Operationalising de-addiction centres and implementing inclusive policies are critical to addressing the escalating substance abuse emergency in the region
Substance abuse in Jammu & Kashmir has escalated to an alarming degree, with leading experts estimating a 400% spike in consumption patterns over the past five years. While the international market is dominated by more lethal and potent drugs like fentanyl, methamphetamine, and cocaine, often trafficked through transnational cartels, the region of Jammu & Kashmir (J&K) is witnessing a dangerous and escalating proliferation of synthetic opioids and prescription drugs. Substances such as Tapentadol, Pregabalin, Tramadol, and even veterinary-grade Avil (Pheniramine) now dominate the local narcotic landscape. These substances, though medically classified for therapeutic use, are increasingly being misused in high doses, often in combination—a trend known as poly-drug abuse.
Their widespread availability through unregulated pharmacies, diverted prescriptions, and illegal channels has created a pseudo-legal drug economy that is more difficult to detect, monitor, and control than traditional narcotics. Unlike heroin or cannabis, whose trafficking can be geographically traced and policed, synthetic pharmaceutical opioids and antihistamines are easily concealed within legal supply chains, making interdiction more challenging. This silent infiltration has led to a surge in drug dependency cases, particularly among the youth aged 16-30, with public health institutions like IMHANS (Institute of Mental Health and Neurosciences, Srinagar) registering 5 to 10 new dependency cases daily, excluding follow-ups.
The consequences of such a trend are profound and deleterious and include overdose deaths, increased psychiatric comorbidities, social isolation, and the disintegration of family structures. Ironically, in stark contradiction to this surge, not a single District De-Addiction Centre (DDAC) under the Government of India’s flagship National Action Plan for Drug Demand Reduction (NAPDDR) is operational across the Union Territory. Twelve districts including Anantnag, Baramulla, Shopian, and Udhampur were officially identified and approved for DDACs under the 2023 Expression of Interest (EOI) notification, but no centre has been activated due to the pending release of advance Grant-in-Aid (GIA) by the Ministry of Social Justice and Empowerment (MoSJ&E), Government of India.
This dissonance between policy formulation and ground-level implementation reflects a deeper structural neglect, turning a promising national blueprint into a silent bureaucratic failure. Of particular concern is the rise in polydrug abuse among the youth, where multiple substances are consumed simultaneously, which is amplifying health risks and complicating rehabilitation. Left unaddressed, this trend threatens irreversible consequences for the region’s most vulnerable demographic.
On this International Day Against Drug Abuse and Illicit Trafficking, it is time to move beyond ceremonial pledges and symbolic observances. What is needed now is institutional accountability, community-anchored action, and the immediate operationalisation of the long-approved but still non-functional District De-Addiction Centres (DDACs) in Jammu & Kashmir—centres that continue to await the sanction and release of Grant-in-Aid (GIA) from the central government. The cost of inaction is no longer abstract but is appropriately tangible, measurable, and tragically mounting with each passing day. Lives are being lost, families fractured, and futures erased, not for lack of policy, but for lack of execution.
Unerthing the disconnect: Why Jammu & Kashmir’s De-addiction centres remain a promise deferred
The Ministry of Social Justice & Empowerment (MoSJ&E), Government of India, launched the National Action Plan for Drug Demand Reduction (NAPDDR) with a bold, five-pillar framework designed to tackle substance abuse through awareness, prevention, treatment, rehabilitation, and reintegration. Recognising the need to decentralise addiction care and expand grassroots-level support, the Ministry issued Notification No. 12/28/2021-DP-II (EO 40896), dated 19/06/2023, inviting eligible NGOs and community-based organisations to establish District De-Addiction Centres (DDACs) in 381 “gap” districts across India—areas most underserved by existing de-addiction infrastructure.
Among the identified zones were twelve districts from Jammu & Kashmir: Anantnag, Baramulla, Budgam, Doda, Ganderbal, Kathua, Kishtwar, Poonch, Ramban, Reasi, Shopian, and Udhampur, with each chosen for their escalating substance abuse patterns, growing youth vulnerability, and lack of accessible support systems. This selection was not arbitrary; it was rooted in epidemiological urgency and the compelling need for institutional care mechanisms. Surprisingly, even after passing of two years, not a single one of these proposed centres has become operational. Despite meeting rigorous compliance standards, including proposal submission, site identification (with several spaces formally granted by District Magistrates), and adherence to the “One NGO – One District” implementation strategy, the release of Advance Grant-in-Aid (GIA) from the central government remains pending.
