On 18 March 2020, just hours after the lockdown was announced in Kashmir to contain the spread of the COVID-19 pandemic, 22-year-old Nazia* received a call from her parents in Srinagar, asking her to immediately return home from Chandigarh, where she is pursuing engineering from a private university.
At first, Ms. Nazia was reluctant and tried to convince her parents to let her stay back with friends at their rented apartment but eventually gave in as her parents refused to relent. It wasn’t her wish to stay with her friends or her cherished independence that made her want to stay in Chandigarh. What Ms. Nazia really wanted to indulge in her dependency on heroin, a deadly addiction that she had latched onto sometime after arriving in the city.
It was Ms. Nazia’s classmate and friend from Kashmir who had introduced her to heroin in college. When she returned to Srinagar, Ms. Nazia tried to get in touch with local peddlers through her friends in Chandigarh. She, however, failed to procure the drugs.
“With every passing day it was getting difficult to hide my addiction from my parents,” she said, “but [my] withdrawal symptoms were pretty bad. I was getting irritated on small issues, and started staying aloof from my family.”
Two weeks later, as her condition further worsened, Ms. Nazia managed to get in touch with Mudasir Aziz, a psychotherapist, who counsels persons with drug addiction and psychiatric ailments at the government-run Drug De-addiction Centre (DDC) in south Kashmir’s Anantnag.
“She sounded desperate on the phone. She wanted to get rid of her addiction but without letting her parents know,” recalled Ms. Aziz, also a resident of Srinagar, she added that “Nazia needs counselling and hospitalization to help her quit.”
But except the DDC in north Kashmir’s Baramulla district, no other de-addiction centre is operational in the Kashmir Valley as they remain shut since the outbreak of COVID-19. Acute cases of heroin addiction, as with Ms. Nazia, are currently being sent to the government-run Institute of Mental Health and Neuro-Sciences (IMHANS) in Srinagar. At present, there are eight such patients under treatment there.
But, said Ms. Aziz, psychiatric institutions can, at best, only detoxify an individual with drug addiction when they actually need regular counselling, proper medical care, and some level of confidence-building to help their rehabilitation. “These things are only possible at dedicated DDCs,” she said.
When Ms. Nazia refused flatly to visit IMHANS for detoxification, partly because of taboo and partly to keep her addiction secret from her family, Ms. Aziz arranged to send medicines at her home discreetly. “She is better now. I am constantly in touch with her,” said Ms. Aziz. “But without proper counselling she has high chances of relapsing.”
Other individuals with drug addiction are, however, not as lucky as Ms. Nazia.
It is a continuous struggle for 30-year-old Musa* as he struggles to not relapse for the fourth time in the three years since he decided to seek help for his addiction. What had begun out of curiosity has turned into a nightmare for him and his family.
“It took him just a few shots to get addicted to heroin,” said Mr. Musa’s cousin Adil*, who is currently attending him at IMHANS. “We first tried to get him admitted to a drug de-addiction centre in Srinagar but it was closed because of Covid-19.”
A resident of Srinagar’s Bemina, Mr. Musa was recently also diagnosed with Hepatitis-C, a disease that has spread by injecting drugs through shared needles, further compounding his woes. “He used to inject heroin by sharing syringes with other addicts,” said Mr. Adil.
Mr. Adil is worried for his cousin, it is becoming increasingly difficult to prevent Mr. Musa from staying in touch with drug peddlers — even inside the hospital. “At DDC they were totally cut-off from outside contacts. But at IMHANS, it is not possible to keep check on every visitors,” said Mr. Adil. “The footfall of visitors inside wards is huge.”
Dr Mohammad Maqbool Dar, head of the psychiatry department at the Government Medical College, Srinagar, said that such breaches were possible since the institution was not an exclusive rehabilitation centre with stringent protocols. “Maybe some lapse could be there as we lack proper security setup at the hospital,” he said. “Unlike police-run DDC’s we have kept wards open to other patients as well. That can sometimes lead to lapse.”
Emerging on a large scale in Kashmir in late 2016, heroin is now commonly available across the erstwhile state as many persons with drug addiction eventually turn to peddling to keep their addiction going. There are “small mobile peddlers who are available on call,” said 23-year-old Haroon*, a resident of highway town Qazigund in south Kashmir’s Kulgam district.
