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Context

• On the occasion of “International Day against Drug Abuse and Illicit Trafficking” the Union Home Minister congratulated all the organizations and people fighting against drugs.

International Day against Drug Abuse and Illicit Trafficking

About

• International Day against Drug Abuse and Illicit Trafficking, or World Drug Day, is marked on June 26 every year to strengthen action and cooperation in achieving a world free of drug abuse.

Genesis

• The International Day against Drug Abuse and Illicit Trafficking is observed to honour Lin Zexu, who played a key role in the demolition of opium trade in Guangdong region of China.

Purpose

• Drug abuse and illicit trafficking continue to pose a significant threat to individuals, families, and communities across the world. To combat this threat, the International Day against Drug Abuse and Illicit Trafficking is observed.

History

• At the International Conference on Drug Abuse and Illicit Trafficking held in Vienna on June 26, 1987, it was recommended that a day should be observed to commemorate the struggle against drug abuse.
• The United Nations General Assembly on December 7, 1987, decided to observe June 26 as International Day against Drug Abuse and Illicit Trafficking.

Aim and Objective

• It aims to raise awareness about the importance of treating people who use drugs with respect and empathy; providing evidence-based, voluntary services for all; offering alternatives to punishment; prioritizing prevention; and leading with compassion.
• The campaign also aims to combat stigma and discrimination against people who use drugs by promoting language and attitudes that are respectful and non-judgmental.

Theme

• The theme for this year is "People First: stop stigma and Discrimination, strengthen Prevention."

Significance

• The day is recognised to highlight the health challenges related to drug abuse and encourage combating measures like prevention, education, treatment, and rehabilitation.
• The day promotes global collaboration and communication between countries, groups, and people to create a world free from drug addiction and illicit drug trafficking.

Examples Of Common Psychoactive Drugs Alcohol Alcohol is a depressant, with ethanol being its primary ingredient. It causes tiredness, impairment in judgment, nausea, and vomiting when taken in large doses. Cannabis Cannabis, popularly called marijuana or weed, is a plant that causes psychoactive changes in the brain when consumed. THC and numerous cannabinoids in the plant result in memory loss and feelings of euphoria. Sensitivity to marijuana changes drastically from person to person, where paranoia, anxiety, depression, and a fast heart rate can occur when one consumes too much. Cocaine Cocaine, derived from the coca plant, is a stimulant that raises dopamine levels in the brain and causes general euphoria. Either short-term or through frequent use, cocaine can cause a host of cardiovascular problems such as cardiac arrest and stroke. Heroin Heroin is a depressant produced by the opium poppy plant. It's usually taken by smoking or injecting into the veins. The drug is physically addictive and can cause changes in the brain that lead to dependence. Heroin users often suffer from heart problems, memory loss, high levels of drowsiness, possible gangrenous effects on the injection site, and a higher risk of STD infection when sharing needles. Hallucinogens Common hallucinogens are LSD, peyote, and mushrooms. There are also dissociative hallucinogens like Ketamine and PCP. Inhalants Inhalants can be either drugs meant to be inhaled or objects that aren't, like aerosols. Solvents are also considered inhalants, the most abused being paint thinners and glues. Nitrous oxide is common for dentistry work but has been illegally sold and abused for its euphoric effects. Prescription Opioids The most common prescription opioids are oxycodone, hydrocodone, codeine, methadone, and fentanyl. Each of these is commonly abused, though the rate of fentanyl overdoses and abuse disorder from the drug has seen a sharp rise in the last decade. Prescription Stimulants Common prescription stimulants are Adderall, Ritalin, and Concerta. They're commonly prescribed for people with behavioral or compulsive disorders, though abuse and dependency on them are common. Methamphetamine Methamphetamine, often shortened to meth, increases the levels of dopamine in the brain and causes euphoria. It causes lasting damage to the mental state of abusers and harms one's cardiovascular health. Psychosis and other neurological problems are common among long-term meth addicts. Tobacco Or Nicotine Tobacco is commonly smoked as cigarettes, in pipes, or chewed. The active drug in tobacco is nicotine, a stimulant that's very addictive and raises the alert level of users. Through either chewing or smoking, tobacco use can lead to respiratory problems and cancers in the mouth. Nicotine is sometimes prescribed to patients who wish to quit smoking as patches.

