Drug Control Law

By

Aakash Sharma

5-Year Integrated B.A., LL.B. (Hons.) Course

Drug Abuse in India, USA & UK

Under the supervision of

Asst. Prof. P. Jogi Naidu

Damodaram Sanjivayya National Law University “Nyayaprastha”,

Sabbavaram, Visakhapatnam-531035 Andhra Pradesh, India

12th February 2021

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 Certificate

This is to certify that the dissertation Drug Abuse in India, USA & UK Seminar Paper Drug
Control Law to Damodaram Sanjivayya National Law University, Visakhapatnam is a record
of original work done by Mr. Aakash Sharma under my supervision and guidance to my
satisfaction.

SIGNATURE OF THE GUIDE

Visakhapatnam

Date: 12-02-2021

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 cknowledgement

I have taken all the possible efforts in this Dissertation. However, it would not have
been possible without the kind support and help of many individuals and
organizations. I would like to extend my sincere thanks to DSNLU, VIZAG for
guiding me through this project.

I am highly indebted to Asst. Prof. P. Jogi Naidu for his guidance and constant
supervision as well as for providing necessary information regarding the project
and also for their support in completion of this project.

I would like to express our gratitude towards our parents for their kind co-operation
and encouragement, which helped us in completion of this project.

My thanks and appreciations also go to our colleagues in developing the project and
people who have willingly helped us out with their abilities.

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 List of Abbreviations
CBT- Cognitive Behavioural Therapy
IDU- Injecting drug users
ILO- International Labour Organisation
MDFT- Multi Dimensional Family Therapy
NDPS- Narcotic Drugs and Psychotropic Substances
NIDA- National Institute on Drug Abuse
OSAP- Office of Substance Abuse Prevention
SUD- Substance use Disorders
UNESCO- United Nations Educational, Scientific and Cultural Organization
W.H.O- World Health Organisation

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 Table of Contents

Introduction................................................................................................................6
Aims & Objectives of the Study................................................................................7
Research Methodology.............................................................................................7
Research Significance...............................................................................................7
Hypothesis...................................................................................................................8
Literature Review......................................................................................................8
Classification of Drugs............................................................................................11
Factors Responsible for Drug Abuse...................................................................13
Psychological Factors.............................................................................................13
Social Factors............................................................................................................14
Economic Factors.....................................................................................................15
Geographical Factors..............................................................................................15
Effects of Drug Abuse..............................................................................................17
Drug Abuse in India.................................................................................................19
Laws Preventing Drug Abuse in India.................................................................25
An Overview of Narcotic Drugs and Psychotropic Substances Act................27
Drug Abuse in U.S.A.................................................................................................33
1. Medico-Legal Dilemmas..................................................................................33
2. Socio-Political Challenges...............................................................................35
Drug Abuse in U.K....................................................................................................40
 The current situation........................................................................................40
 The Public Health Impact of Drug Misuse.....................................................41
 Identification and Assessment of Drug Misuse............................................43
 The cultivation of drugs...................................................................................45
Remedial and Awareness Programmes Controlling Drug Abuse..................47

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 Chapter- I
Introduction
“Drug abuse is a global problem. How to prevent it is also a global issue...
Only by working together can we create a healthier and safer world that is not
plagued by drug-related crime and violence and where the vulnerable feel
they can have hope for the future”1.

Drug Abuse is one of the banes of modern society. It has hit all regions and all
sections of our society. It is found in rural and urban areas, among poor and the rich,
among the men and women, among young or old. But young boys and girls especially
in hostels and in almost all educational and technical institutions most
overwhelmingly practice it. Thus drug abuse is there in almost all the countries of the
world. Day by day alcohol is becoming increasingly available and is used widely.
Addiction has become really a curse upon human beings. It affects not only the drug
addicts but also others directly or indirectly. For common people, it is a weakness of
character. A moral theologian may see it as a matter of vice while as sociologists see
it as a social problem. It is considered sin by religious people and as a crime by law
enforcement groups. The psychiatrist can describe it as a personality disorder
problem. The alcoholics anonymous groups and the treatment center’s call them
patients and alcoholism is handled as a disease.

Drug abuse is also known as substance abuse, and can be defined as a patterned use of
a drug in which the user consumes the substance in amounts or with methods, which
are harmful to them or others. And when an individual persists in use of alcohol or
other drugs despite problems related to use of the substance, substance dependence
may be diagnosed. Thus compulsive and repetitive use may result in tolerance to the
effect of the drug and results in withdrawal symptoms when use is reduced or
stopped. Drugs are chemical substances. Pharmaceutical preparation or a naturally
occurring substance used primarily to bring about a change in the existing process or
state (physiological, psychological or biochemical) can be called a drug. In other
words, any chemical that alters the physical or mental functioning of an individual is a

1
Global action for healthy communities, without drugs. https://www.unodc.org/.../global-action-for-
healthy-community.

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drug. Drugs, by interaction change the biochemical systems of the body. If a drug
alters sensory perceptions, mood, thought process, feelings or behavior it is known as
a psychoactive drug. Pharmacology is that branch of science, which investigates drug
actions.Certain drugs are legally permitted and at the same time others are illegal.
Alcohol and tobacco are legally permitted as certain drugs for medication. However,
medically used drugs can also be abused. It can be used too much, too long, too often,
with wrong combinations etc. As a result, tolerance and dependency is produced
illegal drugs like Heroin, Cocaine, etc. are detrimental to both body and mind. These
drugs are taken for reasons other than medical, in an amount, strength, frequency
manner that damages the physical or mental functioning of an individual and is called
as 'Drug abuse'. Its use leads to addiction, which develops tolerance and dependence
while others cause both physical and psychological dependence.
Over-the-Counter availability of medicines is also a triggering point. Most illicit use
of drugs starts at the age of 16-17 years of age. It starts with merely smoking of
cigarettes and gradually drowns the person into the trap of drug abuse. Stress,
anxiety, peer pressure, poverty are some of the main causes of drug abuse. There are
people, mostly in north India, who are surviving on drugs. These people have taken
refuge on the roads and railway platforms. Many rickshaw pullers use the money they
earn during day to have drugs in the evening or night. They prefer drugs over food,
which is a pathetic truth.
Aims & Objectives of the Study
This research paper will explore drug abuse in India, U.S.A & U.K. with the
objective of studying the current scenarios and mainly focusing on the situation in
India with respect to drug abuse and detailed analysis of the NDPS Act enacted in
India for substance abuse. Analyzing the factors responsible for substance abuse
and after effect of it also.

Research Methodology
The research methodology is not empirical, it’s purely doctrinal. The secondary
sources of data collection such as the books and various journals have been used
with the help of access to the library and the software. The database, which is used
in the particular project, is from library Google books, and articles from the
internet. The study is explanatory in nature.

Research Significance

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 The significance of this research is to impart knowledge about the ill effects of the
substance abuse in long term and enumerating the prevention awareness
programme for substance abuse.

Hypothesis
The researcher assumes that mostly the substance abuse is very popular among the
youth across the globe due to the changing lifestyle nowadays and has lead to a
serious problem because of it.

Literature Review:

1. Substance Abuse in the United States: Findings From Recent Epidemiologic

Studies by Jeffrey D. Schulden, MD, Yonette F. Thomas, PhD, and Wilson M.
Compton, MD, MPE
Recent research on the epidemiology of substance use disorders (SUDs) has provided
important insights into these conditions and their impact on public health. In the
United States, annual surveys of drug use in household and school populations serve
as one of the primary sources of information about the distribution of illicit drug use.
This research has demonstrated continued shifts in trends in illicit drug use in the
United States and called attention to rising rates of prescription drug misuse and
abuse. Findings have also continued to highlight the substantial comorbidity of SUDs
with other psychiatric disorders and with the ongoing HIV epidemic. Building on
these foundations, future challenges for research in substance abuse epidemiology
will include using novel methodologic approaches to further unravel the complex
interrelationships that link individual vulnerabilities for SUDs, including genetic
factors, with social and environmental risk factors.

2. A.A. Blaze-Gosden, 'Drug Abuse' (1984) 57 Police J 216

The type of legislation proposed above would take an immense effort of political and
diplomatic will to obtain. "Draconian, Racist, Fascist, Bullying", may be the least of
the epithets directed against those who dare to demand real action against the
originators of the present worldwide flood of narcotics. The individual law
enforcement agencies are helpless as constabulary Canutes in the face of the deluge.
Yet it is they who are implicitly criticized for failing to stem the flow of drugs to
housing estates and back streets and schools. If blame exists it must be directed

8
against national politicians and their international appointees.
If the social and economic costs outlined above for the U.K. are extrapolated on a
global scale, the costs to the world community are astronomical. It has taken a
tremendous effort on the part of the W.H.O. to eliminate smallpox - it will take a
much greater effort to eliminate the drug traffic.
It may be that the normally discreet police and customs' response to criticism for the
drug situation may have to be more robust in future and place the blame where it
belongs, in the laps of those in positions of authority nationally and overseas.

3. Sandra Anderson Garcia, 'Drug Abuse in America: Medical and Socio-Legal

Dilemmas' (1992) 11 Med & L 323
Since 1914 when the Federal Harrison Narcotics Act put restrictions on the use of
cocaine, and the period of Prohibition between 1919 and 1933, the United States has
tried to curb the use of drugs and alcohol. Many of the efforts have proved to be futile
for several reasons. The social fabric of communities that spawn drug abusers has
either remained untouched over decades or has deteriorated. Knowledge about the
causes, consequences and treatment of drug addiction has not kept pace with the flood
of illegal drugs and their derivatives into the country and the rise in alcoholism within
large segments of the population. Factors such as the steep increase in violent drug-
related crime, the birth of drug exposed babies and the growing number of children
actively involved in the drug culture has posed intractable problems to a society that
seeks concurrently to control the behaviour of drug abusers while protecting their
individual rights.
4. Adolescent drug abuse - Awareness & prevention by Bharath
Chakravarthy, Shyam Shah, and Shahram Lotfipour
The abuse of alcohol and drugs has resulted in significant morbidity and mortality
among adolescents worldwide. Many of these youth will lose their lives to drugs and
alcohol and a significant number are likely to grow up to become problem drug users.
Although, the substance abuse problem is complex and large in magnitude, there is a
substantial amount of evidence-based research available to physicians, community
leaders and schools to implement interventions that can decrease adolescent substance
abuse rates. Because this issue is not peculiar to any one community or culture, we
recognize that individual interventions may not be universally effective. Therefore,
we emphasize the NIDA strategy of targeting modifiable risk factors and enhancing

9
protective factors through family, school and community prevention programmes, as
a generalized framework for healthcare and community activists to use when
researching programmes and strategies best suited for their own community.

