DR R G WISEMAN PINTO
The word narcotics evoke images of danger and destruction. Derived from the Greek word meaning ‘to numb’, the term was coined by the ancient physician Galen to describe substances that dull the senses. Although narcotics have been used for centuries, their harmful effects have overshadowed their medical value since the early 20th century, when many of these substances were declared illegal. Despite strict laws, their appeal persists, fuelling addiction, ill health and organised crime across the world.
Narcotics are derived from natural sources, produced synthetically, or created by combining different substances to enhance their effects. Opium, cannabis and poppy extracts are plant-based narcotics, while LSD and ecstasy are chemically synthesised. Whatever their origin, prolonged misuse can have devastating consequences for individuals, families and society.
Medicine, however, has long recognised the legitimate role of narcotics in pain management. Drugs such as morphine remain indispensable in relieving severe pain, particularly in patients with terminal illnesses such as cancer. Used under strict medical supervision, they improve quality of life. Misused, they lead to dependency, addiction and irreversible damage to multiple organs.
The pathological effects of narcotics are extensive. Chronic users may experience neurological complications such as seizures, cardiovascular problems including tachycardia, hypertension, myocardial ischaemia and sudden cardiac arrest, and respiratory conditions ranging from respiratory failure to lung abscesses and granulomas. Kidney diseases such as glomerulonephritis and nephrotic syndrome are also common. Shared needles increase the risk of infections such as HIV, while overdose or hypersensitivity can result in sudden death.
Over the years, I have seen patients admitted following overdoses and others whose years of substance abuse had left their organs beyond repair. What strikes me most is the despair and isolation that often drive people towards narcotics. The temporary escape they offer comes at an enormous cost, affecting not only users but also their families and communities.
The global narcotics trade continues to expand. An estimated 275 million people, or 5.6 per cent of the world’s population, have used narcotics. Traffickers employ increasingly sophisticated methods to transport drugs. During the recent international Operation Orion, authorities intercepted narco-submarines up to 25 metres long carrying 225 tonnes of cocaine and 1,000 tonnes of marijuana. Such seizures highlight both the scale of the trade and the enormous demand that
sustains it.
India is not immune to this crisis. Despite stringent surveillance at ports, airports and borders, narcotics continue to enter the country. Goa, in particular, has faced this challenge for decades. What began during the hippie movement of the 1960s and 1970s has evolved into a widespread problem extending beyond coastal areas to schools, colleges and affluent social circles.
As a pathologist practising in Goa for many years, I have encountered numerous cases in which the effects of narcotics were unmistakable. Autopsies frequently reveal severe damage to the lungs, liver and kidneys, along with needle marks and abscesses that bear witness to prolonged substance abuse. These findings are sobering reminders of the destruction narcotics inflict in both life and death.
Goa has taken important steps through de-addiction centres and counselling services, but much more remains to be done. Schools and colleges must strengthen drug awareness programmes that address not only the dangers of narcotics but also the psychological and social factors that contribute to addiction.
Countries have adopted differing approaches to narcotics, with some legalising certain substances while others impose severe penalties, including life imprisonment or capital punishment. This lack of uniformity complicates international efforts to combat trafficking. At the same time, advances in technology, particularly artificial intelligence, are providing new tools for surveillance, intelligence gathering and the detection of trafficking networks.
Ultimately, tackling narcotics requires a coordinated effort involving law enforcement agencies, healthcare professionals, educators, families and communities. Equally important is ensuring that people struggling with addiction have access to compassionate treatment and rehabilitation.
The younger generation will play a crucial role in reversing this trend. By promoting mental wellbeing, resilience and strong community support, we can offer healthier alternatives to substance abuse. With sustained commitment and collective action, I remain hopeful that we can reduce the impact of narcotics and build a healthier, drug-free future.
(The writer is professor of pathology, former head of department and former dean, Goa University, and president, South Asian Academy of Cytopathology and Histopathology)
