43 Crore Tablets Later, Punjab's De-Addiction Programme Can't Answer a Basic Question

Recovery, Undefined: The Question Punjab's Committee Couldn't Get Answered

Imagine sitting on that assembly committee. You ask a simple question - of the patients who started Buprenorphine treatment in 2022, how many are actually drug-free today? The answer you get back isn't a number. It's a redefinition: a person still taking Buprenorphine, under medical supervision, counts as "de-addicted." No timeline.

No exit point. Compared, officials say, to insulin for diabetes. You are left holding a report with 43.44 crore tablets procured and no way to say whether that number represents healing or a new, government-supplied form of dependency.

That discomfort shouldn't be resolved too quickly. Buprenorphine substitution therapy is not a scam or a failure dressed up as policy - it is a globally accepted, evidence-based approach that keeps opioid users alive, off the black market and out of the cycle of overdose that kills people on unregulated heroin or synthetic opioids.

The easy answer would be to say the rising tablet count proves harm reduction is working. But the same numbers, read differently, could mean something less comfortable: a treatment system that has stopped asking what "recovery" means because the honest answer might be uncomfortable to report.

Here is the genuine tension. Harm reduction, by design, doesn't always aim for complete abstinence - it aims to reduce death, disease and crime associated with drug use, even if some dependency continues indefinitely. Judged by that standard, rising registrations and procurement could be read as success: more people alive, more people supervised, fewer overdoses.

But judged against the promise of a "de-addiction programme"

• a term that implies an end point - the same numbers look like evidence the system has quietly substituted one dependency for another, without ever admitting that's what it's doing. The committee's frustration is well placed, but the finger shouldn't point only at Buprenorphine. It should point at what's missing around it: 15 beds for 250 daily patients at Ludhiana's de-addiction centre is not a treatment gap, it's an admission that psychosocial rehabilitation - counselling, social reintegration, the parts of recovery medicine alone cannot do - has been squeezed out by a system leaning almost entirely on pharmacology. And the reported cases of patients dissolving and injecting the tablets intravenously show what happens when a substitution drug is deployed without the monitoring infrastructure to actually supervise it. The honest resolution isn't "stop the therapy" or "keep expanding it unquestioned." It's that a program calling itself de-addiction owes the public an actual, measured definition of recovery - one that isn't just "still taking the substitute, under medical supervision"
• backed by the counselling and monitoring capacity to make that definition mean something. Until Punjab can answer the committee's original question with a real number, not a redefinition, the honest label for this programme isn't de-addiction. It's managed maintenance - which may still be worth doing, but deserves to be called what it is.