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 Chapter- II
Classification of Drugs
Now days different classification systems of drugs exist. Broadly speaking it can be
divided into two major groups –
 Legal drugs
 Illegal drugs
Legal drugs are those drugs, which are manufactured, produced, bought and sold
within the confines of the law. Drugs like aspirin cough syrups; laxatives, antacids,
vitamins and certain contraceptives etc. are legal drugs, which can be obtained
without a prescription from the physician. These non-prescription drugs are used for
hunger control, sedation, stimulation, dandruff, constipation, relief etc. and are
produced and marketed for billions of dollars throughout the world.
Drugs and medications dispensed by pharmacists on prescriptions given by doctors
and dentist are called prescription drugs. They include analgesics, contraceptives,
antibiotics, medicated shampoos, stimulants, sedatives, antidepressants, anesthetics
etc. At the same time many psychoactive prescription drugs like amphetamines,
barbiturates, narcotics etc. are abused to alter the state of consciousness and
sensitivity to pain etc. Huge quantities of alcohol, tobacco, coffee, and tea are used,
abused and misused as social drugs. They are legally available psychoactive drugs.
Thus these are divided into 3 categories:
(a) Non-prescription drugs
(b) Prescription drugs
(c) Social drugs – nicotine, caffeine and alcohol
Illegal drugs are those, which are not used legally but are abused. Largely it can be
further divided into two according to its potentiality to produce high and low
dependence:
 The amphetamines, cocaine, the depressants and the narcotics etc. produce
high dependency.
 Marijuana and other hallucinogens produces low dependency.
Illegal drugs are varying in nature according to their ability to produce clinical
dependency. Heroin, cocaine, amphetamines, barbiturate etc. are strongly dependence
producing drugs. At the same time Marijuana, LSD, Psilocybin etc. are weekly
dependence producing drugs.

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Addictive Drugs: Addictive Drugs are divided according to its nature, origin,
mechanism of action and effects. They are studied under various categories, viz.
1. Narcotic Analgesics
In Greek, the prefix ‘narco’ means to deaden or to be numb. Analgesic means 'pain
killing' or 'pain relieving'. These drugs slow down a person and create feelings of
euphoria. Dentists and doctors mostly prescribe these as painkillers. Codeine.
Morphine, Percodan etc. are important among them. Some illegal drugs like Heroin
and Brown sugar are narcotics. Medically the term 'narcotic' signifies opium and
opium derivatives or synthetic products that have opium-like effects. They arc rather
painkillers with high addictive nature.
2. Stimulants
Chemicals and drugs, which temporarily stimulate mind and body and excite or speed
up the central nervous system, are called stimulants. Substances that people take to
attain extraordinary powers of' mind and body are called "pep" pills. These are called
"uppers" because they lift the person up from despair and despondency and give them
mental balance, exhilaration and a super sensual feeling of happiness. Stimulants are
available in the form of pills and are prescribed by doctors. But young men misuse
them for getting a kind of intoxication and ecstasy feeling. Commonly used stimulants
are Nicotine and Caffeine. The active and powerful stimulants are Cocaine and
Amphetamines. The younger generation is badly attracted to these drugs. 'They reach
the brain through blood and upset the nervous system.
3. Depressants
Depressants at times called "downers", depress or slow down the functions of mind
and especially the central nervous system, the heartbeat and respiration. People resort
to chemicals to have relaxation, calmness and proper sleep.
4. Cannabis
Cannabis is the term, which refers to marijuana and other drugs, produced from Indian limp-
plant, cannabis sativa. It has been cultivated for centuries in different parts of the world for its
tough fibre of the stem, for the oil in its seed, and for its psychoactive properties. More than
60 cannabinoids can he prepared from cannabis plant, the important drug under this category
are Charas (Hashish), Ganja (Marijuana), Bhaang etc.

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 Chapter- III

Factors Responsible for Drug Abuse

A common acronym in addiction circles is H-A-L-T, meaning Hungry, Angry,
Lonely, and Tired. These are emotions leading to vulnerability and subsequent
substance abuse2.
Alcohol and drug abuse has emerged as a serious concern. The geographical location
of the state further makes it highly vulnerable to the problem of drug abuse. In earlier
days the huge amount of alcohol consumption was the social evil for which the state
could not implement any effective measures, but now a days the gravity of the
situation has aggravated by the increasing use of narcotic drugs and other
psychotropic substances. There are several factors, which provide impetus to the
current situation in the state.

Psychological Factors
Psychological factors are the important factors that influence most of the children and
adolescent persons to use illicit drugs. The psychological aspects such as stress,
anxiety, depression can lead to persons to use narcotic drugs and other psychotropic
substances.
Most of the students are feeling stress from their home and education centers. Drastic
growth in the education field has caused the parents to lay more stress on the students
to study; it has caused anxiety and depression on the children. Anxiety signals a threat
but it can overwhelm the ego. When anxiety is overwhelming, a person relies on
defense mechanisms such as denial, avoidance, rationalization, regression, projection,
etc. In order to get out of this anxiety and depression students are resorting to the
prescription drugs, which has high side effects to brain and body. Parental neglect of
children is another psychological factor, in this present world most of the parents do
not get adequate time to look after their children and most of the time they are
hesitating to interfere in the personal matters of their children, this makes them a
feeling that they are neglected, the growing number of divorce in the state supports
this argument. Among college students, it is found that, love failure is another cause
for drug abuse; the depressed students took to the use of substances and drugs. Some
people use drugs for ecstasy and to get sexual vigorousness.

2
Thombs, D. (2006). Introduction to Addictive Behaviors. New York: Guilford Press, p.126

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All the people who use drugs for the first time feel that they can overcome their
problems by using drugs, but in reality over time the changes in the brain caused by
repeated drug abuse could affect a person's self-control and ability to make sound
decisions, and at the same time create an intense impulse to take drugs.

Social Factors
When someone takes drugs, he is generally looking for a benefit or is ward. The
motivators behind the initial drug use can lead to addiction. There are several social
factors that increase the chances of developing a drug addiction. Social factors include
the institutions that influence the behavior of individuals. The negative influence of
these social institutions adversely affects the mind of youngsters and students and
entangles them in the trap of drug addiction. These are including, peer groups, family,
community religion etc.
Some of these factors have grave relevancy in the rapid increase in the incidence of
drug abuse. The social factors include:
 Peer Pressure
Particularly in teens, peer pressure can have an effect on drug use. Studies prove that
most of the students starts using drugs under the influence of their friends. If anyone
in a peer group is addicted to narcotic drugs he will try to spread the habit among
other persons too. Peer influences have been found to be among the strongest
predictors of drug use during adolescence. It has been argued that peers initiate youth
into drugs, provide drugs, model drug-using behaviors, and shape attitudes about
drugs.3 Membership of a social group that supports drug or alcohol use encourages
people to keep on using these substances.
 Family
Most of the parents in Kerala are not aware of the fact that their children are addicted
to drugs.4 This is often caused by the parental negligence of children and non-
interference of parents in the matters of their sons and daughters. Studies revealed that
in a good number of cases, the families of drug- users were not ‘normal’ and family
relationship was not ‘affectionate’. In testing the relationship between drug usage and
‘staying away from parents’, it was found that residence with parents was as
3
http://alcoholrehab.com/drug-addiction/peer-pressure

4
Asianet news report titled ‘clean campus safe campus’.

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important in the incidence of drug usage as residence in hostel. In other words family
background is significant in drug usage.
The nature of family control, the discipline imposed by parents over the children, the
parent’s interest in their friends. Leisure activities and their future career prospects
and parents remain conscious of their obligations towards their children were found to
be important factors which determine the children’s inclination to step into the world
of drugs.5
 Easy Availability of Drugs
One of the important factors that help the growth of drug usage among children and
adolescence is the easy access to the drugs and substances. As far as the state of
Kerala is concerned, the news reports6 and police investigations have proven that
many drug mafias and rackets have been functioning in the state focusing their
attention on youth and adolescents who are addicted to drugs. And they are
campaigning among the students influence them by praising the faulty merits of these
kinds of drugs. It is reported that these rackets uses the persons who are highly
addicted to drugs (locally called ‘jungies’) to influence the other persons.

Economic Factors
The studies reports that increasing unemployment leads to the increase of the
incidents of drug abuse among the youth. The tremendous stress, rejection, fear and
frequent bouts of depression that often result from being unemployed are high risk
factors for the development of a substance abuse problem. Many people who are
struggling with the negative effects of unemployment turn to alcohol or drugs to
mitigate the discomfort and sense of helplessness they feel. This is a serious mistake,
and it can destroy your entire life. There are incidences that these unemployed
persons got trapped in the gang of drug mafias and rackets and do the illegal job as
drug dealers.

Geographical Factors
Kerala’s coastal area has always been a vulnerable point. Thrissur district, which has
the longest coastline among the districts from Veliyankode in Ponnani Taluk in the

5
Social problems in India, Ram Ahuja, Rawat publications – New Delhi, 3rd edition, 2014, p.375

6
The Hindu June 4, 2014.

15
north to Kodungalloor in the south, had registered a large no. of cases relating to
smuggling and trafficking. In fact it has been identified as a transit point for
contraband and drugs. The district’s hilly hinterland bordering the Western Ghats is
vulnerable areas as far as drugs are concerned.
The Central Board of Excise & Custom’s failure to operationalize Customs
Preventive Commissionerate in Kerala had earlier rendered the state’s 600- kilometer
coastline vulnerable to smuggling and drug trafficking activities.
Enforcement agencies have sounded an alert on drug cartels using Kochi as a transit
point for smuggling heroin to Sri Lanka. It is suspected that truck carriers from West
Bengal, Madhya Pradesh &Bihar arrive in the city with heroin consignments, which
are in turn smuggled, to Sri Lanka with the help of agents7.