Drug abuse in India

• Drug addiction is spreading fast among Indian youth. According to a survey by the Ministry of Social Justice and Empowerment, India has more than 70 million drug addicts.
• It is a serious health problem which not only destroys the person involved but his entire family, the society and the nation.
  • It promotes anti-social behaviour such as stealing, crime and violence.
• It affects the economic growth of a country by generating unaccounted money that is also used for terror funding and anti-national activities.
  • Therefore it is also a serious threat to national security.
• India is located between the two largest Opium producing regions of the world;
  • Golden triangle on the eastern side: Thailand, Myanmar, Vietnam and Laos.
  • Golden crescent on the North-Western side: Pakistan, Afghanistan and Iran.

Drugs, substance abuse

Fatal Addiction

• According to the Global Burden of Disease Study, illicit drugs are estimated to have killed nearly 7.5 lakh people worldwide in 2017 alone.
• The estimated number of lives lost in India was 22,000. According to some estimates, the global drug trafficking trade is worth a staggering $650 billion.

High on Heroin

• According to GOI report, India had 2.3 crore opioid users, in 2018, a five-fold jump in 14 years.
• The maximum growth was reported in the consumption of heroin.
• In 2004, the number of opium users (20,000) was more than twice that of heroin (9,000).
• Trends reversed some 12 years later: heroin consumers went up to 2.5 lakh, almost double that of opium consumers, noted the report titled the Magnitude of Substance Use in India. The findings were prepared by AIIMS' National Drug Dependence Treatment Centre.

Drugs, Types, Users

• From traditional plant-based drugs such as cannabis, cocaine, and heroin to synthetic drugs such as tramadol, consumption of narcotic substances in India has increased manifold in recent years.
• In terms of users, India's illicit drug markets are mostly dominated by cannabis and opioids.
• Cannabis in the form of bhang is legal in India. Its other forms -- ganja (marijuana) and charas (hashish) -- are illegal.
• Opioids are sold as opium (doda, phukki or poppy husk), heroin (brown sugar, smack) and pharma opioids.
• Nearly 3.1 crore people in India are estimated to be cannabis users, according to the AIIMS report.
• Of them, 1.3 crores (1.2 per cent) use ganja and charas, while the rest consume bhang.

Consumption Across States

• Uttar Pradesh has the highest number of cannabis users, followed by Punjab, Sikkim, Chhattisgarh and Delhi, according to the AIIMS report.
• The use of illegal cannabis in India is lower than the global average. However, opioid use is three times higher here.
• Of the total opioid users, nearly 77 lakh or over one-third are in the harmful or drug-dependent category due to excess use.
• Roughly one-third of such cases are from Uttar Pradesh, Punjab, Haryana, Maharashtra and Delhi.
• However, in terms of population percentage, the north-eastern states top the list.
• Nearly seven per cent of the population in Mizoram, for instance, consume opioids, followed by Nagaland (6.5 per cent), Arunachal Pradesh (5.7 per cent) and Sikkim (5.1 per cent), according to the AIIMS report.

Inhalers

• According to the AIIMS report, India has nearly 12.6 lakh users in this category, of which one-third are in the harmful or dependent category. Maharashtra has the maximum (6 lakh) users, followed by Telangana (2 lakh), Kerala (1 lakh) and Delhi (63,000).

IN A NUTSHELL,

Major findings of Survey by AIIMS at National and State level:

Alcohol

• At the national level, about 14.6% of people (among 10-75 year old) are current users of alcohol, i.e. about 16 Crore people. Prevalence is 17 times higher among men than women.
• Among people consuming alcohol in India, Country liquor (‘desi’) (about 30%) and spirits (IMFL – Indian Made Foreign Liquor) (about 30%) are the predominantly consumed beverages.
• About 5.2% of Indians (more than 5.7 crore people) are estimated to be affected by harmful or dependent alcohol use. In other words, every third alcohol user in India needs help for alcohol related problems.
• States with the high prevalence of alcohol use are Chhattisgarh, Tripura, Punjab, Arunachal Pradesh
• and Goa.
• States with high prevalence (more than 10%) of alcohol use disorders are: Tripura, Andhra Pradesh,
• Punjab, Chhattisgarh, and Arunachal Pradesh.

Cannabis

• About 2.8% of Indians (3.1 Crore individuals) report having used any cannabis product within past 12 months (Bhang – 2% or 2.2 crore people; Ganja/Charas – 1.2% or 1.3 Crore people).
• About 0.66% of Indian (or approximately 72 lakh individuals) need help for their cannabis use problems.
• Though bhang use is more common than ganja/charas, prevalence of harmful/dependent use is proportionately higher for ganja/charas users.
• States with the higher than national prevalence of cannabis use are Uttar Pradesh, Punjab, Sikkim, Chhattisgarh and Delhi.
• In some states the prevalence of cannabis use disorders is considerably higher (more than thrice) than the national average (e.g. Sikkim, Punjab).

