Drugs in the global village


Extent of Illicit Drug Supply
Patterns and Trends in Illicit Drug Supply
Arrests, Convictions and Imprisonments
Not reported

                                        EXTENT, PATTERNS AND TREND IN DRUG ABUSE

                                                                      Extent of Drug Abuse

The Estimated population is 884.4 million for 1992 (p.187) and the urban population 26% (185)(HDR 1995).

            India responded to the Annual Report Questionnaire (ARQ) 9 out of 12 times between 1983 and 1994. Overall, the item response rate in the 1994 ARQ part II is satisfactory. In 1995, two comprehensive reviews of drug related research were prepared by the Ministries of Health and Welfare. The reviews indicate that drug information is abundant but it applies to selected populations only and cannot be used with confidence to produce national estimates (India 1995a and 1995b). Estimates provided in the ARQs and related research appear to be subject to different degrees of variability and reliability. The focus on small scale studies should be reassessed and consideration should be given to conducting a national drug survey as a component of the ongoing socio-economic survey in order to produce more reliable estimates. In spite of data limitations, an attempt to produce national population estimates is made in table 5.
            The Government of India reports that the development of  a drug information system is constrained by lack of adequate planning and coordination and states that technical and financial assistance are needed to develop it (p. 5) (ARQ 1994,II).         
            Opium abuse is widespread and well anchored in tradition in many part of India, but more so in rural areas. Opium abuse ranges between 6.3 and 18.9 in rural areas of Rajasthan and Punjab. In urban areas, it is significantly lower, i.e., Rajasthan City (1.3 per cent) and Delhi (0.1 per cent) (p.2-3)(India 1995b and table 3). In Jodhpur, the quantity consumed ranges from 0.2 to 11.8 grams per day and most (61 per cent) consume 3 grams per day (p.44) (table 5) (India 1995a). Registered abusers in treatment data confirm this pattern (table 1). (The type of prevalence was not reported. It is assumed to be current daily abuse).

            In rural Rajasthan, every person is likely to have consumed opium more than once in his/her lifetime for medical, ceremonial or social reasons (p14-15)(India 1995a). In a sample of drug abusers in Rajasthan (S=200) 72.5 per cent abuse “doda”, a derivative of opium and 27.5 per cent abuse opium (p.59). Abuse among all respondents is daily, 68.5 per cent twice a day and 30.5 per cent three times a day (p.60). Quantities abused increase with duration of abuse (p.67, 68).  Most (88 per cent) abused opiates for durations ranging from 5 to 20 years. Abuse drops significantly after 20 years of  abuse (p.64). Most abuse is funded from personal earnings (87 per cent) (p.72). Initiation to drug abuse was attributed by respondents to medical use (40 per cent) and  social reasons such as friends influence, customs and common use in the village (45.5 per cent) (p.66) (Nahar and Bhati 1995).

            The pattern of opium abuse observed in Rajasthan is likely to apply to other selected rural areas but not to urban centres. Opium abuse in urban areas is significantly lower and ranges between 0.1 and 1.4 per cent (table 3).

            Heroin  dependence is estimated to be 0.5 per cent in the slum areas of Delhi. Heroin abuse is 0.08 per cent in Delhi, 0.13 per cent in Bombay and 1.5 per cent in Hyderabad among male students. Crude estimates of heroin abuse prevalence in urban metropolitan cities have been estimated to range between 0.3 and 0.5 per cent  (p.4-5)(India 1995b)(table 3). Opiates are the most prevalent drug of abuse among people in  treatment (table 1).

             Like opium, cannabis abuse is widespread and well anchored in tradition in India. It is consumed as a spice in food (i.e., pakoras) and in “bhang”sweets and drinks during festivals, marriages, among other ceremonies (India 1995a). The prevalence of cannabis abuse in five cities of the Southern States of  Karnataka was  2.4 per cent by the early 90's (table 3) (p.5-7)(India 1995b). (The type of prevalence was not reported. It is assumed to be current daily abuse. Other less recent estimates are reported in table 3).

            Amphetamines  abuse is reported mainly among university students. Its prevalence was estimated to be between 0.5 and 5.2 per cent among male university students in the 70's and between 0.1 and 0.7 per cent around 1987. Medical students abuse amphetamines more frequently than other students (about 1 per cent are regular abusers) (p.7) (India 1995b) (table 2). Registered abusers in treatment data confirm this pattern (table 1). 

            Tranquillizers abuse, with and without prescription, is common in urban areas. Abuse of tranquillizers is reported among students and ranges between 8 and 9 per cent among high school and university students in Delhi around 1976-1978 and between 1.0 and 3.0 per cent among students in other metropolitan urban areas in 1981 (p.9) (India 1995b) (table 2) (Slightly different findings are reported in India 1995a:20). Registered abusers in treatment data confirm this pattern (table 1). 

            Barbiturates  abuse is reported mainly among higher education students. Their abuse ranged between 0.4 and 5.4 per cent among college students in 1977 and between 6.5 and 25 per cent among medical students (p.8) (India 1995b).

            Methaqualone  abuse is reported mainly among university students. Its abuse was estimated to range from 5.9 to 20.6 per cent among university students in the Punjab in 1978 (p.8) (India 1995b).

            Cocaine abuse is reported mainly among university students. Its experimental abuse was estimated to be about 2.4 per cent among university students in Delhi around 1978 (p.8) (India 1995b) (table 2). Registered abusers in treatment data confirm this pattern (table 1). 

            Hallucinogens  abuse is reported mainly among university students. Their Abuse was estimated to be about 3.8 per cent among college students in Bombay around 1974 and 1.6 per cent among university students in the Punjab in 1977  (p.9) (India 1995b) (table 2). Registered abusers in treatment data confirm this pattern (table 1). 