7
Based on a report published in the magazine ‘Kerala calling’, July 2012.

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 Chapter- IV
Effects of Drug Abuse
Drug abuse has far reaching effects on society. It will negatively affects social,
cultural and economic development of a society. As far as the reports and studies
show that the family structure and moral conduct of the society have badly affected
by the drug consumption.

1. Social effect
Drugs corrode the basic structure of a whole society, by affecting a cultured human
society in all aspects including destabilizing families, reducing human productivity,
corrupting trustworthy governments and honest police, and demoralizing law
respecting citizens. In Kerala most of the families of drug addicts does not know even
the fact that their children are addicted to drugs. According to the National Institute
on Drug Abuse (NIDA), 50 to 80 percent of child abuse and neglect cases involve
substance abuse by the children's parents. Prostitution is another social evil that have
aggravated in the state due to the increase in drug abuse. Another effect is that, with
the closing down of bars the demand for illicit drugs has increased in the state. The
studies says that the state has been witnessing a spurt in the use of drugs, mainly
ampoules of restricted drugs, in the wake of the liquor curbs as well as tight
enforcement against drunken driving. It is feared that the situation may aggravate
further with the closure of bars and reduction in liquor supply. According to police
and excise sources, drug abuse has increased after the closure of 418 bars in April.
They are easy to consume, give prolonged kick and the police cannot easily detect
them. Till this May, the excise and police registered 939 cases under the Narcotic
Drugs and Psychotropic Substances Act (592 by police and 347 by excise). Of this,
over 500 cases were initiated during April-May and the majority pertained to
restricted drugs. Enforcement officials admit that this is only the tip of the iceberg as
it is very difficult to crack the well-established racket with the present infrastructure
of the enforcement agencies8.
Another evil effect of drug abuse is the increase in the number of HIV positive
patients. Injecting drug users (IDUs)9 often share needles and syringes. One HIV

8
Deccan chronicle, ‘with bars shut drug abuse goes up in Kerala’ (news), august 30, 2014

9
IDU’s are addicts who inject instead of smoking, snorting or orally consuming drugs.

17
positive addict in the group spreads the infection to the rest through such exchange of
needles and syringes.
2. Increase in Crime Rate
Increase in crime rate is another effect of drug abuse in Kerala. Particularly most of
the sexual offences happening Kerala is the result of the use of narcotic drugs and
psychotropic substances. According to the crime records Kerala possesses first rank in
registered crimes in 2012.10 The innumerable reports of crimes against children and
crimes committed by children highlighted the seriousness of the situation. The crime
records shows that most of the accused persons indulged in sexual offenses have
consumed one or other kind of narcotic drugs or substances before committing the
crime.
3. Economic Effects
Drug abuse is a social evil. It destroys not only vitals of the society but also adversely
affects the economic growth of the state because this is a trade which generates large
un-accounted money which, in turn, leads to adoption of several means of money
laundering. The money generated is used for various purposes including anti-national
and terrorist activities and even clandestine trading in arms and ammunition. Drug
trafficking activities have sharply increased over the years and unscrupulous persons
dealing in drugs have flourished despite hard punishments provided under the law
because they have been able to evade the process of law. News reports show that even
in medical stores in Kerala, the medicinal drug sellers provide highly seductive
narcotic drugs without the prescription of authorized medical practitioners. The drug
mafias and rackets who illegally trafficking and selling expensive narcotic drugs
makes huge amount of profit without even paying the tax. It is believed that the
migrant workforce from North India plays an important role in smuggling medicines
to Bangladesh. An investigation by the Central Zone Drugs Control Department
revealed that daily- wage workers who come to Kerala are going back home with
bundles of analgesics such as codeine phosphate and dextropropoxyphene 11. These
medicines are later smuggled to Bangladesh.

10
National crime record bureau report 2013.

11
Dextropropoxyphene belongs to a group of medicines called opioids. Opioids mimic the effects of
naturally occurring pain-reducing chemicals (endorphins). They combine with the opioid receptors in
the brain and block the transmission of pain signals.

18
 Chapter- V
Drug Abuse in India
Drug abuse is a social evil. It destroys not only vitals of the society but also adversely
affects the economic growth of the country. Drug abuse is a global phenomenon. In
India, the use of opium and cannabis has been in existence since long ago. In the last
three decades, however new drugs like heroin, amphetamine type stimulants (ATS),
cocaine and pharmaceutical compounds have made their entry and are being used
especially in metropolitan cities. Currently, India is not merely a country for the
transit of such drugs from the ‘Golden Triangle’ or ‘Golden Crescent’; it has also
become a country of consumption.12
The population of India has reached over 1 billion people and is rising. The country is
growing at an incredible pace. Its culture, social values, demographics and economy
is rapidly changing, and these stresses are having an impact on the people. Some
evidence suggests that there is an increasing use of illicit drugs and reported numbers
point to over 3 million drug addicts in India. However, the World Health Organization
does note that there is significant difficulty in estimating drug usage and addiction
rates in the country due to poor bureaucratic processes and census reporting. 13 Drug
abuse among children and adolescents is one of the major challenges that India has
been facing even before the foreign invasion. The Indian culture successfully handled
mind-altering substances without the worry of excessive use. The natural
psychotropic plants in India, namely cannabis, poppy, khat and datura, were kept
under control for thousands of years. Cannabis was used by being blown from a
hubble-bubble pipe as madak and brewed with teas as bonda chai.14
In fact, opium use prospered even with invasions from Alexander and the Mughals. It
was only after the British invasion that it was monopolized. The British used to buy at
least 15 million pounds of tea from China and has nothing to sell in return. To balance
the deficit, it aggressively sold opium to China. While controlling cannabis was
difficult for the fact that it can be grown anywhere in India, the British systematically
controlled the cultivation, consumption, production and sale of opium in India.
12
National Drug Demand Reduction Policy, Ministry of social justice and empowerment, March 2013,
https://socialjustice.nic.in/pdf/NDDRP-march2013.

13
http://alcoholrehab.com/drug-addiction/drug-addiction-in-india.

14
Y K Shabarwal, National seminar organized by Delhi High court, https:// delhihighcourt.nic.in

19
Over the years, drug addiction is becoming an area of concern as traditional moorings,
effective social taboos, emphasis on self-restraint and pervasive control and discipline
of the joint family and community are eroding. The processes of industrialization,
urbanization and migration have led to loosening of the traditional methods of social
control rendering an individual vulnerable to the stresses and strains of modern life.
The fast changing social milieu, among other factors, is mainly contributing to the
proliferation of drug abuse, both of traditional and of new psychoactive substances.
The introduction of synthetic drugs and intravenous drug use leading to HIV/AIDS
has added a new dimension to the problem, especially in the Northeast states of the
country.15 Detecting this threat of spreading drug abuse among Indian citizens the
government of India have framed several policies and laws.

Kinds of drug abuse

Drugs can be categorized as Depressants, Stimulants, Hallucinogens and Narcotics.
Depressants includes alcohol, tranquilizers, calmpose, valium etc. Stimulants are,
cocaine and amphetamines. The third category, i.e. Hallucinogens, are LSD, ganja
etc. Narcotics drugs include, opium and its derivatives such as heroin, brown sugar,
Tidigesic, morphine, pethedine, fortwin etc. In Kerala, alcohol, ganja, brown sugar
and tranquilizers are greater in abuse16.

Effects of drug abuse

Drug abuse has become a social problem because it has afflicted the family, the
economy and the community. And abuse of all drugs has adverse effects on physical,
psychological and social conditions of the user. Under nutrition, loss of appetite,
bronchitis and generalized debility, which may lead to a host of other problems, are
the physical complications. Psychological effects include anxiety, depression,
insomnia, paranoia, deterioration of personality and other severe mental illness.
Abstinence from the work place, accidents, criminal involvement, prostitution etc. are
social ill-effects of substance abuse.17 Drug abuse is a complex phenomenon, which
has various social, cultural, biological, geographical, historical and economic aspects.

15
http://socialjustice.nic.in

16
Kerala calling, magazine, February 2004

17
Id.

20
The disintegration of the old joint family system, absence of parental love and care in
modern families where both parents are working, decline of old religious and moral
values etc. lead to a rise in the number of drug addicts who take drugs to escape hard
realities of life. Drug use, misuse or abuse is also primarily due to the nature of the
drug abused, the personality of the individual and the addict's immediate
environment. The processes of industrialization, urbanization and migration have led
to loosening of the traditional methods of social control rendering an individual
vulnerable to the stresses and strains of modern life.
Causes of drug abuse
There are many reasons for a person turning to drugs, which include social causes
such as influence of peer group, for pleasure, rebelliousness to family and society etc,
Economic causes such as poverty, unemployment etc., changing life style of people
and acts of drug pushers to help drug vendors. The fast changing social milieu, is
mainly contributing to the proliferation of drug abuse, both of traditional and of new
psychoactive substances.
The introduction of synthetic drugs and intravenous drug has led spreading of
HIV/AIDS this has added a new dimension to the problem, especially in the Northeast
states of the country. Drug abuse has led to a detrimental impact on the society. It has
led to increase in the crime rate. Addicts resort to crime to pay for their drugs. Drugs
remove inhibition and impair judgment egging one on to commit offences. Incidence
of eve - teasing, group clashes, assault and impulsive murders increase with drug
abuse. Apart from affecting the financial stability, addiction increases conflicts and
causes untold emotional pain for every member of the family. With most drug users
being in the productive age group of 18-35 years, the loss in terms of human potential
is incalculable. The damage to the physical, psychological, moral and intellectual
growth of the youth is very high. Adolescent drug abuse is one of the major areas of
concern in adolescent and young people's behavior. Over the last three years, there
has been an increase in cases of drug abuse among children in the 10-16 years age
group in the city. As per the data of city-based drug de-addiction hospitals, hardly any
case of drug abuse among children was reported five years back.18

