ENDLESS LOOP OF DRUG AND NARCOTIC SUBSTANCE ABUSE: AN INDIAN PERSPECTIVE
Author: Akshita Bansal, V Year of B.B.A.,LLB from University of petroleum and Energy Studies, Dehradun.
Narcotics are addictive substances that diminish pain perception and generate euphoria in their users (a feeling of exaggerated and unrealistic well-being). The Greek term narkotikos, which meaning "numbing" or "deadening," is the source of the English word narcotic. Although the phrase can be given to any substance that dulls sensations or induces drowsiness, it is most usually used to refer to opioids, which include all natural and manufactured compounds that behave similarly to morphine.
Narcotics are both the oldest and the most powerful analgesics (pain relievers) known to humans. The opium poppy (Papaver somniferum) was mentioned in ancient Sumerian and Egyptian medical books as the source of a milky fluid (opium latex) that may be used to cure coughing, insomnia, and discomfort as early as 4000 B.C. The opium poppy, also known as ying su ke in Chinese medicine, was suggested for the treatment of asthma, acute diarrhoea, and dysentery, as well as chronic discomfort and insomnia. Opium latex includes between 10 and 20% morphine, which is a white crystalline powder with a bitter flavour in its pure form.
Narcotics are central nervous system depressants that cause the user to fall into a stupor. These substances provide euphoria or a feeling of intense well-being, and they are highly addictive. In as little as two to three days, the body develops a tolerance to drugs, requiring higher doses to get the same effect. Most countries in the twenty-first century have severe regulations against the production and distribution of narcotics due to their addictive properties. When opium addiction became a widespread social problem in developed countries in the nineteenth century, these regulations became necessary.
Opium, the first of the opioids to be widely utilised, has long been a popular folk cure that often resulted in addiction; in fact, many famous Victorian pharmaceutical medications for "female ailments" contained opium. However, the mid-nineteenth-century advent of the hypodermic needle boosted the number of addicts by allowing opioids to be given directly into the bloodstream, greatly enhancing their effects.
CLASSIFICATION OF NARCOTICS
The rhesus monkey was utilised to classify a range of narcotic agonists, mixed agonist-antagonists, and antagonists using drug discrimination and drug reinforcement processes. A five-tiered categorisation was devised:
Morphine-like agonists were compounds that reinforced responses, produced discriminative stimulus effects similar to morphine, and suppressed withdrawal in morphine-dependent rhesus monkeys.
The ability of morphine-like mixed agonists-antagonists to elicit abstinence symptoms in morphine-dependent monkeys distinguished them from pure agonists. The prototype for a third class of narcotic agonists was ethylketazocine.
These compounds had a unique set of interoceptive stimuli, failed to maintain substantial responses in comparison to morphine-like agonists, and did not reduce or initiate withdrawal in morphine-dependent rhesus monkeys. The ethylketazocine-like mixed agonist-antagonists were identical to the ethylketazocine-like agonists, with the exception that they both had the ability to cause morphine withdrawal.
Narcotic antagonists (e.g., naltrexone) did not share interoceptive effects with either morphine or ethylketazocine, but they were able to block both types of agonists' discriminative effects. In morphine-dependent rhesus monkeys, narcotic antagonists also caused narcotic cessation. The current classification approach could be beneficial for detecting new narcotic qualities, elucidating links between narcotics and other pharmacological classes, and comparing classifications based on other narcotic effects.
INDIA HAS WIDESPREAD DRUG PROBLEM
According to research published jointly by the UN Office of Drugs and Crime and India's Ministry of Social Justice, millions of Indians are addicted on alcohol, cannabis, and opioids, and drug usage is a prevalent phenomena in Indian culture.
More than 40,000 men and boys (aged 12 to 60) were interviewed in the national household survey, while supplemental studies looked at drug consumption among women and jail prisoners, as well as in rural and border areas. According to the survey, the most often overused substances in India are alcohol, cannabis, opium, and heroin. The most often injected pharmaceuticals are buprenorphine, propoxyphene, and heroin.
The survey estimated that 62.5 million persons in India, a country with a population of little over a billion people, use alcohol, 8.75 million use cannabis, two million use opiates, and 0.6 million use sedatives or hypnotics. According to the survey, between 17% and 26% of these people are dependent users who require immediate treatment. About one-quarter of those who use opiates and cannabis will seek therapy, compared to one-sixth of persons who drink alcohol.
