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Drug Abuse in India

June 26 is celebrated as International Day against Drug Abuse and Illicit Trafficking every year. It is
an exercise undertaken by the world community to sensitize the people in general and the youth in
particular, to the menace of drugs. The picture is grim if the world statistics on the drugs scenario is
taken into account. With a turnover of around $500 billions, it is the third largest business in the
world, next to petroleum and arms trade. About 190 million people all over the world consume one
drug or the other. Drug addiction causes immense human distress and the illegal production and
distribution of drugs have spawned crime and violence worldwide. Today, there is no part of the world
that is free from the curse of drug trafficking and drug addiction. Millions of drug addicts, all over the
world, are leading miserable lives, between life and death.

India too is caught in this vicious circle of drug abuse, and the numbers of drug addicts are increasing
day by day. According to a UN report, One million heroin addicts are registered in India, and
unofficially there are as many as five million. What started off as casual use among a minuscule
population of high-income group youth in the metro has permeated to all sections of society.
Inhalation of heroin alone has given way to intravenous drug use, that too in combination with other
sedatives and painkillers. This has increased the intensity of the effect, hastened the process of
addiction and complicated the process of recovery. Cannabis, heroin, and Indian-produced
pharmaceutical drugs are the most frequently abused drugs in India. Cannabis products, often called
charas, bhang, or ganja, are abused throughout the country because it has attained some amount of
religious sanctity because of its association with some Hindu deities. The International Narcotics
Control Board in its 2002 report released in Vienna pointed out that in India persons addicted to
opiates are shifting their drug of choice from opium to heroin. The pharmaceutical products
containing narcotic drugs are also increasingly being abused. The intravenous injections of
analgesics like dextropropoxphene etc are also reported from many states, as it is easily available at
1/10th the cost of heroin. The codeine-based cough syrups continue to be diverted from the domestic
market for abuse

Drug abuse is a complex phenomenon, which has various social, cultural, biological, geographical,
historical and economic aspects. The disintegration of the old joint family system, absence of parental
love and care in modern families where both parents are working, decline of old religious and moral
values etc lead to a rise in the number of drug addicts who take drugs to escape hard realities of life.
Drug use, misuse or abuse is also primarily due to the nature of the drug abused, the personality of
the individual and the addict's immediate environment. The processes of industrialization,
urbanization and migration have led to loosening of the traditional methods of social control rendering
an individual vulnerable to the stresses and strains of modern life. The fast changing social milieu,
among other factors, is mainly contributing to the proliferation of drug abuse, both of traditional and
of new psychoactive substances. The introduction of synthetic drugs and intravenous drug use
leading to HIV/AIDS has added a new dimension to the problem, especially in the Northeast states of
the country.
Drug abuse has led to a detrimental impact on the society. It has led to increase in the crime rate.
Addicts resort to crime to pay for their drugs. Drugs remove inhibition and impair judgment egging
one on to commit offences. Incidence of eve- teasing, group clashes, assault and impulsive murders
increase with drug abuse. Apart from affecting the financial stability, addiction increases conflicts and
causes untold emotional pain for every member of the family. With most drug users being in the
productive age group of 18-35 years, the loss in terms of human potential is incalculable. The
damage to the physical, psychological, moral and intellectual growth of the youth is very high.
Adolescent drug abuse is one of the major areas of concern in adolescent and young people's
behavior. It is estimated that, in India, by the time most boys reach the ninth grade, about 50 percent
of them have tried at least one of the gateway drugs. However, there is a wide regional variation
across states in term of the incidence of the substance abuse. For example, a larger proportion of
teens in West Bengal and Andhra Pradesh use gateway drugs (about 60 percent in both the states)
than Uttar Pradesh or Haryana (around 35 percent). Increase in incidences of HIV, hepatitis B and C
and tuberculosis due to addiction adds the reservoir of infection in the community burdening the
health care system further. Women in India face greater problems from drug abuse. The
consequences include domestic violence and infection with HIV, as well as the financial burden.
Eighty seven per cent of addicts being treated in a de-addiction center run by the Delhi police
acknowledged being violent with family members. Most of the domestic violence is directed against
women and occurs in the context of demands for money to buy drugs. At the national level, drug
abuse is intrinsically linked with racketeering, conspiracy, corruption, illegal money transfers,
terrorism and violence threatening the very stability of governments