            Studies estimating lifetime prevalence of drug abuse in the general population are rare. Based on one study in Karnataka, the lifetime prevalence of drug abuse among students in the late 80's ranges from 6.9 to 15.9 per cent  while current abuse between 2.4 and 9.5 per cent; in the general population the lifetime prevalence ranges from 5.1 to 10.4 per cent versus  1.5 to 3.7 per cent for current abuse (p.37). Around the same time, in 1989, current drug abuse in Culcutta has been estimated to be 1.6 per cent and drug dependence in West Bengal in 1990 at 0.35 per cent (p.39)(India 1995a)(table 2).

            In spite of data limitations, data reported is used in table 5 to produce selected population estimates in order to illustrate analytical potential. The main findings suggest that drug abuse lifetime prevalence ranges from 5.1 to 10.4 per cent and current drug abuse from 1.5 to 3.7 per cent. Current drug abuse of opium ranges from 0.7 to 1.4 per cent in rural areas or 4.58 to 9.16 million current opium abusers. Drug dependence ranges from 0.35 to 0.5 per cent of the population or 3.09 to 4.42 million. Heroin dependence in urban areas ranges from 0.3 to 0.5 per cent or 690,000 to 1.15 million heroin dependent abusers.

Abuser Characteristics

            Drug abuse tend to be more pronounced among men (p.13-14) (India 1995b).  Drug abuse among women ranges between 1.2 and 7 per cent depending on the drug of abuse and the location. The preferred drugs of abuse among women tend to be licit drugs, although other illicit drug abuse is reported. Very few women attend treatment centres. Drug abuse among affluent and low income women as well as sex workers is reported. Drug abuse is attributed also to marriage breakdown (p.23-5) (India 1995a) (see table 2).

            Drug abuse is common among those aged 16 to 35 and tend to be more pronounced among those who are 18 to 25 years old. Among abusers in treatment from October 1993 to March 1994, 44 per cent are 18 to 30 years old and 35 per cent between 31 and 45, 16.01 per cent among those 46 and older, and 4.54 per cent among those between 12 and 17 years. Opium abusers tend to be older than other drug abusers  (p.25-27) (India 1995a).

            An attempt to map existing drug abuse data by abusers characteristics in table 2 confirms suspicions of high variability. It shows also that most information available focuses on students, probably due to the ease of surveying them and not necessarily because of a pronounced abuse among them. In the 70's, cannabis abuse among students ranges from 3 to 40.8 per cent, sedatives 3.2 to 9.0 per cent, amphetamines 0.5-5.2 per cent and analgesics 7.9 per cent among women. As suggested above medical students maybe abusing amphetamines more frequently than others. However, recent surveys among students suggest experimental or non significant levels of  abuse in general (India 1995a; 1995b). A similar attempt to map drug abuse by characteristics such as income, education, occupation/employment, religion and marital status  led to the conclusion that variability is high and that drug abuse is widespread among every social group surveyed (p.27-37)(India 1995a).

            Drug abuse in Rajasthan is described below as an illustration of the traditional pattern of drug abuse in India. Opium abusers in Rajasthan tend to be aged between 31 and 60 (91 per cent), with a high concentration among the 41 to 50 years old (46.5 per cent), less educated, earn lower income, less likely to read newspaper and more likely to be exposed to movies. Religion, marital status, birth place, family structure, radio listening and tv exposure are not associated with drug abuse  (p. 38-55) (Nahar and Bhati 1995)..



            Non traditional abuse of other drugs such as cocaine, heroin, LSD among other drugs has been presenting new problems in urban settings in Rajasthan, especially among younger generations. Abuse of opiates is increasing among students and  medical staff (p.5). Drug abuse among non-student youth is widespread, although not as well recorded (p.16-17) (Nahar and Bhati 1995).

            Cannabis is  abused in Rajasthan by farm laborers, rickshaw operators, porters, truck drivers among other hard working groups to relieve fatigue and facilitate sleep (p.6-8) (Nahar and Bhati 1995).

                                                                       Regional Variations

            Opium and cannabis are  abused  in rural areas by tradition while in urban areas, in addition to these traditional drugs, heroin  has gained ground and psychotropic substances such as Methaqualone, Benzodiazepines, amphetamines and hallucinogens are making headway, especially among students. Concern is increasing over the spread of non-traditional drugs to rural areas. In addition, a drug abuse appears to be pronounced in the Eastern and Western border areas where drug cultivation, production and trafficking are concentrated. Similarly, drug abuse has gained ground among populations living along trafficking routes: i.e., in  Imphal in the North East, which serves as a transit point for trafficking from Myanmar (p.37-40) (India 1995a) (See table 3 for selected drug abuse measures by region).


            Cannabis has been abused as long as 4000 years ago according to the religious mythology of India. Cannabis and opium were used for medical purposes during the Mughal period in the middle ages. Traditional abuse has been widespread and institutionalized in religious rites to a point that drug dependence has not been  stigmatized but rather perceived as part of every day life (p.1-4) (Nahar and Bhati 1995).

            Between 1893 and 1894, it was estimated that habitual cannabis abuse ranged from 0.5 to 1.0 per cent of the population (excluding “bhang”). The prevalence of dependent cannabis abuse in a Punjab village was estimated to be 2.2 per cent and 1.2 per cent in the Punjab State by the end of  70's.  The prevalence of cannabis abuse in neighboring Rajasthan was around 4 per cent in the early 80's, and 2.4 per cent in five cities of the Southern States of  Karnataka by the early 90's (p.5-7)(India 1995b) (table 3).

            Between 1773 and 1880, British India contributed significantly to the spread of opium cultivation and distribution in the region, in spite of resistance in targeted countries. While early opium abuse has been associated mainly with medicinal purposes, abuse for intoxication was popularized by Indian traders who taught the young the “art of enjoying” opium (Renard 1992:25-46, 67).

