‘Every high has to have a low’

Representational Image

When we enter 23-year-old Harshita Patel's [name changed] home, the first thing we notice is how spick and span it is. Everything sits neatly in its place. We settle into her bedroom, where she offers us chocolate cake, the perfect munchies snack, though we're both completely sober.

What was your first encounter with drugs, we ask. "Does weed count?" she says. We say yes. "I was 15. I was already smoking cigarettes, but that's when I tried my first joint." How did it feel? "I was smoking greens [cheaper strain of marijuana] back then, so everything just felt slow." Why try it? "It feels silly now, but at 15, you feel just so much. Still, it wasn't about coping. It always came from a place of curiosity."

For many Gen Zs, drugs are ubiquitous. If you weren't using, someone around you was. When this writer was in college just a year ago, it wasn't uncommon to hear of someone who showed up to an 8 am lecture coked up. Some classes were even recommended "best when high."

Patel is now a public relations executive, juggling a high-paced profession along with all the other demands of adulting. It leaves less time and bandwidth than college life, so her drug use has reduced - weed a few times a week, MDMA about once a month or whenever she goes for a concert. And she's not the only one.

The MBA students who recently overdosed on MDMA were at an EDM gig in Goregaon. Increased sensitivity to sound and colour, and a surge in mood and energy make Molly a top party drug. "Suddenly, it feels like everyone is on drugs," Patel says.

Why the sudden rise? "Every day, you see influencers your age on yachts, buying BMWs, travelling Europe. It feels like you're always behind. Then you scroll a little further, and [US President Donald] Trump is quite literally starting World War III. Climate change is eating our planet. There's an impossible goal and no time to reach it," she says, "If a pill can make you feel grateful to be alive for eight hours, why wouldn't you take it?"

A couple of years ago, Patel was diagnosed with Borderline Personality Disorder (BPD), a condition marked by extreme emotional swings and impulsivity.

"I will always remember my first trip on ecstasy [aka MDMA or Molly]. I did it with someone I really liked at that point, and he was a very guards-up kind of person. When the drug hit us, it was like all our walls came down. I remember being grateful to even be alive," she recalls, "We were both just open, and we had the best conversation of our lives. When you take ecstasy, all ego goes away. You have ego death. It's like you understand how the other person's mind operates, how their gears go round. It's like having sex with minds, but better."

Euphoria, which recently returned to OTT platforms for a third season, is one of the most graphic representations of drug abuse among teenagers. PIC/PINTEREST

"Because of BPD, the lows have always felt so extreme. But when I took ecstasy, I realised that I can feel the good at extremes too. On ecstasy, you feel things you have felt before - like gratitude or happiness - but it's so elongated. You're reminded that those feelings were inside you all along," she says.

How does she ensure safety? "I don't go over one tab. That is generally considered safe. And I never buy from an unverified source. I source from a dealer who is verified by friends," she says.

Over the last few months, she has cut down her usage of X, but weed continues to help her. "There was a weird time in my life when a lot was going on - break ups in relationships and friendships.

Attachment - especially with BPD - is very intense for me. With weed, I had this feeling of, ‘It really doesn't matter'. There was so much anger I was holding on to, and I could just let it go."

But dependence and addiction are a very real risk. "That's the sad reality. Anyone who says otherwise is in denial. Drugs are unnatural. I am very vigilant of the fact that this is not real, and it is going to end," she says.

"I've crashed really badly two times [after Molly]. I got really depressed," she recalls, "It felt like things have gone really bad in my life. All my insecurities became 10 times worse. Sometimes, the after effects of the drug are more fatal than the drug itself," she says.

"It's a cliche, but every high has to have a low. You know how, when you're young, they tell you, ‘Don't laugh too much, or you'll cry later'. It's literally that."

How is addiction cured?

Addiction remains a deeply misunderstood mental illness. Many don't recognise it as one, even though "the WHO has termed this as a mental illness," says Khalid Khan, counsellor at Hands For You Rehab Centre in Malad.

With easy access to drugs and information on "micro-dosing" or "stacking" (multiple micro-doses paced out), young users often justify their behaviour. "They become defence mechanisms. To a child who is using, their reasons feel genuine. They don't see the distorted and damaged reality of substance abuse," Khan says.