India has braced itself to face the menace of drug trafficking both at the national and international
levels. Several measures involving innovative changes in enforcement, legal and judicial systems
have been brought into effect. The introduction of death penalty for drug-related offences has been a
major deterrent. The Narcotic Drugs and Psychotropic Substances Act, 1985, were enacted with
stringent provisions to curb this menace. The Act envisages a minimum term of 10 years
imprisonment extendable to 20 years and fine of Rs. 1 lakh extendable up to Rs. 2 lakhs for the
offenders. The Act has been further amended by making provisions for the forfeiture of properties
derived from illicit drugs trafficking. Comprehensive strategy involving specific programmes to bring
about an overall reduction in use of drugs has been evolved by the various government agencies and
NGOs and is further supplemented by measures like education, counseling, treatment and
rehabilitation programmes. India has bilateral agreements on drug trafficking with 13 countries,
including Pakistan and Burma. Prior to 1999, extradition between India and the United States
occurred under the auspices of a 1931 treaty signed by the United States and the United Kingdom,
which was made applicable to India in 1942. However, a new extradition treaty between India and the
United States entered into force in July 1999. A Mutual Legal Assistance Treaty was signed by India
and the United States in October 2001. India also is signatory to the following treaties and
1961 U.N. Convention on Narcotic Drugs
1971 U.N. Convention on Psychotropic Substances
1988 U.N. Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances
2000 Transnational Crime Convention

The spread and entrenchment of drug abuse needs to be prevented, as the cost to the people,
environment and economy will be colossal. The unseemly spectacle of unkempt drug abusers dotting
lanes and by lanes, cinema halls and other public places should be enough to goad the authorities to
act fast to remove the scourge of this social evil. Moreover, the spread of such reprehensible habits
among the relatively young segment of society ought to be arrested at all cost. There is a need for
the government enforcement agencies, the non-governmental philanthropic agencies, and others to
collaborate and supplement each other's efforts for a solution to the problem of drug addiction
through education and legal actions.


Drug Addiction and Abuse Drug Addiction and substance abuse is a chronic, relapsing disease
wherein the drug user compulsively spends time looking for and using an illegal drug. This form of
addiction is characterized by neurochemical and molecular changes in the brain. Some of the
common drugs used by drug addicts are heroin, cocaine, lysergic acid diethylamide (LSD), mandrax,
barbiturates and a variety of opiates. Estimates indicate that there are around three million drug
addicts in India.

Traditionally in India, drug addicts are usually the responsibility of the family or the social group to
which they belong. In most cases, drug addicts are treated through general health services, on a
voluntary basis. Now, State level hospitals also offer rehabilitation facilities for indoor treatment to
hard-core addicts through their psychiatry departments. Besides State run treatment centres, there is
a network of de-addiction centres run by voluntary organizations. Also, community based treatment
programmes are operated in different regions of the country.

The main thrust of these programmes is to strengthen the ties of addicts to their family and
community and get the community to cooperate in the rehabilitation process. The de-addiction
centres run by non-governmental organizations employ various systems of medicine such as
allopathy, homeopathy, ayurveda, naturopathy and yoga coupled with a range of psychotherapies to
cure addicts.

The Drug Abuse Information Rehabilitation and Research Centre (External website that opens in a
new window) (DAIRRC) is a registered Charitable Trust that is involved in rehabilitation of addicts. It
was founded in 1982 in the city of Mumbai. This centre provides a wide range of rehabilitation
services such as Heroin addiction treatment, Cocaine addiction treatment, Solvent Abuse Treatment,
Treatment for addiction to Prescribed Medication, Methadone addiction treatment and Treatment for
addiction to all Other Drugs of Abuse. More information and pictures of the rehab centre (External
website that opens in a new window).

If drug addicts are to be completely rehabilitated, it is necessary for the local community to be
involved in the treatment and social integration of addicts. To promote such an initiative a number of
de-addiction camps (External website that opens in a new window) are being regularly organized at
the community level through voluntary organizations. These camps provide counselling, treatment
and rehabilitation facilities to drug addicts in the localities they live in. Building awareness and
creating therapeutic communities are other concepts that help in the rehabilitation of addicts. More
on de-addiction camps (External website that opens in a new window).