            Opium was sold in the open market prior to india’s independence but prohibited thereafter, except in licensed shops. In the late 70's, the prevalence of opium abuse in rural areas of Rajasthan and Punjab ranged between 6.3 and 18.9 per cent. In the early 90's, opium abuse prevalence in Rajasthan city was 1.3 per cent and  0.1 in Delhi (India 1995b) (table 3). 


            Opium abuse is widespread in Kashmir, Uttar Pradesh, Bihar, Punjab, Rajasthan, Madhya Pradesh, Haryana and Himachal Pradesh. In Western Rajasthan, for example, it is served as drink just as alcohol is served in Western societies, although it is usually smoked elsewhere. It is also used for medical purposes even for infants. Cases of infant overdose have been reported (p.8-9) (Nahar and Bhati 1995). 

            Rajasthan is used below to illustrate trends in opium abuse in rural India which makes three quarters of the total population or 654.5 million. It should be noted that opium abuse may be higher in Rajasthan than elsewhere in rural India. Opium abuse is well anchored in tradition in Rajasthan. Drug abusers as well as non abusers report traditional abuse (98.5 and 99 per cent respectively) (p.126). Drug abusers report opium abuse during celebrations of births (96 per cent), marriages (98,5 per cent), festivals (92 per cent), purchases of assets (39 per cent) and death (88.5 per cent). Similar practices are reported by non abusers (p.128).  Opium is used to relieve fatigue (p.123), as pacifier for infants and for intentional overdosing of female infants and for miscellaneous medical purposes (p. 124). Community attitudes disapproving these practices remain feeble among drug abuser and non abusers alike (3 versus 1 per cent respectively). Further, the attitude of drug abusers towards non abusers tend to be negative (79 per cent). Even among non abusers, one per cent hold negative attitudes towards members of the community who do not consume drugs for traditional (p.135)  (Nahar and Bhati 1995). 

            However, some ambivalence may be seeping through the cracks among the majority of drug abusers (85 per cent) and non abusers (90.5 per cent)  (p.132). Opium serving customs may be changing as they are more prevalent among drug abusers (92.5 per cent) compared to non abusers (83 per cent) (p. 130). Community resistance to drug abuse is reported by drug abusers (39 per cent) and non abusers (80.5 per cent) (p.137).  Yet, drug abuse remains widespread in spite of legislated prohibition (p.20, 176) (Nahar and Bhati 1995).

            Few drug abusers in treatment reported heroin abuse in the early 80's. However, by the mid 80's, a third of the drug abusers in treatment reported heroin abuse in Delhi. In the 90's, Ministry of Health treatment centres in large  urban centres reported that  a third to half of their patients were heroin abusers (p.4)(India 1995b). Treatment centres managed by the Ministry of Welfare and which service smaller urban centres and rural areas, report that about one fifth of the patients were heroin abusers in 1993/94  (ARQ 1994, part II, p.9). Qualitative observations  also suggest that heroin abuse has spread from affluent to low class consumers, among other groups  (p.41)(India 1995a; ARQ 1992,1993,1994, PartII:13).

            While reports indicate than concern relating to heroin dependence has been increasing, it should be noted that this may reflect a shift from traditional drugs (i.e., opium and cannabis) to new drugs (i.e., heroin, morphine, Buprenorphine) among drug dependent abusers and not necessarily an increase in the rate of abuse in the general population.  Selected quantitative data on drug abuse in India do lend support to this view (table 3).

            Similarly, suggestions to a shift from traditional drugs (i.e., opium and cannabis) to other new drugs (i.e., cocaine, hallucinogens and sedatives) among selected student populations and drug dependent abusers could not be substantiated by available quantitative data mapped in tables 1, 2 and 3. This observation applies to amphetamines and analgesics as well, in spite of concerns voiced in their regard (table 2). In other words, abuse of “new” drugs remains marginal even among students and drug dependent abusers.



Mode of Intake

            About half of the heroin abusers inject this drug in North Eastern States (Sehgal 1990 and Pal et. Al., 1990). In Manipur about half of the drug dependent abusers inject drugs. It is estimated that from 1 to 2 per cent of the population in these states inject heroin, while a minority smoke it. In comparison, in Bombay 3.3 per cent of the drug abusers inject heroin while the remaining smoke it (34.3 per cent) or inhale it (“Chase the Dragon”) (62.3 per cent). Among drug abusers in a Delhi hospital, smoking heroin is the most common mode of intake, although injection is also reported. Injecting drugs is considered insignificant in Delhi, Bombay, Pune, Goa, and Madras (p.42) (table 4) (India 1995a; Sehgal 1990).


            Concern over drug abuse by injection has been increasing, especially in the North Eastern States bordering Myanmar. Injecting drug abusers appear to be aware of HIV related risks and yet injecting equipment is shared among peers or in “shooting galleries.” Private injecting equipment is rarely sterilized and tends to be primitive. Injecting practices appear to be similar in North Eastern India and  Myanmar  (p.50-51)(India 1995a) (see also table 8 and UNDCP 1995 Myanmar CDP).

            The intake of opium varies depending on prevalent customs in the region. In Jammu and Kashmir it is mostly smoked. In the Punjab, it is primarily ingested since smoking it is a taboo. In Western Rajasthan and Gujarat, it is eaten or drunk. In Jodpur, the majority of drug dependent abusers take opium pills while other abusers drink opium infusions (p.42-43)(India 1995a).

            Cannabis is widely smoked, but it is also chewed. Some consume it in the form of snuff. It is also consumed widely as a drink (“bhang”) during festivities and as an additive in food (i.e., pakoras and candies) (p.44) (India 1995a).

            Multiple drug intake is common among drug abusers (i.e., Delhi, Orissa, Madras, Karnataka, street children in Delhi, and students in Karnataka). However, most drug abusers in government treatment centres report single drug abuse (81.97 per cent) (p.43) (India 1995a).

