Story Publication logo April 24, 2015

Kashmir's War on Drugs


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The India-Pakistan border overflows with heroin. Journalist Michael Edison Hayden and photographer...

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Multiple Authors
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A counseling center for India's growing population of drug users. Image by Sami Siva. India, 2014.

SRINAGAR, India — A.N. was waiting for the school bus to take him home one day in 2005 when four masked men carrying AK-47s sprinted out from a white coupe and unloaded a storm of bullets. They tore apart a man, dropping him flat onto his back in front of a nearby pharmacy. A.N. remembers the blood spilling out of the victim's torso onto the ground behind the bus stop. He remembers listening to the sound of the getaway car screeching away as onlookers from a market started to gather. And he remembers going home that night and crying to his father, harboring a sense of panic so intense that he felt feverish.

Ten years later, A.N., now 24, spends most of his day looking for jobs online and meditating on what he calls his "lost years" — from roughly 2006 until 2010 — when he dropped out of school and started abusing opiates. A polite, pensive man with a round face, jet-black hair, and delicate features, A.N. sips chai and chats with friends like M.M., 32, another ex-opiate user, and Yasir Arafat Zahgeer, 30, a social activist and counselor who advised both men in their recovery from addiction. In Srinagar one evening in December 2014, as they walk along the dimly lit pavement of the Habba Kadal bridge, known by many locals as the "suicide bridge" because of its attraction to jumpers, their conversation switches among politics, cricket, and news stories like those of the region's slow recovery from the September 2014 flood. They also speak about trauma and the unanswerable question of what life could have been like had they been born in a less violent place with simpler politics — somewhere other than Kashmir.

A.N. and M.M. are among an unknown number of young Kashmiris who have abused opiates as a way of coping with post-traumatic stress disorder (PTSD) — trauma they experienced growing up in an atmosphere where violent conflict was the norm and a police or military presence loomed over every street. "Eighty percent of Kashmiris have experienced some kind of trauma related to violence," says Arshad Hussain, 38, a psychiatrist at the Government Medical College in Srinagar, the summer capital of the state of Jammu and Kashmir. There are no reliable government figures on opiate use in Kashmir. Hussain guesses that about one-fifth of young men in Srinagar have used opiates at some point. "Drug abuse is a big issue in Kashmir," says Hussain, one of the region's leading PTSD researchers, "because trauma is a big issue in Kashmir."

A lush, mountainous region of 7 million people and claimed by both India and Pakistan, Kashmir today sees violence erupt only periodically. Ten days before my visit in December 2014, militants killed 11 soldiers and police officers near the border with Pakistan. But in A.N.'s lifetime, roughly 43,000 people have been killed as a result of the conflict, according to Indian government figures. Many in Muslim-majority Jammu and Kashmir have wanted the state to be part of Pakistan or be independent, creating tensions that have often led to violence. Rights groups like Human Rights Watch suggest that the number of dead is likely much higher due to a proliferation of unmarked graves and disappearances that activists say still require accountability from the government.

"I had seen dead bodies before, of course. We all had in Kashmir, growing up. On roadsides, all around Srinagar," A.N. says.

In Srinagar, a city of about 1.2 million people that's marred by the ubiquity of angry-looking webs of barbed wire, drug abuse is an extremely taboo subject. Unusual for India, few places serve alcohol publicly in Srinagar — and the places that do are mostly hotels that cater to international tourists. The vast majority of the city's population is Muslim, and an atmosphere of religious observance is commonplace. For this reason, along with concerns with how past drug use might affect their ongoing search for employment, A.N. and M.M. asked to be identified only by their initials. "I'm telling you my story because I want to help people like me," says A.N. "The first thing you see going to school as a kid in Kashmir is men standing with guns. Do you think it's any wonder why so many of us grow up abusing drugs?"

Zahgeer, the counselor and A.N.'s friend, used to work at the Police De-Addiction Centre, a treatment facility established by the Jammu and Kashmir state police, before leaving in 2013 to work with the Society for Promotion of Youth and Masses, a nonprofit that focuses on drug rehabilitation for juveniles. Zahgeer says that the majority of people he knew growing up dabbled in opiate-based pills, cannabis, or harder drugs like heroin, a phenomenon that inspired him to pursue a career as an activist at 16 in hopes of drawing greater attention to Kashmiri youth who fall into drugs. Cannabis use is fairly common in Srinagar, according to Zahgeer, because it can be found growing in forests and along roads outside the city. Heroin and other opiates are sometimes cultivated locally but are far more likely to originate in Afghanistan and then be smuggled across the nearby border with Pakistan.

