Churachandpur, 60 km to the south of state capital Imphal, is a hub of injecting drug users (IDUs) thanks to its proximity to the Golden Triangle, notorious for opium and heroin production. The Golden Triangle, in narcotic parlance, includes the contiguous border area of Thailand, Laos and Myanmar from where drugs are sourced and peddled to northeast India and beyond.
"The injecting drug users mix heroin with water and inject in their body with the help of a syringe," a member of the NGO SHALOM, which works with drug users, told IANS.
The town, along with Ukhrul and Chandel districts, have the most number of IDUs in the state. There are an estimated 38,000 IDUs in Manipur, which has a population of around 2.5 million.
Locally known as No.4, a small chit of heroin costs anywhere between Rs.50 and Rs.300 in Churachandpur.
"Lack of socio-economic development and proximity to drug trafficking routes make the problem worse for youngsters who are unemployed. They get into drugs and never come back," Chhakchhuk from SHALOM told IANS.
Manipur recently saw a crippling economic blockade for over 120 days that worsened the situation for residents.
There are four hangout zones -- locally known as hot spots -- in Churachandpur where the IDUS indulge in drugs.
At one of these places, a 16-year-old fiddles with a syringe which contains some fluid. Her kohl-lined eyes are burning red, not with anger but with the effect of drugs. Ask her what her name is and she tells you to "get lost" without batting an eyelid.
What is most concerning is that these drug users share needles with each other, increasing the chances of contracting HIV. Locals say these places also see a lot of sexual activity.
According to NGOs in Manipur, out of 38,000 injecting drug users in Manipur, 5,000 are female and highly vulnerable to HIV.
As per independent estimates, HIV prevalence among IDUs was over 15 percent in seven districts of the country in 2008.
While Amritsar topped with 30.40 percent, Churachandpur was second, with 28 percent of IDUs suffering from HIV.
"A majority of the female IDUs are sex workers who peddle drugs in the state from neighbouring Myanmar," said an NGO functionary in Imphal.
According to the state Narcotics Control Bureau (Imphal Unit), heroin manufacturing units have mushroomed in Manipur.
In a press conference in Imphal earlier this month, Bijoy Shahni, assistant director of the Narcotics Control Bureau (Imphal Unit), said heroin was being illegally transported from Myanmar through Manipur to other parts of the country via Nagaland and Assam.
Likewise, he said drugs like Ephedrine and Pseudoephedrine tablets are also smuggled to Myanmar through Manipur.
To reduce the looming health threat local NGOs like SHALOM and SASO provide fresh needles to IDUs and advise them not to share needles. While they have been able to make some impact, Manipur still has a long way to go.