Opioids

• At the national level, the most common opioid used is Heroin, (current use 1.14%) followed by Pharmaceutical opioids (current use 0.96%) and then Opium (current use 0.52%).
• Prevalence of current use of opioids, overall is 2.06% and about 0.55% of Indians are estimated to need help for their opioid use problems (harmful use and dependence). More people are dependent upon Heroin than Opium and Pharmaceutical Opioids.
• Of the total estimated approximately 60 lakh people with opioid use disorders (harmful or dependent pattern) in the country, more than half are contributed by just a few states: Uttar Pradesh, Punjab, Haryana, Delhi, Maharashtra, Rajasthan, Andhra Pradesh and Gujarat.
• In terms of percentage of population affected, the top states in the country are those in the North East (Mizoram, Nagaland, Arunachal Pradesh, Sikkim, Manipur) along with Punjab, Haryana and Delhi.

Sedatives and Inhalants

• About 1.08% of 10-75 year old Indians (approximately 1.18 crore people) are current users of sedatives (non-medical, non-prescription use).
• States with the highest prevalence of current Sedative use are Sikkim, Nagaland, Manipur and Mizoram. However, Uttar Pradesh, Maharashtra, Punjab, Andhra Pradesh and Gujarat are the top five states which house the largest populations of people using sedatives.
• Inhalants are the only category of substances for which the prevalence of current use among children and adolescents is higher (1.17%) than adults (0.58%).
• At the national level, an estimated 4.6 lakh children and 18 lakh adults need help for their inhalant use (harmful use / dependence).
• In terms of absolute numbers, states with high population of children needing help for inhalant use are: Uttar Pradesh, Madhya Pradesh, Maharashtra, Delhi and Haryana.
• Cocaine (0.10%) Amphetamine Type Stimulants (0.18%) and Hallucinogens (0.12%) are the categories with lowest prevalence of current use in India.
• Nationally, it is estimated that there are about 8.5 Lakh People Who Inject Drugs (PWID). High numbers of PWID are estimated in Uttar Pradesh, Punjab, Delhi, Andhra Pradesh, Telangana, Haryana, Karnataka, Maharashtra, Manipur and Nagaland. Opioid group of drugs are predominantly injected by PWID (heroin – 46% and pharmaceutical opioids – 46%). A substantial proportion of PWID report risky injecting practices.

Access to treatment Services:

• In general, access to treatment services for people affected by substance use disorders is grossly inadequate. Just about one in 38 people with alcohol dependence report getting any treatment. Only about one in 180 people with alcohol dependence report getting inpatient treatment / hospitalization for help with alcohol problems.
• Among people suffering from dependence on illicit drugs, one among 20 people has ever received inpatient treatment/ hospitalization for help with drug problems.

Impact of Drug Abuse on the User

Isolation

• The use of drugs can create a false sense of security and comfort that can lead to a loss of interest in social activities and relationships. The user may become consumed by their addiction, neglecting their social and familial responsibilities and alienating themselves from those who care about them.

Stagnation

• Stagnation from drug abuse often leads to a false sense of satisfaction and comfort, leading the user to rely on drugs to escape from the challenges of reality. This can result in a cycle of dependence, where the individual becomes increasingly reliant on drugs to function, which can stunt their personal growth and development.

Damaged Relationships

• Drug abuse can have a major impact on one's relationships, causing hurt and strain on personal and professional connections. Drug abuse can alter one's behavior, causing a lack of reliability, trustworthiness, and communication. Very quickly, these can erode the foundation of relationships.

Financial Distress

• Drug use can foster legal and criminal issues, leading to financial ruin, fines, and even imprisonment, which can cause further financial strain. Additionally, addiction can lead to a lack of financial planning and responsibility, causing the user to spend money on drugs instead of necessities such as food, housing, and utilities.

Mental Health Problems

• Abusing drugs have been known to produce mental health issues, such as anxiety, depression, and psychosis. Substance abuse can alter brain chemistry, affecting mood and cognitive function, and leading to mental health problems that can be difficult to overcome.

