Why India's Drug Policy Should Pivot Towards Public Health and Harm Reduction

The NDPS Act 1985 fails to acknowledge drug addiction as a disease, requiring treatment and rehabilitation, rather than punitive action.

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Drug addiction is a complex and widespread health issue in India and across the world. However, despite increasing crackdowns on drug cartels in India by law enforcement agencies, drug use and cases reported under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 are on the rise. The National Crime Records Bureau (NCRB) reported nearly 60,000 cases under the NDPS Act in 2020 – marking a two-fold increase in the last decade alone. This raises questions about the efficacy of current legal frameworks in deterring drug abuse and addiction, and the constraints of solely focusing on supply-side strategies.

The NDPS Act 1985 criminalises both ‘possession of drugs for personal use/consumption’ and ‘possession of drugs for trafficking’ thereby treating both consumers and peddlers of drugs as criminals. This fails to acknowledge drug addiction as a disease, requiring treatment and rehabilitation, rather than punitive action. Further, crime data suggests a disproportionate focus of law enforcement agencies on cases of personal consumption of drugs rather than the root issue of drug trafficking. What is even more concerning is that despite the increase in drug busts, treatment and rehabilitation in case of drug addiction continue to be a low priority. A nationwide study by the Ministry of Social Justice and Empowerment in 2019 found a treatment gap of 75% for drug use disorders, revealing that among those who need treatment for substance use disorders, very few receive it.

It is time for an effective and compassionate re-evaluation of India’s drug policy that is grounded in scientific evidence, rather than one solely based on repression, punishment and incarceration. Sound drug policies must consider the proportionality of criminal justice response, and prioritise public health and harm reduction i.e reducing the harms associated with drugs. This is based on the premise that treatment of drug use disorders is the key operational objective towards drug demand reduction.

What are some of the steps that a progressive government invested in people’s health and well-being may take? In the recently concluded Winter Session of Parliament, I submitted a Private Member’s Resolution towards a ‘Humane Drug Policy based on Public Health and Harm Reduction’ which was scheduled to be introduced on the 23rd of December, 2021. However, due to the premature conclusion of the session, the introduction did not take place – the following are the policy recommendations entailed in the resolution.

Firstly, the Union government must strongly consider amending the NDPS Act to decriminalise possession of “small quantities” of drugs for personal consumption (“small quantities” as defined in the NDPS Act 1985). The State must ensure that those apprehended for personal consumption of drugs are directed to compulsory de-addiction treatment or rehabilitation rather than being prosecuted and served punitive action. In the course of amending the Narcotic Drugs and Psychotropic Substances Act, the Government must also consider making a distinction between addicts, first-time drug users and recreational drug users.

Also read: India Needs To Start Looking at Addiction as a Psycho-Social Problem

Beyond legislative action, there are various steps that must be taken in terms of policy implementation. Firstly, beyond policing activities, the National Fund to Control Drug Abuse must be effectively utilised for de-addiction programmes and other evidence-based treatment facilities for substance use disorders. While the current NDPS Act provides for some scope of rehabilitation, implementation, in reality, is very poor. People who use drugs must be able to access such services without the threat of punitive sanctions. Secondly, the Government must direct regular state-level surveys to assess the extent of substance abuse disorders, degree of drug dependence and related health implications such as viral hepatitis and HIV. Such regular micro-data collection would capture at-risk districts and at-risk population groups, and thereby better inform policy response.

The Northeast region is particularly susceptible to drug abuse, given that several states in the region serve as major routes for the distribution of narcotics to the rest of the country due to the geographical location. A combination of environmental and structural factors, such as under-development and insurgency, have made local youth highly vulnerable to drug abuse. Despite a lower population, several states in the Northeast see higher illicit drug use than the national average, and worryingly higher prevalence of HIV, primarily from intravenous drug users. Therefore, alongside the ongoing crackdown on drug traffickers, it is necessary to provide health and welfare services to individuals and communities affected by substance use.

A 2015 UN study titled ‘Women Who Use Drugs in Northeast India’ examined how such women have substantially different needs and higher risks than their male counterparts, and therefore the need for formulating policies and programmes that cater to these specific needs and risks. It is crucial to foreground the fact that drug policies disproportionately affect marginalised communities. Thus the health and well-being of such communities must be prioritised while framing India’s illicit drug policies.

There is an urgent need to prioritise treatment, education and rehabilitation – for stigma, shame and silence only perpetuate this illness. Channelling funds that would otherwise be utilised primarily for incarceration, substantially towards treatment and rehabilitation will go a long way towards addressing the root of drug addiction. As a society, we must collectively envision and take steps to minimise the stigma and discrimination. There is a need to move beyond a criminal justice approach, to a human rights and health-led approach to drug addiction together with legal regulation and control.

Pradyut Bordoloi is a Congress Lok Sabha MP from Nowgong, Assam. He received assistance from Evita Rodrigues, LAMP fellow, for this piece.