"The idea that drug usage is solely a city problem is a lie," said Gary Lewis, the UN Office of Drugs and Crime's regional representative for South Asia. He went on to say that injecting drugs and high-risk behaviours can be found in both urban and rural regions.
Injecting drugs is pretty frequent across the country, not just in the north eastern areas, contrary to popular belief. "It's worth noting that heroin abuse and IDUs [injecting drug users] have also been recorded from rural India," the paper states. Sharing needles was prevalent (three injecting drug users shared one needle on average), as did hazardous sex.
According to Mr Lewis, the potential number of persons seeking treatment—approximately 0.5 million opiate addicts, 2.3 million cannabis users, and 10.5 million alcohol users—is a big concern for India right now. He went on to say that low enrolment in treatment programmes and long periods of drug use before seeking treatment are still major concerns.
We have an addiction problem in India. The statistics in Punjab are staggering: roughly 75% of the children, or 3 out of every 4 children, are heavily hooked to drugs. Mumbai, Hyderabad, and other Indian cities are quickly gaining a reputation for drug abuse, and their populations are growing. India's future generation will be compelled to compete with narcotics like cannabis, alcohol, and cigarettes as its effects expand to our youth. There was no place for discussion about rehabilitation centres at least two decades ago, but it is now a pressing requirement as the number of drug users and the need for rehabs rises daily. Rehab centres abound in Delhi, seeking to keep up with the flood of addicts. Over 500 centres across India collaborate to rehabilitate addicts and reintegrate them into healthy productive lifestyles, but India is struggling with addiction.
MEANING OF SUBSTANCE ABUSE
Excessive use of a drug in a way that is harmful to oneself, society, or both is referred to as substance abuse. Both physical and psychological reliance are included in this description. Physical dependence is a physiologic state created by long-term use of a drug, in which withdrawal symptoms appear when the substance is stopped. In the absence of physical dependency, psychologic dependence refers to a strong desire to continue taking a substance. Alcohol is a drug that can cause both physical and psychological dependence, according to these definitions. Alcohol is one of numerous drugs of abuse discussed in this chapter. It's worth remembering, though, that the scope of alcohol-related problems in the United States is so vast that alcohol is sometimes lumped in with other narcotics of abuse. When people hear the words "substance abuse," they almost invariably think of illegal narcotics. These drugs were made illegal in the first place because they have the potential to be addictive or have serious health repercussions. Some people believe that consuming illegal drugs is dangerous and abusive as a result.
Many patients who regularly use these substances will try to convince people that they are not having any problems because they are unaware that they are hooked. The consequences of drugs cause great human suffering, and illegal narcotics manufacturing and sale have resulted in crime and bloodshed all across the world. The International Day Against Drug Abuse and Illicit Trafficking is commemorated every year on June 26th.
SUBSTANCE USE AND ADDICTION
Drug misuse is a multifaceted issue with social, cultural, biological, geographic, historical, and economic implications. The breakdown of the traditional joint family system, the lack of parental love and care in modern families where both parents work, the decline of traditional religious and moral values, and other factors have resulted in an increase in the number of drug addicts who use drugs to escape the harsh realities of life. The kind of the drug abused, the individual's personality, and the addict's surrounding environment all play a role in drug use, misuse, and abuse.
The conventional systems of social control have loosened as a result of industrialization, urbanisation, and migration, leaving an individual open to the pressures and strains of modern life.
Synthetic substances and intravenous drug use, both of which lead to HIV/AIDS, have given a new dimension to the problem, particularly in the Northeastern parts of the country. Drug addiction has had a negative impact on society. It has resulted in an upsurge in crime rates. To pay for their narcotics, addicts turn to criminality. Drugs lower inhibition and impair judgement, encouraging people to engage in criminal behaviour. Teasing, group fights, assaults, and impulsive murders are all on the rise as a result of drug use.
Addiction raises tensions and causes tremendous emotional agony for every family member, in addition to harming financial stability. The loss of human potential is immeasurable because the majority of drug users are in the productive age bracket of 18-35 years. The impact on youth's physical, psychological, moral, and intellectual development is significant.