                                                  COSTS AND CONSEQUENCES OF ABUSE

            National and regional morbidity data are not available. Selected measures are available on the basis of local studies (ARQ 1994, Part II:54). Selected measures of drug abuse related morbidity presented in table 6 suggest that a high proportion of the drug dependent abusers suffer from medical and/or psychiatric problems. Over two fifths of the drug abusers in counseling and treatment in Ministry of Welfare centres in Delhi developed medical and psychiatric problems. About one third of this group suffered from respiratory diseases such as tuberculosis and 21 per cent from digestive system related problems. Some also developed skin and muscular problems, general weakness and loss of weight. Similar findings were reported in other studies (p.47) (India 1995a). Ministry of Health treatment centres report higher drug related medical and psychiatric problems (68.7 and 75 per cent respectively) (p.20-21) (table 6)(India 1995b). Concern over drug abuse by injection has been increasing as it has been associated with   the spread of HIV (table 7 and 8). It has been estimated that 10 per cent of HIV infections are due to drug abuse by injection while the other contributing factors are unprotected heterosexual transmition and blood transfusion (p.48)(India 1995a). In Manipur, about 31.55 per cent of the injecting drug abusers are HIV positive (higher rates are reported elsewhere), most are males (96.81 per cent) and under 30 years of age (91.07 per cent) (Sehgal 1990).

            According to a study in Rajasthan, a significant proportion of drug abusers reported health problems (48.5 per cent) compared to less than one per cent among non abusers (p.113).  Among the diseases reported are tuberculosis (12.3 per cent), asthma (7.2 per cent), high blood pressure (2 per cent), physical weakness (13.4 per cent), coughing (18 per cent). About 49.4 per cent  of the drug abusers who reported ailments, attributed them to drug abuse (p.115). In addition, drug users reported suffering from tension (43.5 per cent) and 52 per cent reported using drug to relieve tension (p.117-118). Drug abusers also work fewer work hours (p.107) (Nahar and Bhati 1995). Drug abuse has been associated with anti-social behavior ranging from stealing to murder, breakdown of social relations with family members, discontinuing schooling and increasing debts  (p.52-53)(India 1995a).  

            Expenditures on drugs are significant ranging from $8.16 to 22.16 per person per week (p.46) (India 1995a) (see table 5 for other cost estimates). According to a study in Rajasthan, self reported economic status tends to be more comfortable among non drug abusers (p.109). Indebtedness, although limited among both drug abusers and non abusers, is more significant among drug abusers (p.110) (Nahar and Bhati 1995).

            Assuming that the population estimates and the expenditures are acceptable, drug dependent abusers spend from 419.71 to 4,877.36 million dollars on drugs in India (table 5).

                                                 NATIONAL RESPONSES TO DRUG ABUSE

                                                                         National Strategy

            A comprehensive drug strategy aiming to reduce demand and supply of drugs has been adopted. The Ministry of Welfare devised a three-pronged strategy to reduce the demand of dependence-producing drugs: (1) awareness building and public education for drug abuse prevention; (2) community mobilization for the identification, treatment and rehabilitation of drug dependent abusers; (3) training for governmental and non-governmental staff engaged in drug abuse prevention. A large number of NGOs are supported by the government to carry prevention and treatment activities. Further, a drug control master plan has been drafted with the financial and technical assistance of UNDCP (p.54-55)(India 1995a)(ARQ 1994, Part II:44-45).

                                                    Structure of National Drug Control Organs

            There are two central government unit responsible for liaison and coordination of national drug control policy, the Narcotics Control Bureau and the Central Bureau of Narcotics.  The latter is the competent authority empowered to issue authorizations and certificates for the import and export of narcotic drugs and psychotropic substances.

            The Narcotics Control Bureau,established in 1986 within the department of revenue in the Ministry of Finance, is responsible for supply control. The Ministry of Health and Family Welfare is responsible for the drug related regulation and drug treatment. The Ministry of Information and Broadcasting coordinates drug related awareness programmes. The Ministry of Education and Youth Affairs is responsible for preventive education. The Ministry of Welfare coordinates drug demand reduction activities including prevention, treatment and rehabilitation and training of NGOs. UNDCP makes a significant contribution to the development of national programmes  (India 1995a:56; 1995b:25-26).

Treaty Adherence

            India is party to the 1961 Convention as amended by the 1972 Protocol, the 1971 Convention and the 1988 Convention.

Measures Taken with respect to Drug Control

Recently enacted laws and regulations

Laws enacted  in 1993 concern  poppy cultivation and scheduling of psychotropic substances (ARQ 1993, Part I). Acetic Anhydride, a precursor chemical used in converting opium into heroin, has been declared a controlled substance (p.58) (India 1995a). 

            The Narcotics Drugs and Psychotropic Substances Act enacted in 1985 and amended in 1988. Under this act, no person can produce, manufacture, possess, sell, purchase, export or import narcotic drugs and psychotropic substances, except for scientific and medical purposes. Stringent penal provisions are provided for in case of violation.  The Prevention of Illicit Traffic in Narcotic Drugs and Psychotropic Substances Act was enacted in 1988 (India 1995a:54-55; 1995b:26-27).
Licensing system for manufacture, trade and distribution

There is a government-controlled licensing system. Several narcotic drugs and psychotropic substances were reported having been manufactured in 1993 (ARQ 1993,Part I). Implementation of the licensing system is at the State jurisdiction level (p.58) (1995a).

Control system

            Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and  psychotropic substances  (ARQ 1993,Part I). However, dispensing of psychotropic substances without prescription is widespread (p.58) (India 1995a).

            Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances (ARQ 1993,Part I).
            Control of non-treaty substances, if any: None reported.

            Other administrative measures: None reported.