18
Times of India, June 26, 2013

21
Demand reduction strategy - a welfare approach
The issues relating to drugs are tackled by the Government of India through its two-
pronged strategy viz. supply reduction and demand reduction. Whereas the supply
reduction is under the purview of the enforcement agencies with the Department of
Revenue as the nodal agency, the demand reduction strategy is under the domain of
social sector and the Ministry of Social Justice & Empowerment in Government of
India is responsible for implementation of demand reduction strategy in the country.
Over the years it was realized that the drug abuse is not only a problem arising out of
the availability of such intoxicating drinks and drugs but it has a great deal to do with
the social conditions which create the demand for or the need for consumption of such
substances. The vulnerability of the modern society plays a catalytic role in promoting
the consumption and abuse of narcotic and psychotropic drugs.
The findings of studies/reports indicate to the relationship of drug abuse with the
socio-economic conditions or the social dynamics of the population. Therefore, the
approach is to recognize drug abuse as a psycho-socio medical problem, which can be
best, handled through community based interventions.
Keeping the aforesaid approach in view, the Govt. of India has a three- pronged
strategy for demand reduction consisting of:
 Building awareness and educating people about ill effects of drug abuse
Building awareness and educating people about ill effects of drug abuse.
 Dealing with the addicts through programme of motivational counseling,
treatment, follow-up and social-reintegration of recovered addicts.
 To impart drug abuse prevention/rehabilitation training to volunteers with a
view to build up an educated cadre of service providers.
The objective of the entire strategy is to empower the society and the community to
deal with the problem of drug abuse.19

Treatment and Rehabilitation of Addicts - Government - NGO Collaboration

The Ministry of Social Justice & Empowerment, as the focal point for drug demand
reduction programmes in the country, has been implementing the Scheme for
Prohibition and Drug Abuse Prevention since the year 1985-86. As implementation of
programmes for de addiction and rehabilitation of drug addicts require sustained and

19
https:// www.ncbi.nlm.nih.gov

22
committed/involved effort with a great degree of flexibility and innovation, a State-
community (voluntary) partnership appears to be particularly strong mechanism for
service delivery. Accordingly, under the Scheme, while major portion of the cost of
services is borne by the Government, the voluntary organizations provide actual
services through the Counseling and Awareness Centres such as de-addiction cum
Rehabilitation Centres, De-addiction Camps and through awareness Programmes.
The basic objective of the scheme is to create facilities for treatment, at Centres run
through voluntary organizations, is to ensure that the support of the family and the
community is mobilized to the maximum. These Centres adopt a wide variety of
approaches, systems and methodologies for treatment and rehabilitation of the addicts
suitable and adaptable to the social customs, traditions and culture. However this do
not in any way undermine adoption of scientific, modern and established systems of
treatment.20
Awareness and Preventive Education
The Counseling and Awareness Centers are engaged in a wide range of awareness
generation programme in varied community settings including village Panchayat,
schools etc. Besides these Centers, the Ministry has been actively utilizing the various
media channels, print as well as audio-visual for educating the people on the ill effects
of drug abuse and also disseminating information on the service delivery.21
International Cooperation - An Enrichment Process
The Ministry of Social Justice & Empowerment, in collaboration with the
International Labour Organization and UNODC, implemented a project on
"Developing Community Drug Rehabilitation and Workplace Prevention
Programmes", to sensitise and train the voluntary organizations and workplace
settings on prevention of alcoholism and substance abuse in workplace. It is viewed
that the work environment of an individual is the most important area of preventive
intervention for a potential addict as he still enjoys economic security. The loss of a
job further aggravates the addictive behavior. This aspect was not getting its due
importance under the on-going programme. With the sincere efforts made under the
project, a number of corporate institutions have also volunteered their involvement in

20
Pratima Murthy, N. Manjunatha, “Substance use and addiction research in India”

21
P Murthy, Substance use and addiction research in India, 2010, https:// www.ncbi.nlm.nih.gov

23
the project.22
While all round efforts are being made for prevention and containment of drug abuse
in our society, a long journey is yet to be covered before India can draw some
satisfaction. Even though these policies and schemes are there in the country there is
no following up for the implementation of them, the increasing drug usage in the
country is evident for this. The problem having transnational causes and implications
shall require Herculean efforts on the part of all the Government. The empowerment
of society through sensitization and awareness is the only solution to support the
efforts of enforcement agencies in containing the proliferation of drug trafficking and
drug abuse. In addition to these policies several anti-drug laws as well as
constitutional provisions are there in the country to tackle this menace.

22
Id.

24
 Chapter- VI
Laws Preventing Drug Abuse in India
Drug abuse is a serious social problem. The drug abuse is growing and an ever-
increasing number of youth is becoming addicted. The smuggling of narcotic drugs
and psychotropic substances into India, and illegal trafficking in such drugs and
substances lave led to drug addiction among a sizeable section of the public,
particularly the adolescents has assumed serous and alarming proportions in the recent
years. Drug addiction threatens to kill the whole generation. No individual, family or
community is safe where illicit drugs take control. Drugs may control the body and
mind of individual consumers, the drug crop and drug cartels may control farmers,
and illicit trafficking and crime may control communities. Drugs destroy lives and
communities, undermine sustainable human development and generate crime. Drugs
affect all sectors of society; in particular, the young people.

Constitutional Mandates
India's approach towards Narcotic Drugs and Psychotropic Substances is enshrined in
Article 4723 of the Constitution of India. Which mandates the government to prohibit
the use and consumption of intoxicating drinks and drugs, which are injurious to
health. The right to health has been perhaps the least difficult area for the court in
terms of justifiability, but not in terms of enforceability. Article 47 of Directive
principles of state policy provides for the duty of the state to improve public health.
This Article is based on Gandhian principles. However, the court has always
recognized the right to health as being an integral part of the right to life guaranteed
by Article 21 of Indian constitution.in the case State of Punjab v Mohinder Singh,
the Supreme Court held that right to health is a fundamental right guaranteed under
Article 2124.

Article 25325 of the Constitution empowers the Parliament to legislate for the purpose

23
The State shall regard the raising of the level of nutrition and the standard of living of its people and
the improvement of public health as among its primary duties and, in particular, the State shall
endeavor to bring about prohibition of the consumption except for medicinal purposes of intoxicating
drinks and of drugs, which are injurious to health.

24
AIR 1997 SC 1225

25
Parliament has the power to make any law for the whole or any part of the territory of India for

25
of discharging obligations under international conventions and foreign treaties.
Accordingly, the Narcotics Drugs and Psychotropic Substances Act, 1985 was
enacted in November 1985, to give effect to the provisions of the existing UN
Conventions. It contains stringent provisions for the control and regulation of narcotic
drugs and psychotropic substances, and provides an essential framework and
appropriate provisions for administrative action.

Anti-Drug Laws
The statutory control over narcotic drugs in India is exercised through a number of
Central and State enactments. The Opium Act of 1857, Opium Act of 1878 and the
Dangerous Drugs Act of 1930 were enacted a long time ago. However with the
increase in drug abuse and illicit drug traffic certain deficiencies in the existing laws
surfaced which made it necessary for the Parliament to enact a comprehensive
legislation to combat this challenge. For e.g. the Dangerous Drugs Act, 1930 provides
for a maximum term of imprisonment of 3 years with or without fine and 4 years with
or without fine for repeat offences.
As a result of experience gained on account of India’s participation in various
international conventions that are single convention on Narcotic drugs, 1961,
Convention on psychotropic substance 1971, Convention on illicit traffic in Narcotic
Drugs and Psychotropic substance 1988 and realizing India’s obligation under Article
25326 of the Universal Declaration of Human Rights 1948 and Article 12 of the
International Covenant on Economic, Social and Cultural Rights 196627, which are
reflect the concern of the international community for the protection of the
individual's right to the enjoyment of the highest attainable standards of physical and
mental health and the gravity of the problem and the need to enact laws in tune with
times, the Narcotic Drugs and Psychotropic Substances Act of 1985 was passed by
Indian Parliament as a comprehensive legislation on narcotics, providing for stringent
and long term prison sentences and heavy fines for offenders. Offender under this Act

implementing any treaty, agreement or convention with any other country or countries or any decision
made at any international conference, association or other body.

26
Everyone has the right to a standard of living adequate for the health and Well-being of himself and
of his family.

The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the
27

Highest attainable standard of physical and mental health.

26
includes the cultivator, supplier, and seller as well as the drug consumer28. The
amended Drugs and Cosmetics Act 2008 and Rules also provide for deterrent
punishment and stringent control over manufacture, sale, and distribution of
psychotropic substances. The amended Act provides that any drug deemed to be
adulterated or spurious when used by any person for or in the diagnosis, treatment,
mitigation, or prevention of any disease or disorder is likely to cause his death or is
likely to cause such harm on his body as would amount to grievous shall be
punishable with imprisonment for a term which shall not be less than ten years but
which may extend to imprisonment for life and shall also be liable to fine which shall
not be less than ten lakh rupees or three times value of the drugs confiscated,
whichever is more. The fines realized in such cases will be paid to the relative of the
deceased or the aggrieved person29. Despite these harsh punishments, the crime is on
rise.

An Overview of Narcotic Drugs and Psychotropic Substances Act

The NDPS Act, 1985 is one of the harshest laws in the country. It prohibits
cultivation, production, possession, sale, purchase, trade, use and consumption of
narcotic drugs and psychotropic substances except for medical and scientific purposes
under license.
The NDPS Act 1985 sets out the statutory framework for drug law enforcement in
India. The main elements of the control regime mandated by the Act are.
 The Act prohibits the cultivation, production, manufacture, possession, sale,
purchase, transportation, ware housing, consumption, interstate movement,
transshipment and import and export of narcotic drugs and psychotropic
substances except for medical or scientific purposes and in accordance with
the terms and Conditions of any license, permit or authorization given by the
government.30
 The central government is empowered to regulate the cultivation, production,

28
Y.K Shabharwal, Narcotic Drugs and Psychotropic substances, National Seminar organized by Delhi
High Court in collaboration with Government of Delhi.
http://www.supremecourtofindia.nic.in/speeches

29
Section 12, Drugs and cosmetic (amended) Act 2008

30
Section 8 of the Act

27
 manufacture, import, export, sale, and consumption, use etc. of narcotic drugs
and psychotropic substances.31
 State governments are empowered to permit and regulate possession and
interstate movement of opium, poppy straw, the manufacture of medical of
medicinal opium and the cultivation of cannabis excluding hashish.32
 The central government is empowered to declare any substances, based on an
assessment of its likely use in the manufacture of narcotic drugs and
psychotropic substances as a controlled substance.33
Given India’s size and the federal nature of polity, a number of agencies both at the
center and the states have been empowered to enforce the provisions of the Act. These
agencies include the department of customs and central excise, the Directorate of
Revenue Intelligence, the Central Bureau of Narcotics and the central Bureau of
Investigation and the central level and state police and Excise departments at the state
level. The Union Ministries of social Justice and Empowerment and Health are
responsible for the demand, reduction aspects of drug law enforcement, which
broadly covers health- care and the de-addiction, rehabilitation, and social re-
integration of addicts.34
Chapter IV (15 to 40) of the Act deals with prohibition of offences and penalties
related to cultivation, production, transportation, selling, and purchasing of poppy
straw35, coca plant36, coca leaves37, prepared opium38, opium poppy39, opium40,

31
Section 9 of the Act

32
Section 10 of the Act

33
Section 9 A of the Act

34
Malik, Commentaries on Narcotic Drugs and Psychotropic Substances Act, 1985. Law publishers
(India) pvt. Ltd, 2012, p.5

35
Section 2 (xviii) of the Act defines "poppy straw" as all parts (except the seeds) of the opium poppy
after harvesting whether in their original form or cut, crushed or powdered and whether or not juice has
been extracted therefrom.

