Non-government agencies, including Department of Narcotics Control (DNC), or non-government bodies, do not know the exact number of drug abusers in the country. The DNC is not even sure about the number of drug spots in the city. "Since independence, we haven't carried out any survey on drug abuse or drug dealing. But, we know drugs are available everywhere in the country - from metropolises down to the upazila, and even at many of the villages," a DNC high official said.

Some new drugs also have joined the league. Yaba tablet and Sinkara syrup are being increasingly abused, in addition to the popular drugs including cannabis, heroin, phensedyl, hashish or charas, opium, sedatives and hallucinogenic pills, and Nalban in addition to the injecting drugs like pethedrin, morphine, Tidigesic, Monogesic and Bunogesic. You can also get the costlier drugs like Ecstasy tablet, cocaine and LSD in Dhaka.

Contrary to the common perception that drug addicts mostly comprise of uneducated lower class people and delinquent upper class youths, people from almost all the professional are represented in the category. "Apart from rickshaw-pullers, sex workers, petty criminals and students, many times we caught university teachers, government officials and employees, engineers, physicians, businessmen, musicians, journalists, policemen and so on taking drugs," said Department of Narcotics Control (DNC) Director Mofazzal Hossain. A recent survey of CARE-Bangladesh covering a number of districts revealed that the age of drug abusers ranges from 10 to 41 years.

For instance, surveys have found a rapidly increasing prevalence of HIV/AIDS among the injecting drug users (IDUs), many of whom are professional blood donors. So, the danger of HIV infection making a quick inroad into the general population is obvious, considering that the country mainly relies on professional blood donors to meet its blood-transfusion needs. "It is not only a crime, but also a social disease that has seized people of all ages and all socio-economic classes," observed a teacher of psychology at the Dhaka University. The disease set alarm bells ringing for the nation, when the sixth round of National HIV Serological Surveillance, 2004 - '05 reported that as high as 7.1 percent of the IDUs in the capital tested HIV positive.

The survey report said that approximately 44 percent of the female IDUs were street-based sex workers, some 82 percent of whom had shared needles/syringes while taking drugs in the previous six months. They constitute the group that has a direct HIV-transferring link with the general population. The findings of the survey reiterate the warning issued by its forerunners that time is running out fast for Bangladesh to act to prevent the concentrated epidemic from spreading to other social sections, and thus pull the nation out of the drug HIV quicksand it is sinking into.

Not only the lower-class, the problem has spread to all socio-economic classes, and only a small portion of the female drug addicts winds up at the rehab centers. Many of our female patients come from the upper class, mostly students of English-medium schools and private universities. Most of the women addicts are aged between 16 and 30 years. Most of them are Yaba and heroin addicts. The girls acquire the habit from their male class-mates and buy the drugs with their help. Sources said that a significant number of girls studying at public universities and colleges also abuse, and become addicted to, drugs. Its not possible to say anything statistically. But its true that the number of female drug addicts is increasing in the society.

Though some non-governmental organizations (NGOs) have conducted surveys on female drug addicts, their focus was limited to the injecting drug users (IDUs), who constitute one of the groups with the highest risk of spreading HIV/AIDS. Almost all the IDUs covered by these surveys belonged to the lower class, with a large portion comprising sex workers. But no study has been carried out so far by any agency that gives a picture of drug addiction among the women of middle and upper classes. There is serious lack of information here. Recent studies in Tanzania show that a large percentage of adolescents are sexually active. At the same time, they lack basic knowledge about the functioning of their bodies and the risks involved in becoming sexually active at an early age. This ignorance often puts them at risk. Unwanted pregnancies, hazardous abortions, as well as sexually transmitted diseases, including HIV/AIDS are a real threat to uninformed youth.

The Rapid Situation Assessment (RSA) survey recently carried out by CARE Bangladesh reports an 'alarming rise' of drug abuse among women. Of the female respondents, 55 percent were married. More than half of them were either illiterate or had not completed primary schooling. Of the rest, 35 percent had secondary schooling, and 26.7 percent primary education. Only 7.9 percent of the female drug addicts surveyed were living with their families, 46.3 percent living at brothels, 24.8 percent on footpaths, 18.2 percent at railway stations, and 14 percent at urban and suburban slums. Nearly 65 percent of the female respondents are commercial sex workers. However, the study also found that some nurses and female medical students take drugs in their dormitory rooms. In most cases, they started taking drugs at the age of 16 to 25 years. Women are also engaged in drug pushing, both in and outside the capital. The survey found women peddling drugs in the districts managing the police, the Detective Branch and the Criminal Investigation Department of police, and the Department of Narcotics Control.

