DR.FIAZ MAQBOOL FAZILI
June 26th is International Day is remembered for efforts against drug abuse and trafficking. On this day, we reiterate our resolve to meet the challenges posed by drug addiction. While we may have missed opportunities previously to address this issue when its scale was more manageable, today, we are confident that through concerted and collective global efforts, we can effectively confront these challenges.
Kashmir’s decades-long conflict has birthed a parallel epidemic in the shape of a devastating drug crisis fuelled by trauma, unemployment, crime and sophisticated trafficking networks. As per the source of information, with 8% of Jammu & Kashmir’s population (nearly 1 million people) addicted to substances—surpassing Punjab’s rate—and 90% of addicts using heroin, the region faces a generational catastrophe. This complex nexus of narco-network, psychological trauma, and institutional gaps demands urgent, data-driven solutions. The anatomy of addiction is quite disturbing, among substance prevalence and trends Heroin dominance is now evident 77.67% of opioid-dependent individuals (52,404 people) use heroin, with 61% injecting it daily. Average monthly expenditure ₹88,183 per user. Among poly-drug users 90% of abusers consume multiple substances, including cannabis (11.6%), prescription opioids (e.g., SP Proxyvon), and inhalants (shoe polish, Fevicol) .
Evolution of abuse began with a shift from cannabis( a local profuct fgtiwn widely at many places-of kashmir (1990s) to medicinal opioids (2000s) to chemical addiction – heroin (post-2010).In victim demographics, 56% initiate at 11-20 years; 90% of addicts aged 17-33 , Male predominance (98.3%); but 36,000 female cannabis users, rising heroin use among women,25% unemployed, 67% education below high school, 15% graduates .Srinagar city is highest treatment-seeking population (41,110 OPD cases in 2023 at SMHS Hospital), one of the reason’s may be easy accessibility to dedicated de addiction center as compared to other districts. .Kupwara/Baramulla are considered primary heroin transit routes , while poppy cultivation surged 200% in Baramulla (2023) . Pulwama/Anantnag has high youth injection rates; HCV prevalence is 19.9% as per sources.
Despite the law enforcing agencies and anti-narcotic bureau,s good work catching lot of traffic profits and attach properties ,the surprise detainees are a good number of women.The impact on the supply chain of suffering with price inflation Heroin costs ₹1,500/gram in Kupwara vs. ₹3,000/gram in Srinagar. Trafficker profiles are startling, youth (18-30) recruited as paddlers, there are some black spots too when policeman or Army jawans are facing the allegations of helping the trade . Addicted youth,s transition to peddling to fund habits 78% cite unemployment as motivation. As police closes snooze narrows on tools of transport and methodology modern smuggling tactics include drone trafficking. Pharmaceutical diversion is also an issue despite ban on sales of Codeine-based syrups and SP Proxyvon tablets traded via corrupt medical supply chains. State response law enforcement efforts are commendable 2,756 arrests, 1,850 FIRs (2022); heroin seizures up 133% since 2019, asset forfeiture, even when there is limited use of NDPS amendments.
Rehabilitation infrastructure needs a boost in Quality and quantity although there is lot of improvement from previous situation.Currently there are de-addiction Centers, two public (IMHANS, PCR Srinagar), 10 district ATFCs (no inpatient beds) , 1 bed per 5,000 addicts; no rural coverage. Treatment gaps need review IMHANS OPD, from 5 patients/day (2016) → 170/day (2023) and sad story is 80% cannot afford care .
The major barrier to treatment is social stigma especially when victim is from a well known, or reputed family or a female . Only 48 female patients sought help (2022) despite 1.67% female addiction rate.It is believed parents take their children especially females out of state to avoid identification so a large chink may be escaping our count . No parent shall ever come and register his or her ward with a unit to register unless he or she is seeking treatment .There is lack of proper education and awareness deficit, 90% unaware of de addiction processes, only 8% knew of Srinagar’s center and facilities available there. There is a resource crunch with lack of qualified or experienced psychiatrists or counsellors (1:100,000 ratio) to deal with such a huge number of victims. Another aspect is no regular HCV/HIV testing in ATFCs that may pose an epidemic in coming days. .Breaking the chain through integrated solutions with supply disruption strategies topping the list of priorities.Tech-Enhanced surveillance can be done by deploying more AI drones with thermal imaging along transportation points fortifying human intelligence.We need to implement blockchain-tracked opioid prescriptions with exemplary fines to prevent pharmaceutical diversion and surprise visits by drug controller of pharmacies around education hubs , tution centers , colleges . Financial disruption is another point of deterrent , action through fast-track asset forfeiture or freezing of peddlers’ assets has been in news for some time . A proposal of integrating PTSD screening in all de-addiction protocols, after interacting with civil society or social groups, mohalla committees and some sort of training education is imparted to religious preachers or Imams in addiction science is another area to be worked on for cohsive coordinated efforts .
Treatment needs to be decentralised, and one of the ways is mobile clinics for Kupwara/Baramulla,or increase de addiction centers at district or sub district levels even introducing tele-psychiatry units in remote districts with cooperation of Directorate health and Village help workers . Gender-specific Center’s( esp female segregation where privacy and confidentiality is ensured ) the childcare (Kupwara pilot model) need to be extended to all towns too. Vocational reintegration by a robust scale SKIMS-linked “Farm-to-Rehab” programs for agricultural skill-building .Policy and governance reforms include a unified command center by establishing J&K Drug control agency merging Health, Police, civil society , traffic, marriage bureaus, state recruitment board and revenue departments. Some sort of legal amendments are to be made enhancing punishment for traffickers and habitual or repeat offenders . “Prevention is better than cure”, the- adage still holds good and relevant. School “PeerGuardian” programs with anonymous reporting apps. Mandatory Urine Drug Screening (UDS) in colleges, for obtaining admission or renewal of driving license, and make drug free certificate as annexure to application of jobs and registration of marriages
Case Study a story shared by a person wants to remain anonymous, lesson here is “catch them early with early warning signs of addiction behaviours the “Victim-to-Peddler “pipeline. Samir name changed (2016),trauma trigger suffered injuries during one of the protests-initiated cannabis at 14 for “de-stressing then graduation to Heroin,switched to heroin (₹2,500/session) within 1 year eventually stole maternal savings. Peddling descent became low-level peddler to fund addiction arrested at 17. The Psychosocial analysis, revealed trauma -induced PTSD + peer networks + economic despair = accelerated victimisation.
Key take away a call for collective warfare. Kashmir’s drug crisis thrives on institutional fragmentation and unhealed trauma. To win this war, we need to have Short-Term plan s of emergency funding for 20 new inpatient centers by 2026; drone surveillance grids in Kupwara and in long-Term enact Kashmir Drug Control Act allocating 2% health budget to addiction,integrate mental health into ASHA worker protocols. The crisis demands not just enforcement, but healing—of land, minds, and a generation betrayed.
(Data Sources: IMHANS-K Surveys, J&K Police Reports, NDDTC Studies. Tables: District-wise data synthesized from 2022-23 IMHANS-K survey , sewrch engines, AI sources and JKPI analysis.)
The Author is a Surgeon at Mubarak hospital, Healthcare policy analyst, Certified Professional in Quality improvement in Hospitals can be reached at drfiazfazili@gmail.com
