To what extent can large-scale surveys like NDUS ensure effective drug-demand reduction when implementation capacity varies significantly across States?

Large-scale surveys like **NDUS** act as a *diagnostic backbone* for drug-demand reduction by mapping prevalence, age-wise exposure, and regional patterns. With an expanded sample of **~20 lakh respondents**, it offers district-level evidence to tailor interventions, prioritise high-burden areas, and evaluate programmes such as **Nasha Mukt Bharat Abhiyaan (NMBA)**. However, outcomes depend heavily on State capacity—public health infrastructure, de-addiction professionals, funding absorption, and enforcement-health coordination. Surveys ensure *agenda-setting and targeting*, but cannot guarantee *uniform execution*. **Stats for value-addition:** * **Alcohol:** **15+ crore users**, including **30 lakh minors (10–17 years)**. * **Cannabis & opioids** follow alcohol in prevalence. * **RDS arm:** **2.1 lakh** from dependent populations; **household arm:** **17.6 lakh** across **400 districts**. **State variation example:** Punjab, despite high opioid burden, expanded OOAT and community outreach, showing survey-led targeting works when capacity exists. In contrast, smaller States struggle with counsellor shortages and treatment access, limiting NMBA impact. **Pointers for impact:** * Enables **localised IEC campaigns**, early screening in schools/colleges, and **data-driven resource allocation**. * Success improves when paired with **capacity-linked funding, workforce expansion, and digital monitoring (e.g., wastewater pilots)**.

India’s Drug Survey to Probe Ritual Use and Modern Addiction

Q: Should public health frameworks differentiate between ritualistic substance use and contemporary addiction, or does this risk weakening harm-reduction efforts?

Public health frameworks should recognise the **contextual difference** between ritualistic, socially regulated substance use and contemporary, often commercialised or high-potency addiction patterns. Differentiation helps avoid *policy misclassification*, improves community cooperation, and strengthens culturally sensitive prevention. However, the State must ensure this does not dilute **harm-reduction** priorities or normalise unsafe consumption. Historically sanctioned use is typically **low-frequency, community-moderated, and bound by norms**, whereas contemporary addiction shows **early initiation, higher dependence, synthetic variants, and solitary consumption**, increasing disorder risk. Yet, claiming ritualistic use is “safe” without evidence could weaken prevention messaging. **Relevant stats to balance harm discourse:** * **15+ crore alcohol users in India**, including **30 lakh minors (10–17 yrs)** (NDUS 2019 baseline). * Post-COVID rise in **digital drug markets & rarer psychoactive substances** demands stricter prevention. **Risk example:** If policies over-emphasise ritual exemption, high-burden States may deprioritise **OOAT, IEC, and treatment expansion**, undermining NMBA outcomes. **Balanced framework approach:** * Classify by **potency, frequency, and disorder evidence**, not by social sanction alone. * Integrate **cultural mapping with clinical screening**, ensuring differentiation strengthens policy precision, not complacency.

The 2025–26 National Drug Use Survey will cover nearly 20 lakh people, tracking emerging substances, post-pandemic shifts, and centuries-old, socially sanctioned practices for the first time

Gopi

•January 2, 2026•5 mins read

India’s Drug Survey to Probe Ritual Use and Modern Addiction

Not Started

1. Overview of the National Drug Use Survey (NDUS) 2025-26

The Union government’s National Drug Use Survey (NDUS) 2025-26 is a comprehensive nationwide assessment aimed at understanding the prevalence and patterns of substance use and substance use disorders across India. Scheduled to be conducted throughout 2026, the survey will cover nearly 20 lakh individuals, representing a significant expansion from the 5 lakh individuals surveyed in the previous 2017-18 round. This scale ensures more robust, representative data at both State and district levels.

For the first time, NDUS 2025-26 will document indigenous forms of substance use, which include locally grown or prepared substances that are socially sanctioned and integrated into ritualistic practices. Understanding these practices is critical for designing culturally sensitive interventions and differentiating between socially accepted substance use and patterns that lead to addiction or health risks.

