InDepth | Inside Kashmir's Rehab Centres Leading a Collective Fight Against Addiction

Ahmed* arrived at Srinagar’s Addiction Treatment Facility at the Institute of Mental Health and Neurosciences (IMHANS) carrying years of attempts to give up drugs behind him. The 28-year-old civil-engineering graduate’s dependence began with cigarettes, moved to cannabis and eventually to prescription opioids. Each substance came at a different point in his life, each harder to leave behind than the last. After a breakup in 2018 and growing pressure at home to join the family business, he began smoking weed. What started with a few joints a day eventually rose to as many as 15, settling at around eight to 10. Then came pharmaceutical drugs. Tramadol, commonly known by the brand name Proxy, entered his life at two capsules a day. Soon, he was taking as many as 15. Later, he moved to tapentadol, another opioid painkiller, consuming up to 15 tablets a day.

He quit in 2022. But quitting one drug did not end his struggle with dependence.

For around two years, Ahmed continued getting treated at IMHANS in Srinagar. Although he had stopped using the drugs, anxiety and insomnia persisted. He eventually began taking buprenorphine (BPN), a medication used to treat opioid dependence. At one point, he falsely claimed that he was using intravenous heroin to obtain it. He was initially prescribed three tablets, later reduced to two. By 2025, he was taking three to five tablets a day, he says, without misusing them. It was another chapter in a recovery that had never been straightforward.

This time, Ahmed was admitted to IMHANS. For him, staying inside the facility offered something that repeated OPD visits and medication had not: distance. Cut off temporarily from the people, routines and circumstances that had shaped his dependence, he was placed on a strict daily schedule built around treatment. Counselling gave him space to look beyond the immediate struggle of stopping drugs and think differently about his dependence and what life after it could look like.

“From this corner, I see other patients with cases worse than mine. I think about how I wasted some precious years, and how bad my situation could have been had I not decided to come to rehab,” he says, sitting on his bed inside the IMHANS rehabilitation centre. The ward is a large hall lined with beds, nearly all occupied. Patients of different ages lie or sit on them, some speaking quietly among themselves, others accompanied by family members who sit beside their beds..

When asked how he feels about his recovery, he rates himself “75 out of 100”. The number captures both the progress and the distance he still has left to travel.

A Crisis Bigger Than One Patient

Ahmed’s story is no longer an isolated one. As drug dependence has spread across Jammu and Kashmir, rehabilitation has moved from the margins of the response to its centre. Government hospitals have expanded de-addiction services, non-profit organisations are working with recovering users, counsellors are taking prevention efforts into schools and colleges and even the police has entered the rehabilitation space.

The scale of the response reflects the scale of the crisis.

In a written reply to a starred question tabled by MLA Devyani Rana, the health and medical education department said 32,517 patients had registered for addiction treatment across Jammu and Kashmir since 2022. Outpatient services are now functional in 20 districts, while inpatient services are available at all nine Government Medical Colleges. Eleven addiction treatment facilities (ATFs) are functional in the Kashmir Division and nine in the Jammu Division, with another ATF in Jammu sanctioned but yet to become operational.

Under the nasha mukt Bharat abhiyan, a government-led campaign to tackle substance abuse through community awareness, prevention, stricter action against drug trafficking, and expanded treatment and rehabilitation services, J&K has launched the 100-day nasha mukt J&K abhiyaan. The campaign focuses on grassroots outreach, training frontline workers, conducting awareness drives, and connecting people struggling with addiction to treatment and rehabilitation.

The government says addiction treatment facilities are now operational in every district of Kashmir Division and nine districts of Jammu Division, providing outpatient department (OPD) services and dedicated inpatient beds. Psychiatrists have also been posted in all government medical colleges to provide specialist support.

Official estimates put the number of people affected by substance dependence in J&K at more than 13.5 lakh, more than twice the estimate from 2022. In the Valley, a 2022 survey identified around 70,000 people affected by substance use, including nearly 50,000 heroin users. Heroin has become the most dominant drug in the Valley’s dependence scale, accounting for an estimated 90–95 per cent of dependence cases in some surveys. A large proportion of those dependent on drugs also inject them, bringing with it the additional risks of hepatitis C and HIV.

The response, consequently, has had to expand into a collective effort, of government hospitals treating dependence, non-governmental organisations (NGOs) providing rehabilitation, counsellors helping people rebuild their lives, police running treatment centres and families accompanying patients through the long process of recovery.

For Ahmed, for instance, staying at the facility meant being removed from his familiar environment, following a disciplined routine and having the time and space to think about recovery differently. “My mind shifted after that first session. I realised my addiction was only one part of the problem; my thinking and overthinking were another,” he says.

Jausiya Mehraj, a counselling psychologist at IMHANS says treatment at the in-patient department (IPD) combines medication, detoxification and psychological intervention, with patients typically spending 10–15 days in the detoxification phase before being shifted to maintenance medication or discharged. “The dependence stage is the last stage of substance abuse,” she says, adding that patients often arrive with substance-induced problems such as anger outbursts. The centre also screens for associated health problems and refers patients for treatment, including Hepatitis C cases.

Psychologists assess patients’ histories and premorbid personalities to understand why they began using substances, she says, adding that patients are kept there until they “reach a functional stage”. The centre is also planning skill-development programmes, including computer and plumbing courses, to help patients rebuild their lives after rehabilitation.