36
Section 2(vi)(a) the Act defines "Coca plant" as the plant of any species of the genus Erythroxylon.

37
Section 2(vi)(a) defines “coca leaf means” as the leaf of the coca plant except of a leaf from which
all ecgonine, cocaine and any other ecgonine alkaloids have been removed.

38
Section 2(xi)(b) defines “prepared opium” as any product of opium by any series of operations
designed to transform opium into an extract suitable for smoking and the dross or other residue
remaining after opium is smoked.

28
cannabis plant41 and cannabis42. All these offences are triable by special courts and
the punishments prescribed range from imprisonment from 10 to 20 years for first
offences, to 15 to 30 years for any subsequent offences together with monetary fines.
In addition to persons directly involved in trafficking narcotic drugs and psychotropic
substances, any person who finances trafficking or harbors a person in trafficking or
abets, or is a party to a criminal conspiracy. Including a criminal conspiracy to
commit an offence outside India is also liable to the same scale of punishments.
The most important mandate of this Act is that it provides punishment for the
consumption of any kind of narcotic drugs and psychotropic substances.43 The earlier
provisions of this Section made possession of small quantity of any narcotic drug or
psychotropic substance, which is proved to have been intended for personal
consumption and not for sale and distribution or consumes any narcotic drug or
psychotropic substance punishable under the Act.
But the new provision clearly stipulates that whoever consumes any narcotic drug or
psychotropic substance shall be punishable. Thus, the provision of small quantity for
personal consumption has been completely deleted and substituted by provision of
mere consumption. Punishment varies accordingly to consumption. In the case Alpesh
Kumar v. State of Rajasthan44, the accused was caught for illegally possessing two
cigarettes containing 500 ml.gm of heroin, the accuse argued that it was for his
personal consumption but interpreting section 2745 r/w S.8 of the Act the supreme

39
Section 2 (xvii) of the Act defines "opium poppy" as the plant of the species Papaver somniferous
L.; and the plant of any other species of Papaver from which opium or any phenanthrene alkaloid
can be extracted and which the Central Government may, by notification in the Official
Gazette, declare to be opium poppy for the purposes of the Act.

40
Section 2 (xv) of the Act defines “opium" as the coagulated juice of the opium poppy, S.2, (xv).

41
Section 2 (iv) of the Act defines “cannabis plant" as any plant of the genus cannabis.

42
Section 2 (iii) defines Cannabis (hemp) as charas that is the separated resin, obtained from cannabis
plant and ganja, that is, the flowering or fruiting tops of the cannabis plant.

43
Section 27 of the Act.

44
AIR 2004 SC 952

45
Section 27 states that Whoever, consumes any narcotic drug or psychotropic substance shall be
punishable, - (a) where the narcotic drug or psychotropic substance consumed is cocaine, morphine,
diacetyl-morphine or any other narcotic drug or any psychotropic substance as may be specified in this
behalf by the Central Government by notification in the Official Gazette, with rigorous imprisonment
for a term which may extend to one year, or with fine which may extend to twenty thousand rupees; or
with both; and(b) Where the narcotic drug or psychotropic substance consumed is other than those

29
court held that the accused was guilty.
Prior to 2001, in cases pertaining to drug users, the Supreme Court, took into account
the actual drug content in calculating quantity and not the entire quantity seized 46.
After the 2001 notification, the penalties were determined by the quantity of drugs
involved, but the NDPS Act did not provide any guidance of ascertaining the quantity
of narcotic drugs or psychotropic substances. In 2008, the Supreme Court in E.
Michael Raj v Intelligence Officer47, Narcotic Control Bureau held that “in the
mixture of a narcotic drug or a psychotropic substance with one or more neutral
substance/s, the quantity of the neutral substances is not to be taken into consideration
while determining the small quantity or commercial quantity of a narcotic drug or
psychotropic substance. It is only the actual content by weight of the narcotic drug
which is relevant for the purposes of determining whether it would constitute small
quantity or commercial quantity.”
By the amendment in 1989 Section 31A was inserted in the NDPS Act, which
imposes mandatory death penalty for certain repeat crimes involving a large quantity
of drugs. The death sentence is mandatory in that there is no punishment laid down in
Section 31A other than death. In June 2010, An NGO the Lawyers Collective
challenged this provision in Indian Harm Reduction Network v Union of India48 on
grounds of infringing fundamental rights under Articles 21 (protection of life and
liberty) and 14 (equal protection of law) of the Constitution of India. It also
questioned the appropriateness of a death sentence for drug trafficking, which does
not involve killing or taking of human life and is merely an economic offence.
Section 64A of the NDPS Act provides immunity from prosecution to addicts49
volunteering for treatment, if they are charged with consumption or offences
involving small quantity. This provision is in keeping with International Drug
Conventions that encourage alternatives to penal sanctions where the offence is of a

specified in or under clause (a), with imprisonment for a term which may extend to six months, or with
fine which may extend to ten thousand rupees or with both.

46
Hussain v State of Kerala (2000) 8 SCC 139; Ouseph v State of Kerala (2004) 4 SCC 446

47
(2008) 5 SCC 161

48
AIR 2013 SC 562

49
Section 2 (i) defines ‘addict’ as ‘a person who has dependence on any narcotic drug or psychotropic
Substance’.

30
minor nature or where the offender is dependent on drugs her/himself.50
The Act has been amended twice; in 1989 and 2001. The first amendments in 1989
leaned towards greater stringency by introducing mandatory minimum sentences of
10 years, restrictions on bail and mandatory capital punishment for repeat offenders.
Following the amendments, persons caught with small amounts of drugs faced long
prison sentences, without the possibility of release on bail. Courts criticized the harsh
and disproportionate sentencing structure, which led to a fresh set of reforms in 2001
to rationalize punishment on the basis of whether the quantity of drugs involved is
“small” “commercial” or “intermediate” and provide some leniency towards drug
offenders who also use drugs.51
Though the NDPS Act provides for stringent provisions for curbing drug abuse and
illicit trafficking of narcotic drugs and psychotropic substances, the Act has certain
defects, for example Patients with severe pain in India are not able to get opioid
medicines for pain relief because the state NDPS Rules make it difficult for hospitals
to store and dispense opioids. Hospitals have to obtain licenses for stocking, import,
export, transport etc., each license requiring concurrence from different departments
(Excise, Drugs Control, Health administration). These licenses need to be valid at the
same time, though often the validity period of a license is as short as a month. By the
time the institution gets a second license, often the first would have expired validity.
On the other hand, though the NDPS Act allows medical use of narcotic drugs and
psychotropic substances, stringent regulations and onerous licensing procedures
together with controls under the Drugs and Cosmetics Act, 1940 have impeded access
to opiates for millions of patients.
In order to rectify these disabilities of the Act, recently on February 2014 the
Loksabha has passed the NDPS (amendment) Bill. The amendments make important,
path breaking changes for medical access to narcotic drugs by removing barriers that
date back to 1985, when the Act was first introduced. The amendments also include
provisions to improve treatment and care for people dependent on drugs, moving

50
Article 36 (1) (b), Single Convention on Narcotic Drugs, 1961, as amended by the Protocol
Amending the Single Convention on Narcotic Drugs, 1972,
https://www.unodc.org/pdf/convention_1961

51
The Narcotic Drugs and Psychotropic Substances act Ignoring Health; Infringing Rights,
http://www.lawyerscollective.org

31
way from abstinence oriented services to treating drug dependence 52 as a chronic, yet
manageable condition.53 This will now change as Parliament has adopted a new
category of “essential narcotic drugs” in section 2(viiia) of the Act – a list, which the
Central Government can notify on the basis of expediency in medical practice. Drugs
identified as essential will be subject to Government Rules, which will apply
uniformly throughout the country, bringing to an end the unwieldy and inept practice
of obtaining multiple State licenses for possession, transport, purchase, sale,
distribution, use and consumption. And the amendments broaden the object of the
NDPS Act from containing illicit use to also promoting the medical and scientific use
of narcotic drugs and psychotropic substances
It is true that the efficacious provisions of the Act are worth for curtailing the illicit
trafficking of narcotic drugs and drug abuse but when we consider the changing life
style of people and growing demand for narcotic drugs for medicinal purposes these
provisions are inadequate and needs to be amended. And more than adopting a
punitive approach to the drug users the anti- drug laws should adopt means to
rehabilitate them and make them useful citizens to the country.

52
Drug dependence is the body's physical need, or addiction, to a specific agent. There is therefore
virtually no difference between dependency and addiction. Over the long term, this dependence results
in physical harm, behavior problems, and association with people who also abuse drugs,
https://www.google.co.in

53
http://www.lawyerscollective.org/updates/parliament-passes-ndps-amendment-bill-2014

32
 Chapter- VII
Drug Abuse in U.S.A
Reports of widespread drug abuse in America have been made in the popular press
and in scholarly writings for several decades. Depending on the socio-political
climate during any given period, approaches to viewing and responding to drug usage
have varied in terms of definition (illegal and legal drugs); characterization (transitory
fad or epidemic); groups targeted for intervention ('moonshiners' making 'bootleg'
whisky during the 1920's Prohibition, 'hippy' members of the 1960's 'counter-culture',
youth told to 'Just Say No!' by Nancy Reagan in the 1980's, or pregnant addicts in the
1990's); the types of intervention (civil or criminal); and the magnitude and nature of
national commitment to ameliorate the problem at different levels (confronting
international drug cartels, emphasizing 'law and order' type legislation that limits the
rights of all citizens, or mass arrest of individuals). This variance in definition,
purpose and practice has forced society consistently to struggle to answer effectively
fundamental questions about the nature of drug addiction, the rights of drug addicts
whose behaviour the government seeks to control, and society's rights and obligations
in the matter.

