Good morning with a fresh

Stop Addicted winter breathe

Breathe
DRUG
ABUSE
OUR TEAM AND TABLE OF CONTENTS
Obaidur Reza Choudhury Nyrit Mahmood
Background: Prevention
Current status in Bangladesh Approaches to prevent

Syeda Samiun Nahar Mohaiminur Rahman

Cause & risk factors Organizations working on it
Factors relevant to the risks Government & Private

Samina Sultana Chowdhury Asif Iqbal Shohan

Sign/symptoms Existing Policy in BD
How to identify drug abuse Policies relevant to narcotics control

Supervisor : Dr. Mohammad Delwer Hossain Hawlader

MBBS, MPH, PhD
Associate Professor & Chairman,
Department of Public Health, North South University
 01
Background: Drug abuse and its impact
on Bangladesh
● Drug addiction is a burning problem in
Bangladesh affecting a majority of population
especially the youths between the ages of 18 and
30 years.
● Multiple drug use has aggravated the overall
situation affecting our personal, economic, social
life and impairing health status.
● The dangers of drug addiction have affected all
class population of our country.
THE GOLDEN TRIANGLE &
GOLDEN CRESCENT
Bangladesh, though not a drug producing
country has now become a victim of drug.
Bangladesh is situated in the crucial point
between the ‘Golden triangle' (Myanmar,
Thailand and Laos) and the ‘Golden
crescent' (Pakistan, Afghanistan and Iran).
It is also surrounded by the major drug
producing countries of Asia. Bangladesh
with its easy land, sea, and air access is
becoming a major transit point.
 Addiction in which drug
Old Agent Newer Agent
Phensedyl drug Yabba
Ganja (cannabis) LSD
Pethidine Khat
Heroin Ecstasy
Cocaine Glue/DOB

In recent times, Yaba has gained popularity

and has become a "fashionable" drug. It is
estimated that there were about 4.6
million regular users of Yaba (several
combinations of N-methylamphetamine
and caffeine sold within BDT 300 to BDT
2000, as red or pink pills) in Bangladesh.
 02

Cause & Risk Factors

Of Drug Abuse
Drug addiction can start with the experimental use of
a recreational drug in social situations, and, for some
people, the drug use becomes more frequent. For
others, particularly with opioids, drug addiction begins
with exposure to prescribed medications or receiving
medications from a friend or relative who has been
prescribed the medication.

The risk of addiction and how fast you become

addicted varies by drug. Some drugs, such as opioid
painkillers, have a higher risk and cause addiction
more quickly than others.
Causes
● Recreation
● Curiosity, experiment
● Peer Pressure
● Influence of media, western lifestyle,
celebrities
● Stress relief
● Coping mechanism
 Risk Factors
● Younger age group
● male>female
● Poverty
● Mental illness (depression, anxiety, stress etc.)
● Ease of access
● Ignorance about harm
● Early exposure, family history
● Not being able to differentiate drugs
 Vulnerable Groups

Male Female Unmarried

94% 21% 65%

students or Influenced by friends Addicted to more than

unemployed one drug

56% 85.7 % 64.3 %

 03

Signs/symptoms
 Physical Symptoms

1. Bloodshot or glazed eyes 2. Dilated or constricted pupils

3. Dental issues
4. Sleep problems

5. Weight changes
6. Skin changes

7. Changes in hygiene
 Behavioral Symptoms

● Increased aggression, irritability or defensiveness.

● Changes in attitude/personality.

● Mood swings.

● Lethargy, depression.

● Involvement in criminal activity.

