Srinagar, Kashmir – Afiya’s frail fingers pick at the loose threads of her worn, dark-brown sweater. She sits at the edge of her bed in the rehabilitation ward of Shri Maharaja Hari Singh (SMHS) Hospital in Kashmir’s Srinagar.

As the faded and stained clothes hang loosely on her thin frame, and with her eyes cast down, she says: “I used to dream of flying high above the mountains, touching the blue sky as a flight attendant. Now, I am trapped in a nightmare, high on drugs, fighting for my life.”

Afiya, age 24, represents one of the thousands of individuals in the region struggling with heroin addiction, as a growing epidemic consumes young lives in this disputed area.

A 2022 study by the Government Medical College in Srinagar showed that Kashmir now leads Punjab, a state known for its own prolonged battle with a drug crisis, in narcotics use per capita.

According to an Indian Parliament report from August 2023, nearly 1.35 million people in Kashmir out of its 12 million population are drug users, marking a sharp increase from the approximately 350,000 users the previous year, as reported by a survey from the Institute of Mental Health and Neurosciences (IMHANS) at the Government Medical College in Srinagar.

The IMHANS survey also found that 90 percent of drug users in the region are between the ages of 17 and 33.

In 2023, SMHS alone treated over 41,000 drug-related patients – a figure that averages to one person being brought in every 12 minutes, representing a 75 percent increase from 2021.

The rise in drug cases within Kashmir is largely due to its proximity to the “Golden Crescent,” a region covering parts of neighboring Pakistan, Afghanistan, and Iran where opium cultivation occurs on a large scale. Additionally, chronic unemployment, triggered by the loss of partial autonomy in 2019 and followed quickly by the COVID-19 pandemic, has fueled stress and despair, driving youth towards substance abuse.
Dr Yasir Rather, a psychiatrist at IMHANS, notes that while various addiction treatment facilities have been established throughout the region since 2021, outdated laws and social stigma impede effective support for patients with severe addictions like Afiya. She often requires hospitalization as a result of her condition.

‘It seemed harmless’

“You will get through this,” whispers Afiya’s mother, Rabiya, gently brushing her daughter’s damp hair from her face. Only partially listening, Afiya is more focused on peeling away the blue hospital blanket to allow fresh air to touch the deep, black wounds on her hands, legs, and stomach – caused by heroin injections.

Afiya dreamed of becoming a flight attendant but ended up battling addiction. At first, she and her friends only used cannabis before moving on to heroin, which seemed harmless yet ultimately led her further into dependency.
Due to surgical and therapeutic techniques, the film shows the liver and kidneys’ surface and how they function from within. Also depicted is the process of excess amphetamines breaking out from the capillaries into the surrounding tissue.
The professor says there has been a significant increase in substance abuse among women, attributing it mainly to mental health struggles and unemployment. He also points out the irony that while they are seeking heroin, they are often refusing treatment for their drug-inflicted wounds.

‘Ruthless hunger’

Afiya explains the vicious cycle of finding drugs by sharing an experience of searching for a dealer in the region, how she was introduced to using needles, and ultimately succumbing to the powerful lure of heroine. Despite her initial euphoria, this “ruthless hunger” for heroin led her to resist any form of treatment and face dire consequences of her dependency.

Government statistics and health professionals highlight the progress of the drug problem spreading rapidly across the region. The success and increased accessibility of the drug divide the communities and further challenge the effectiveness of attempts at rehabilitation and therapy.
The professor notes the rise in use of heroine over other drugs due to its quick effects, potency, and its reputation of being safer. He concludes that overcoming this will require more than just rehabilitation and therapeutic efforts, but substantial changes in how society collectively addresses and supports those battling addiction.