Self-help techniques have proved to be quite useful in the treatment of different types of addictions. A
popular group that offers such techniques is Narcotics Anonymous (External website that opens in a
new window). This group conducts private meetings where addicts learn from other addicts how to
remain drug free and recover from addiction. These meetings are conducted regularly in cities such
as Bangalore, Mumbai, New Delhi and Chennai.

Currently, the ministry supports 361 voluntary organisations (External website that opens in a new
window) that maintain 376 De-addiction-cum-Rehabilitation Centres (External website that opens in a
new window) and 68 Counselling and Awareness Centres (External website that opens in a new
window) in different regions of the country. The government also runs 100 De-addiction Centres
(External website that opens in a new window) at its hospitals and Primary Health Centres for those
who need long-term rehabilitation.

The National Centre of Drug Abuse Prevention (External website that opens in a new window) has
identified 8 NGOs (External website that opens in a new window) with strong technical capabilities to
provide training and information at regional levels, monitor programmes and implement the Drug
Abuse Monitoring System (External website that opens in a new window). These NGOs are Galaxy
Club (External website that opens in a new window), Kripa Foundation (External website that opens
in a new window), The Calcutta Samaritans (External website that opens in a new window), Mizoram
Social Defence and Rehabilitation Board (External website that opens in a new window), Muktangan
Mitra (External website that opens in a new window), Society for Promotion of Youth and Masses
(External website that opens in a new window), TT Ranganathan Clinical Research Foundation
(External website that opens in a new window) and Vivekananda Education Society (External website
that opens in a new window).

Source: National Portal Content Management Team, Reviewed on:12-02-2010

HEALTH CAREDealing with drug abuse


Drug addiction is a growing problem in India and drug abusers can recover if they are
motivated to seek treatment.

Police and Forest Department personnel destroy cannabis plants illegally cultivated in a
village on the Kerala-Tamil Nadu border. A file picture.

Rahul was 30 when he died of a drug overdose, alone in a hotel room. He had been abusing drugs
for 10 years, since he was in college. He began with smoking marijuana with friends, but after a tragic
motorcycle accident when his pillion rider was killed and he was badly injured, he began to abuse
painkillers. He graduated to multiple mainline drugs and became dependent on them. Despite several
rehabilitation efforts, he was unable to give up the habit. After his parents asked him to leave the
house, he went to stay with his sister's family, but even her support and motivation did not help him
quit the habit. He wanted desperately to live a normal life, but he simply lost hope.

HOPE, support and motivation are what thousands of people like Rahul, who die in their prime every
year in India owing to drug abuse, need in plenty. The number of drug abusers may be high, but help
is available, for those who seek it.

Identified as a disease in 1956 by the World Health Organisation and the American Psychiatric
Association, drug abuse is the illicit consumption of any naturally occurring or pharmaceutical
substance for the purpose of changing the way in which a person feels, thinks or behaves, without
understanding or taking into consideration the damaging physical and mental side-effects that are

Drug abuse and addiction lead to a complex set of social, medical and economic problems with
serious implications. According to experts, it is widely prevalent, cutting across age, class and
gender. Yet, it is difficult to estimate the number of drug abusers or formulate a comprehensive
approach to deal with the issue primarily because it involves a "hidden population" that does not seek
treatment and hence remains under-reported. This makes it difficult to assess the problem, estimate
costs, both social and economic, and design intervention strategies.

Realising the need for extensive data and information on the issue, the Ministry of Social Justice and
Empowerment and the United Nations Office on Drugs and Crime published in 2004 one of the most
comprehensive baseline studies, "The Extent, Pattern and Trends of Drug Abuse in India: National
Survey". The major components of the survey that used multiple methodologies and indicators
included a National Household Survey (NHS) of randomly selected men across the country; the Drug
Abuse Monitoring System (DAMS), which compiled data from new patients at treatment centres; a
Rapid Assessment Survey (RAS), which analysed information from interviews with drug users, key
informants and focus group discussions in 14 urban sites across the country; and several thematic
studies on women, the rural population, people in the border areas, and prisoners.