Depression And Anxiety

• The use of many drugs, whether they be stimulants, depressants, hallucinogens, or cannabis, can cause acute symptoms of anxiety and paranoia, which can become chronic with continued use. The fear of withdrawal symptoms can also contribute to anxiety and depression, resulting in a cycle of dependence and worsening mental health.

Provoking Existing Mental Health Conditions

• Excessive use of drugs can disrupt the balance of chemicals in the brain and worsen the symptoms of pre-existing mental health disorders and conditions. For example, someone that suffered from mild anxiety might have frequent panic attacks after having used drugs for a while.

A Criminal Record

• Consuming drugs can impact one's criminal record, causing legal and criminal issues that can have long-term consequences. Substance abuse can lead to a range of criminal activities, including drug possession, drug trafficking, and theft, which can result in arrests, fines, and even imprisonment.

Lost Dreams

• Drugs can lower one's ambition, taking away their motivation and instead transferring their interest to nothing but getting high. Much of this is rooted in the addictive nature of drugs and how they release chemicals in the brain that appeal to one's mood and state of temporary well-being.
• The cravings can become so great, that using the drugs may supersede one's talents, career plans, and educational plans.

Death

• Death is an unfortunate end for many that abuse drugs. During use, it can happen from an overdose, respiratory failure, cardiac arrest, living damage, and kidney failure.

The Effects of Drug Abuse on Health

• Drug use can also impact mental health, causing depression, anxiety, and psychosis, which can further contribute to poor physical health outcomes. Additionally, substance abuse can lead to a weakened immune system, making individuals more susceptible to infections and illnesses.

Effects of Drug Abuse on The Brain

• Drugs affect the brain by gradually depleting chemicals such as dopamine, epinephrine, and serotonin. Over time, listing damage can cause memory loss, serotonin syndrome, and psychosis.

Effects of Drug Abuse on Behavior

• The behavioural effects of drug abuse are far-reaching. People that use drugs often have a harder time making responsible and rational choices. It may cause users to engage in riskier sexual activity and use drugs in ways that heighten the chances of getting sexually transmitted infections, such as sharing dirty needles.
• People with drug addictions often resort to stealing merchandise from their families to continue their habit after depleting their funds, like pawning personal electronics, and video games.

Effects of Drug Abuse on Unborn Babies

• Women that abuse drugs while pregnant considerably heighten their chances of having a stillbirth. Drug consumption during pregnancy is the same as directly forcing a small child to use drugs. Though in the womb, it can create birth defects, cause a wide host of mental, developmental, and brain disorders, and reduce life expectancy.

The Impact of Drugs on Society

Ill Health

• Areas, where drug abuse is heavy, tend to have higher rates of illness, including those which are sexually transmitted but also other issues like hepatitis, staph infections, and unsanitary living conditions.

Families

• Families, where drug abuse is found, are often broken, have frequent arrests, and pass their influences down to children. Additionally, genetics can play a part in one's susceptibility to drugs, where a child would likely grow up with an addictive personality and be more susceptible to becoming drug addicted themselves unless they're avoided.

Workplace Issues

• People that abuse drugs often have a hard time holding down employment. They may not perform their duties well, causing write-ups and eventual termination.

Crime

• Crime and drug abuse are closely related. People that use drugs have a high chance of stealing, committing robbery, or burglarizing homes to find valuable items to aid in sustaining their habit.

Environmental Damage

• The chain of manufacturing drugs has caused much damage to the environment, from destroying vital farmland to increasing ground pollution.
• Drug needles are a common problem for people living in urban areas where drug abuse is heavy, to the point where biohazard containers have been distributed in some cities to keep addicts from throwing them on the ground.

The Economic Impact of Addiction

• The economic impact of addiction is significant. The cost of addiction treatment, healthcare, and criminal justice system is staggering. This includes healthcare costs, lost productivity, and expenses related to crime.
• Furthermore, addiction also impacts the economy by reducing tax revenue. People who suffer from addiction are less likely to be employed, pay taxes, and contribute to the economy. This, in turn, affects the government's ability to provide social services, infrastructure, and other public goods.
• Drug addiction has a ripple effect on the economy that extends far beyond just the cost of treatment and healthcare. The impact of addiction can be felt in many sectors, including education, social services, and criminal justice.
• One significant economic impact of addiction is the burden it places on the criminal justice system. As mentioned earlier, individuals who suffer from addiction are more likely to engage in criminal activities.
• This leads to increased costs associated with law enforcement, court proceedings. Moreover, many inmates have substance abuse disorders, which means that prisons must provide specialized treatment programs for them.
• Another way addiction affects the economy is through lost productivity. People who suffer from drug addiction are often unable to work or maintain steady employment due to their condition. This not only affects their own income but also reduces tax revenue for the government.
• Furthermore, addiction can lead to poverty and homelessness. When individuals lose their jobs or face legal consequences due to drug use, they may struggle to make ends meet or find affordable housing. This puts a strain on social services such as welfare and homeless shelters.