One of the key areas of concern in adolescent and young people's behaviour is adolescent drug misuse. In India, it is believed that by the time most males reach ninth grade, about half of them had used at least one substance of abuse type.
Addiction-related increases in HIV, hepatitis B and C, and tuberculosis cases contribute to the community's reservoir of infection, burdening the health-care system even more. Drug misuse is more prevalent among women in India. Domestic violence and HIV infection, as well as financial hardship, are among the repercussions.
At both the national and international levels, India has prepared to meet the threat of drug trafficking. Several steps have been implemented, including innovative reforms to the enforcement, legal, and judicial systems. The imposition of the death sentence for drug-related offences has proven to be a significant deterrent.
To combat this threat, the Narcotic Drugs and Psychotropic Substances Act of 1985 was adopted with strict requirements. The Act stipulates a minimum sentence of ten years in prison, with a maximum sentence of twenty years, and a fine of one lakh rupees, with a maximum fine of two lakh rupees. Various government agencies and non-governmental organisations have developed a comprehensive plan involving specialised programmes to reduce overall drug use, which is reinforced by measures such as education, counselling, treatment, and rehabilitation programmes. Substance abuse can be addressed at three levels: the individual, the local (social, national, etc.), and the international.
A combination of biological understanding with the examination of underlying sociocultural elements is required at the individual level. At the national and international levels, all countries must work together to address the problem of substance abuse, taking into account local socio-cultural and political circumstances.
LEGAL FRAMEWOR REGARDING CONSUMPTION OF DRUGS IN INDIA
The Narcotic Medications Control System in India was designed with the need for narcotic drugs and psychotropic chemicals for medicinal purposes in mind, as well as the country's duties under UN conventions. India has ratified the UN Single Convention on Narcotic Drugs (1961), the Convention on Psychotropic Substances (1971), and the Convention on Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988), all of which prescribe various forms of control aimed at limiting the use of narcotics drugs and psychotropic substances for medical and scientific purposes while also preventing their abuse.
The country's administrative and legislative framework in the realm of narcotics has been established in conformity with the spirit of the UN Conventions. The Narcotics, Drugs, and Psychotropic Substances (NDPS) Act, 1985 is the primary legislative instrument used by the Indian government in this area. Various ministries and departments of the Indian government, as well as state governments, carry out various functions related to drug demand and supply reduction. Various enforcement authorities within the Ministry of Finance, Ministry of Home Affairs, and State Governments are in charge of drug supply reduction.
PROCEDURAL SAFEGUARDS AND IMMUNITIES UNDER THE NDPS ACT
The 1985 Narcotic Drugs and Psychotropic Substances Act takes drug offences seriously and imposes harsh punishments. The Act uses a graduated system of punishment, with the severity of the penalty varied depending on whether the offence involves minor, commercial, or intermediate quantities of narcotic drugs and psychotropic substances. For offences involving commercial quantities of drugs, a minimum sentence of ten years in prison is required, with the possibility of a sentence of up to twenty years. Repeat offences carry a penalty of one and a half times the first sentence, and in some cases, the death penalty. The Act also includes procedural safeguards in addition to these strict measures, which are as follows:
Personal search: Anyone being searched has the right to have their belongings searched in front of a Gazetted Officer or a Magistrate (Section 50). The officer searching the person must inform the person that he has the right to be searched in front of a Gazetted Officer or a Magistrate, and that if the person wishes to be searched in front of a Gazetted Officer or a Magistrate, he must be taken to the Gazetted Officer or the Magistrate and searched. If the officer has grounds to believe that taking him to a Gazetted officer or a magistrate will not be practicable without providing him the opportunity to surrender the drug, prohibited substance, or other item, he may search him under Section 100 of the Cr. P. C. [Section 50(5) and 50 (6)].
Searches: Searches can be authorised by Gazetted Officers of authorised Departments under Section 41 of the NDPS Act. This type of authorization must be based on written documentation. Under Section 42, searches can be conducted without a warrant (from a magistrate) or authorization in specific instances (from a Gazetted Officer). In the event of such searches, the officer must transmit a copy of the written information or the basis for his belief to his immediate superior within 72 hours.
Arrests: The individual who has been arrested should be informed of the reason for his arrest as quickly as possible [Section 52 (1)]. The person or the confiscated item should be forwarded to the magistrate if the arrest or seizure is based on a warrant issued by that magistrate [Section 52(2)].