Mr. Haroon hails from an affluent family and was first introduced to cannabis by school friends at the age of 15. “After taking it for a few years I was able to quit it successfully,” he said. In late 2016, a friend from school who was now a drug peddler reached out to Mr. Haroon. “I have a beautiful thing for you,” he had told him over the phone, arousing his curiosity.
The next day Mr. Haroon along with his two friends met the drug peddler. “He offered us heroin. We have never seen or heard about it before that,” he recalled. Out of curiosity, Mr. Haroon and a friend tried the drug. “It felt good,” he recalled.
For the next one month Mr. Haroon and his friend met the drug peddler at a roadside eatery in Qazigund to shoot up heroin. “He never asked for money. It was all free,” said Mr. Haroon. But the free run stopped exactly after a month. All of a sudden, the drug peddler had stopped answering his phone and never showed up at the eatery either.
It was then that Mr. Haroon and his friend realised the debilitation that addiction of heroin caused. “Without realising we were both addicted to heroin by then,” said Mr. Haroon. The duo ended up purchasing a gram of heroin for 1500 rupees.
“We were perhaps the first ones to try heroin in south Kashmir,”said Mr. Haroon’s friend Hassan*. “Back then, there were only a few peddlers who sold it. Now it is freely available.”
At the peak of their addiction, they consumed three grams a day each. Over the years, the price of one gram of heroin has gradually risen to about 6000 rupees today. “We must have spent 50 lakh rupees between us on heroin,” Mr. Haroon said with remorse.
Mr. Haroon was thrice admitted to the DDC in Anantnag for his addiction. But every time he was discharged, he would meet his old contacts and relapse. “I almost quit it a few months before the COVID-19 lockdown. I was clean for months. But during lockdown, with no way to keep myself distracted,” said Mr. Haroon. “I relapsed.”
Recently, his condition worsened as he started injecting heroin instead of snorting it as was his habit earlier. “He needed immediate help but all DDC’s were closed in Kashmir. So we took him to a private de-addiction centre in Mukerian city of Punjab,” said Mr. Haroon’s uncle. Having returned from rehab, he is currently kept in isolation at his home.
Kashmir needed a separate facility run by trained professionals who could handle patients with opioid addiction, said Dr Akash Yousuf Khan, senior consultant psychiatrist at the government-run hospitals in north Kashmir’s Sopore and Baramulla.
In a typical week, Dr. Khan counsels around 30 individuals with drug addiction in Sopore, and since the last two years all of them are addicted to heroin. “It is now a community level problem which is spreading fast,” said Dr. Khan.
Earlier cases of drug addiction reported to Dr. Khan were mostly cannabis, opioids, and other prescription drugs. “But now it is completely heroin. And the worst part is that all of them use it through intravenous injections,” said Dr. Khan. “This is really deadly.”
With the number of individuals addicted to heroin running into thousands, according to a recent survey by the IMHANS, the three main DDCs in Kashmir can accommodate no more than 50 individuals. The researchers estimate about 2 percent of the population in the Anantnag and Srinagar district were addicted to drugs.
Dr. Mohammad Muzaffar Khan, Director of the Youth Development and Rehabilitation Centre, Kashmir said that patient admissions to hospitals had stopped owing to the COVID-19 pandemic. Two months after the lockdown, “we started OPD but not IPD yet,” said Dr Khan. “I know because of this people had to suffer a lot.”
Dr. Khan, however, said that it was assumed that addiction would be curbed with the lockdown. “We thought during lockdown the addiction will go down as people have no contact with each other. But we were wrong. It has increased manifolds in fact. We need proper infrastructure to deal with such a huge rush,” he said. “During the first two months when the lockdown was strict we offered patients consultation on phone and online.”
In the last three months, after the COVID-19 lockdown was eased in mainland India, at least ten boys of Mr. Haroon’s age, whom he personally knew, have visited Haryana and Punjab for treatment. “I can count around 300 heroin addicts in Qazigund belt only whom I know,” said Mr. Haroon.
According to Altaf Hussain Shah, in-charge of the DDC in Baramulla, the COVID-19 lockdown saw a substantial increase in new cases and a relapse in the older cases of heroin addiction. “In the last three months we admitted 50 heroin related cases, and counselled another 100 in OPD,” said Mr. Shah.
Being the only functional DDC, Mr. Shah is getting requests from across Kashmir; parents begging him to help their children overcome addiction. “We have just five beds. How can we accommodate so many people?” said Mr. Shah. “It seems our entire young generation is addicted to heroin, and we don’t know yet.”
The cover story originally appeared in our 14-20 September print edition.