Panaji: The addiction treatment facility (ATF) at the South Goa District Hospital draws a steady flow of heroin users seeking to quit, though most arrive only after years of dependence, when money sources are exhausted, and withdrawal becomes unbearable. Counsellors say a smaller number come early with a clear intent to rebuild their lives.“They come when they finally realise that they’ve spent so much money on drugs over the years and can no longer afford them and experience severe withdrawal symptoms,” said Enola Pereira, counsellor at the ATF. “Once they’re on treatment, they become stable, join work again, and can keep their jobs,” she added.With medicines provided free, treatment does not add financial strain and allows patients to focus on recovery.While outcomes vary, the centre has documented sustained abstinence in some cases.Pereira cited the case of a 52-year-old man with a 28-year history of heroin dependence who has remained off opioids and other substances for the past six years. He previously consumed one gram of heroin three times a day and injected for 25 years, in addition to heavy smoking and occasional alcohol use. With medication and counselling, he stabilised, continues follow-ups, and managed early withdrawal symptoms including sleep disturbance, restlessness, body aches and cravings.The facility, launched in 2023 at the South Goa district hospital, has treated patients aged 16 to 65. Among recent cases is a 20-year-old college dropout brought by his mother after the family ran out of money. He started experimenting four years ago in his friend circle, sought money from home on pretexts, and played online video games to fund heroin. He approached the centre when he could no longer pay, and withdrawal set in. He told counsellors he regretted starting heroin, wants to cut ties with friends who still use heroin and fears being contacted again by his supplier.The centre has 35 registered former opioid users on regular opioid substitution therapy (OST), provided free under the Union ministry of social justice and empowerment. Most are from lower socio-economic backgrounds. Alcohol dependence dominates the case-load: about 75% of patients are alcohol-dependent, 20% opioid-dependent, and five per cent cannabis users said Dr Mamata Borkar, psychiatrist and in charge of the district mental health programme at the South Goa District Hospital.All registered opioid users at the centre are male. Most use heroin by snorting, and a majority are from other states living in Goa, said Dr Mamta Borkar, psychiatrist at the South Goa District Hospital. “Heroin users are not aware of what happens in the long run. Initially it’s the high and confidence that they experience which gets them addicted. After that it’s only downhill,” Borkar said.Relapse remains a key concern, especially when patients miss follow-ups or return to their native places. A 33-year-old man with an eight-year history of opioid, alcohol, and tobacco use registered last year with withdrawal symptoms including stomach ache, body pain, insomnia, poor appetite, and suicidal thoughts. He returned to his native place in January, relapsed, and came back recently with withdrawal symptoms, requiring treatment to restart from baseline. He has been off heroin for six days.The ATF offers medical assessment, detoxification, counselling, relapse-prevention programmes, free medication and follow-up care, including OST that replaces illicit opioids with prescribed medicines under medical supervision.