Within 48 hours of an arrest, an officer must submit a comprehensive report to his official supervisor [section 57].
IMMUNITIIES FOR DRUG OFFENCES
Officers: Officers operating in good faith in the performance of their obligations under the Act are free from litigation, prosecutions, and other legal actions (Section 69).
Addicts: If they volunteer for de-addiction, addicts charged with drug consumption (Section 27) or small-scale offences will be exempt from prosecution. If the addict does not finish treatment, his or her immunity may be revoked (Section 64A).
Offenders: The federal or state governments can grant immunity to an offender in exchange for his testimony in a case. The government, not the court, provides this immunity (Section 64).
Juvenile offenders: The Juvenile Justice (Care and Protection of Children) Act, 2000 governs juvenile offenders (under the age of 18).
Diplomatic immunity, if applicable.
PUNISHMENT FOR OFFENCES
The NDPS Act takes drug offences very seriously and imposes severe punishments. The length of the sentence and the amount of the fine varies depending on the crime. The penalty for various crimes is determined by the amount of substance involved: tiny quantity, more than small but less than commercial quantity, or commercial quantity. For each medicine, small and commercial volumes are reported.
Abetment, criminal conspiracy, and even efforts to commit an offence are all punishable under the NDPS Act in the same way as the offence itself.
Preparing to commit an offence carries a half-penalty. Repeat offences carry a one-and-a-half-time punishment, as well as the possibility of death. Because the penalties under this Act are so severe, it includes a number of procedural safeguards. The Act also provides for some immunities.
DRUG TRAFFICKING IN INDIA: HOW IT STARTED
Initially, Arab merchants arrived in India and introduced the Opium drug, which was initially employed as a treatment or cure for ailments but later became addictive. The Hague International Opium Convention was held in 1912, and Britain signed the pact, which specified that the use of opium would continue wherever the region was taken or administered by Britishers.
The Dangerous Drugs Act, 1930, was adopted by the Colonial administration in 1930, and it puts a total seizure or grab on the practise of using the Opium drug for therapeutic purposes.
The public observed examples of Sikh militancy involved in drug trafficking in Punjab in 1980. Miscreants routinely used the Wagah-Attari border to transport drugs across the border.
The Samjhauta Express was created to run between Amritsar and Lahore on a daily basis in order to help the illegal narcotics trafficking from Pakistan to India. Following that, the Indian government adopted "The Narcotic Drugs and Psychotropic Substance Act" in 1985.
CHALLENGING DIMENSION OF THE PROBLEM OF DRUG ABUSE IN INDIA (CURRENT SCENARIO)
Drug misuse is currently viewed as a complex issue because it is linked to other significant crimes like organised crime, human trafficking, and money laundering. The National Crime Records Bureau (NCRB) said that in 2010 and 2009, narcotics worth Rs.19.51 crore and Rs.17.05 crore were seized, demonstrating the magnitude of the problem. Drug addiction can impair a person's memory and lead to death. HIV/AIDS, heart attacks, cancer, and other disorders may be caused by it.
Drug misuse is a taboo subject in any society, but it is especially so in developing nations such as India. There are numerous reasons to make drug abuse a criminal offence, including the following: drug abuse is harmful to one's health and can lead to death; and it is critical to educate young people about the dangers of drug usage. The usage of drugs is likewise outlawed by the Indian Constitution, and it is the state's responsibility to prevent misuse of drugs under Article 47. Apart from these issues and preventative actions, drug misuse remains a problem, necessitating a drug abuse research.
Statutory provisions in India- The Indian legislature is continually working to reduce the problem of drug misuse by enacting legislation to carry with the objectives of international treaties and conventions to which India is a signatory.
These international treaties and conventions are as follows
1.Convention on Narcotic Drugs, 1961.
2.Convention on Psychotropic Substances, 1971.
3.Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988.
4.Transnational Crime Convention, 2000.
