The challenges of treating yaba addiction in women
As a photography student in Dhaka, I began researching yaba addiction among women in Bangladesh.
I met with girls and women at various stages of addiction and treatment; from those who hesitated to call themselves addicts, to others who identified as addicts and had been through treatment.
I wanted to know how, in this conservative country, women were exposed to, and accessed, illegal drugs -- as well as why they felt compelled to do so. Additionally, I wanted to ascertain the extent of their knowledge about side-effects of the drug and the potential of rehabilitation.
I found that there were different push factors within different social classes, but a common factor for addiction was untreated mental health issues. Depression, anxiety -- and eventually the consequences of both left untreated -- manifest in drug abuse.
Among the elite, the appeal of taking a party-drug lingers, or a desire to lose weight; for middle-class housewives, their de-facto seclusion within their homes, or conflict with their in-laws, can lead them to using. Among street children, many use once they have been prostituted -- either as a coping mechanism, or because their clients force them.
Regardless of how the women are hooked, addicts continue to take the drugs because they crave the feeling of the high and want to feel that their problems have been left behind.
Rehab in Dhaka (the only part of the country where women can receive treatment) is generally prohibitively expensive -- except in cases where NGOs step in and provide free treatment. Some women I spoke to recounted the benefits of Narcotics Anonymous and the 12-step program, and some saw value in the rigidly-structured therapeutic community method. Others seemed to dislike the structure of the therapeutic community method -- they spoke about their release dates as though they were in jail.
I saw some rehabs trying their best, professionally, but struggling -- because of a lack of qualified female drug counsellors in Bangladesh and/or funding. Not enough women are trained in this skillset here, but with 1.1 million female drug users (16% of the addicted population in 2016 according to Madok Drobbo O Nesha Sangstha as reported by Dhaka Tribune), Bangladesh will need to focus on rehabilitating its addicts to ensure a productive generation.
Many women are afraid of rehab; they fear that they will undergo electroshock therapy and be tied up, beaten, tortured, and dehumanized by staff. Unverified accounts of third parties speak of non-addicts being “imprisoned” by low-reputed rehabs that accept to pacify women who are deemed problematic. Many women do not believe rehab centres operate ethically.
It is true that some private rehabs operate only for the money. They do not mind if the patients relapse, because that will mean further business for them. The same is true for many rehabilitation centres operating in Florida, US, which profit from insurance claims; so, globally, addicts are being taken advantage of in their vulnerable state.
There are insufficient legitimate, regulated facilities to treat addicts in Bangladesh. More addicts would seek treatment if they were certain that they would receive professional care. There need to be more facilities that do not treat their patients as numbers to be drugged into submission.
Selecting a rehab is a vital step in the recovery process, and it need not be rushed. Before parents place their addicted daughters in rehab, they must research what treatment entails, and understand its limits. Addicts remain so for life. They cannot be cured of addiction, but can only manage it. An addict can stay clean in rehab and relapse, once out, because all the triggers of addiction remain in their personal lives.
Some of the triggers of addiction include: Stress due to family expectations; unemployment and a lack of job opportunities; infringement of human rights; sexual harassment in public spaces; and sexual abuse at home.
Also, young people continue to be exposed to yaba as part of a “fun” night. They have few public spaces in which to spend time; and have to pay high transport costs to get to a community space in the city. Aside from eating out, many youths tell me they have nothing to do but spend time at their friend’s homes or with their dorm-mates -- and with few activities (sporting and cultural) they get high.
Alcohol is difficult to acquire here. It requires an alcohol license -- which many do not procure -- and the individuals without licenses fear being caught by the police asking for bribes. To obtain the license, Muslim citizens must obtain a doctor’s permission and then apply for the license -- then may still be limited in quantities of purchases, and lose their right to sit on a jury. Many are instilled with fear to be caught with a parcel of beer.
However, yaba is abundantly available, portable, and concealable. It is now competitively priced with the alcohol many fear buying. When yaba first became popular, about a decade ago, when heroin could be bought at Tk50 per packet, it cost about Tk1,200 per pill.
But it can now be found (mostly adulterated) for Tk150 per pill. A locally-brewed Hunter beer can be bought for Tk150 and used to be available for Tk100-120 just a year ago. Dealers are known to provide people with a “buy five, get one free” deal, to build the habit. Yaba is harmful to the consumer, community, and cannot be consumed responsibly -- unlike alcohol.
As the drug war wages on, the scarcity of marijuana is frustrating some addicts, and the slightly increased price of yaba is yielding larger profits for the remaining dealers. Marijuana has been legalized in Uruguay, Canada, and some US states, and has medical merits.
While some Dhaka-based contacts of mine warn that the country is not ready to legalize marijuana or alcohol because their use would be abused, I think that keeping certain substances, which are either not harmful or can be consumed in moderation, on the market, can help prevent future yaba addiction.
Another way to end yaba addiction is to tackle mental health issues. Bangla-medium schools (and many English-medium schools) lack school counsellors, but they are absolutely necessary to catch depression and anxiety at a young age. Building healthy coping mechanisms into the youth can steer them away from the escapism they currently seek.
Anna Milovanovic-Fazliu is a documentary photographer with an LLM from the University of Kent.