According to the report, apart from alcohol (62.46 million users), cannabis (8.75 million users),
opiates such as heroin, opium, buprenorphine and propoxyphene (2.04 million users), and sedatives
(0.29 million users) are the drugs most abused. Between 17 per cent and 20 per cent of current drug
users were classified as dependent users (addicts). The users were mostly male; the Rapid
Assessment Survey found only 8 per cent of drug users to be women. By and large, young, under-
employed males and marginalised populations were prone to drug abuse. Drug abuse causes a
range of health complications - from weakness, loss of body weight and respiratory disorders. Often,
under the influence of drugs, addicts also indulge in high-risk behaviours such as unsafe sex and
needle sharing, which has contributed to the spread of infectious diseases such as HIV/AIDS and
Hepatitis C. One of the most important effects of drug abuse is impaired judgment and a lack of
rational thinking. Addicts develop psychological problems such as depression, anxiety and irritability,
apart from personality problems.

People start on drugs for a number of reasons, from curiosity and recreation to the need to cope with
stress. What begins as abuse can often lead to dependence. Physically, the body develops tolerance
for it, and more of the drug is needed to experience the same effect. This leads to increases in
consumption, which eventually leads to physical dependence. At that stage, lack of the drug causes
severe withdrawal symptoms, which disappear if the drug is taken again; this ensures that abusers
remain hooked (see chart).

Users are almost always young, initiated into drug use with alcohol and then with cannabis and its
derivatives. Often, they graduate to other, more potent, drugs such as narcotic analgesics,
stimulants, depressants, hallucinogens and volatile solvents. Most abusers consume multiple drugs.
According to Dr. S. Mohan Raj, a psychiatrist in Chennai who has been treating patients with drug
dependence problems for several years, the easy availability of drugs, curiosity, peer approval and
thrill-seeking are the most common reasons for drug abuse among the youth.

Partha (26), a regular party-goer in Chennai, says that it is easy to get marijuana and heroin in the
city, but more expensive "party" drugs such as acid, ecstasy and cocaine are usually ordered from
dealers in Goa, Manali, Mumbai and Bangalore.

The incidence of drug abuse is also high among people with untreated psychiatric or emotional
problems, who often resort to taking drugs as a coping mechanism. Thus drug abuse may be primary
or secondary to an existing emotional problem. Deeper emotional issues caused by dysfunctional
families, feelings of self-hate, low self-esteem, and physical or mental abuse are some issues that
need to be addressed during the identification and treatment of the problem.
AS in all diseases, timely treatment is essential. But unfortunately warning signs often go unheeded,
especially among the youth. There is almost always deterioration in the normal daily functioning.
Sleeping late, mood changes, deterioration in academic performance, behaviour problems such as
aggression, rebelliousness and hyperactivity, lack of concentration and so on, are often ignored by
family members as signs of adolescence rather than symptoms of addiction. To sustain their habit,
with which they become obsessively preoccupied, addicts often lie, steal and manipulate family

According to Dr. R.R. Cherian, Director, Research and Treatment Programmes, of the Chennai-
based T.T. Ranganathan Clinical Research Foundation, often the drug abusers do not have a
chance to develop a personality and values of their own because they start on drugs very young.
Some are college dropouts, and most have no commitment to work, marriage or family.

A patient's recovery process thus involves not only abstinence but also lifestyle changes.
Detoxification, the first phase in treatment, involves medical management to make the withdrawal
process safe and comfortable. For effective care and full recovery, psychological support is
necessary and coexisting psychiatric problems have to be identified and treated simultaneously with
the addiction. According to Dr. Cherian, bringing the abusers back into the mainstream as soon as
possible is important for complete recovery. It is also crucial not to make an issue of past failures.
Motivating abusers to seek treatment and abstain from drugs is another key factor, and the role of
family, friends and employers is crucial in this. Says Dr. Mohan Raj: "If a person says, `I want to give
it up but I am not able to', then it is easy for us to do whatever is needed to be done. But if he is not
keen on stopping, whatever we do is not going to be successful."

In fact, according to the various components of the National Survey, hardly a third of drug-
dependants reported having taken treatment (it was as low as 2 per cent in one of the components).
There was also a significant time lag between the onset of dependence and the seeking of treatment,
largely owing to a lack of knowledge about the need for treatment and rehabilitation and access to
treatment facilities.

There is a general perception that "will power" alone is enough to stop taking drugs. While personal
motivation is indeed crucial to recovery, it is important that patients and their families know that drug
abuse is a disease that can be treated with appropriate and timely medical and psychological help.