Tracking substance use systematically helps policymakers design targeted prevention and treatment strategies. Ignoring emerging patterns or socially sanctioned substance use could lead to underestimation of risk groups and ineffective interventions.

2. Historical Context and Significance

The previous survey (2017-18) revealed alcohol as the most commonly used substance in India, with over 15 crore users, including around 30 lakh minors aged 10-17 years. Other substances included cannabis, opioids, sedatives, inhalants, cocaine, amphetamine-type stimulants, and hallucinogens. However, the earlier survey faced limitations in covering specific populations such as school and college students, prison inmates, and other high-risk groups.

The upcoming survey aims to fill these gaps, providing nuanced insights into substance use across age groups, socio-economic strata, and institutional settings. These findings are crucial for evidence-based policymaking and for evaluating the effectiveness of national initiatives like the Nasha Mukt Bharat Abhiyaan.

Comprehensive historical comparison ensures that policy measures evolve with changing substance use trends. Failure to capture these dynamics risks perpetuating outdated or ineffective intervention strategies.

3. Methodology and Sampling Framework

NDUS 2025-26 employs a dual-method sampling strategy:

Household Survey:
- Covers 400 districts across all States and Union Territories
- Includes men and women aged 10 to 75 years
- Encompasses approximately 4.4 lakh households and 17.6 lakh individuals
Respondent-Driven Sampling:
- Targets drug-dependent populations in roughly 350 districts
- Covers around 2.1 lakh individuals

Combined, these two components ensure a total sample of approximately 19.7 lakh individuals, providing statistically robust and regionally representative data.

Accurate sampling is essential for policy validity. Insufficient or biased sampling would compromise reliability, undermining interventions and resource allocation.

4. Scope of Substance Use Assessment

NDUS 2025-26 will assess both conventional and emerging substances:

Alcohol remains the most widely consumed.
Cannabis, opioids, sedatives, inhalants, cocaine, amphetamine-type stimulants, and hallucinogens continue to be monitored.
For the first time, indigenous substances used in culturally sanctioned settings will be documented.
Emerging trends of “new and rarer” psychoactive substances will be explored.
Innovative techniques, including wastewater testing, will evaluate community-level drug consumption.

Understanding the full spectrum of substances, including culturally specific and emerging drugs, is critical for responsive public health and law enforcement policies. Neglecting these trends can result in policy gaps and hidden health burdens.

5. Special Population Studies

The survey will undertake targeted analyses of:

Prison inmates
School and college students
Other higher education populations

These populations were inadequately covered in the 2017-18 survey, limiting insights into high-risk groups. Including them allows for focused interventions and assessment of substance use determinants in controlled and semi-controlled environments.

Studying special populations ensures that interventions are context-specific and effective, particularly for prevention among youth and rehabilitation in institutional settings.

6. Policy Linkages and Governance Implications

NDUS 2025-26 findings will feed into national and State-level drug demand reduction strategies. Notably, the survey will:

Evaluate the impact of the Nasha Mukt Bharat Abhiyaan
Generate recommendations for substance-related health policies
Inform resource allocation for prevention, treatment, and awareness programs

By linking data to policy, the survey strengthens evidence-based governance and helps monitor the effectiveness of ongoing interventions.

Without systematic evaluation, government initiatives risk being generic or misaligned with regional and demographic needs, reducing their public health impact.

7. Emerging Considerations Post-COVID-19

Officials note that drug use patterns are dynamic and may have shifted following the COVID-19 pandemic. Socio-economic disruptions, mental health stressors, and changes in social behavior may influence both substance use prevalence and the emergence of new psychoactive substances.

Continuous monitoring allows timely adjustments to policy and resource deployment. Ignoring post-pandemic shifts could exacerbate substance-related health and social challenges.