How to identify if someone is doing drugs?
● Cigarette wrapping papers ● Rolled up banknotes

● Syringes ● Cut-up straws

● Burnt spoons or bottle caps ● “Cutting” surfaces like mirrors or glass

● Bongs ● Razor blades

Signs of Abuse Related
to Specific Drugs
 Yaba
Method of consumption Symptoms of Addiction
● Oral tablets ● Increased need for the drug
● Heating on aluminium foils ● Loss of appetite and weight
● Snorting crushed powder
● Restlessness or pacing
● Injecting through solvents
● “Ice” another derivative of yaba ● “Meth mouth”
● Red, flaky skin
● Schizophrenic behaviour
● “Yaba binge”

External/visible effects
● Insomnia
● Euphoria
● Tremors
● Increased strength and aggression
● Increased temperature
● Raised blood pressure
Heroin
 Heroin
Method of consumption
Symptoms of Use
● White powder
● Snorted or smoked if pure form ● Depression, anxiety, mood swings
● “black tar” form ● Hyperactivity and exhaustion
● Possession of burned spoons, needles
Effects of abuse
or syringes, missing shoelaces, glass
● Social- Loss of family relation, money loss pipes
● HIV or Hepatitis B and C. ● Increased sleeping
● Chronic pneumonia ● Apathy and lack of motivation

● Distorted mental functioning ● Warm, flushed skin

● Constricted pupils
● Blood clots, leading to stroke, embolism
● Extreme itching
● Kidney disease

● Death
 Glue Sniffing
Background Symptoms of Use
● Common user- Childs from poor family and slums
● ● Chemical odors on the breath or clothes
Paint thinner,nail,varnish,remover,gasoline
● ● Paint or other stains on body parts/cloths
Widely prevalent among street children
● ● Sudden change in friends and hobbies
Precursor to other forms of drug abuse
● ● Slurred speech
Inhaled through bags
● Runny nose or nosebleeds
● Ulcers or irritation around oral cavity
Effects of abuse

● Sudden death
● A weakened immune system
● Lung, kidney, brain damage
● Coma
● Spasms
● Social- Destrcution of child’s future.
- Pickpocketing and mugging for money
Prevention
Causes of drug Treatment Programs
taking behavior

PREVENTION &
CONTROL OF
DRUG ABUSE Community
Sources of illicit Organizing skills
drugs
 Primary Prevention Secondary Prevention Tertiary Prevention/ Treatments
● Avoid under peer pressure ● Law Enforcement for addicts

● Hospitalization
● Behavioral Therapies
● Occupational Therapies
● Changes in addicts social
environment

● Communicate
● Public Policy

● Education & Counselling

PROGRAMS FOR DRUG PREVENTION

Family Based Drug Prevention

● Self-awareness
● The enhancement of parent-child communication skills
● Family bonding
Educational Institution Based Drug Abuse Prevention
● Handle aggression
● Problem Solving skills
● Communication skills

Community Based Drug Prevention

● Effective research-based program
● Expert consultation
 Remedial Measures

● Awareness & prevention must start at home

● Drug cartels should be taken down & removed together
● Inpatient & Outpatient Rehab
● Drug & Alcohol Detox
● Addiction treatment medications
 Barriers to Preventing and Treating Drug Substance Use Disorders in Rural
Communities in Bangladesh

● A complicated system of care to treat SUDs

● Lack of interagency coordination and communication
● Lack of mental health services
● Stigma & confidentiality concerns
● Insufficient capacity in hospitals
● Limited resources and personnel
● Motivation for change
● Misuse of laws
 Organizations Working On It
Government & Private
05
Government
Organization Department of Narcotics Control, Bangladesh

• APON( Ashokti Punorbashon Nibash)

• Dhaka Ahsania Mission
• BADF (Bangladesh Anti-Drug Federation)
• Work For a Better Bangladesh
National • CREA( Community-health Rehabilitation Education and Awareness)
Organizations • AMAR Home(Addiction Management and Rehabilitation Home)
• ADHUNIK

• UNODC(United Nations Office on Drug and Crime)

• WHO(World Health Organization
International • BRAC(Bangladesh Rural Advancement Committee)
Organizations • CARE(Cooperative for Assistance and Relief Everywhere)
• CARITAS
 APON (Ashokti Punorbashon Nibash)

Drug Control Activities: Detoxification, treatment, rehabilitation, awareness and

counselling.
Target Groups: Local addicts and their family members.