1. Medico-Legal Dilemmas
Legal and Illegal Drugs
American authorities have had a long-standing problem with deciding which drugs to
declare legal or illegal, and with convincing the public that there decisions are based
on credible medical, social and legal factors. Over the years, what has often appeared
to be the use of arbitrary decision-making has resulted in public indifference and law
breaking, and enforcement marked by confusion and ineffectiveness.
During the colonial period and the early nineteenth century, drinking alcohol was a
popular pastime in taverns and other places where social discourse and relaxation
prevailed. Children and adults drank alcohol in great quantities with no threat of
criminal sanction or social ostracism for drunkenness, which was not associated with
violence and crime. However, by the turn of the nineteenth century, changes in the
economic and social structures led to the notion that public drunkenness was a social
ill in need of a cure. The ensuing temperance movement resulted in the ratification of
the Eighteenth Amendment to the Constitution forbidding the manufacture, sale or

33
transportation of alcoholic beverages.
Addiction: Causes and Nature
Notwithstanding the vagaries of political forces during any given period regarding the
nation's approach to drugs, policy decisions made by medical and legal personnel
related to the prevention, treatment and control of drug addiction rely heavily on their
view of addiction. One definition of addiction is, 'a biomedical disease, such that the
overt behavior of addiction is driven by genetic/physiological processes that act
beyond the individual's volitional sphere of control'.54

Several aspects of this definition represent the crux of the disagreement among
professionals over addiction concerning (1) whether drug ad- diction is a disease; (2)
whether the causes of addictive behaviour result from a genetic predisposition,
'deviant' socio-cultural patterns or a free, willful choice; and (3) whether addicts lose
the ability to control their behaviour. There are several far-reaching implications of
the different answers to these questions, such as the type of institutional or
community based prevention efforts that are promoted. Whether treatment regimens
are geared towards recovery and relapse prevention or confinement and control also
largely depends on policy-makers' views of addiction, as does the assignment of, or
exculpation from, criminal responsibility for the conduct of addicts.
Although the pathogenesis and nature of diseases such as cancer, multiple sclerosis,
Huntington's chorea and arthritis vary greatly, no one would argue that they are not
diseases. However, there is no similar consensus about whether addiction is a
disease55, due in large part to researchers' inability to provide conclusive answers for
those who question two of the most widely held assumptions upon which the classical
disease model of addiction has rested: predisposition and loss of control.56
The existing evidence of a genetic involvement in alcoholism is growing, but it is not
universally accepted among investigators. According to Boris Tabakoff, scientific
director of the National Institute of Alcohol Abuse and Alcoholism, in about two-

54
Peele S Visions of Addiction Major Contemporary Perspectives on Addiction and Alcoholism (1980)
6.

55
Alexander BK The Disease and Adaptive Models of Ad- diction: A Framework Evaluation 1987 J
of Drug Issues 17 (1): 47-66.

56
Fingarette H Heavy Drinking: The Myth of Alcoholism as a Disease (1988) 15.

34
thirds of alcoholics one can find a genetic component that is either strong or weak. 57
There is little evidence of a genetic predisposition for becoming addicted to cocaine
and other drugs, and while the search for the cause of addiction to cocaine is still in its
early stages, thus far scientists have not determined why some people become
addicted while others do not. They have examined theories from how cocaine affects
the complex circuitry of the brain to the psychological history of addicts.58
The concept of loss of control is routinely associated with issues of personal weakness
and individual choice. One court analyzed the issue whether a heroin addict's loss of
behavioural controls should mitigate his criminal responsibility for unlawful
possession. Dicta of the court asserted that two factors go to make up self-control (or
lack thereof), which governs the activities of addicts: physical craving to have the
drug, and the addict's 'character' or moral standards.59 The court's discussion is a clear
example of combining the medical model with non-medically oriented concepts:
'[Where the addict's moral standards are overcome by his physical craving for the
drug, he may be said to lose "self-control", and it is at this point, and not until this
point, that an addict will commit acts that violate his moral standards.60

2. Socio-Political Challenges
Making decisions about the detection, control and treatment of drug dependent
persons is but one of a myriad of challenges that America faces as the country gropes
to contain what has been called a drug epidemic.
Although the scope of this article precludes an exhaustive examination of any of the
most pressing issues, the following entries are presented to reflect their breadth, depth
and interconnectedness.
Economic and Human Costs
 Drug Testing in the Workplace
Yearly, billions of dollars are lost to absenteeism, inferior performance and accidents

57
Thompson L Alcohol: The Deadly Drink Tampa Tribune 7 May 1989 1-H. See also Alexander 50
(discussing the 'genes-susceptibility' hypothesis of the acquisition of alcoholism).

58
Salner R What's the Hook? Chicago Tribune 16 July 1989 Tempo 2; Experts Finding New Hope on
Treating Crack Addicts New York Times 24 August 1989 1.

59
United States v Moore 486 F 2d 1139 1145 (1973).

60
Id.

35
as a result of the abuse of alcohol and other drugs. The issue of drug testing in the
workplace is controversial because of its threat to a person's right to privacy, and the
prospect of the misuse of false positives and dated records to discriminate against
people. Nevertheless, pre- employment drug testing and testing for cause are
becoming an accepted practice throughout many of the country's top companies,
where 70% test for drugs. Law must test certain positions, such as some within the
Department of Transportation. The confidentiality and use of test results, the costs,
and the consequences of an employee's exercise of the right to refuse testing are
critical challenges for the workforce.
 Drug Testing Mothers and Newborn Children
Issues of privacy, confidentiality of records and doctor-client trust per- vade the
practice of using test results as a basis for arresting or coercing into treatment
pregnant and postpartum women, and for taking their new- born children into
protective custody. Some suggest that a cost/benefits analysis will reveal that the cost
of driving drug abusing women away from prenatal care and separating newborn
children from their mothers and families for indefinite periods may be too high to pay
for the sake of detection, control and punishment of some women.
 'Boarder Babies'
Because of their mothers' poverty, drug-induced chronic illness, in- difference, and
other reasons, a growing number of drug-exposed babies are abandoned in public
hospitals. Many of these 'boarder babies' are critically ill, sometimes requiring heroic
and expensive measures to enhance their chances for survival. Authorities are
searching for ways to provide adequate care for the babies and to help the mothers
regain custody. Under a strategy being tested in New York City aimed at keeping
families together, encouraging drug treatment, and saving millions of dollars in foster-
care expenses, thousands of drug abusing mothers who are willing to agree to
conditions such as counseling and parenting classes are allowed to take their newborn
babies home from the hospital.61
 Effective Treatment
Among those in the treatment community who ascribe to various theories of the
causes and consequences of drug addiction is an ongoing debate over what constitutes

61
Treaster JB Plan Lets Addicted Mothers Take Their Newborns Home New York Times Metropolitan
19 September 1991 A col 3.

36
effective treatment. Although national entities like the Office of Substance Abuse
Prevention (OSAP) and the National Institute on Drug Abuse (NIDA) have large
sums of money to fund treatment programmes, competition is keen for grants.
Moreover, the diverse nature of the problems being studied across jurisdictions has
precluded many widely generalizable treatment paradigms for abusers of alcohol and
other drugs. Hard to reach groups like Native Americans residing on isolated
reservations, and who have an inordinately large number of victims of alcoholism and
foetal alcohol syndrome pose particular problems for the treatment community.
 Relapse Prevention
A corollary of the evolving knowledge and practice in the treatment community is the
challenge to understand and respond appropriately to re- lapse. If, for instance, relapse
is an inevitable part of the quest for recovery of a person addicted to a drug as potent
as 'crack' cocaine, it is debatable whether punishment, such as the loss of custody of
one's child or the revocation of probation, is more an unjust and counter-productive
response to relapse than one with therapeutic potential.

Criminal Justice System Breakdown

 Crime, Murder and Gang Violence
A newscast on 26 September 1991 reported that Houston, Texas, with 500 homicides
during the prior nine months, had moved into sixth place on the list of cities with
record numbers of homicides, may of which are drug related. A disproportionate
number of murder victims and perpetrators have been young black male members of
well-organized inner-city rival gangs. Some argue that the charge to 'get tough on
crime' is more a part of an attempt to limit the rights and freedoms of all persons
through an ultra- conservative agenda than it is a prescription for ameliorating the
enormous drug problem. They point out the near total absence of plans to address the
societal conditions that promote drug abuse, gang violence and related crime.62
Moreover, aside from Mrs. Nancy Reagan's widely publicized admonishment to
young people to 'Just Say No' to drugs, there has been no concerted national effort to
understand and respond to the problem of child and adolescent drug abusers and
pushers. A report in September 1991 of the arrest of a mother whose three-year-old

62
National Institute of Justice/Research in Action Drugs and Crime 1989 (June 1990) (reporting drug
use by charge at arrest for 21 cities).