This funding impasse has paralysed the initiative at its very foundation, rendering critical infrastructure inert at a time when it is most needed. This is not merely a bureaucratic bottleneck but can be regarded as a structural failure in public health governance. At its core, it reflects a dangerous contradiction: the existence of a robust national framework without the political or administrative will to activate it.
Pertinently, the NAPDDR was envisioned as a transformative plan, yet its failure to activate approved DDACs in J&K raises critical questions: Why, despite demonstrated need and full procedural compliance, have these centres been left non-operational? What explains the administrative silence on the disbursement of GIA for already sanctioned proposals? How long must vulnerable populations wait before policy translates into accessible care?
As addiction trends spiral across the region with alarming spikes in synthetic opioid use, increased prevalence of prescription drug misuse, and youth populations disproportionately affected, the cost of delay is no longer theoretical. It is measurable in emergency room visits, untreated trauma, broken families, and lost lives. Again, on the occasion of this International Day Against Drug Abuse and Illicit Trafficking, one truth that is undeniable is that a policy without timely funding is only a fiction. In regions like Jammu & Kashmir, where addiction has become a silent epidemic, every day of inaction compounds the crisis.
The proposed DDACs were never intended to be simple detox units. These centres represent more than infrastructure—they are potential lifelines for a generation in crisis. Despite the importance of these centres in de-addiction initiatives, they remain unrealised blueprints, and their physical infrastructure remains dormant, with their promises unmet. With every passing day, the absence of action deepens the human, economic, and cultural toll. Failing to operationalise these centres is not just a missed opportunity; it is a collective forfeiture of hope, dignity, and recovery for thousands of affected individuals and families across the region.
Their vision encompassed much more and included:
– Culturally responsive, stigma-free community healing spaces
– Trauma-informed mental health and addiction counselling
– Vocational training for socio-economic reintegration
– Youth-focused outreach and early intervention programs
– Family-oriented support mechanisms for sustainable recovery
Despite all of this, the entire process remains locked in administrative limbo, not due to a lack of planning or commitment from grassroots actors, but due to an avoidable failure in resource mobilisation. It must be remembered that the operationalisation of the DDACs in J&K cannot be treated as a footnote, for it is a national imperative.
A public health emergency hiding in plain sight
What we are witnessing in Jammu & Kashmir is not a bureaucratic anomaly; it is rather a systemic public health emergency concealed beneath layers of administrative inertia. Ground-level surveillance and emerging healthcare data point to a staggering 400% rise in substance use presentations between 2020 and 2025. Of grave concern, young individuals aged 16 to 30 now account for nearly 60-70% of those affected, signalling a generational crisis with long-term social and economic consequences.
Public sector health infrastructure is buckling under the weight of demand, with chronic overcapacity in government hospitals, limited availability of addiction specialists, and minimal outpatient follow-up mechanisms. Meanwhile, private de-addiction and rehabilitation services remain financially out of reach for the majority, further widening the treatment gap. In such a context, the continued non-operational status of the District De-Addiction Centres (DDACs), despite formal identification and administrative approval, must not be viewed merely as a delay in execution. It constitutes an ethical breach—a failure of duty in the face of escalating human suffering.
If left unaddressed, this negligence will not only exacerbate the current addiction crisis but will also erode public trust in health governance mechanisms, making future interventions more difficult and less effective.
Policy myopia: The 2025 oversight that cannot be ignored
In May 2025, the Ministry of Social Justice & Empowerment (MoSJ&E), Government of India, issued a second national call for Expressions of Interest (EOI) under the National Action Plan for Drug Demand Reduction (NAPDDR). This round extended eligibility for the establishment of District De-Addiction Centres (DDACs) to 296 additional districts across the country. Notably and alarmingly, Jammu & Kashmir was entirely absent from this latest notification. Neither were the previously approved 12 DDACs in J&K revived, nor was a single new district in the region included.
This exclusion is more than an administrative lapse; it reflects a critical failure in strategic vision and policy continuity. From this key, hard questions emerge: Why were 12 fully approved and compliant districts in J&K dropped from the renewed national de-addiction plans without explanation? Why was Jammu & Kashmir entirely excluded, despite a documented addiction surge across all 20 districts? What justifies leaving sanctioned, ready-to-operate DDACs unfunded, while the crisis on the ground escalates by the day?