M.M. is soft-spoken and hunches over in shyness when he speaks. Like A.N., he's unemployed, and also like A.N., he says he's looking for pretty much any permanent position he can get. The friends met through intersecting social circles near Dal Lake, a popular tourist attraction that sits at the center of Srinagar, and they bonded over drugs. M.M. said he became addicted in 2003, a few months after the Indian Army arrested him in a raid. The soldiers held him in an interrogation center for three months, and M.M. claims soldiers tortured him before releasing him. (A spokesman for the Indian Army declined to comment on M.M.'s allegations.)

Shortly after leaving the interrogation center, M.M. experimented with a drug called Spasmo-Proxyvon (SP), an opiate-based pill often prescribed to help pregnant women with labor pains. "I was beaten for three months," M.M. says. "Soon after I came out of that detention I started using drugs."

After developing an addiction to opiates through SP, M.M. graduated to what is known as "brown sugar," a smokable form of heroin. He struggled with opiate addiction for the next 10 years, before Zahgeer helped him stop.

It's sometimes difficult even for locals to keep track of the alphabet soup of military organizations stationed here: the BSF, CRPF, RR, CSIF, SOG, JKAP, TA, all of which are afforded special privileges, under the 1958 Armed Forces (Special Powers) Act, to arrest people without obtaining warrants due to Kashmir's distinction as a conflicted area. Human rights groups like Amnesty International have criticized the act, saying it allows abuses to go unchecked, and allegations of torture, like M.M.'s, have haunted the region for many years. In Kashmir, Hussain says, "you are not dealing with people who just want to have fun. These users need psychological help with trauma, and when they don't get it, drugs become the answer."

SP and other opiate-based medications are often the first step toward an opiate addiction in Kashmir. SP, for example, is currently only legally available in Kashmir at hospitals for pregnant women and as a replacement drug to help bring users off heroin — not unlike methadone, another synthetic opioid commonly used in the United States — according to local doctors and pharmacists. Since 2006, it has become much harder to purchase SP at local pharmacies here, thanks to the efforts of psychiatrists like Hussain who successfully petitioned Wockhardt, the maker of the drug, to stop promoting it in Kashmir in 2006. (A media representative from Wockhardt declined to comment.) Still, the popularity of opiate-based pills like SP persists through the black market and often provides ink to local crime blotters, as with the police seizure of 912 tablets of SP in April 2014.

Inspector General A.G. Mir, 46, who heads the Jammu and Kashmir police, acknowledges that drug abuse has become a serious problem in his home city of Srinagar. His office walls, lined with intricate khatamband woodwork, a kind of chiseling that resembles a sprawling mural of tiny floral designs, also feature several anti-drug propaganda posters. One shows a human head made of pills, bearing the headline "Say no to drugs — before it's too late!"

Mir says that the police are trying to be sympathetic to the problems opiate addicts face in Kashmir and acknowledges that many of them stumble into over-the-counter opiates by accident, as Hussain and Zahgeer allege. "We came to the conclusion that these users are people who have a disease," Mir says. "This state has been impacted deeply by violence, and because of this psychological problems are engrained in society."

One way the police responded was by creating a help line, along with the Police De-Addiction Centre, where Zahgeer used to work. The center is a place where people can come without fear of arrest, according to Mir.

One man, a middle-aged laborer from Srinagar who declined to be named, spoke about his 20-year-old son, whom he brought to the de-addiction center for help with over-the-counter opiates and cannabis in December 2014. He sat in a small waiting room with yellowing walls and no heating. Other nervous-looking fathers sat rubbing their hands, waiting for the release of their sons. "I was looking for a way to help him stop using drugs and get his life on track," he said.

A.N. says that though good-intentioned, the de-addiction center is a failure in the eyes of many users, largely because the majority of them do not trust the police. "Nobody wants to go to the police for help with their drug problem," he said.

Help in the form of psychological treatment for PTSD is what young users need most in Kashmir but are reluctant to seek, according to Hussain. He says that it is a struggle for users to reach into a painful place in their psyche and find the root of a drug problem. Combined with the looming fear of religious judgment and a mistrust of authority figures, it makes this crisis a tricky one to resolve.

"One boy I treated was 4 years old when his father was shot in the head and killed by crossfire between militants and the police," recalls Hussain.

"They were riding together on a motorbike, and then the body of his dead father lay on top of him for two hours before someone came to take him off. Now he's 16 and addicted to Spasmo-Proxyvon. He started treatment with me for a few weeks and then gave up and ran away."



Drug Crises


Drug Crises

Drug Crises
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Health Inequities

Health Inequities
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Outbreaks and Epidemics

Outbreaks and Epidemics

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