New Drug in Town: How Tapentadol Is Emerging as a New Threat in Manipur
HEALTH
Imphal: Even as Manipur struggles to recover from the devastation of the conflict, another crisis is quietly taking shape. Drug-treatment workers say Tapentadol, a prescription opioid painkiller, is increasingly being abused as a substitute for heroin, locally known as No. 4. The shift appears to have taken place after heroin prices rose sharply following the outbreak of violence, reaching around Rs. 4,000–5,000 per vial. Treatment workers say users who could no longer afford heroin turned to Tapentadol, reportedly obtaining the tablets from the market and, in some cases, crushing and injecting them. Even though heroin prices have since returned to around Rs. 1,000 per vial, Tapentadol abuse continues.
Image: Tapal bought without prescription
Gobby Soraisam, Project Manager of Vision of Hope, a drug rehabilitation centre at Khonghampat Mantri Leikai, said one Tapentadol user died in August after reportedly injecting crushed tablets, with cardiac arrest suspected as the immediate cause. Another user seeking counselling was hospitalised after developing a serious infection at an injection site. His addiction, Soraisam said, had begun while he was studying in Delhi.
The concern is compounded by reports of Tapentadol being easily accessible despite being a prescription medicine. Treatment workers say cases of Tapentadol dependency, including among women, are now appearing at treatment facilities across the State.
For Manipur, this is an ominously familiar story. The State has endured successive waves of substance abuse. Heroin became deeply entrenched from the 1980s, bringing dependency, overdose, infections, drug-related crime, family breakdown and premature deaths.
Pharmaceutical drugs added another chapter. During the 1980s and 1990s, Spasmo-Proxyvon, or SP, and cough syrups such as Phensedyl and Corex were widely abused. Some pharmaceutical tablets were crushed and injected, demonstrating how legitimate medicines could become instruments of devastating addiction.
Image: Serious Infection at injection site
Tapentadol therefore enters an ecosystem already scarred by pharmaceutical and illicit-drug dependence.
The danger is not simply the emergence of another drug. It is the repetition of a familiar cycle: availability, substitution, dependence, illness and death—followed by intervention only after the damage has become visible. The State must act before that cycle completes itself.
Image: Tighten control regime needed on over the counter sales of prescription drug among pharmacies in Manipur
Guruaribam Mansoor, Counsellor at Vision of Hope, strongly advocates that pharmacists strictly observe prescription requirements and that health authorities monitor emerging patterns of Tapentadol misuse. Hospitals and rehabilitation centres, he said, also need updated guidance on dependence, withdrawal and complications associated with its misuse and injection. He added that treatment providers, healthcare professionals, civil-society organisations and government agencies must mount an early awareness campaign.
Image: Guruaribam Mansoor of Vision of Hope
Manipur has already paid too high a price for addiction. The warning signs are here. The State still has a window to act—but that window must not be allowed to close.
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