Indian Parliament has enacted two Central Acts, which are as follows
1.The Narcotic Drugs and Psychotropic Substances Act, 1985, and
2. The Prevention of Illicit Traffic in Narcotic Drugs and Psychotropic Substances Act, 1988.
THE EXISTING THREE-PRONGED STRATEGIES TO ADDRESS THE DRUG PROBLEM IN INDIA
As enshrined in its constitution (Article 47) and being one of the signatories of the United Nation's International Conventions, India had the onus act to eliminate the use of illicit drugs, to develop measures to prevent drug use and to ensure availability of treatment for people with drug use disorders. India has adopted the three-pronged strategies - supply, demand and harm reduction.
Following the 1971's UN Convention on Psychotropic Substances, the Ministry of Health and Family Welfare, Government of India, established an Expert Committee to look into the issue of drug and alcohol use in India.
The Committee's report was submitted in 1977, and the Drug De-addiction Programme (DDAP) was implemented in 1985-19867 after receiving clearance from the Planning Commission. The DDAP's main goal was to reduce drug demand. India passed the Narcotic Drugs and Psychotropic Substances (NDPS) Act in 1985, which was revised three times, the most recent in 2014. The NDPS' main goal was to "prevent and combat drug misuse and illicit trafficking," with a clear focus on supply reduction. In 1988, the consultative group (an advisory council established under the NDPS Act) devised a national programme to combat drug abuse.
A one-time payment was also given to 122 De-Addiction Centres (DACs) of various psychiatry departments of government medical colleges and district hospitals under the DDAP. Several non-governmental organisations (NGOs) across the country were financed by the Ministry of Welfare to create counselling and DACs with the goals of community awareness, treatment rehabilitation, and human resource development. Following that, the Ministry established ten Regional Resource and Training Centres (RRTCs) to mentor, train, and provide technical assistance to a variety of different non-governmental organisations. The National Institute of Social Defence oversees the activities of RRTCs (NISD).
There has been a significant expansion of services in all aspects over the previous three decades. In 2013, the Ministry of Social Justice and Empowerment released the National Drug Demand Reduction Draft Policy, a draught policy for reducing drug demand. The Ministry has launched the 'Central Sector Scheme of Assistance for Prevention of Alcoholism and Substance Abuse and Social Defence Services to expand on existing programmes. In 2018, the Ministry of Social Justice released its five-year strategy, titled "National Action Plan for Drug Demand Reduction."
Currently, there are about 400 non-governmental organisations (NGOs) operating as Integrated Rehabilitation Centres for Addicts across the country. The DDAP has also expanded its scope to include the newly created Drug Treatment Centres, in addition to the former DACs (DTC). These are sections of general hospitals where a dedicated service with dedicated staff provides outpatient-based care for substance use disorders and free medications are administered.
The provision of low-threshold, community-based opioid replacement therapy was added to the harm reduction feature in 2005. (OST). It was initially supported by the Department of International Development until 2007, when it was handed over to the Ministry of Health and Family Welfare. Under the targeted interventions, the National AIDS Control Organization (NACO) continued the OST and Needle Syringe Exchange Programs (NSEPs).
Alcohol and substance use problems are now covered by the Mental Health Care Act (2017). This action is anticipated to promote adherence to human rights, non-discrimination, respect for the right to autonomy and confidentiality, and availability and access to the minimal standard of care and rehabilitation for people with substance use problems. The NISD and the RRTCs have developed a minimum standard of care for NGOs, while the NDDTC and AIIMS have prepared one for government DACs.
CURRENT AND FUTURE CHALLENGES RELATED TO DRUG ABUSE IN INDIA
The Ministry of Social Justice and Empowerment has undertaken two nationwide drug surveys in the previous three decades (after the commencement of the NDPS), both of which were released in 2004 and 2019. According to the findings of these polls, drug use in India is on the rise. Opioid use has risen from 0.7 percent in the previous report to a little more than 2% in this one, bringing the total number of people using opioids from two million to more than 22 million. Worse worse, heroin has surpassed natural opioids (opium and poppy husk) as the most widely abused opioid. This was also confirmed by a large-scale epidemiological research from Punjab. Other synthetic substances, as well as cocaine, have seen a major surge in use. The poll results indicate that we need to enhance our current system, make a more determined effort, and close the gaps. The government could want to focus on the following in the coming years:
(i) The National Mental Health Survey (2015-2016) revealed a treatment gap for substance use disorders of more than 70%. The conclusion was confirmed in a recent national study on substance use disorders, which revealed a roughly 75% treatment gap for drug use disorders. To make matters worse, only 5% of people with illicit drug use disorders obtained inpatient treatment. This high treatment gap indicates that health care is inaccessible, underutilised, and of poor quality. To satisfy this unmet need, treatment and rehabilitation facilities for substance use disorders should be expanded. The Ministry of Health and Family Welfare's DTC programme may be a good place to start, but it isn't enough. The scheme is now being implemented by the NDDTC, AIIMS. There's a chance that other centres will be involved as well. Because both the ministries of Health and Social Justice are directly responsible for drug demand reduction, a coordinated and determined effort is required to bridge the treatment gap with a minimal level of service. Drug surveys would be done at regular intervals across the country to uncover the undercurrents of substance abuse in India and to help the government make educated judgments.