The Recovery Process

About two hours from Srinagar, in south Kashmir’s Tral, CAUSE, a non-profit organisation, has run one of the region’s major drug de-addiction centres since 2010. In 2023, it was converted into a rehabilitation centre in collaboration with the Ministry of Social Justice and Empowerment. Patients from across south and central Kashmir are admitted here, either through hospital referrals or the J&K Police.

A typical day for patients is a mix of routine and recreation: counsellors engage them in cricket and other games, while regular counselling sessions allow them to confront the reasons and patterns behind their addiction. The centre has a medical officer who stays on the premises, along with a psychiatrist, psychologist, two counsellors and 15 caregivers working in shifts.

Among the patients is Asif*, who was around 17 when he first used heroin. Today, he works as a mechanic, but between 2016 and 2019, he says, his life was increasingly consumed by drugs. It began during Ramadan, when a friend visiting from Chandigarh offered him heroin. “After consuming around three grams, I drove home... I stayed indoors for two days, and then I called the same friend to ask where I could get heroin again,” he recalls. By 2019, he says he would use as much as he could get. He withdrew from his family, spent most of his time in his room and says eight of his friends began using drugs, too. That year, he says, he was chased by the police in Srinagar. He alleges that the officers fired two or three shots at him. He did make it home, but was later taken to the Srinagar Police Control Room after his family became suspicious. He was given medication and released, but that did little to break his dependence. He later moved to Delhi with a friend. Within six months, he says, they spent around Rs 13 lakh on drugs. By 2020, he had begun injecting drugs. There were attempts to seek treatment, but the cravings overpowered his resolve.

This year, he entered the rehab centre. “I have been here for 20 days,” he says. “I am finally able to pray, eat properly... Sometimes we watch movies, or we play cricket or listen to music.” Counselling happens every two days, with family members also being brought into the process. “I saw 13 of my friends die because of addiction in the past few years,” he says. “I would get scared, but the urge to do drugs would come back. This time, I am surrounded by people who help me fight that urge.”

From Drugs to Work

In north Kashmir’s Baramulla, Government Medical College has expanded its de-addiction services as the number of patients seeking treatment for substance use has grown. Tajamul Hussain, head of psychiatry, says that until 2019, patients with substance-use disorders were treated in the general psychiatry ward. Following training conducted in collaboration with All India Institute of Medical Sciences, New Delhi, the hospital established an addiction treatment facility (ATF) OPD in May 2022. Since then, more than 1,700 patients have received treatment. A six-bed IPD was added in 2024 and has treated more than 100 patients.Hussain stresses that de-addiction and rehabilitation are different stages of care.

“The first stage is motivation. If a patient is not motivated, we cannot treat them,” he says. Once a patient agrees to admission, they undergo detoxification, where withdrawal symptoms are managed through medication alongside psychotherapy and motivational enhancement therapy. Patients generally stay admitted for seven to 10 days before continuing treatment through the OPD.

But for Hussain, recovery does not end with discharge. “Unemployment is a risk factor for relapse,” he says. “They had nothing to do at home and no work. So they would go back to the same company they used to keep, and because of peer influence, they would relapse.”

Hence, the programme goes beyond treatment to address unemployment as well. Goverment Medical College Baramulla worked with the district administration, employment department and social welfare department to connect recovered patients with government schemes. Counsellors were placed within the hospital’s OPD so that patients did not have to visit government offices, where stigma often made them reluctant to seek help. The counsellors assess their education, interests and aspirations and guide them towards employment, higher education or entrepreneurship.

Of around the 1,200 patients currently under treatment, Hussain estimates that 500–600 have recovered. After excluding those already employed, around 200–300 unemployed patients became the programme’s target group. So far, 100 have been identified as eligible and 51 have been rehabilitated through various government schemes.

Beyond Arrests

In Kashmir, the response to addiction has increasingly extended beyond hospitals and NGOs, with the J&K Police also running de-addiction centres across districts. The same institution responsible for enforcing the Narcotic Drugs and Psychotropic Substances (NDPS) Act now also operates spaces where people struggling with addiction seek treatment. At its Baramulla centre, counsellor Mohammad Ashraf Mir, who has worked there for a decade, says the drug landscape has changed considerably in recent years.

The centre, established in 2012, saw heroin use peak between 2019 and 2024, which Mir attributes partly to its easy availability in north Kashmir, particularly through the Kupwara and Uri routes. He says drugs were also brought into the Valley through drones and other means. But tighter border controls and stricter enforcement of the NDPS Act have since made heroin harder to obtain.

However, he now sees young users shifting towards pharmaceutical drugs, particularly pregabalin. Patients have told him they can order it online through third-party platforms, with one patient reporting that the price of a box rose from about Rs 1,900 to Rs 3,000 over successive orders.

Yet, behind the changing availability of drugs, there are young people whose lives have already been shaped by dependence. A boy from Sopore, now 19, left school in Class 8 and began working as a labourer. He first used charas in 2016 after a friend introduced him to it, then moved to heroin in 2017 and later to codeine and prescription drugs, including pregabalin. His health deteriorated to the point that working became difficult. His family had tried to persuade him to quit, but he couldn’t help returning to drugs. Now, in treatment for the first time, he attends counselling and exercise sessions and says that he has thrown away the drugs he had at home. Cravings, however, remain. For now, his ambition is deliberately modest. “I want to work and earn again. Apart from that, I just want to have a normal life,” he says.

(*Names have been changed on request)

Zenaira Bakhsh is an Assistant Editor at Outlook