The reality of de-addiction centres in Assam

On the International Day Against Drug Abuse, the crisis within Assam’s rehabilitation centres demands urgent public reckoning - between the promise of recovery and the reality of exploitation –

Kaushik Nath (kaushiknath2023@gmail.com)

Every year on June 26, the United Nations observes the International Day Against Drug Abuse and Illicit Trafficking - a solemn global occasion meant to strengthen cooperation and collective resolve toward a world free of drug abuse. Across Assam, rehabilitation centres unfurl banners, hold awareness programmes, and flood social media with photographs of smiling residents. But behind this carefully curated public performance lies a deeply troubling reality, often cruel and increasingly lucrative for those who exploit it.

Drug abuse has long cast a shadow over Assam and the broader Northeast. The state's proximity to trafficking routes, combined with unemployment and social fragmentation, has made addiction a grave public health emergency. In response, rehabilitation centres mushroomed across the state over the past decade, initially born of genuine social need, but increasingly transformed into profit-driven enterprises that prey upon desperate families and vulnerable individuals.

The owners of these establishments have discovered that grief is a profitable commodity. Parents who watch their children spiral into addiction are willing to spend whatever it takes for a lifeline. Rehabilitation centres in Assam have exploited this desperation with calculated precision, building a cottage industry around suffering, one that remains largely unregulated, underscrutinised, and shielded by the moral authority of appearing to do good.

The recent surge in the number of these centres has resulted in a significant commercial boom. Where genuine rehabilitation demands trained professionals, therapeutic infrastructure, psychiatric care, and long-term follow-up, many of these establishments offer little more than confinement. Centres operate out of rented buildings with inadequate ventilation, overcrowded rooms, shared and filthy toilet facilities, and nutrition so poor that residents have described their experiences in terms that bear no resemblance to medical care. The most chilling testimonial that has become a commonplace remark among those who have passed through these centres is stark: jail is better than rehab in Assam.

This is not merely an anecdote. It reflects the lived experiences of young men and women who entered these centres in search of healing and emerged traumatised, angrier, and, in several documented instances, more inclined to drug use than they were before. The environment inside many of these facilities is not therapeutic - it is punitive. Physical and mental abuse, credibly alleged by multiple former residents, has reportedly been concealed through the tampering of closed-circuit television footage. Owners have gone so far as to manipulate security recordings to prevent accountability, ensuring that what happens within those walls remains invisible to the families who entrust them with their loved ones.

The marketing of these centres reveals the depth of cynicism at work. Recovery anniversaries - occasions meant to celebrate genuine milestones of sobriety - are turned into photogenic events staged primarily for social media. Photographs of beaming residents are shared on Facebook pages, carefully composed to reassure anxious parents and attract new admissions. Families scrolling through these posts see what appears to be a thriving community of healing. They can't see the intimidation, deprivation, and resentment building in the hearts of those being held.

The consequences of this failure are not abstract. When individuals leave these centres carrying unaddressed trauma and fresh grievances, they return to the world more broken than when they arrived and often with a renewed and intensified vulnerability to addiction. The very institutions meant to interrupt the cycle of dependency are, often, reinforcing it.

The state government has not been entirely silent on these failures. In 2022, Assam's Social Justice and Empowerment Minister Pijush Hazarika issued firm directives to rehabilitation centre owners stipulating that no room should house more than four residents, that toilet facilities must serve no more than five to seven people, that residents must receive nutritious food, and that regular health check-ups must be conducted. Centres failing to comply within three months were warned that residents would be transferred to government facilities. The minister also raised the possibility of skill development training for up to one thousand residents as part of a broader recovery initiative.

These were reasonable expectations. They were, in fact, the bare minimum that basic human dignity demands. However, the financial incentives of owners unwilling to reform easily outweigh directives issued without rigorous enforcement, as demonstrated by the intervening years. Many centres continue to operate without valid documentation. Conditions that violate the very standards outlined by the minister persist. The structural gap between government pronouncements and ground-level reality remains wide and deeply damaging.

Against this backdrop, the public health consequences are now measurable and alarming. According to the 2025-26 report from the Union Health Ministry, Assam has recorded the highest number of people living with HIV in the entire Northeast, accounting for 33,145 individuals, with an estimated HIV prevalence of 0.13 per cent. Of the 13,809 women diagnosed with HIV across the Northeast, Assam alone accounts for 6,809 cases, nearly half the regional total. The state also reported 146 pregnant women testing positive for HIV, again the highest in the Northeast, raising grave concerns about mother-to-child transmission. Researchers have established a clear link between intravenous drug use, inadequate harm reduction services, and HIV transmission. The failure to provide genuine, effective rehabilitation is therefore not merely institutional negligence; it is a public health crisis with cascading consequences for generations to come.

Genuine rehabilitation requires qualified medical and psychological professionals, structured therapeutic programmes, proper residential conditions, nutritional care, vocational support, and sustained follow-up after discharge. It demands accountability from centre owners, independent inspection by government authorities, and a legal framework with teeth. Most fundamentally, it requires a social compact in which the welfare of the patient takes absolute precedence over the profits of the proprietor.

On this International Day Against Drug Abuse, it is not enough to raise slogans. The state must undertake immediate, mandatory, and unannounced inspections of every registered and unregistered rehabilitation centre operating within its borders. Centres that fail to meet basic standards must be shut down without delay. Criminal accountability must be established for owners found to have abused residents or tampered with evidence. And the voices of former residents, long dismissed and silenced, must finally be heard.

The measure of a society's commitment to those struggling with addiction is not the number of centres that carry a rehabilitation sign on their gates. It is what happens to the human beings inside those gates. Until Assam confronts that question with honesty and resolve, every June 26 celebration will remain what it currently is: a ceremony of commemoration with very little to celebrate.