Health in Bhutan

It is important to understand the correct situation of drugs and alcohol problem in Bhutan in order to formulate effective control mechanisms and to provide adequate treatment and rehabilitation services to the affected. Bhutan’s drugs abuse problem is less compared with that of other countries. It is estimated that less than 7% of youth abuse drugs on a daily basis.
The types of drugs abused are mainly pharmaceutical such as pain medicines like Spasmoproxyvon (SP+), sedatives likes Nitrazepam (N10), marijuana and cannabis, inhalants and solvents like dendrite, paint thinners, and correcting fluid. However, we cannot afford to remain complacent. The negative impact of drugs on individuals and their families is overwhelming. Addiction is considered a medical disorder.

Addicts have high risk of coming in conflict with the law

But, unlike other types of illnesses, addiction affects youth in their prime age and permeates into all aspects of their lives. Drugs can interfere with learning, whether it is academic or vocational due to the damage it causes to the brain and body. It affects their social learning and relationships. It affects their functioning and finances. Addicts have high risk of coming in conflict with the law due to their vulnerability to frauds and violence.

Many youth affected by drugs have lost their lives due to overdose. The problem is magnified in the Bhutanese context due to low level of awareness and capacity to deal effectively with the addicts. Lack of adequate facilities and trained professionals to treat and rehabilitate them compound their problem. Restrictive laws that are more punitive than reformative add to the burden of care.

But on the other hand, the problem of alcohol abuse in the country is by far the biggest public health issue that necessitates urgent action. Alcohol has been the biggest killer and burden on health care services for the past several decades. Majority of alcoholic patients die in their prime age due to cirrhosis. Death due to alcohol surpasses that of combined AIDs, TB, and Malaria. Yet, we do not even have a dedicated public health control programme to address the problem.

Alcohol is a multi-faceted problem

One government official observed recently: “We spend millions of Ngultrums to refer and treat late stages of cancer; outside Bhutan but spend less on preventable diseases like cirrhosis.” Alcohol not only affects the individual’s health, functioning and finances, but also affects the family, their relationships and well-being. Alcohol is also highly correlated with domestic violence, motor vehicle accidents and suicide in Bhutan.

Alcohol is a multi-faceted problem and requires multi-stakeholder approach. Just leaving it to the Health Ministry is not solving the issue. Health ministry has established detoxification and treatment services in all hospitals and BHUs in the country. Health workers trained on detoxification and provided with basic essential medicines. The treatment is fairly simple and cost-effective.

However, treatment records show very small numbers receiving treatment. This shows that either the addicts are not coming for treatment or the health workers are not proactively offering the treatment. If we can increase the detoxification of alcoholics, the rate of cirrhosis due to alcohol can be reduced and deaths prevented. Services are already available. All we need is to create more awareness and upscale the treatment.