Social Measures

            Not reported since no information is available to the reporting authority.


Penal Sanctions related to social measures

            Not reported
Other social measures

            Not reported
                                                        SUPPLY REDUCTION ACTIVITIES

Crop Eradication
Alternative Development
Not reported


Primary Prevention

            Adult literacy rate was 34 per cent  in 1970, increasing to  50 per cent  in 1992 (p.163). Gross enrolment ratio for those aged 6 to 23 years was 40 per cent in 1980, increasing to 50 per cent  in 1990 (p.163).Public expenditure on education has been estimated at  3.5 per cent of GNP in 1990 (p.179). Daily newspapers were read by 3 per cent of the population and televisions owned by 4 per cent of the population in 1992(p.171)(HDR 1995).

            Improvements in school enrolment and the levels of literacy, reported above, are likely to have taken place mainly among the urban population (26 per cent). Even so, improvements in education may be considered a preliminary condition for both urban and rural development and drug control. Thus, in spite of the appearance of a significant level of drug prevention activities as described below, the reach of the programmes is probably very limited.

            In this context, it is reported that the media are active in promoting drug prevention. Television, radio, newspapers, magazines, cinema, videos, drama, music  and audio visual and graphic means  targets the general public in rural and urban areas. For example, newspapers carry articles which target the general public and videos are produced to target students and the general public  from time to time. Special programmes target the illiterate population by using drama and music. There are no legal restrictions concerning the portrayal of drugs in the media. Formal and informal mechanisms for the collaboration of the media with health professionals, law enforcement agencies and government Ministries are reported. Media programmes, though significant, vary across the country and are limited in coverage  (p.39-41)(ARQ 1994,Part II). NGOs appear to play a significant role in developing drug prevention related awareness at the community level. Media programme effectiveness is rarely evaluated. According to one study, televised programmes are more effective than radio and newsprint (India 1995a:66-68).

             Prevention activities through education have been taking place in primary, secondary and higher educational settings, but they are not part of a standard curriculum. NGOs appear to be the main driving forces in this area. The targets of these programmes are parents, youth groups, street children, high school and higher education students, drop outs and the general public. Preventive drug education in colleges and universities is carried out more frequently than in high schools.  Programmes consist of a wide range of activities including  educational packages for high schools, distribution of  printed material, lectures, essay competitions, workshops and video shows. A lack of trained personnel and resources is reported. Effectiveness has not been evaluated (p.28-30)(ARQ 1994,Part II). Public objection to preventive education in the areas of drugs, AIDS and sex has been reported (India 1995a:64-65).

            Drug education programmes are part of the basic education for doctors, nurses, pharmacists, other health workers, social workers, law enforcement personnel and counselors but not teachers. Continuing training is provided to teachers and all the professional groups above, except for pharmacists (p.29). Post training for personnel working with drug dependent abusers is provided to doctors, psychiatrists, social workers, psychologists and yoga therapists. Financial and technical international assistance has been provided and a training master plan is in final stages of development (p.53)(ARQ 1994,Part II). Training of  para-professionals and volunteers to work under the guidance of trained professionals is considered an imperative. In addition, government and NGOs’staff need further training (India 1995a:64-66).

            The work force consist of 33.45 per cent of the population, of which 13.09 per cent are women (1990 estimates). Drug abuse related guidelines are provided to employees and workers organizations by ILO. Drug demand reduction information is distributed. Regulation re drug testing is not available. Transport workers, laborers, self employed, shopkeepers, farmers and farm workers, rag pickers among other groups have been identified as high risk groups. Drug related studies in the workplace are rare. Demand reduction activities in the work place consist of prevention, treatment and rehabilitation. Employee assistance programmes are reported (p. 31-34)(ARQ 1994, Part II). Research information available suggests that employee assistance programmes tend to be alcohol related. In one study it is reported that employees who do not seek medical treatment tend to  consult other types of healers and tend to abuse alcohol and drugs (p.83-84) (India 1995a).

            Prevention programmes are carried out by civic groups, professional organizations, trade unions, voluntary agencies, religious groups, political parties, parent-teacher associations, drug dependent abusers self-help groups, law enforcement agencies and NGOs. Prevention activities target youth, parents and drug abusers in self help groups. Activities are coordinated by the Ministry of Welfare and the NGO Forum. Community participation and coordination are subject to constrained resources (p.35-36) (ARQ 1994, Part II). Programme effectiveness is rarely assessed. Interventions of women groups leading to closing of alcohol shops in selected locations have been reported (India 1995a:69-70).

            Leisure activities are part of drug prevention programmes. Youth, women, community groups, slum areas are targeted  in a variety of activities organized by NGOs, including video, film, pantomime and puppet shows, street corner activities and public meetings. Resources are too limited to permit extending the scope of programme coverage (37-38) (ARQ 1994, Part II). 

            Culture specific intervention programmes are rare. Selected studies suggest that a significant proportion of the population do not perceive traditional drugs such as opium and cannabis as harmful (p.64) (India 1995a).
            The finding below could guide the development of culture relevant programmes. In Rajasthan, the first to know about drug use are spouses (41 per cent), followed by friends (35.4 per cent) and mothers (17 per cent) (p.73). In spite of  widespread traditional use, people who are first to know about drug abuse expressed disapproval (80 per cent) (p.74) and many maintained their disapproval over time (57.5 per cent) (p.79). Several mechanisms were used simultaneously to dissuade abusers: “objection” (82.5 per cent), “make understand” (92.5 per cent), group influence (57.5 per cent), “criticism” (16 per cent) among other approaches  (p.77). Drug abuse persisted in spite of early intervention by significant others (p.82) (Nahar and Bhati 1995).

