Punjab’s prisons are awash with de-addiction pills. But is that good news?

In 2017, the Punjab government introduced a new therapy for victims of drug abuse.

It involved putting users of opioids like heroin – colloquially called chitta – on a combination of less potent opioids to wean them off their addiction.

The substitute – buprenorphine and naloxone pills – was meant to be taken orally and under medical supervision. According to a psychiatrist who works in one of Punjab’s central jails, the therapy drastically reduced the vulnerability of an addict.

“Firstly, there is no intravenous use because of which an addict is likely to get infected with HIV, hepatitis or other diseases,” he said. “There is almost zero chance of drug overdose death.”

The therapy was rolled out across more than 529 clinics over the years and met with limited success. In November 2023, the Punjab government informed the Assembly that around 80-90% of patients who complete this treatment at the state’s Outpatient Opioid Assisted Treatment clinics relapse into addiction.

Strikingly, in the last four years, the supply of buprenorphine pills to Punjab’s prisons has surged and the number of inmates registered with deaddiction clinics has doubled, the Punjab government’s figures show.

But is that good news?

The Punjab and Haryana High Court does not seem to think so. It recently asked the government to explain the staggering use of buprenorphine pills in the state’s prisons.

Some drug experts warn that this could be a sign of another ballooning addiction crisis in a state already grappling with endemic opioid abuse. But others say that, despite the risks, this is the only therapy to mitigate the risks of drug addiction in Punjab.

‘Strong possibility of abuse’

In June, a judge filed a report to the Punjab and Haryana High Court, flagging the fact that nearly 70% of the Mansa district jail’s inmates were dependent on drugs like buprenorphine and naloxone.

The therapy was prescribed to them by an outpatient opioid assisted treatment or OOAT clinic in the jail.

The High Court took suo moto cognisance of the report and sought a report on the total number of inmates across the state’s prisons that were on opioid assistant therapy.

A reply filed by the Punjab government on August 31 revealed that the Mansa jail was not an exception.

Nearly 45% of the inmates lodged in different jails of the state were victims of drug abuse who were seeking the treatment through similar clinics in prisons. Most of these drug-dependent inmates are “in the prime of their youth,” the High Court had observed in its September 8 order.

Strikingly, 83% of the drug dependent inmates in Punjab’s prisons had no history of seeking treatment for substance abuse before entering the jail, the government disclosed.

Lawyers and anti-drug campaigners Scroll spoke to say that even drugs prescribed for harm reduction can be misused in absence of proper supervision and monitoring of prisoners. “There is a strong possibility that OST drugs in jails are being abused by those who are addicted to strong drugs,” said Dr Mohan Sharma, a well-known anti-drug campaigner in Sangrur.

‘Let’s not create another dependence’

Days before the Punjab High Court took note of the problem, a legislative committee of the state assembly recorded a sharp rise in demand for buprenorphine pills.

The government procured over 43 crore buprenorphine pills in the last four-and-a-half years to run its opioid substitution therapy for the victims of drug abuse across the state, the committee said in a report tabled in August.

The number of pills supplied to clinics in jails also surged by 75% – from approximately 46 lakh tablets in 2022 to more than 80 lakh tablets in 2025.

In the first six months of this year alone, already 45 lakh pills of buprenorphine have been supplied to jails.

The number of prison inmates registered with the deaddiction clinics nearly doubled between 2022 and June 2026, from 23,367 to 40,830. A little over half of them had registered for opioid substitution therapy for the first time.

This has raised fears that drug abuse victims may just shift to some other type of addiction in jails, which in this case is buprenorphine.

“Why has the supply of these tablets gone up so sharply?” Aam Aadmi Party legislator Jagrup Singh Gill said in the Assembly.

Gill headed the committee that recorded the rise in supply of buprenorphine pills. He pointed out that the sharp increase in supplies did not match the rise in the number of prisoners. “We must ensure that while trying to free people from drug addiction, we do not end up creating dependence on another medicine,” Gill added.

The committee report rued the fact that the government was unable to specify how many addicts had completely recovered in the last five years following their treatment inside jails.