Often, people seek treatment only after reaching a dependent stage. Close family members are often
reluctant to seek professional help because they lack knowledge about drug abuse, do not want to
accept the extent of the problem, or fear social ostracism. Dr. Cherian says: "We have to educate the
family, educate them about relapses... the family is always in denial... Sometimes we tell them to be
tough with the patient, but they are not willing... they do not know how to be ... Also, addicts need to
be made accountable for their own lives... "
Family counselling is important particularly as dealing with an addict can be physically and
emotionally draining and it usually focuses on educating the family about the issues involved and how
to deal with the situation without getting angry, judgmental or frustrated. For instance, it is natural for
family members to doubt what the recovering addict says. But they need to understand that this can
damage his self-esteem and lead to a relapse.

Relapse prevention is also an important part of the recovery process. Isolating recovering addicts
from friends who use drugs is essential. Support groups such as Narcotics Anonymous (N.A.) (an
international brotherhood where recovering addicts help and motivate each other to abstain from
drug abuse) are of enormous help in preventing a relapse.

Abdul, a member of N.A. in Chennai, says that he has been in and out of rehabilitation programmes
20 times, but it was only after he joined N.A. that he was finally able to give up drugs.

GIVEN that drug addicts come from all walks of society, interventions need to be localised. Apart from
government strategies for the reduction of demand and supply of drugs , prevention interventions
targeted at specific subgroups are also needed.

According to the National Survey, focussed interventions are needed to prevent the initiation of new
users and the progression of occasional and casual users to dependent users, and for the treatment,
aftercare and rehabilitation of established dependent users. The survey also found that prevention
programmes based only on information dissemination were rarely successful, especially if the
approach depicted exaggerated risks associated with drug use in order to frighten people into
abstinence. According to the survey, a less sensational, scientific approach, which presents accurate
information of facts and risks, would be highly effective.

FOR instance, the issue of drug abuse is rarely addressed in schools. It is important that parents and
educational establishments carry out targeted interventions as most users get initiated into drugs in
the high school or college stage.

Another vulnerable group is the rapidly growing middle class with rising purchasing power. Drug
abuse is rising in this population. While there is a huge change in the lifestyles of people in this group
there is no corresponding rise in social nets to protect them.

In Chennai, Partha feels that the social circle has grown because of the increasing presence of
Business Process Outsourcing outfits and Information Technology companies that employ young
people in large numbers. There are very few places where these people can go for entertainment or
to socialise. Clubs and lounge bars are expensive and are also required now to shut early. (The city
police cracked down on bars and pubs after an incident in which a young girl died after being run
over allegedly by four drunken youth.) As a result, many people have nowhere to go after midnight
and tend to get together at friends' homes and "smoke grass" or "do a few lines of cocaine", he says,
adding, "Canabis is simply the cheapest way to `get a trip'. Alcohol is expensive."

At the lower end of the spectrum of those vulnerable are a rising number of educated unemployed
graduates. Rural people, another vulnerable group, are dominant opium abusers. According to the
National Survey, between 51 per cent and 76 per cent of drug users were from rural areas, and
between 16 and 49 per cent were illiterate.

IT is a matter of concern that more and more women are becoming drug-dependent, and it is
essential that a gender-specific approach is taken to address the issue. According to the National
Survey, interventions among women have to examine issues such as drug abuse by women
themselves, the burden on women due to drug abuse in the family, treatment, and access to
treatment available to them.

Data from the thematic study on drug abuse and women carried out as part of the National Survey
show that 30 out of 75 women drug abusers were "Injecting Drug Users", which belies the myth that
most women abuse only tranquillisers. Another study of the Survey reported that the burden on
women due to drug abuse by a family member was significant, affecting their health apart from
isolating them and their family from friends and society. Drug-related domestic violence was also
quite common. The study also showed that women drug abusers often felt the lack of adequate
treatment facilities and the need for separate treatment centres.

Given the large and rising number of drug abusers and the complex nature of the problem, it is
important that the issue is brought into the domain of public health care and related to such other
issues as crime prevention, health care, lifestyle changes and education. It should become part of a
larger public discourse, rather than a problem to be dealt with after it reaches a chronic stage.

(The names of persons affected by drug abuse have been changed in the article.)


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