            In general, family members do oppose drug  abuse. However, families, friends and relatives do also provide encouragement to consume drugs (31 per cent) (p.96). Drug abusers  are given respect by their children (95.5 per cent) (p.101) but they also face discrimination by family members (56.5 per cent ) (p.98); they are at least sometimes ignored (65.5 per cent) (p. 100). It seems that drug abusers have good relations “only to a limited extent”: with parents (20.5 per cent), with brothers (26.5 per cent) and with spouses (30.5 per cent) (p.105) (Nahar and Bhati 1995).      

Treatment and Rehabilitation

            Population per doctor has been estimated to be 2,439 and 3,333 per nurse for the years 1988 through 1991. Public expenditure on health as percentage of GNP has been estimated at 0.5 in 1960 and 1.3 in 1990 (p.171). Population with access to health services has been estimated at 85 per cent in the years1985 through 1993. Population with access to safe water has been estimated at 79 per cent in the years1988 through 1993 (p.159) (HDR 1995).

            In spite of the rather widespread access to health services, traditional drugs such as opium and cannabis are still widely “abused” for medical purposes, especially in rural India, which makes 74 per cent of the population; hence, the development of drug dependence among a portion of them. As efforts to improve health care services are ongoing, they are likely to contribute to the efforts to reduce drug abuse.

            The Ministry of Welfare is the national body responsible for the coordination of drug treatment programmes (p.44). UNDCP provided financial and technical assistance (p.45). There is no inventory of treatment and rehabilitation programmes in the country and no standardized record keeping systems in treatment facilities (p.46)(ARQ 1994,II). The Ministry of Health provides treatment in hospitals, in 7 regional “de-addiction” centres and community centres as well as 16 “de-addiction” centres in medical colleges, 10 in districts hospitals and one in a prison (India 1995b: 27-28). Similarly, the Ministry of Welfare provides services in 217 counseling centres and 121 “de-addiction” centres. About 290,608 patients were treated, all sought treatment for the first time (p.46). In 1994, about 93,234 patients were treated. The Ministry of Welfare distributes an inventory of rehabilitation programmes to NGOs at the state level (p.47). The rate of relapse is significant. Counseling and Yoga are considered to be effective in treating drug abusers (p.48). The following treatment programmes have been reported: detoxification, drug free counseling, seeking out drug dependent abusers in their environment,  outreach programmes, self help groups, support to families of drug dependent persons, emergency aid centres, and acupuncture. In-patient treatment programmes last 10 to 30 days (p.50). Treatment approaches have been changed recently. Integrated treatment and rehabilitation programmes with focus on drug abusers in the North East has been reported. Treatment cost estimates are about $4.66 million, in addition to an investment of 2.5 million since 1988.  There is health insurance to cover drug treatment and rehabilitation (p.51). International financial and technical assistance have been provided and more help is needed. The number of  treatment facilities is considered too limited. Services lack standardization and there is not enough trained personnel (p.52)  (ARQ 1994,II).


            The Ministry of Welfare has been encouraging continuity of services ranging from counseling through treatment in specialized centres, NGOs and hospitals. Drug treatment is provided on a voluntary basis. Treatment modalities vary widely and most treatment appears to be community based (p.77-84). Although a significant portion of detoxification cases start with in-patient treatment lasting up to 30 days. Early intervention is encouraged but need to be developed further (p.84). Drug education is often used as an integral part of treatment (p.87). Self help groups are widespread and the family is considered as an effective player in this category (p.87-88). Behavior therapy is used in 25 to 50 per cent of the cases (p.88-89). A variety of counseling and psychotherapy based modalities appear to be one of the corner stones of  treatment (p.89-91). Pharmacotherapy is used in hospital and community based treatment. Buprenorphine and Clonidine appear to be the leading maintenance agents but the use of sedatives and analgesics is also common (p.91-92). Family therapy is used by about 28 per cent of the psychiatrists and the second most common treatment modality used in Ministry of  Welfare counseling and treatment centres (p.92-93).  Alternative and traditional medical approaches such as “ayurveda,” homeopathy, naturopathy and yoga are used. Limited information form evaluation studies suggest that  treatment centres tend to have poorly trained staff and that yoga based interventions appear to be effective in reducing anxieties associated with drug withdrawal symptoms (p.85-87). Relapse ranges between 30 and 90 per cent. Relapse prevention and continuity of care following treatment are reported but these need to be  improved according to 40 to 66 per cent of patients (p.93-96)(India 1995a).

            According to the Ministry of Health report, a wide range of treatment modalities are used in India. Drug education is commonly used as a component of treatment (p.50-51). Self help groups such as Narcotics Anonymous are widespread in major cities. Some are  affiliated with hospitals and Employee Assistance Programmes (p.51-52). A short term intervention package, partly based on behavioral principals, is used by Ministry of Health treatment centres (p.52-53). Counseling and psychotherapy are considered as emerging treatment models in both government and NGO’s sectors (p.54). Sports and religious activities, among other relapse prevention approaches, are used in  Ministry of Health treatment centres with an aim to prolong the periods of abstinence following treatment (p.55). Pharmacotherapy is reported. Disulfiram is used to treat alcohol dependence. Methadone is rarely used due to high cost in India. Antagonist drugs such as “Naltrexone” are prescribed to patients who can afford them. Buprenorphine and tincture opium are used to treat dependence on opiates (p.55-56). The use of family therapy is reported in selected centres. Evidence suggests that it reduces relapse but supporting research is rare  (p.56-57) (India 1995b).



            Drug abusers make 10 to 18 per cent of the offenders within the criminal justice system. Most are males.  General medical care is provided to all drug abusers in prisons. Some prisons also provide detoxification services, drug counseling, vocational training, general education, social integration and after care (p.59). International assistance has not been provided in this area. Services provided are limited due to limited resources (p.60) (ARQ 1994,II) (India 1995b:32).

