reported indicate an increase in opioid injecting practices. Previously, the Rapid Situation and Response Assessment carried out in 2008 reported that 4% out of 1,045 drug users surveyed injected opioids. The National Size Estimation Survey of the Most At Risk Populations conducted in 2013, reported 423 intravenous drug users, with the Western Province, the North Western Province, the Southern Province and the Central Province accounting for the highest such users.
According to the Behavioural Surveillance Survey spanning the period of 2006 and 2007, needle and syringe sharing was common among injectors (42.3%). The Integrated Biological and Behavioural Surveillance Survey spanning the period of 2014 and 2015, reported that 66% (215 out of 324 injectors) injected more than twice a week and 55% of them shared needles and syringes.
Chairman of the Board, Prof. Ravindra Fernando said that not only was currently available data in this regard inadequate but that such data lacked evidence on emerging issues such as drug injecting, overdoses, HCV and other co-morbid conditions.
“Treatment for drug use is still provided as an alternate to incarceration and does not include pharmacological options for the management of withdrawals or cravings,” he said.
“On the question of services, there are limited services available and most of them are located at specialized units attached to mental health services. Thus, the services are not popular among the general community and PWUDs and PWIDs do not come to seek treatment or related services, thus fueling injection driven HIV also,” he explained.