37
was selling 'crack' cocaine, while not the norm, reflects the serious national problem
of the involvement of very young children in the drug culture.
 Overcrowded Courts63 and Jails
Describing a criminal justice system overwhelmed with drug cases, New York State
Chief Judge Sol Wachtler said: 'What was once a rising tide of drug cases, and then a
drug epidemic, is now a crisis nearly out of control.'64 California Chief Justice
Malcolm Lucas asserted in his State of the Judiciary address that 'drug-related cases
are swamping the courts. The system has begun to take on so much water we are close
to foundering. Too often, civil cases get drowned'.65
It is estimated that between 70 and 90% of the defendants charged with drug and
drug-related offences are indigent, with no capability of hiring counsel to represent
them. Thus, indigent defence resources have been over- whelmed, creating a
dangerous imbalance in resources allocated for police, prosecution and indigent
defence. Indigent defence is a critical part of the country's criminal justice system,
and state and federal agencies are grappling with how to channel adequate resources
to prevent a total collapse of the indigent defence system under the weight of drug
cases. A major outcome of the ongoing imbalance in the allocation of resources to
police and prosecutors is overcrowded jails and prisons, resulting in much maligned
early release programmes and calls for new prisons. It was announced in June 1989
that New York will build the nation's first prison exclusively for drug addicts and
alcoholics as part of an $888.6 million plan to put 7 100 more inmates behind bars.66
Many states are experimenting with various forms of intermediate sentencing
featuring home based intensive supervision programmes for first offenders, parolees
and probationers whose movement is electronically monitored through beepers

63
The portion in this section discussing indigent defence is adapted from Murphy T System Balance:
Indigent Defense and the War on Drugs Unpublished working paper National Centre for State Courts
March such as better community based programmes, better run prisons and jails, and an improved
National Academy of Corrections). 1991.

64
Wachtler S New York State of the Judiciary 4 December 1989, reprinted in State Court Journal
Spring 1990 14 (2): 27.

65
Lucas MM, remarks of 12 February 1990, quoted in Moore WJ Courting Disaster National Journal 3
March 1990 503.

66
New York to Build Prison Just for Addicts and Alcoholics The Tampa Tribune-Times 25 June 1989
16-A col 1.

38
connected to their ankles. Such programmes have advantages over jail or prison such
as less cost, inmates' continued contact with their families and communities, and the
discipline of complying with the requirements of external constraints while
developing internal controls through counseling, work and community restitution. It is
interesting to note that some offenders choose jail time rather than what they describe
as the isolation and constant supervision of authorities during home arrest.

39
 Chapter- VIII
Drug Abuse in U.K.
It would seem impossible for any country to be involved in a war without knowing it.
It would seem even more unlikely that the most advanced countries in the world could
be simultaneously involved in an international war without recognizing the fact. Yet
that seems to be the case, certainly so far as the politicians are concerned. They do not
seem to have fully appreciated the fact that the flood of illegal drugs pouring into the
west from areas as widely dispersed as Pakistan and Bolivia are as devastating in their
effects on peoples and economies of the target countries as an attack with
conventional weapons.
National law enforcement agencies cannot stop the flow of drugs from beyond their
own frontiers with purely national legislation and the sooner the law-makers
recognize that fact the sooner a serious counter-attack can be launched against the
international drug- traffickers and their financiers.
What evidence can be offered to substantiate the claim that politicians do not fully
appreciate the nature of the problem and the need for urgent action on an international
scale? Consider our own Home Secretary, Mr. Leon Brittan, who has been quoted as
saying that the battle against drug abuse can be won through co-operation between
governments, law enforcement agencies, professionals, schools and families, though it
will be "slow and painful", with the price of ultimate failure being unthinkable.
Unless Mr. Brittan means by "co-operation", some form of international legislation
enforceable upon individual states by the imposition of internationally agreed
penalties, he is merely uttering pious hopes. The type of international legislation
which is urgently needed will be dealt with later but it may be of value to consider
first the social, economic and potential political costs if the current situation is
allowed to continue to its logical conclusion.

 The current situation

Some form of "co-operation" has existed for years, not only at an official level,
between governments and law enforcement agencies, yet still the narcotics pour in
and more and more people are drawn in to drug abuse. Ever more rapidly the market
for the drug-traffickers is growing - from high status, wealthy addicts to the lower
social classes. This market change has a direct effect, which may be observed by the
rise in crime related to the need to obtain money by addicts who have no other source

40
of funds. A juvenile or unemployed addict needs an estimated £200 per week to cater
for his drug needs (in some areas the cost may be as low as £120 and in others it may
be higher). Taking £200 as a reasonable average, consider the cost overall to just the
United Kingdom, of our addicts. If there are, approximately, 140,000 addicts in the
country not on the register, and if each needs £200 per week, the dealers are gathering
£28,000,000 per week! If one quarter of the addicts can afford to pay for their drugs
from legitimately obtained funds, then the remaining three-quarters. 105,000 people
need to obtain £21,000,000 per week by illicit means.
Remember - these addicts must have their drugs. It can, therefore, come as no surprise
to anyone that crimes involving theft must rise inexorably. The fact that theft is taking
ever greater amounts of money from the general economy of the country may be seen
not only from bare criminal statistics but also from recent statements issued by British
insurance companies to the effect that the costs of claims have grown to the extent
that the insurers are looking to increased premiums and no-claims schemes to recoup
their losses.
Quite frequently the police come in for criticism in relation to crime levels - usually
linked to sarcastic comments about police pay. Yet the number of police available for
all duties limits the numbers available for deployment against drug abuse and even
those who are employed directly against the drug trade are insufficient to deal with
but a tiny fraction of the problem on a force or even national scale.
Police and customs have a whole variety of tasks to carry out of which narcotics
control is only a fraction. The drug-traffickers have one aim and that is to get the
drugs from their place of origin to the addicts at a profit . . . and they are succeeding.
In 1983 the U.K. authorities seized 201 kilograms of heroin. Yet this amount was
estimated by the Customs as only one-tenth of what was available on the streets.
Think of the meaning of this in cash terms and compare the amounts with the
resources made available to police and customs to combat the illicit trade.

 The Public Health Impact of Drug Misuse

The harms associated with illicit heroin use include increased mortality from overdose
and from other directly or indirectly associated harms such as increased risk of
infection with blood-borne viruses (HIV, hepatitis B and hepatitis C); high levels of
depression and anxiety disorders; social problems such as disrupted parenting,

41
employment and accommodation; and increased participation in income-generating
crime.
Mortality, particularly in heroin-dependent users, is high, with estimates of between
12 (Oppenheimer et al., 1994) and 22 times (Frischer et al., 1997) that of the general
population. In England and Wales, there were 1,382 drug-related deaths in 2005
(National Programme on Substance Abuse Deaths, 2005). The majority (59%) were
cases of accidental poisoning, although a sizeable proportion (16%) was a result of
intentional self-poisoning. Opioids (alone or in combination with other drugs)
accounted for some 70% of the deaths, and cocaine 13%. Many of the deaths appear
to be due to multiple drug toxicity, especially the presence of central nervous system
depressants (for example, alcohol and benzodiazepines), rather than simply an
‘overdose’ of an opioid. This is supported by research that shows those whose deaths
were attributed to overdose have opioid levels no higher than those who survive, or
than heroin users who die from other causes (Darke & Zador, 1996). Recent cohort
studies have shown that mortality rates from methadone-related death are decreasing
(Brugal et al., 2005).
HIV infection is a major problem for injecting drug users, with the number of new
diagnoses of HIV in the UK holding at around a hundred for the last few years, with
5.6% of all UK diagnoses attributed to injecting drug use by the end of 2005 (Health
Protection Agency et al., 2006). There are differences in geographical distribution of
HIV in the UK, with rates higher in some centres such as London. Approximately
50% of injecting drug users has been infected with hepatitis C, but this rate, like the
HIV prevalence rate, is lower than in many other countries (Health Protection
Agency et al., 2006). Transmission of both hepatitis A and B continues even though
there are effective vaccines. Needle and syringe sharing increased in the late 1990s,
and since then has been stable with around one in three injecting drug users reporting
this activity in the last month (Health Protection Agency et al., 2005).
Psychiatric comorbidity is common in drug misuse populations, with anxiety and
depression generally common, and antisocial and other personality disorders
in opioid-using populations (Regier et al., 1990, 1998). The national US
Epidemiological Catchment Area study of the prevalence of mental health disorders
reported a 47% lifetime prevalence rate of substance misuse (drugs and alcohol)
among people with schizophrenia compared with 16% in the general population, and
found that more than 60% of people with a diagnosis of bipolar I disorder had a

42
lifetime diagnosis of substance misuse disorder. Around one in five of the people in
the NTORS sample had previously received treatment for a psychiatric health
problem other than substance misuse (Marsden et al., 2000). Drug misuse disorders
complicated by other comorbid mental disorders have been recognized as having a
poorer prognosis and being more difficult to treat than those without comorbid
disorders; comorbid disorders are more likely to be chronic and disabling, and result
in greater service utilization.
Lost productivity and unemployment increase with the severity and duration of drug
misuse, and personal relationships are placed under considerable strain by dependent
drug use. Problems with accommodation are also common in such groups. For
example, prior to intake in the NTORS, 7% of the study group were homeless and
living on the street, 5% were living in squats and 8% were living in temporary hostel
accommodation (Gossop et al., 1998).
Drug misuse may also have a negative impact on children and families (see Section
3.11). In the UK it is estimated that 2–3% of all children under the age of 16 years
have parents with drug problems (ACMD, 2003). While use of opioids does not
necessarily impact on parenting capacity, registration on UK child protection registers
for neglect has been correlated strongly with parental heroin use, and parental
problem drug use has been shown to be one of the commonest reasons for children
being received into the care system (Barnard & McKeganey, 2004).