            Persons who have undergone programmes for treatment and rehabilitation are offered the following social reintegration services: special assistance in finding employment, training, counseling, counseling to families of former drug abusers, halfway houses and mutual help groups support. Most services are provided by NGOs (61). International assistance has not been provided in this area. Services provided are limited due to limited resources (62)(ARQ 1994,II).

            Findings from a recent study in Rajasthan provide useful information treatment information for programme planning. Readiness for de-addiction is reported by 85 per cent of the drug users (p.141). Among those who tried to quit drug abuse (N=30), 76.6 reported reduced quantity consumed and 13.3 per cent became drug free (p.142). Drug abusers report that availability of treatment is the main motivator for attempting it (50.9 per cent), followed by social workers (33.5), family, friends among others make the remaining 15.6 per cent (p.146). Most drug abusers are aware of the existence of de-addiction centres (87.5 per cent) (p.148). Few made an effort to contact de-addiction centers (18.5 per cent) (p.149). But those who did, assessed the contact positively (89.1 per cent) but few entered their name on a drug registry and few opted for treatment (p.150). Most (96 per cent) also reported that dead diction centers are the ways to become drug free (p.163). But only 45.5 per cent reported that they are aware of the efforts of the government to create a drug free environment (p.164). Many drug abusers (47 per cent) suggested that government effectiveness would be increased by having more “mobile dead diction camps” (p.165) (Nahar and Bahti 1995).

            Among drug abusers who attempted to quit opium abuse (N=37), about 27 per cent reported feeling better and 2 per cent did not experience any difference but other reported weakness (35.1), feeling seek (18.9), anxiety (18.9) and insomnia (13.5) (p.152). Some detoxicated former abusers report improved economic situation (33.3 per cent) while the remaining two thirds reported adverse effects as they could not work as hard without drugs (p.153). Drug abusers report more affectionate behavior among family members after detoxification (59.4) than among friends (18.9) (p.155) (Nahar and Bahti 1995).

            Detoxicated former drug users who relapsed (n=37) report health as the leading reason for resuming use (35.1 per cent), followed by social pressure (24.5), “abstention did not make a difference” (21.6), adverse effect on economic condition or work (16.3) (p.157). Drug users who relapsed report as much use (40.6 per cent), less use (32.4) and increased use (27) (p.158). Most of those who relapsed report readiness to try quitting drug use again (67.6 per cent) and have taken steps to get treatment (p.157-160). Most hold a negative attitude towards drug use (78.5 per cent) (p.161) (Nahar and Bahti 1995).       

            Among those who did not attempt to quit drug abuse (N=170), most did not have any specific reason for not trying to quit (64.7 per cent) while others mentioned fear of death (17.6 per cent), social pressure (5.3), addiction (5), disease (2.9), old age (1.8), physical weakness (1.8), bad company (1.2) and waiting for treatment (0.6) (p.144)(Nahar and Bahti 1995).



                                                                  Demand Reduction Tables

Table 1*    Drug abuse by type of drug among people treated in government treatment centres in India

                                    1993/94           70's
Opium                          14.34                                      
Heroin@                      19.82                         
Morphine                     1.48                
Analgesics                    1.97                

Cannabis                      12.54

Cocaine                        0.4
Amphetamines              0.15                                                                                        
Hallucinogens               0.32
Benzodiazepines           1.35
Other sedatives             6.0

Alcohol                        41.67

Total (N)                                93,234     80,809

Sources: *1993/1994 data are taken from ARQ 1994, part II, p.9 and India 1995a:14-15 and the 1970's data are taken from India 1995b. An attempt to map data from other years was aborted due to significant inconsistencies.
@ heroin data includes smack and brown sugar.



Table 2*     Drug abuse by type by selected abusers characteristics in India

                                    90's                 80's                 70's                 60's or before                        
Opium                                                                                      Traditional                   
            students                                    1%                   traces
industrial workers         0.02    

            students                                    traces
industrial workers         5.67d

Morphine                                             traces

Analgesics                    widespread                                                                  
            Students                                                           7.9%f                          

Cannabis                                                                                              Traditional
            students                                                            3- 40.8%

            Students           experimental                             2.4%

            students            experimental     0.1- 0.7%        0.5-5.2%

            Students                                                           1.6 - 3.8%

            Students                                   1.0-3.0%         3.2-5.8%                                                                                                                                                         8-9%
All drugs
            Gender 96.5%
            age                   common among 16-35, pronounced among those 18 to 25 years old
            students            6.9-15.9% lifetime prevalence versus 2.4-9.5% current abuse in late 80's
            other                the association between other characteristics and drug abuse is subject to high variability.
            All                    5.1-10.4% lifetime prevalence versus 1.5 - 3.7% current abuse in late 80's

Sources:* India 1995a and 1995b reporting multiple sources. Data appears to be subject to high variability.
@ heroin data includes smack and brown sugar. f= female; m= males



Table 3    Selected measures of trends in drug abuse* in India

                                                All Drugs          Opium  Heroin  Cannabis

India prior to 1945                                           Free sale                                  traditional
India after 1945                                                Sale license
Rural Rajasthan/Punjab 70's                              6.3-18.9%
Agra city 1969                                     1.4%
8 villages Uttar Pradesh 1979                           0.7%
Delhi slums 1987                                                                      0.5%d
Bombay 1987                                                                          0.13%ms
Hyderabad 1987                                                                      1.5%ms
Delhi 1987                                                                               0.08%
Rajasthan City early 90's                                   1.3 %
Delhi early 1990's                                             0.1%                           
urban metro areas1995                                                 0.3-0.5%

India 1893-1894                                                                                              0.5-1.0%
Punjab village   end 70's                                                                                   2.2 %
Punjab State end 70's.                                                                          1.2%
Uttar Pradesh 70's                                                                                            16.1-17.5%
Rajasthan early 80's                                                                                          4 %
Karnataka early 90's                                                                                         2.4%

Karnataka 1987                       1.5 - 3.7%
Culcutta 1989                           1.6%
West Bengal 1990                    0.35%d

Source: India 1995a; 1995b
*likely to be frequent or daily drug abuse but not certain
d= percentage of drug dependent abusers
ms: male students







Table 4    Selected measures of drug injection and intake modes* in India

Manipur, Mizoram,Nagaland States                  1-2%p
Manipur 1990 @                                              50%d              
Bombay 1989                                      3.3%d 
Delhi, Pune, Goa, Madras 1988-90                  insignificant

Source: India 1995a:42-44. p=prevalence in general population. d=prevalence among dependent drug abusers. @Sehgal 1990.