Methods of intervention: Residential treatment, rehabilitation and regular training

SOME OF THE
ORGANIZATIONS Dhaka Ahsania Mission:
AT A GLANCE
Drug Control Activities: Prevention, education, training, treatment,
counselling, research and rehabilitation.
Target Groups: Impoverished populations, but especially youths and women.
Methods of intervention: Increase awareness in community through campaigns, training in mass awareness
techniques, non formal education and income generation.
 BADF( Bangladesh Anti-Drug Federation):

AIMS AND OBJECTIVES

SOME OF THE – To coordinate the activities of member organizations and get the media to focus on them.
ORGANIZATIONS
AT A
GLANCE(Cont.) – To help member organizations prepare and implement anti-drug programmes.

– To liaise between the different national and international organizations engaged in anti-drug
activities.

– To create awareness among people about the evils of drug abuse through seminars, meetings,
training workshops, publication of magazines, stickers, posters, articles and other relevant materials.
 06

DRUG ABUSE
AND
EXISTING POLICY
IN BANGLADESH
 BANGLADESH DEPARTMENT OF
NARCOTIC CONTROL (DNC)
• Bangladesh Department of narcotic control was
established on 2 January 1990 under the Ministry of
Home Affairs and is related to National Narcotics
Control Board. 

• The agency is responsible for issuing licenses for the

import, exports, sales, transport, etc. for drugs in
Bangladesh. It also carries out raids against illegal
narcotics.

• The department has its own intelligence branch.

The last revision was done in 2020

 Classification of Intoxicants
C Class Intoxicants-
B Class Intoxicants-
A Class Intoxicants-
● ● Denatured and Methylated spirit,
Hemp plant, Herbal
● Opium cannabis, Vang Chlordiazepoxied, Diazepam
● Poppy ● Alcohol, All types of wine, ● Triazolam
● Afim (Pethidine) rectified spirit, Beer, LSD ● Tranquilizer or Hypnotic medicine
● Cocaine and its derrivaties ● Barbiturates, not mentioned in class B or other
● Cannabis resin Amphetamine stimulants, Depressant medicine
● Methyl Amphetamine,
● Oxycodone not mentioned in classes A & B.
Phencyclidine.
 SUMMARY OF THE NARCOTICS LAW BY
DEPARTMENT OF NARCOTIC CONTROL

The Narcotics Control Act prohibits Handling precursors without the

import, export, sale, purchase, requisite license, permit or pass
manufacture, processing, transport, attract imprisonment of 2 to 10
possession, use or any other kinds of years while violation of any
the operations except for medicinal, condition
scientific, or legitimate industrial of the license attracts imprisonment
purposes under license, permit or pass. of up to 5 years and a fine.
(Section 9)
Relevant Policies

If anyone keeps any instrument,

Violation any provision of Section 9 which is used to produce
intoxicants, he will be punished for
For class A- minimum two years to
maximum life imprisonment for 2 to 15 years imprisonment with
committing crime. fine as additional.

For class B- minimum 6 months to

15 years imprisonment.
For class C- not more than one year
imprisonment or fine of TK 10,000/= Punishment for letting houses or
or both. vehicles to use in commission of
crime is imprisonment of not
more than five years or fine or
both.
Current challenges in Narcotic policy in Bangladesh

• Corruption • Lack of
appropriate
knowledge and
awareness

Increase in drug Familial and

trafficking social support

Actual
implementation of Inadequate quality
Existing policy treatment and
prevention centers
 Prevention and Control method for policy
implementation-

Drug taking Sources of

behavior elicit drugs Knowledge

Implementation Drug laws

Treatment
program

Community
Community Family,Individual Support
and
and social
social and Agencies
support
support
 LAST BUT NOT LEAST!