Group therapy helps addicts come to terms with their addiction. PIC/ISTOCK

How do we rehabilitate users then? Khan explains, "The first stage is a confined environment, where the patient has no access to drugs. Users may become aggressive, abusive, or experience hallucinations during withdrawal."

Once the detox is complete, "We begin physical activities - yoga, meditation, sports, games. Initially, the person is placed in group therapy," Khan says, "Then we begin one-on-one sessions with a psychotherapist, following the Minnesota Model of Addiction Treatment."

"The hardest part comes after you leave rehab," says Khan, "That's why it is important that one stays in touch with a psychiatrist even after the programme is done, and follows the 12-step Narcotics Anonymous programme."

Can drugs help?

Psychedelics are re-entering medical conversations, albeit cautiously. Substances like Ayahuasca, ketamine, and LSD are being studied for treating depression, PTSD, and addiction under strict clinical settings. Ketamine, for instance, is already used in controlled doses for treatment-resistant depression, offering rapid relief. Ayahuasca and LSD have shown potential in guided therapy, helping patients process trauma and emotional distress.

In How to Change Your Mind, journalist Michael Pollan documents both scientific research and his own experiences, describing how psychedelics, when supervised, can aid mental health - though risks remain outside regulated use. He argues that substances like LSD or psilocybin temporarily disrupt rigid patterns of thinking, what he calls the "default mode network" of the brain. This can help people break out of negative loops like depression or addiction.

How does an overdose happen?

Khalid Khan, medical counsellor and life coach at Hands For You Rehabilitation Centre, Malad, tells us, "Time perception changes when you're on drugs. You might think five hours have passed, but it's just been five minutes. Users think enough time has passed for them to take another dose, and then end up overdosing."

Khalid Khan

Drug use is highly prevalent at raves. "The lights, the sweat, the overall high of the energy of the place also contributes to how you're feeling. You feed off the high in your environment, and want to keep indulging," he says.

Since supply is unregulated, drugs are often laced with other possibly dangerous substances to add bulk. This can also lead to an accidental overdose or reaction. "You can buy MDMA anywhere between Rs 1000 to Rs 5000 per dose," says Khan, "The cheaper ones are laced with fentanyl, sometimes even glass fibre or ajinomoto."

‘Need to switch from shame to education'
Anish Gawande, national spokesperson for NCP tells us how policy can help

Drugs are not a new problem in India, argues Anish Gawande, national spokesperson for the NCP. The issue, he says, is denial. "Our response has been shaming people, denying the problem, and refusing to consider global best practices for harm reduction."

Gawande calls for a shift from a "shame-first" to a harm reduction-first approach, built on three pillars. "First is education. People must understand risks and how to respond to overdoses. You need to know how to take somebody to the hospital and describe their symptoms," he says, "Hospitals, too, need to recognise symptoms, as stigma often prevents honest disclosure."

Anish Gawande

"Second is infrastructure. First aid kits should include naloxone, and venues like concerts and nightclubs - which are fully aware that individuals using drugs frequent these spaces - must have doctors on call."

"The third is policy. The Narcotic Drugs and Psychotropic Substances Act, 1985 criminalises users instead of helping them. We need to treat them first as human beings, and only then, if necessary, as criminals. The simplest approach is mental healthcare facilities for those struggling with addiction."

What the numbers say

According to the National Survey on Extent and Pattern of Substance Use in India, 2019:
>>  3.1 crore individuals are cannabis users, and 72 lakh people suffer from cannabis problems
>>  1.18 crore individuals are users of sedatives (non-medical use)
>>  1.7 per cent of children and adolescents are inhalant users as compared to adults of 0.58 per cent. Nearly 18 lakh children need help for inhalant use
>>  It is estimated that about 8.5 lakh people are injecting drugs
Drug abuse is highly underreported in India, hence, the on-ground numbers are likely much bigger.

Rs 1K-Rs 5K
Cost of one dose of MDMA

3 to 6 hrs
How long the high lasts

30 to 45 mins
When MDMA's effects begin to show