Table 5 Selected drug abuse and drug dependence population estimates in India

                                                            Population                    urban                rural                
Population in million                  P          884.4                           229.9               654.5  

                                                            All drugs                     heroin  opium
Lifetime prevalence                   %        5.1 - 10.4                                            
                                                p          45.1- 91.98                                         

Current abuse                           %         1.5 - 3.7                                               0.7-1.4
                                                p          13.27-32.72                                         4.58-9.16

Drug dependence                     %         0.35-0.5                       0.3-05             
                                                p          3.09-4.42                     0.69-1.15        

                        range                                                                                        0.2-11.8g/day
                        mode                                                                                        3 g/day            

Abusers expenditure
range/person/week*                             $8.16-22.16
range/person/year*                               $135.83-1108
range/dependents/year (million)@         $419.71-4,897.36

Government expenditure
1994/95 Demand reduction                  $4.6
Source: drug prevalence estimates are taken from India 1995a or 1995b drawing from multiple sources. The population estimates are preliminary projections of IDAAS/UNDCP for illustration only. It is proposed that more reliable estimates could be used to produce more accurate population projections; thus, facilitating more reliable estimation of drug demand quantities and expenditures.             
*assuming a seven day week and 50 weeks per year based on daily expenditures provided in India 1995a:45-46. The exchange rate used is 30 Rupees to one US$. @The total expenditures for drug dependent abusers per year calculated in million dollars.


Table 6 Selected measures of drug abuse related morbidity in India*

                                                Medical/psychiatric                                       medical           Psychiatric

Delhi/welfare centres 1994        over 40% of dependent abusers           
Northern India 1991                 90% of heroin dependent abusers
Rajasthan 1994                        12.4% of opium dependent abusers
Jodhpur/gov.centres 1979         38.76% of opium dependent abusers
Kerala State 1991                                                                                                                    10-20%
Nimhans, Bangalore 1994                                                                                 68.7%              75%     

Source: estimates are taken from India 1995a:47 and 1995b:21 drawing from multiple sources.      * dependent abusers


Table 7 Selected measures of HIV/AIDS in India

                                                Population Type                     HIV                            

Bombay 1986-88c                   STD clinic patients                    0.75%
Bombay 1988-90c                   STD clinic patients                    6.85%
Bombay 1990-92c                   STD clinic patients                    10.6%
Bombay 1992c                         Sex workers                             36%
Bombay 1989-92c                   blood donors                            0.36-5.13%m
Madras 1991c                          blood donors                            0.34%
Madras 1991c                          blood recipients                        0
Ahmedabad©                           commercial blood donors          5-35%                        
Manipur 1990 @                      blood donors                            2.5%
Manipur 1990 @                      other high risk groups    0.49%
Nagaland @                             others                                       1.7%

Manipur 1990 @                      injecting drug abusers                31.55-54.5%              
Nagaland @                             drug addicts (most IDU)           50.0%
Maharashtra 1991                    injecting drug abusers                0.81%
De-addiction centres 1995b      drug abusers in treatment          2%

Source: estimates are taken from India 1995a:49 and 1995b:22 drawing from multiple sources.
C= estimates are taken from Combat International 1992 drawing from multiple sources. @ Sehgal 1990 and Pal et.al., 1990






Table 8 HIV among injecting drug abusers in Manipur, India, 1986-1992

                                                N                                             HIV                            
1986                                        128                                          0-2.0
1989                                        245                                          5.6-11.5
1992                                        250                                          62.3-72.1

Source: Sarkar et.al., 1993:97


Sources of Information

Supply Reduction

Not reported
                                                                        Demand Reduction


ARQ 1994,1993, 1992. Reply to the UNDCP Annual Report Questionnaires for the years cited.

Combat International 1992 Miscellaneous abstract of conference papers on Aids from Combat International, Volume 1, Issue 3. September 1992

HDR 1995 The Human Development Report 1995, UNDP, New York, Oxford University Press.

Nahar U.R. and Bhati B.S. 1995? Creation of Drug Free Villages - A Bench Mark Survey of the Drug Users and Non Drug Users  UNDCP and the Ministry of Welfare, Government of India

Pal S.C. et.al., 1990 “Explosive Epidemic of HIV Infection in North Eastern States of India, Manipur and Nagaland”

Renard R.D. 1992 “Socio- Economic and Political Impact of Production, Trade and Use of Narcotic Drugs in Burma” prepared for the United Nations Research Institute for the Social Development and United Nations University, June 1992 draft.

Sarkar S. et.al., “Rapid Spread of HIV among Injecting Drug Users in North Eastern States of India” in Bulletin on Narcotics, volume XLV, no.1, 1993

Sehgal P.N. 1990 “HIV Infection among Intravenous Drug Users in Manipur State, India” A workshop report.

India 1995a  “Drug Abuse, Consequences and Responses: India Drug Country Report 1995, Welfare Sector” Ministry of Welfare, February 1995, New Delhi


India 1995b  “Drug Abuse, Consequences and Responses: India Drug Country Report 1995" Ministry of Health and Family Welfare, 1995, New Delhi


** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section is primarily based on Annual Reports Questionnaires Part I for 1993.