India’s anti-drug war’s frontline warriors are the enforcement agencies notably the State Police, State Excise, Forest Department, Narcotics Control Bureau (NCB), Directorate of Revenue Intelligence (DRI), Customs, and Border Security Force (BSF). The Government of India and the various state governments have invested crores of rupees in these agencies to tackle the drug menace. The multibillion-crore rupee drug-trafficking business has also attracted international drug barons, created local cartels, and left a legion of peddlers serving jail terms. The industry’s proceeds are laundered through banks, supermarkets, forex bureaus, clearing and forwarding companies, hotels and real estate, lottery and gaming companies, hospitals, high-end bars and exclusive clubs.
The ‘whole of government’ approach by the Narendra Modi regime has resulted in a 30-fold rise in the value of seizure of drugs and a 181 per cent jump in narcotics-related cases till 2022. However, figures based on seizure statistics do not give the real volume of trafficking happening, consumption figures, and societal damage.
A great attraction for drug traffickers is the well-developed financial infrastructure in the country. A large number of licensed commercial banks with their extensive branch networks in the region, thousands of microfinance institutions and mortgage finance companies, innumerable forex bureaus, efficient Hawala networks unregistered/unlicensed ‘saving and lending’ organisations, and knowledgeable chartered accountants and lawyers, are indubitably the best in the world. This vast infrastructure can efficiently absorb all kinds of ill-gotten wealth, be it drug trafficking, trafficking or any other criminal enterprise.
Another added attraction is the slow judicial processes and the soft approach of the judiciary. Drug traffickers and peddlers who would normally face the gallows or life imprisonment in most countries, get away in India very lightly on technicalities and procedural lapses of the enforcement agencies. Fancy, high-priced senior lawyers can extricate any criminal from any legal imbroglio, effortlessly. Such flaws are not available for exploitation in most countries.
Another factor is the political patronage that can be purchased using the proceeds of drug trafficking. Drug traffickers use the proceeds to contribute to political campaigns and to buy influence with government officials, law enforcement officers, politicians, and the media. Once drugs, crime and dirty money get entrenched, then any threat to destabilise this underworld could actually be detrimental to the entire economy, political structures, and law and order, as seen recently in Manipur.
India is following the American drug war logic that prioritises and justifies drug prohibition, criminalisation, and punishment which has fuelled the expansion of drug surveillance and control mechanisms in numerous facets of everyday life in the United States, negatively impacting key social determinants of health, including housing, education, income, and employment. In pursuing this approach, Indian bureaucracy and enforcement agencies have effectively and possessively retained the stranglehold on the anti-drugs movement and campaign. As a result, most anti-drug campaigns are narrated, advertised, and reinforced as a legal problem, whereas in reality, it is a health problem that needs to be addressed by physicians, nurses, teachers, and social workers.
Physicians and healthcare providers can play a significant role in promoting individual and community health and engaging in policy reform. Rather than supporting the health and well-being of individuals, families, and communities, the US drug war has exacerbated harm in these systems through practices such as drug testing, mandatory reporting, zero-tolerance policies, and coerced treatment.
An important factor that only medical professionals and allied health workers can easily understand is the Social Determinants of Health (SDOH), which are “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” There is a growing recognition in the fields of public health and medicine that SDOH play a key role in driving health inequities and disparities, such that focus on individual-level medical interventions will have limited effects without the consideration of the macro-level factors that dictate how effectively individuals can manage their health.
For instance, differences in access to nutritious foods, safe neighbourhoods, stable housing, well-paying job opportunities, enriching school environments, insurance, and healthcare can lead to differential health outcomes for individuals, their families, and their communities. And as these mid, and downstream SDOH have gained more attention, we must also focus on more macro SDOH to understand “how upstream factors, such as governance and legislation, create structural challenges and impose downstream barriers that impact the ability and opportunity to lead a healthy lifestyle.”
Most Indian anti-drug campaigns organised, managed, and directed by enforcement agencies are heavily focused on marathons, distributing T-shirts, flash mobs, and talks by officials. Apart from this, enforcement agencies periodically make bonfires of seized drugs in the presence of politicians. These are just cosmetic exercises, which cannot deter any drug trafficker, peddler or even a determined drug consumer. The enjoyment value that drugs give is unparalleled, and drug users crave this intensely. The focus should therefore be on the health ramifications caused by drug consumption, which only medical professionals and allied health workers especially pharmacists, can address effectively. Drug use or substance use has complex biological and social determinants and are medical conditions involving disruption of key brain circuits.
Hence drug use prevention programs and policies should be based on sound evidence-based principles which only can reduce substance misuse and related harms significantly. Evidence-based behavioural and Medication-assisted Treatments (MAT) applied using a chronic-illness-management approach have been shown to facilitate recovery from substance use disorders, prevent relapse, and improve other outcomes, such as reducing criminal behaviour and the spread of infectious diseases. Hence, the Government of India and all state governments should realise that it is time to change how we, as a society, address drug and substance use consumption and consequent disorders.
What India needs is a public health-based approach to address the broad individual, environmental, and societal factors that influence drug consumption and substance misuse and its consequences, to improve the health, safety, and well-being of the entire population. It should aim to understand and address the wide range of interacting factors that impact drug use and substance use disorders in different communities and states and coordinate efforts across diverse stakeholders to achieve significant reductions in drug consumption.
The writer is a retired officer of the IRS and the former director-general of the National Academy of Customs, Indirect Taxes & Narcotics. Views expressed in the above piece are personal and solely that of the author. They do not necessarily reflect News18’s views.
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