In a crowded outpatient corridor at Srinagar’s main psychiatric hospital, a young man in a black hoodie keeps his gaze fixed on the floor, fingers worrying the edge of his registration slip as if he might tear his way out of the room. His father stands a few steps behind, hands clasped, shoulders bent inward, as nurses call out names in quick succession and the smell of antiseptic mixes with the sour sweat of people who have not slept. When their turn finally comes, the doctor barely has to ask what brings them here; the track marks on the son’s forearms answer first.

A generation hooked on heroin

Across Jammu and Kashmir, stories like this have become frighteningly common. A government backed survey made public in early 2026 identified around seventy thousand substance users in the Valley, nearly fifty thousand of them hooked on heroin, with a large share injecting the drug rather than smoking it. Other official and academic estimates suggest that roughly 2.8 percent of the Valley’s population are substance users, and that around ninety five percent of them are dependent on heroin, placing Kashmir among the regions with the heaviest opioid burdens in South Asia.

At the Institute of Mental Health and Neurosciences in Srinagar, the pressure of those numbers is visible in the daily routine. Doctors there say they now see 300 to 350 follow up patients a day, along with five to ten new cases, and that about ninety percent of these new patients are heroin users, many of them injecting. Between April and November 2024 alone the institute documented 1,137 drug related cases, a figure that would have been unthinkable a decade ago, when cannabis and pharmaceuticals dominated the addiction charts.

How Kashmir landed on the heroin route

Kashmir did not become a heroin hotspot by accident. Geographically, the Valley sits close to the Golden Crescent, the arc of territory covering parts of Afghanistan, Pakistan and Iran that has long served as a production and trafficking hub for heroin bound for global markets. Afghan heroin moves across Pakistan, filters into India through states such as Punjab, and from there is routed towards Kashmir along trade roads, mountain tracks and, increasingly, across the Line of Control through aerial drops and small cross border networks.

A 2025 district wise analysis of narcotics trends found that heroin seizures in Jammu and Kashmir had grown more than fivefold in four years, from about fifteen kilograms in 2018 to eighty kilograms in 2022. The sharpest increases were recorded in valley districts, with Anantnag emerging as a major hotspot, accounting for nearly twenty kilograms of seized heroin in 2022, followed by Pulwama and Baramulla, which together represent close to sixty percent of all heroin seized in Kashmir. For law enforcement this confirms the region’s place on the trafficking map; for residents it means that a global supply chain now ends in their mohallas.

Conflict, trauma and the search for numbness

Three decades of insurgency and counterinsurgency have left Kashmir with more than visible scars. Studies and clinical observations point to high rates of depression, anxiety disorders, post traumatic stress and obsessive compulsive symptoms among people who grew up surrounded by gun battles, crackdowns and political uncertainty. For many young Kashmiris, particularly those who came of age after 2010, the years have been carved up by cycles of protest, curfews and the 2019 communications blackout that cut them off from the outside world.

Psychiatrists at IMHANS and other centres say it is not unusual to meet heroin users who describe first trying substances as a way to quiet intrusive memories or blunt a sense of hopelessness about the future. The drug’s immediate effect, a warm flood followed by a soft detachment, can feel like relief in a life that otherwise offers very little control. One clinician in Srinagar summed it up bluntly to a reporter: “In a conflict zone, heroin is not just a drug. It is an attempt to forget where you are.”

 Economic pressure and the cost of a habit

Heroin dependency is also an economic story, told in the language of debt. Case histories compiled by local media and health workers describe young men spending tens of thousands of rupees every month on heroin, sometimes upwards of eighty thousand, in a region where secure jobs are scarce and many families depend on small businesses or seasonal labour. To keep a son’s use going, parents sell gold jewellery, take high interest loans, pawn land or silently drain savings meant for daughters’ marriages.

As the addiction deepens, the circle tightens. Some users begin ferrying small quantities of heroin for local dealers in exchange for free doses; others slip into petty theft, stealing phones, cash or household items that can be pawned. Police and doctors both describe a pattern in which young men move back and forth between the informal economy of street level dealing and the formal system of courts and de addiction wards, never quite leaving either behind.

Kashmir’s heroin narrative is usually written in the masculine, but women are increasingly part of the picture, often in ways that remain hidden. In one widely reported case, a twenty four year old woman described how she first used heroin as a teenager, encouraged by friends who presented it as a way to escape family stress and the grind of early marriage. Her story, of small doses that quickly became a daily need, is echoed in hospital wards where female patients speak quietly of injecting in bathrooms or taking jobs that allow them to finance a habit without asking for money at home.

Stigma for women who use heroin is even harsher than for men. Families worry not only about health and law but also about reputation and marriage prospects; some hide their daughters’ addictions for years, seeking help only when an overdose or a public incident forces the issue. Doctors in Srinagar say that when women finally do come in, they often present with more advanced physical and psychological complications, having delayed treatment out of fear.

Needles, viruses and layered illness

As heroin has moved from smoke to syringe, its risks have multiplied. A recent hospital based study of injection drug users in Kashmir found very high rates of hepatitis C infection, alongside measurable levels of hepatitis B and HIV, underscoring how shared needles and improvised injecting practices are driving a second epidemic beneath the first. Many of the participants reported starting with non injecting opioid use and shifting to injections within months, chasing a stronger effect once tolerance to smoked heroin set in.

The same study highlighted what clinicians see every day in waiting rooms: addiction rarely travels alone. People who inject heroin in Kashmir show high levels of depression, anxiety disorders and other psychiatric comorbidities, often rooted in past trauma. Treating them therefore requires more than detox; it demands an integrated approach that addresses both dependence and the mental health conditions that feed it, in a system that is already overstretched.

