Recovery counsellors share some unusual cases
Twenty-seven year old Danish Alam* is no longer afraid of academic exams. He now has a “smart substance” to help him. He does not forget things and stays focused while studying like never before. But is he aware of the harm he is causing himself?
Alam, a student of Organic Chemistry at the University of Karachi, actually enjoys exams unlike his peers. But in 2015, he failed all his major subjects because he couldn’t remember a thing in the examination hall.
“I was studying Pharm-D at KU back then,” said Alam. “Everyday I felt like a panic attack was coming on.”
Alam had what is known as exam anxiety: an intense feeling of fear or panic before or during an assessment. After Alam failed his semester, he gave up on his education because he said there was no hope left in him. But in 2018, he resumed his studies.
“I had no money six years ago but now I earn enough to support my family,” he said. “It has also given me the confidence to continue my education.”
But it is not just the money that has enabled Alam to go back to the same university that “terrified” him six years ago – he has a secret.
“It’s true that it is a drug, but it’s a smart one,” he said. “You can stay focused for up to 12 hours if you take it.”
Alam was alluding to modafinil, a drug used to treat narcolepsy and other sleep disorders. Narcolepsy is a sleep disorder that causes sudden deep sleep, hallucinations and sleep paralysis.
Modafinil is a psychoactive stimulant drug. It stimulates different neurotransmitters (chemicals that send messages in the brain) to promote wakefulness. It also leads to euphoria and changes in mood, perception and thinking.
The drug is prescription-based all over the world, but you can easily buy it over-the-counter at any medical store in Pakistan for Rs200 to Rs350.
“Students mostly take this drug during their exams,” Iqra Naz, a clinical psychologist in Karachi, said while speaking to SAMAA Digital. “But what they don’t realise is that it leads to severe addiction.” She added that she has seen a number of cases where people take modafinil with carbonated drinks to “enjoy their active state for the sake of enjoyment”.
In the long-term modafinil can disrupt sleep and reportedly put users in a zombie-like state. They never feel refreshed after sleep. Chronic use can also damage the memory.
It’s not hard for vulnerable individuals to find alternatives to more conventional drugs that are not easily available or are too expensive. Cocaine, ecstasy, and heroin are some of the most commonly known drugs, but there are other substances that work surprisingly well to alter the mind.
“We had an 80-year-old woman who took four to six glasses of khus khus (poppy seeds) every day,” said Naz.
The woman was brought to the clinic by her son. She had started taking poppy seeds with water when she was a teenager, according to her history. Since poppy seeds contain opium-like compounds, taking them long term can cause addiction. Unfortunately, the woman could not be rehabilitated, because stopping her decades-long daily intake only worsened her health.
“All we could do was fix a daily quantity of poppy seeds for her.”
Drug use is also rampant among teenagers, who have a greater risk of developing an addiction when they grow up. Another psychologist, who requested anonymity, told SAMAA Digital that they often receive children as young as eight years old for treatment at their rehabilitation centre in Malir.
When asked about a case that she would always remember, she said she had a 14-year-old client with a disability who had become severely dependent on heroin.
“He was hardly eight years old and had difficulty walking when we admitted him to the primary unit,” she said. Primary unit is a three-month recovery course with recreational activities, regular counselling and medical treatment for individuals aged between eight and 14 years.
His treatment was going well until one day when his family arrived and took him away.
“He started taking drugs again,” she said. “And by the time his family brought him back he had gone past the age criterion and we couldn’t admit him.”
The boy died of a drug overdose in front of her office one night.
“It was a traumatic event,” she said. “He was only a kid when we received him and seeing him die like that was painful.”
Recovery counsellors play an important role by creating for their patients an environment where they know they will be heard without being judged.
When asked about the challenges that are part of her job, she said a real struggle is when a patient is willing to recover, but not willing to listen.
“We have little control over a patient’s will,” she said. “Patients who don’t listen are difficult to treat because we cannot force them to accept their condition.”
According to Naz, it is always easy for people to recover from drug use if they are willing to make a change.
“Our biggest reward is the patient’s feedback,” said Naz. “Their recovery in itself is a motivation for us. It helps us perform better.”
The United Nations revealed in 2013 that 6.7 million people in Pakistan used drugs in 2012, with 4.25 million of them being drug dependent. Only 30,000 of the country’s drug users received rehabilitation and other treatment. In January, the then minister for narcotic control Shahryar Khan Afridi said no drug use survey had been conducted in the country since 2012.
*Name has been changed to protect privacy