Steps taken by the Government

• The Indian government is Coordinating with Various International Organizations including BRICS, SAARC, ASIAN, etc, to share information and intelligence to combat transnational drug trafficking.
• The Union Ministry of Home Affairs has launched the SIMS (Seizure Information Management System) Portal for the digitization of pan-India drug seizure data.
• The National Fund for Control of Drug Abuse was constituted to meet the expenditure incurred in connection with combating illicit traffic in Narcotic Drugs; rehabilitating addicts, educating the public against drug abuse, etc.
• Project Sunrise was launched by the Ministry of Health and Family Welfare to tackle the rising HIV prevalence in northeastern states in India, especially among people injecting drugs.
• ‘Nasha Mukt Bharat’ or Drug-Free India Campaign with a focus on community outreach programs.
• A Narco Coordination Centre (NCORD) has been in operation since 2016 to have effective coordination among various Ministries, Departments, Central and States law enforcement agencies.
• India is a signatory of the following International treaties and conventions;
• United Nations (UN) Convention on Narcotic Drugs (1961).
• UN Convention on Psychotropic Substances (1971).
• UN Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988).UN Convention against Transnational Organized Crime (UNTOC) 2000. 

Challenges

• India’s 15,106.7 km land border and 7516.6 km coastline makes it vulnerable to narcotics smuggling.
• The North-East States that share borders with Bangladesh, Nepal, Myanmar, China, and Bhutan are the hot-spots for drug smuggling.
• The location of India with the ‘Golden Crescent’ on one side and the ‘Golden Triangle’ on the other makes it all the more vulnerable to drug smuggling.
• Additional challenges are “porous” borders, insufficient enforcement apparatus, and a perceived lack of coordination among different agencies.

Tackling the Drug Menace: Way Forward

Behavioural Economics Campaign

• Given the huge success of campaigns like Swachh Bharat, Beti Padhao, Beti Bachao etc, a campaign that leverages behavioural economics to nudge and inform people of the menace of drugs should be initiated in the form of a Jan Andolan.

Support to Drug and Alcohol Addiction Centers

• Drug and alcohol addiction centers should be supported and non-stigmatised, leveraging the support of CSR initiatives of corporates.

Coordination between Customs and other enforcement agencies

• There should be greater coordination between Customs and other enforcement agencies to break the backbone of drug syndicates.

Suitable bye-laws in Society Rules

• Residential welfare associations of housing societies should be mandated to incorporate suitable bye-laws in society rules to inform residents of the criminality of drugs.

Capacity enhancement in the Border Areas

• A need for capacity enhancement in the border areas is imperative for effectively balancing the role of Customs in intercepting narcotics and facilitating genuine trade.

Capacity building of Canine Squads

• Dedicated further capacity building of canine squads in Customs along with leveraging technology to improve detection can be considered.

Instill a strong sense of fear

• In the fight against illegal drugs, it may be time to instill a strong sense of fear, in both the smugglers/peddlers and the users of drugs.

Reduce Stigma

• The stigma associated with drug taking needs to be reduced.
• Society needs to understand that drug addicts are victims and not criminals.
• Proper Counseling is another alternative.

Education Curriculum

• The stigma associated with drug taking needs to be reduced.
• Society needs to understand that drug addicts are victims and not criminals.
• Proper Counseling is another alternative.

Other

• Enhancing skills of care providers.
• Funding for evidence-based interventions.
• Developing programmes for vulnerable groups like youth, street children, women, prisons, etc 

Multifaceted Approach

• Addressing drug addiction requires a multifaceted approach that includes prevention, treatment, and aftercare support. By investing in these areas, we can reduce the economic burden of addiction and create healthier communities for all.

PRACTICE QUESTION Q. The Constitution of India directs the state to improve public health and endeavour to bring about the prohibition of the consumption of intoxicating drinks and drugs which are injurious to health. What is the socio-economic impact of Drug Abuse? Elucidate. Shed light on the steps taken by the Government of India to tackle the menace of Drug Abuse. What are the underlying challenges in this fight against Drug Abuse? Suggest measures to overcome those challenges.

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