Such inconsistencies not only erode public trust in institutional commitments but also undermine the legitimacy of national public health strategies. The exclusion discourages community-based organisations and civil society stakeholders who responded in good faith to earlier EOIs, having demonstrated capacity, readiness, and intent. In J&K, where addiction intersects with longstanding socio-political fragility, youth vulnerability, and service deficits, such policy ambivalence becomes a form of structural neglect. It stalls momentum, weakens morale among implementers, and delays interventions at a time when urgency could not be more critical.
This is not simply a missed bureaucratic opportunity; it is a signal of marginalisation, with a region in the throes of a growing public health crisis risking being deprioritised in national recovery frameworks. Jammu & Kashmir cannot afford to be an afterthought. A responsive, inclusive, and data-informed policy revision is imperative because silence in the face of spiralling addiction is no longer an option.
A practical roadmap involving approval and activation
The gulf between policy approval and on-ground implementation is not insurmountable. What it demands is clarity of vision, urgency of action, and integrity in follow-through. To bridge this operational void and realise the objectives of the National Action Plan for Drug Demand Reduction (NAPDDR), a pragmatic, five-pronged strategy is proposed:
- Immediate release of Grant-in-Aid (GIA): The initial tranche of funding is essential and not merely symbolic. It enables recruitment of trained professionals, acquisition of medical and psychosocial resources, and initiation of community mobilisation. Delays at this stage create downstream bottlenecks that directly affect service accessibility for high-risk populations.
- Reintegration of J&K into the national de-addiction strategy: The exclusion of Jammu & Kashmir in the 2025 EOI must be re-evaluated. Public health planning must be reflexive; districts with worsening indicators should receive renewed focus. Reinstating the 12 previously approved districts will restore faith and accelerate capacity building in this critical frontier region.
- Establish transparent, real-time monitoring systems: A central digital dashboard should display district-wise data on DDAC operations, covering budget disbursal, staffing status, infrastructure development, and community engagement. Such visibility not only builds accountability but empowers stakeholders, including the public, to track progress and demand results.
- Foster decentralised and localised partnerships: Policy must not operate in a vacuum. Collaboration with local NGOs, academic institutions, primary healthcare workers, and district administrators ensures that interventions are rooted in community needs, thereby enhancing acceptance, trust, and efficiency.
- Implement culturally attuned and context-specific interventions: J&K’s social fabric is distinct, defined by regional dialects, faith traditions, and historical traumas. De-addiction strategies must therefore be customised to reflect these nuances, embedding trauma-informed care, family-centric rehabilitation models, and youth reintegration initiatives grounded in dignity and hope.
Augmenting traditional responses with digital innovation
As the global public health landscape adapts to complex, evolving challenges, the tools we deploy to combat addiction must advance accordingly. Traditional service delivery models, while foundational, must now be augmented by digital innovation and data-driven precision. For regions like Jammu & Kashmir, where terrain, trauma, and limited infrastructure constrain reach, technology offers a game-changing opportunity.
A digital augmentation strategy can include:
– Large language models (LLMs): Harnessed to generate culturally appropriate, localised communication for awareness, early intervention, and stigma reduction—particularly among digitally connected youth populations.
– Predictive analytics: Applied to epidemiological and social datasets to identify and forecast emerging high-risk clusters. This enables early intervention, optimal allocation of outreach workers, and proactive public health messaging.
– GIS mapping and geospatial tools: Used to locate service gaps, optimise mobile clinic routes, and create user-centred deployment plans for de-addiction and harm-reduction resources.
These technological augmentations are not theoretical but are globally validated tools. When integrated responsibly and ethically into public health strategies, they transform district-level response models from reactive to anticipatory, and from generalised to personalised.
Accordingly, this commentary calls for urgent and accountable action from the relevant authorities, both at the Union and state levels, to sanction the release of long-pending Grant-in-Aid for the already approved District De-Addiction Centres in Jammu & Kashmir. In light of emerging epidemiological patterns and rising substance abuse trends, it is equally imperative to reassess and expand the inclusion of new districts of J&K under the NAPDDR framework.
Only through decisive, inclusive, and timely intervention can the promise of equitable addiction care be realised and the growing public health emergency arising due to abuse and addiction in the region be meaningfully addressed.
About the writer
Dr Sami Ullah is Co-founder and Chairman of the RADISAT Foundation, which was allotted rent-free space by the District Magistrate Shopian to establish a Drug De-Addiction Centre under the NAPDDR scheme. The project awaits Grant-in-Aid sanction from the Ministry of Social Justice & Empowerment, GoI. He is a public health advocate working at the intersection of forensic science, addiction recovery, and grassroots intervention.
Dr Sami Ullah
sa********@***il.com