Sri Lanka: moving towards health-oriented drug treatment

Study tour of Sri Lankan delegates to India

Sri Lanka has made considerable progress in human development. However, the picturesque island in the South Asian region is not free from drug use. According to latest estimates, there are about 45,000 regular users of heroin and about 600,000 users of cannabis in Sri Lanka. Injecting Drug Users (IDUs) comprise nearly one percent of the current drug using population. Being a low prevalence, yet highly vulnerable country, the Government of Sri Lanka is now moving from a sanction-oriented approach to a health-oriented one to address drug use effectively.

UNODC has been working now for some years in Sri Lanka in building capacities in both community and prison settings, providing and improving treatment, care and support for drug users.

In order to strengthen further the Government's understanding of international best practices in drug treatment and HIV prevention, UNODC organized a study tour for a Sri Lankan delegation to India, which took place from 6th - 8th September 2010. The delegation included members from the National Dangerous Drugs Control Board (NDDCB), the Ministry of Health and Sarvodaya, an NGO. The objective of the tour was to give the visitors an exposure to different, universally recognized treatment alternatives available for drug users, so that they could choose and replicate the options best suited to the Sri Lankan context.

In Delhi, the delegates visited the National Drug Dependence Treatment Centre (NDDTC) at the All India Institute of Medical Sciences, the national nodal agency set up by the Ministry of Health, Government of India. Here, they learnt about the various models of evidence-informed treatment available to drug users. Dr. Rajat Ray, the head of the centre, also shared the results of an operational research study, done jointly with UNODC on Opioid Substitution Therapy (OST) in India.

As part of the tour, the delegates also visited a community clinic run by NDDTC. The centre provides drug treatment services in a community setting. The delegates interacted with clients and their family members and received first-hand accounts of how drug users benefit from OST.

A highlight of the tour was the visit to the Tihar prison in Delhi. In South Asia's largest prison, OST is now available in the prison's de-addiction centre, which maintains linkages to the community drug treatment centres outside the prison, essential for the inmates, once they are released. The delegates interacted with the inmates undergoing treatment as well as the doctors and counsellors thus obtaining a full understanding of the importance of providing health services even to inmates in prisons as a human right.

The tour ended with a visit to three NGO-led initiatives in Delhi and Chennai, which provide drug de-addiction, rehabilitation, treatment and HIV prevention services.

As a result of the visit, the delegates were able to familiarise themselves with both government- and NGO-run de-addiction centres in hospital as well as community settings. The visit helped to understand that drug dependence is a chronic, relapsing disease like diabetes and hypertension, which requires long term medical treatment  that includes both pharmacotherapy and psycho-social support.                                                                                                                     

The delegates also appreciated the fact that OST is an accepted, well-researched and ethical form of treatment for    opioid dependent individuals. They expressed their interest to undertake a pilot study to examine the feasibility of using OST for drug users in Sri Lanka. The study would be useful to inform policy makers and other stakeholders on the potential use of OST in Sri Lanka. The delegates were also keen to build the capacity of service providers working with the drug using population, including mental health professionals, through workshops and training camps. UNODC has offered to extend technical support for these initiatives.



The members of the Sri Lankan Delegation included Mrs. Leisha De Silva Chandrasena, Chairperson & Mr. K. Gamage, Director General, National Dangerous Drugs Control Board, Sri Lanka, Dr. Ethige Jerard Mayel Prasantha de Silva, Acting Director, Mental Health Directorate, Ministry of Health, Sri Lanka, and Dr. Lalith Chandradasa, Director, Sarvodaya.

The study tour was arranged and coordinated by UNODC through its project " Prevention of transmission of HIV among drug users in SAARC countries" and supported by UNAIDS Sri Lanka.