8. Way Forward and Implications for Governance

NDUS 2025-26, scheduled to conclude by the end of 2026 with findings in 2027, represents a major step in India’s evidence-driven public health governance. By integrating culturally sensitive, high-risk, and emerging substance use data, it supports:

Holistic policy formulation
Targeted preventive and rehabilitative measures
Enhanced monitoring of intervention effectiveness
Strengthened State and national coordination in drug control

Ultimately, this survey will enhance India’s ability to reduce substance-related harm and improve public health outcomes in a rapidly changing social landscape.

Quick Q&A

Everything you need to know

Large-scale surveys like NDUS act as a diagnostic backbone for drug-demand reduction by mapping prevalence, age-wise exposure, and regional patterns. With an expanded sample of ~20 lakh respondents, it offers district-level evidence to tailor interventions, prioritise high-burden areas, and evaluate programmes such as Nasha Mukt Bharat Abhiyaan (NMBA). However, outcomes depend heavily on State capacity—public health infrastructure, de-addiction professionals, funding absorption, and enforcement-health coordination. Surveys ensure agenda-setting and targeting, but cannot guarantee uniform execution.

Stats for value-addition:

Alcohol: 15+ crore users, including 30 lakh minors (10–17 years).
Cannabis & opioids follow alcohol in prevalence.
RDS arm: 2.1 lakh from dependent populations; household arm: 17.6 lakh across 400 districts.

State variation example: Punjab, despite high opioid burden, expanded OOAT and community outreach, showing survey-led targeting works when capacity exists. In contrast, smaller States struggle with counsellor shortages and treatment access, limiting NMBA impact.

Pointers for impact:

Enables localised IEC campaigns, early screening in schools/colleges, and data-driven resource allocation.
Success improves when paired with capacity-linked funding, workforce expansion, and digital monitoring (e.g., wastewater pilots).

Public health frameworks should recognise the contextual difference between ritualistic, socially regulated substance use and contemporary, often commercialised or high-potency addiction patterns. Differentiation helps avoid policy misclassification, improves community cooperation, and strengthens culturally sensitive prevention. However, the State must ensure this does not dilute harm-reduction priorities or normalise unsafe consumption.

Historically sanctioned use is typically low-frequency, community-moderated, and bound by norms, whereas contemporary addiction shows early initiation, higher dependence, synthetic variants, and solitary consumption, increasing disorder risk. Yet, claiming ritualistic use is “safe” without evidence could weaken prevention messaging.

Relevant stats to balance harm discourse:

15+ crore alcohol users in India, including 30 lakh minors (10–17 yrs) (NDUS 2019 baseline).
Post-COVID rise in digital drug markets & rarer psychoactive substances demands stricter prevention.

Risk example: If policies over-emphasise ritual exemption, high-burden States may deprioritise OOAT, IEC, and treatment expansion, undermining NMBA outcomes.

Balanced framework approach:

Classify by potency, frequency, and disorder evidence, not by social sanction alone.
Integrate cultural mapping with clinical screening, ensuring differentiation strengthens policy precision, not complacency.

Yes, periodic large-scale surveys can remain policy-relevant, but only when paired with adaptive data cycles and fast institutional uptake. Surveys like NDUS create a national baseline of disease burden, age of initiation, dependent populations, and regional hotspots, which are essential for long-term planning and scheme evaluation. However, substance use is now shaped by synthetic drugs, darknet supply chains, pandemic-linked stressors, and rapid youth uptake, making 7–10 year survey gaps risky. A decade-late dataset may lose field relevance unless the system treats surveys as strategic anchors, not real-time trackers.

Value stats (NDUS 2019 baseline): 15+ crore alcohol users, including 30 lakh minors (10–17 yrs).
RDS + household sample (2025-26 design): ~20 lakh individuals across 350–400 districts.

Optimised global practice: EMCDDA (EU) complements surveys with annual trend updates and wastewater surveillance pilots. India can mirror this by linking NDUS findings to yearly IEC recalibration, digital drug trend cells, and wastewater monitoring, ensuring surveys guide direction, while agile tools update speed.

Attribution

Original content sources and authors

Abhinay Lakshman

The Hindu

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