Needed a national protocol for treatment of substance use disorders

Needed a national protocol for treatment of substance use disorders

Mangalore Today News Network

By Dr. G. Shreekumar Menon

Mangaluru, June 4, 2025: Global substance use management policies are moving towards a more balanced and comprehensive approach that highlights public health, human rights and development outcomes, consistent with the original purpose of the International Drug Control Conventions to promote the health and welfare of mankind.

Drug abuse is increasing in India especially among the youth. Heroin, methamphetamine, cocaine, hybrid Ganja, and MDMA are being smuggled into the country by various international drug gangs.  The youth are the backbone of any country for socio-economic development and drug addiction within this age group, results in decline in literacy levels, loss of productivity and consequently economic loss to the country. In line with India’s vision of becoming a globally developed economy and a prosperous nation, urgent measures are required to treat substance use related disorders, apart from interdicting drug trafficking.

Due to the strategic location of India in Asia, and being an economic hub in South Asia, there has been an upsurge of international narcotics drug trafficking leading to increased drug abuse especially among the youth. Many States are facing critical situations.

Substance use disorders are characterized by a pattern of continued pathological use of a psychoactive substance that results in repeated adverse physiological, behavioural and social consequences. Priority actions that are needed include: developing a National Strategic Program on substance use management; investment plans to improve access to effective substance use management; capacity building and quality assurance to meet the guidelines and standards for evidence-based best practices in substance use management; integrating substance use management in the health care and social welfare system, in the comprehensive continuum of care.

India needs a more effective national system for comprehensive treatment of substance use disorders, which requires a coordinated and integrated response of many actors to deliver policies and interventions based on scientific evidence in multiple settings and targeting different groups at different stages with regard to the severity of their substance use disorder. The public health system is best placed to take the lead in the provision of effective treatment services for people affected by drug use disorders, often in close coordination with the social care services and other community services. At the systems level it needs to be ensured that treatment services are: • Available • Accessible • Affordable • Evidence-based • Diversified.

Organization of specialized services for drug use disorders should be based on multidisciplinary teams adequately trained in the delivery of evidence-based interventions with competencies in addiction medicine, psychiatry, clinical psychology and social work. A gold standard screening test should be conducted to classify the severity level of drug use/addiction before treatment.

The above protocol outlines the pharmacological treatment, psychosocial interventions and aftercare support which will be required to be provided in line with international standards and procedures, while respecting the country’s social, cultural and economic realities. It should provide a humane and scientific approach delivered by skilled practitioners in order to assist the drug dependent person to attain the highest level of personal, professional, familial and social functioning.


When developing a comprehensive treatment system, it is wise to allocate available resources and respond best to patient’s needs. The key public health principle to apply is offering the least invasive intervention possible with the highest level of effectiveness and the lowest cost possible. This is an important principle when designing or reviewing a treatment system and taking into account the treatment standards.

Treatment for drug use disorders should be provided predominantly in health and social care systems, and effective coordination mechanisms with criminal justice system should be in place. Treatment of drug use disorders should be available to offenders with drug use disorders and, where appropriate, be a partial or complete alternative to imprisonment or other penal sanctions. 

Treatment policies, programs, procedures and coordination mechanisms should be defined in advance and clarified to all therapeutic team members, administration, and target population. Roles of national, regional and local agencies in different sectors responsible for the delivery of treatment for drug use disorders and rehabilitation should be defined and mechanisms for effective coordination established. Drug policy interventions should be continually evaluated for their effectiveness. This requires systematic annual efforts to estimate the number of users (user surveys), consequences of use (e.g., hospital data), prices, enforcement, and treatment.

Formalized in 1948, the Universal Declaration of Human Rights recognizes “the inherent dignity” and the “equal and unalienable rights of all members of the human family”. And it is on the basis of this concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient’s rights was developed. The right to health is a fundamental part of our human rights and right to live in dignity. This includes the right to the enjoyment of the highest attainable standard of physical and mental health as enshrined in the Constitution. 

Drug policy interventions should be continually evaluated for their effectiveness. The strategies relevant to drug policy, apart from primary prevention, are provision of health services for chronic drug users, and reform of criminal sanctions against drug addicts. The former UN Secretary General Kofi Annan in his speech at the 68th World Health Assembly on 21 May 2015, has correctly pointed out that “Drug policies should be grounded in scientific evidence and a deep concern for health and human rights. The preamble of the 1961 United Nations single convention on narcotic drugs states that the “health and welfare of mankind”, and I repeat “health and welfare of mankind”, is the main objective of that convention. Unfortunately, current drug policies in many countries will not lead to the achievement of that objective. To the contrary, those policies have resulted in what the United Nations Office on Drugs and Crime has called ‘unintended consequences’. Those unintended consequences include the creation of a huge, international criminal black market that fuels corruption and spreads violence. Let us remember, the wise saying “Addiction: the disease that makes you too selfish to see the havoc that you created or care about the people whose lives you shattered.” – Unknown.

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Dr. G. Shreekumar Menon, IRS (Rtd), Ph.D. (Narcotics)

Former Director General of National Academy of Customs Indirect Taxes and Narcotics & Multi-Disciplinary School Of Economic Intelligence India; Fellow, James Martin Centre For Non Proliferation Studies, USA; Fellow, Centre for International Trade & Security, University of Georgia, USA; Public Administration, Maxwell School of Public Administration, Syracuse University, U.S.A.; AOTS Scholar, Japan. He can be contacted at shreemenon48@gmail.com