(ii) The harm reduction arm of the three-pronged approach needs to be strengthened further. Despite the progress made by the NACO and the GO-NGO model, the coverage of the OST among the IDUs is only seven per cent. It calls for the scaling up of the OST, safely and effectively. The NDPS policy prohibits the NSEP, whereas it is one of the cornerstones of harm reduction, practiced by the NACO. The NDPS policy also advocates a time-limited OST, which does not have any scientific evidence base and might cause more harm (than good). Recovery-oriented OST could potentially replace this time-limited OST policy. These discrepancies and loopholes in the policies need to be fixed.
(iii) The early detection and scheduling of novel psychoactive drugs are current and future difficulties in the supply reduction arm. The International Narcotic Control Board (INCB) recently produced research that revealed India's threat to mephedrone and captagon (a derivative of amphetamine and theophylline). The country's potential problem with precursor chemicals was also mentioned in the report. Furthermore, the rapid expansion of internet-based pharmacies and bitcoin-based transactions for illicit drug usage in India has been highlighted with caution. Another worry raised by the worldwide forum is the misuse of over-the-counter drugs with definite (e.g., benzodiazepines, tramadol, and codeine) or potentially addictive potential (e.g., pregabalin).
In conclusion, India has made proactive and decisive actions to solve its drug-related issues. Despite the fact that the government has an all-encompassing blueprint, a dedicated workforce, and a number of dedicated programmes and policies at its disposal, there is a need to improve current programmes (to address unmet needs), to coordinate efforts between Ministries, to achieve policy uniformity, to make scientifically informed decisions, and to strengthen supply reduction chains.
In Modern times, both men and women use almost all types of illicit drugs, and illicit drug use is more likely to upshot in emergency department visits or overdose deaths for them. "Illicit" means to use of illegal drugs, including marijuana and misuse of prescription drugs. The NDPS Act,1985 was formulated with a view to curb the illicit production, manufacturing, storage, supply and consumption of substances that are banned under the law. NDPS Act views drug offences very severely and penalties are stringent. The quantum of sentence and fine differs with offences and for various offences, the penalty depends on the quantity of drug involved. Producing or manufacturing/cultivating, possessing, selling, purchasing, transporting, storing, and/or consuming any narcotic drug or psychotropic substance is illegal under the NDPS Act. The Narcotics Control Bureau was established in March 1986 under the NDPS Act. The Narcotics Control Bureau (NCB) is India's top law enforcement and intelligence organisation, responsible for combating drug trafficking and illegal substance misuse. It was established on March 17, 1986, to ensure the complete execution of the NDPS Act and to combat its violations.
The goal for which the Act was enacted has been realised through its implementation. The central government, in collaboration with the individual state governments, has been successful in enacting laws to enhance the Act's good impact on society. Offenders identified under the Act have also been given the opportunity for a fair trial based on natural justice principles. A right of appeal has also been established against the Tribunals' decisions.
Drug misuse is a complicated subject with far-reaching consequences for individuals who use it. Overcoming addiction involves major changes in a victim's life in all areas. Given the current condition of Indian affairs, harm reduction concepts applied to drug policy are the only option to rid our country of substance abuse. There is a definite correlation between drug abuse, the type of drug consumed, and the crimes committed. In order to purchase narcotics, addicts are forced to conduct crimes. Addicts are not accepted for employment. As a result, due to a lack of funds, they are unable to meet their fundamental demands. Smuggling, drug selling, theft, and prostitution are just a handful of the illicit activities that people engage in after all this.