Inside the de addiction ward

For families, the decision to seek treatment often comes at a breaking point. In a story published by a Srinagar daily, a young man from south Kashmir recalled the moment his father walked into his bedroom and found him injecting heroin; within hours he was on his way to IMHANS, where he would spend ten days in a ward he describes as both suffocating and life saving. “I lost control of my life,” he told the reporter later, urging others to ask for help “before it is too late.”

Inside such wards the days are rigid: medication, counselling sessions, vitals, group discussions, sleep. Doctors use opioid substitution therapies that are safer and administered without needles, usually sublingual tablets, gradually tapering the dose over months or even years. Patients talk about the violence of withdrawal, about aching bones, sweats, restless nights and thoughts of self harm, and about the small rituals that mark progress, like the first morning they wake up without craving a hit.

Law, order and its limits

Faced with rising addiction and a steady flow of heroin, authorities in Jammu and Kashmir have leaned heavily on policing. In 2022 alone more than a thousand cases were registered under the Narcotic Drugs and Psychotropic Substances Act in Kashmir, with police highlighting major seizures and arrests of alleged traffickers in regular press briefings. Officials link these operations to broader security concerns, describing heroin smuggling as part of “narco terrorism” networks that also seek to finance militancy.

Yet the same seizure statistics that look like success in an official report can be read differently by clinicians and community workers. When heroin confiscations jump from fifteen kilograms to eighty kilograms in four years, it may mean that more drugs are being intercepted; it may also mean that the total volume moving through the region has exploded. Public health advocates warn that focusing primarily on arrests risks pushing drug use further underground, making it harder to reach users with treatment, clean equipment and testing for hepatitis and HIV.

 Harm reduction and the arguments around it

Globally, the evidence on heroin is clear: needle and syringe programs, opioid substitution therapy and easy access to testing and antiviral medication reduce deaths and infections without leading to higher rates of drug use. In Kashmir, movement towards this model has been cautious, slowed by political sensitivities, religious concerns and security calculations.

Researchers and some clinicians in the Valley argue that comprehensive harm reduction is no longer optional. They call for expanded substitution therapy, routine screening for hepatitis and HIV among people who use drugs, structured follow up after discharge and, crucially, access to sterile injection equipment to reduce the risk of blood borne infections. Critics, including some religious leaders and community figures, fear that such measures would normalise drug use or conflict with moral teachings, insisting that the priority should be total abstinence and strict enforcement. The debate plays out in mosques, neighbourhood meetings and legislative sessions, with users and their families caught in the middle.

Community, faith and fragile support

Even as official policy wrestles with the right balance, many of the first responses to heroin have come from the ground up. In several districts, imams have begun devoting Friday sermons to addiction, pairing religious appeals with practical advice on where to seek help and how to recognise early signs of abuse. Civil society groups run awareness drives, school based workshops and small counselling centres, trying to build a culture in which addiction is seen as an illness rather than purely a moral failure.

These efforts vary widely in quality and reach, but they matter. For families that fear being judged at hospitals or are wary of police, a trusted neighbourhood figure can be the first person they speak to, the person who accompanies them to a clinic or helps navigate a bureaucracy that can feel hostile. At the same time, community spaces can also be places of denial, gossip and ostracism, particularly when women or adolescents are involved, reminding activists that awareness campaigns have to be as much about empathy as they are about information.

Campuses and the quiet spread

On college campuses across the Valley, heroin often moves in quieter ways. Administrators and teachers report students slipping away between classes, congregating in secluded corners or nearby alleys, and returning glassy eyed or absent altogether as the semester wears on. A number of the seventy thousand users identified in the recent government survey fall into the college going age bracket, with heroin dominating their drug use patterns.

Counsellors in educational institutions say they are fighting on several fronts at once. They try to keep students enrolled and engaged in their studies while also steering them towards de addiction services that are already overcrowded and often located hours away. Some campuses have introduced peer support groups or tied up with local NGOs, but coverage is patchy, and many students prefer to hide their problems until they reach crisis point.

Between crime and care

In the end, Kashmir’s heroin epidemic forces a basic question: how will the region choose to see the people at its centre. As statistics they are alarming; as patients they are complex; as citizens they are young men and women whose lives intersect with issues far bigger than themselves, from geopolitical rivalries to domestic economic policy.

Policy makers today sit at a crossroads. One route leans primarily on law and order, treating heroin as a security threat to be sealed off with more fencing, more raids and harsher laws. The other accepts that while policing has a role, the heart of the crisis is public health and social fabric, and that serious investment in mental health care, harm reduction, employment and education is the only way to cut the demand that keeps supply profitable. The choice will not be made in a single speech or policy note; it will be made in thousands of small decisions, from how a police officer handles a user at a checkpoint to how a village imam talks about addiction after the call to prayer.

Back in the OPD corridor in Srinagar, the young man in the black hoodie steps out of the doctor’s room clutching a small packet of tablets and a sheet of instructions. His father walks beside him, still a little hunched, but now with an appointment date circled in red and a phone number for a counsellor in his pocket. Outside, traffic noise and the city’s ordinary chaos swallow their figures as they merge into the crowd, one family among thousands trying to pull a life back from the edge of a very quiet, very dangerous war.

Ruvaid Wani is a Kashmiri journalist, storyteller and scriptwriter from Anantnag, writing on sociopolitical crises, addiction and youth in the Valley.

© Greater Kashmir