 Identification and Assessment of Drug Misuse

So prevalent is drug use that all healthcare professionals, wherever they practice,
should be able to identify and carry out a basic assessment of people who use drugs.
Many people who misuse drugs do not present to drug treatment services, with
perhaps 50% of people who misuse drugs not seeking treatment; however this
represents a significant improvement on the position in the UK in the early 1990s,
when perhaps only 20% of people who misused drugs sought treatment. Of those who
do not seek treatment for their drug misuse, a proportion may nevertheless present to
other medical services, the criminal justice system and social care agencies. Many
will not be seeking help for their drug problems and many, for example some of those
primarily misusing cocaine or cannabis, may not be aware of the potentially harmful
effects of their drug use. It is probable that those who present to services for drug

43
treatment have the greatest number of problems (Best et al., 2006b).
Routine screening for drug misuse is largely restricted in the UK to criminal justice
settings, including police custody and prisons (Matrix Research and Consultancy &
National Association for the Care and Rehabilitation of Offenders [NACRO], 2004);
it is sparsely applied in health and social care settings. For example, a recent study of
psychiatric inpatients in London found that only 1 in 50 people admitted to hospital
had undergone screening for drug misuse (Barnaby et al., 2003). The NTA’s updated
Models of Care service framework emphasises the importance of non-specialist (tier
1) services in the identification of drug misuse as a precursor to referral for treatment
(NTA, 2006a). Opportunistic methods for the effective identification of drug misuse
should therefore be considered in a variety of healthcare settings.
For those identified and considering treatment, a good assessment is essential to
continuing care. Assessment skills are important across all of those health’s and social
care professionals who may come into contact with drug misuse. Assessment includes
information about past and current drug use (amount, type, duration, periods
of abstinence and effect of abstinence), history of injecting, risk of HIV and other
blood-borne viruses, medical history, forensics and previous contact with treatment
services. Assessment is a continuous process carried out at every contact with the
individual and his or her healthcare professional, counselor or social worker and can
take place over many years. Urine testing for the absence or presence of drugs is an
important part of assessment and monitoring. Formal rating scales may be helpful in
assessing outcomes and in certain areas of monitoring, for example of withdrawal
symptoms.
The aims of assessment are: to confirm drug use (history, examination and urinalysis);
assess the degree of dependence; identify complications of drug misuse and assess
risk behavior; identify other medical, social and mental health problems; determine
the expectations of treatment and the degree of motivation to change; assess the most
appropriate level of expertise required; determine the need for substitute medication;
and refer to/liaise appropriately with shared care, specialist or specialized generalist
care, or other forms of psychosocial care where appropriate. In addition, immediate
advice on harm reduction, including, if appropriate, access to sterile needles and
syringes, as well as testing for hepatitis and HIV, and immunization against hepatitis,
should take place.

44
  The cultivation of drugs
The illicit traffic in drugs can only be stopped at source. The majority of the drugs are
manufactured from plants grown in known areas in countries that are members of the
United Nations Organization. Plants such as papaver somniferum, the opium poppy,
grow in specific areas over a specific period of time and occupy identifiable growing
areas. No government may justifiably claim not to know that tracts of their national
territory are being used for the cultivation of drug crops. If necessary evidence
obtained by satellite or aircraft over flight may be produced. International legislation
must be produced by means of which governments can be forced to take action to
destroy the crops and any manufactured drugs resulting from them. The legislation
must provide for friendly States to be legally permitted to aid any government, which
claims to be unable to enforce its jurisdiction over any part of its own territory as a
result of lack of resources to do so, whether the lack is in men, money, or material.
The countries in which the drug crops are grown are well known and it is patently
obvious that the huge sums of money generated from the illicit drug trade are used to
corrupt many in authority who should be suppressing the trade in those states. In such
circumstances no ordinary system of penalties will avail to bring about necessary
action. It must be accepted therefore that penalties, which might otherwise be
regarded as draconian, must be provided and must be seen to be aimed at
governments and the powerful, not at ordinary citizens. The countries most involved
are all what are known as Third World or less developed countries. As such they are
in receipt of internationally provided resources such as funds from the IMF, aid from
the World Bank, and assistance from U.N. specialized agencies such as the Food and
Agriculture Organization, U.N.E.S.C.O., W.H.O., I.C.A.O., I.L.O., U.P.O., I.T.U.,
etc. It is through these organizations that penalties may be imposed progressively on
offending countries. No matter how corrupt a government, or individuals within a
government, they can be forced to take action against the illicit drug trade by a
gradual and advertised cutting-off of all international aid. Their trade may also be hit
by imposing a customs requirement upon all the contracting states to treat goods,
passengers and conveyances from the offending state, or even transmitting it, as
subject to maximum search and inquiry. This would have the effect of reducing their
trade almost to a standstill and would ensure that no one would go there who did not
have to, as even a visit would be reasonable grounds for suspicion. For the more
obdurate, corrupt, or merely unwise governments, the full provisions of the old Piracy

45
Laws may be utilized through recognition of the conventions, which pertained, by the
United Nations.
The offence of illegally growing, manufacturing or trafficking in drugs must be
punishable under international law in any competent court of any country where an
offender may be found or into which he may be carried. Equivalent penalties must be
prescribed for those who are proved to have financed any of the drug operations even
though they themselves were not directly involved with the drugs. Similarly, where
international institutions are penalizing an offending state, laws must be enacted
which prohibit and prevent private institutions from dealing with that state upon pain
of prosecution and punishment.
The present system of inter-governmental "co-operation" must be superseded by an
acceptance of the need to pursue traffickers wherever they go without need of any
previous declaration or arrangement, and no trial should be put in jeopardy for lack of
consent by any government to any pursuit or inquiry.
Similar legal provision must be made for the illegal manufacture or trafficking in
synthetic drugs. Most of them require elements, or chemicals or equipment, which
advertises their use for illicit purposes, and the suppliers of the equipment and raw
materials, ensuring that they are supplied only to authorized users, can keep a check.
Suppliers must be required to keep strict and accurate records for inspection by
authorized agencies, and must also be compelled to notify the agencies at once if
materials are stolen, mislaid, or otherwise disposed of other than by means of
legitimate trade.
As the sums of money involved in the drug trade are so enormous, it may be that law
enforcement agencies could be helped more by the financial institutions and even by
government departments with economic responsibilities. When you are dealing with
millions of pounds per week, the very mass or volume of cash transactions must be
recorded and may be detectable. It may be that with the growing use of computers in
the financial world, large cash sums may show up as anomalies in what might
otherwise be apparently normal transactions. For example, in the present economic
situation, few companies are making very large profits. If some companies or
individuals were consistently remitting, transferring, banking, or exporting large
sums, investigation would seem called for if no overtly lawful source could be found!

46
 Chapter-IX
Remedial and Awareness Programmes Controlling Drug Abuse
Botvin et al67 cited several key factors required in prevention programmes to make
them effective. These factors include a need to address multiple risk and protective
factors, provide developmentally appropriate information relative to the target age
group, include material to help young people recognize and resist pressures to engage
in drug use, include comprehensive personal and social skills training to build
resistance, deliver information through interactive methods and cultural sensitivity
that includes relevant language and audiovisual content familiar to the target
audience 68
. Successful prevention programmes should incorporate all of these
characteristics and can then be provided through the family, school, community or
healthcare community.
The 2010 NIDA Report 69
emphasizes both the role of family and community
prevention programmes as vital to deterring child and adolescent substance abuse.
Their findings are summarized below:
Family prevention programmes: The NIDA Report emphasizes strengthening
protective factors through the family, including increasing family bonding and using
appropriate discipline. The following family characteristics place children at a higher
risk for substance abuse: parent with a history of alcoholism and drug abuse, high
levels of family conflict, lack of and/or inconsistent parental discipline. It follows that
eliminating these risk factors can reduce the risk of a child/adolescent abusing drugs
and alcohol. Once these risk factors are identified, families may benefit from formal
prevention programmes that can focus on enhancing family bonding, parenting skills
(including communication, rule-setting, appropriate disciplinary actions) and
changing parental behaviours that may place a child at risk for later abuse70.
One example of a family prevention/treatment programme is multi-dimensional
family therapy (MDFT). This is a comprehensive family-based outpatient or partial
hospitalization (day treatment) programme for substance-abusing adolescents and

67
Bovin G, Griffin KW. School based programmes to prevent alcohol, tobacco and other drug use. Int
Rev Psychiatry. 2007;19:607–15.
68
Id.
69
National Institute on Drug Abuse (NIDA) A research-based guide for parents, educators and
community leaders. 2nd ed. Bethesda, Maryland, USA: NIDA; 2010. Preventing drug use among
children and adolescents.
70
Id.

47
those at high risk for continued substance abuse and other problem behaviours.
MDFT focuses on helping youth develop more effective coping and problem-solving
skills for better decision-making and help the family improve interpersonal
functioning as a protective factor against substance abuse and related problems.
Liddle et al71 compared multi-dimensional family therapy with individual cognitive
behavioural therapy (CBT) and found that although both treatments were promising,
MDFT was more efficacious in treating substance use problem severity, in addition to
creating more long lasting effects than standard CBT.
Community and school prevention programmes: In addition to family
programmes, NIDA emphasizes school and community programmes as being
beneficial in substance abuse prevention. The Report also suggests introducing
programmes at an early-age (pre-school/first grade) to address risk factors for later
substance abuse, such as early aggression, poor social skills and academic difficulty.
One of the many examples of school prevention programmes cited in the NIDA
Report72 is Reconnecting Youth (RY); a school-based prevention programme for high
school students with poor school achievement and a potential for not completing their
education. Participants may also show signs of multiple problem behaviours, such as
substance abuse, depression, aggression, or suicidal behaviours. Students are screened
for eligibility and then invited to participate in the programme. The programme goals
are to increase school performance, reduce drug use, and learn skills to manage mood
and emotions. RY blends small group work (10-12 students per class) to foster
positive peer bonding, with social skills training in a daily, semester-long class. Early
experiments have shown that participation in RY improved school performance (20%
improvement in grade point averages), decreased school dropout, reduced hard drug
use (by 60%), and decreased drug use control problems, such as progression to
heavier drug use73.
Role of healthcare providers in prevention: It is believed that less than 30 per cent
of primary care providers perform any screening for substance abuse and as many as

71
Liddle H. Theory development in a family-based therapy for adolescent drug abuse. J Clin Child
Psychol. 1999;28:521–32.
72
Supranote 69.
73
Thompson E, Horn M, Herting J, Eggert L. Enhancing outcomes in an indicated drug prevention
program for high-risk youth. J Drug Educ. 1997;27:19–41 and Eggert LL, Thompson EA, Herting JR,
Nicholas LJ. Reducing suicide potential among high-risk youth: Tests of a school-based prevention
program. Suicide Life Threat Behav. 1995;25:276–96.

48
69 per cent do not offer any type of counselling 74. Hallfors et al75 cited the following
barriers affecting the screening and prevention services in primary care: lack of tested
screening tools, lack of knowledge, skills and confidence, financial disincentives
(third party services for covering prescription abuse vary widely); and lack of follow
up services and resource limitations.
Efforts from paediatricians and primary care providers to overcome these barriers can
assist in identifying substance abusers and eventually lead to their treatment.

74
Klein JD, Slap GB, Elster AB, Cohn SE. Adolescents and access to health care. Bull NY Acad
Med. 1993;70:219–35.
75
Holfors D, Van Dorn RA. Strengthening the role of two key institutions in the prevention of
adolescent substance abuse. J Adolesc Health. 2002;30:17–28.

49