The protocol

The norms laid down by the Punjab government say that a patient can be put on opioid substitute therapy for a minimum of a year.

In the early stages of the treatment, the medicine is administered in the presence of doctors or medical staff, though patients are later allowed to have the drug on their own later.

Through the process, a patient must attend regular counselling sessions – twice a month for the first two months, followed by one meeting a month for next four months.

While medical officers posted in jails say the drugs are administered to inmates in their supervision, shortage of staff often compels them to seek help of senior or educated prisoners in ensuring the distribution of the drugs.

Anti-drug campaigners and medical experts in Punjab say the clinics in Punjab’s prisons hardly adhere to the norms laid down under the standard operating procedure. “There is a chronic shortage of counsellors, doctors and psychiatrists in these clinics. All of them are essential to the treatment,” said Sharma, the de-addiction expert from Sangrur district. “As a result, the only treatment these inmates in jails get is pills.”

Only eight out of 26 prisons in Punjab have a de-addiction facility, the Punjab government said in its affidavit to the High Court. It does not mention the number of inmates who have been successfully cured of drug addiction in these centres.

A lawyer dealing with cases registered under the Narcotics Drugs and Psychotropic Substances Act in Kapurthala district of Punjab told Scroll that several inmates register with the clinics to access a source of drugs that they can “barter” for favour in prisons.

“Many inmates who enter jail are not dependent on drugs but over a period of time they come in contact with hardcore substance abusers who offer them sort of a barter option,” the lawyer, who has handled over a hundred NDPS cases, pointed out. “The medication or pills they get in their name are then sold to other abusers in reciprocation of some favour or other amenities.”

He added: “This is the main reason why many inmates who are clean at the time of entering jail become drug dependent and get themselves registered with the OOAT clinics.”

But a substantial chunk of new prisoners are in the grips of opioid addiction, medical professionals say.

A doctor in Rupnagar district of Punjab, who served as a medical officer in the district jail for a period of two years, told Scroll that 90% of people caught under the NDPS Act “are drug addicts who double as small-time peddlers in order to earn their daily dose of heroin”.

“Once they land in jail, they suffer from extreme withdrawal for which they have to be hospitalised for some days,” the doctor said. “Eventually, they have to be put on opioid substitute therapy in the jail.”

The general prison atmosphere also drives many towards drug dependency. “It’s certain that once an individual enters prison, they are likely to suffer from anxiety and depression,” the NDPS lawyer said. “Many of those inmates get hooked to hard substances whose supply is not uncommon in Punjab’s prisons and then also opt for OST drugs.”

In August 2022, a first-of-its-kind drug screening carried out across Punjab's prisons found nearly 47% of 30,000 prisoners addicted to drugs.

“The court certainly needs to go deeper to ascertain what’s causing inmates to become dependent on OST drugs,” the NDPS lawyer said.

The matter has been listed for next hearing on October 13.

The other side

The psychiatrist posted in one of the eight central jails of Punjab said that, ideally, the prison is no place to fight addiction or seek rehabilitation.

The atmosphere in the jails instead leads inmates to drugs. “Most of these prisoners are unable to sleep and suffer from severe mental health issues,” he said.

But given the scale of Punjab’s drug crisis, he said, buprenorphine is the far lesser of the two evils.

“If someone who’s addicted to strong opioids like heroin is getting treatment via OST drugs, we are actually doing harm reduction,” said the psychiatrist, seeking anonymity as he is not authorised to speak to the media. “People need to understand that addiction to heroin and addiction to OST drugs aren’t the same thing.”

He argued that there is a high possibility that an addict will most certainly relapse into the abuse of strong substances once he is out of prison. “That’s why we consider it a success if a patient sticks to OST therapy once he’s free from jail,” he said.

However, in the absence of counselling, the buprenorphine pills may only be a temporary fix, Sharma, who headed the Red Cross Drug De-addiction Centre in Sangrur, told Scroll. “You have to understand the cause of the pain,” said Sharma. “These people are not criminals, but victims.”

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