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Koushal Singh* and Sourav Mohanto


Sikkim is a hilly state in Northeast India and the second smallest state of India, is located in the foothills of the Himalayas and shares international borders with Nepal, Bhutan and Tibet. Sikkim is inhabited by indigenous population of Lepchas, Bhutias and Nepalis. Lepchas are traditional inhabitants of Sikkim, whereas Bhutias and Nepalis have migrated from Tibet and Nepal, respectively. Sikkim has an approximate population of 540,493, a literacy rate of 70% and a landscape varying from 300 to 8585 metres in altitude. Sikkim has traditionally been a royal state and was annexed to India in 1975.[1] Sikkim is India‘s third-richest state (after Delhi and Chandigarh), by per capital income.[2] Its literacy rate is India‘s seventh highest. Northeast India is a major source of injection drug users (IDUs) and associated HIV/AIDS. While Sikkim has a history of alcohol abuse and the use of cannabis, drug abuse in Sikkim has only increased substantially over the last five years since large pharmaceutical companies moved base to the state to take advantage of a 10-year tax exemption. There are now about 15 such companies in the state. This has led to increased diversion of legal pharmaceuticals to the illicit market but Sikkim‘s larger problem is that the government almost entirely ignores the state‘s drug problem. There are 1,026 injecting users registered by the National AIDS Control Organisation, but most drug users in Sikkim abuse drugs orally, and with a government that treats drug-addiction purely as a law-and-order problem, violating its own rehabilitation laws in the process, there is, currently, no stemming the tide. At least seven of 10 teenagers in Sikkim abuse pharmaceutical drugs. Alcohol use is traditionally prevalent in Sikkim and recently, IDU behaviour has also been reported, although systematic information on epidemiology and treatment availability of substance abuse in Sikkim is not available.[1,2]

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