According to various websites, buprenorphin is still widely used in the United States to cure heroin addiction. But, in some countries like India and Bangladesh people have become addicted to it. Ironically, they first took this drug during their treatment at rehabilitation centers. Experts said that to check drug abuse, the country should initiate more preventing and awareness raising programmes, especially targeting the school kids and youths that are more susceptible to the vice due to abundance of curiosity.

In 2000, the 189 member states of the United Nations agreed to a broad set of goals, setting international development priorities for the coming years. The Millennium Development Goals build on a number of international conferences held in the 1990s, including the International Conference on Population and Development in 1994. Most of the MDGs will be globally achieved by the year 2015. The sixth goal of MDGs is to combat HIV/AIDS, malaria & other diseases. To achieve the target of this goal, the only one indicator for HIV/AIDS is to increase condom use rate.

The present level of infection among IDUs poses a significant risk as the infection can spread rapidly within the group. Moreover, a large population of IDUs had commercial and non-commercial female sex partners, and condom use was infrequent. So, there is every possibility of spreading the infection through their sexual partners and their clients into the general population. Another concern is the significant number of IDUs in the country who sell their blood professionally. According to the 5th round behavioral surveillance (2003 - '04), 4.3 - 6.7 percent IDUs sold blood in the previous year. At the same time, IDUs are highly mobile and travel to different places where they inject drugs and share needles.

Among female sex workers, HIV prevalence during the sixth round remained low as with the previous rounds. It was less than 1 percent among all groups of female sex, except the casual female sex workers in one of the northwest border areas (Northwest - K1) of the country, in a sample 120 sex workers, where the prevalence rate is 1.7 percent. Though declining, active syphilis rate among female sex workers is still high, ranging from 1.6 percent to 10.7 percent in different locations of the country, according to the sixth surveillance report. Moreover female sex workers in the border areas are considerably mobile, and sell across the border. However, according to a recent report of the United Nations Office on Drugs and Crimes, the number of drug addicts in the country is not less than 4.3 million.

There are two schools of drug addiction treatment. One follows the 12-step programme of Narcotics Anonymous and avoids using medication unless extremely necessary, while the second school, mainly comprising the psychiatrists, treats patients with antipsychotic medicines that have severe side affects. It has been seen that some medicines intended for treating drug addiction are now being widely abused as alternative drugs. Buprenorphin, the generic drug available in the market as Tidigesic, Monogesic and Bunogesic injections, popularly known as Madras and Chennai to injecting drug users, was originally made as an antidote to heroin.

According to the National AIDS/STD Programme (NASP) the estimated number of people living with HIV (PLHIV) was around 7677 as of end of 2005. As of December 2005, a total of 658 cases of HIV/AIDS has been confirmed and reported by the Ministry of Health and Family Welfare (MOHFW), with 176 of these having developed AIDS, out of which 77 have already died. Significant underreporting of cases occurs because of the country's limited voluntary testing and counseling capacity, and inadequate reporting system. The social stigma attached to the disease is an impediment. 5th round HIV surveillance also revealed high Hepatitis C (HCV) prevalence in IDUs, as 54.2 percent tested positive for HCV out of 1619 IDUs sampled. During the sixth round testing for HCV among IDUs done in eight sites, the HCV prevalence varied from as low as 2.5 percent in southeast - D to as high as 57.5% in northwest - D.

There are lots of discussions about the roots of HIV/AIDS but, until now, there has been no conclusion. Some people say that the virus was made in a laboratory by accident. Some say that the virus existed for a long time in the forests of Central Africa, and that it was transmitted through interaction between monkeys and people. However, there is no total certainty about the source of HIV/AIDS. Actually, it is not too important to know where the disease comes from and who discovered it. The most fundamental thing is to know that this disease has spread into all countries in the world and that we must protect ourselves, because there is neither a cure nor a vaccination against it.

Nicholas Biswas is Principal, Hope Training Institute run by Christian Service Society, Khulna.