Though it’s informal, yet the basic unit of human organization has
always been the family. So friendly behaviour and caring attitude from
the dearest ones around a person from the very beginning can really
contribute to a big change in this regard. We may hope as a primitive
organization every member of each family will play a vital role
combating the drug abuse war.
 D.E.A.D –
Drugs End All
Dreams

Tagline : Delete drugs or they will delete you from this world
Article

Review
 Legal and Social Consequences of substance use:
Results from a nationwide study in Bangladesh

Authors-
Mohammad Delwer Hossain Hawlader , Mohammad Hayatun
Nabi ,Amir Hussain,Saad Ullah Al Amin, Sanjana Zaman, and Iqbal
Masud

Published online: 20th December 2020

Journal: Routledge (Taylor and Francis Group)
 Introduction
► Substance use is one of the major public health
concerns since the ancient period and it contributes
to 4% of total Disability Adjusted Life Years (DALY)
globally.
► In Bangladesh, an estimated number of drug users
are more than a million who spend over BDT 70
million every day on illicit drug use.
► The consequences of substance use might be very
serious. Depression, anxiety, and insomnia are the
most frequent mental health consequences of
substance uses.
 Objectives of the Article
►This study was aimed at identifying the legal and
social consequences of substance use in
Bangladesh through a nationwide study.
►The broader objective lies in assisting
policymakers, families and the society to be more
responsive in the prevention of substance use and
its relapse.
►To categorize and determine various samples of
substance users irrespective of age, sex, education
status, culture etc.
 METHODS
Study
Design Population Questionnaire
Descriptive type Bangladeshi
Self-administered
of Cross- Adults
and structured
sectional survey Patients from 50 Questionnaire
rehabilitation
centers, 20 per
center .
Sampling
Technique Sample Size Data .
was based on 994 people
-Prevalence rate participated
collection
-Design error Face-to–face
-Confidence interview using a
Duration of structured
interval
. -Adjusting non- the study questionnaire by
response. January to trained data
December collectors
2018
 Methods
►Statistical Technique:
► Descriptive analysis and statistics.
► Result: Number and percentage.

►Data processing software: SPSS ( version 25)

►Ethical Consideration:
▪ Privacy and confidentiality of the respondents were maintained.
▪ Permission and Informed written consent were obtained.
▪ Ethics approval was obtained from the Institutional Review
Board of North South University.
 RESULTS
► Table 1-sociodemographic variables -male substance user (98.9%), age
group 19-30 years (48%) and 31-45 years (41%) , educational status
(graduate or postgraduate (19.1%) , (35%) of cases were businessmen, and
the second-most (29.7%) group of participants were
unemployed.Unmarried and married were 43.8% and 48.4% respectively ,
less than 30,000-taka earners 55% and 96.3% were living with families.

► Table 2- Types of drug used by the substance users- amphetamine (76%)

and cannabis (75%), Alcohol and phensedyl (50%), heroine and sleeping
pill usages were 47% and 21.6% respectively.Substances such as
morphine/pethidine, buprenorphine, cocaine, opium, LSD, painkillers
varied from 0-10%.
 Results cont.

►Table 3- legal consequences of substance use : arrested (49.5%), among

arrested in were in custody (43% once, 41.9% were 2 to 5 times and the rest
more than 5 times) , drug use (54.8%), trafficking (44.3%) , went to prison
(52.1%).

►Table 4- familial loss and social loss the substance users : lack of family
interaction (74.8%), destruction of family relationship (69.9%) , left home
(13.7%) , got divorced (8%) , faced bullying (59.5%) , lack of good relation at
workplace (50%), lack of social support or isolation from society (51%)
Critical
Comments
► Systematic and specific study.

► Greater validity due to variant and massive

sample size.

► Containing complete variables and factors

relevant to consequences of substance use.

► Explains the nationwide determinants influence

the Legal and social consequences.
Numbers of scientific evidence
portraying the consequences of
substance use were very limited in
Bangladesh. This study found several
important legal and social
consequences due to substance use.
Families and respective communities
can support the recovery with the help
of existing interventions and treatments
and mutual support programs. Finally,
attention can be drawn of the
policymakers to promote awareness of
the family members and society to be
more supportive and prevent substance
use and its relapse.