By Natalie Tecimer

India is rarely considered a major counter-narcotics target of the United States, yet it is an increasing source of illegal drug trafficking to the United States. However, the majority of the narcotics trafficked from India into the United States are not typical illegal narcotics; instead, controlled prescription drugs (CPD) and their precursor chemicals make up the majority of trafficked goods. Despite this emerging reality, counter-narcotics cooperation is rarely mentioned prominently in official high-level dialogues between the United States and India, and the United States has not placed a concentrated effort in counter-narcotics in India.

Narcotics abuse in the United States is a continuing problem for law enforcement, treatment professionals, and the public. Since 2000, drug related deaths have skyrocketed. The top three drugs that are the cause of death are heroin, cocaine, and prescription drugs. CPD abuse is the largest drug threat for the U.S. population, outnumbering deaths from heroin and cocaine combined. The National Institute of Health’s 2014 report on drug abuse estimates that at least 52 million Americans have abused prescription drugs in their lifetimes.

India is one of the world’s largest producers of CPDs and their precursor chemicals. Precursor chemicals can be used for a variety of licit medications, including cough syrup and decongestants, as well as illicit synthetic narcotics, including lean and methamphetamine. India is one of the world’s top traffickers of precursor chemicals—the most recent data from the U.S. Department of State’s Bureau for International Narcotics and Law Enforcement Affairs (INL) International Narcotics Control Strategy Report, shows that India is one of the largest exporters of chemical substances; it was the second largest exporter of ephedrine, the largest exporter of pseudoephedrine, and the largest importer of ephedrine.

CPDs and precursor chemicals are often trafficked from India directly to the United States, but they are also used by traffickers in third countries who then export the finished product to the United States. Indian ephedrine has been repeatedly found in Mexico, whose cartels are the largest supplier of methamphetamine to the United States.

India’s law enforcement is increasingly aware of the illicit CPD production and trade. In late January 2015, India’s Narcotics Control Bureau (NCB) made large drug busts at M/s Provizer Pharma, a wholesale pharmaceutical seller and exporter, and Swastik Herbal Care, both in Surat, Gujarat. On January 31 and February 1, 2015, the Ahmedabad Zonal Unit in Gujarat seized tens of thousands of controlled prescription pills, in twenty packages, including Xanax, Methylphenidate powder, Zolpidem, opiods, and other pain medication. The NCB’s Narcontrol report stated that the suspected destination was the United States and Europe. In a follow-up operation, the Ahmedabad Zonal Unit seized more drugs and confirmed the drugs’ destination was the United States.

U.S. counter-narcotics programs focus on both supply reduction and demand reduction. The INL, however, does not have supply reduction programs in India. U.S. counter-narcotics efforts in India are limited, and focus mostly on demand reduction.

There are growing attempts at regional cooperation in South Asia, but they are not necessarily focused in the CPD and precursor chemical trade nor in supply reduction strategies. The opium and heroin trade is the unifying factor for South Asia counter-narcotics; production in Afghanistan travels through Pakistan, into India, and the rest of South Asia. From September 9-11, 2015, delegates from India, Afghanistan, Bangladesh, Bhutan, Iran, Maldives, Myanmar, Nepal, Sri Lanka and the United States convened in Delhi for the Sub-Regional Drug Focal Point Meeting of South Asia, hosted by the Colombo Plan Drug Advisory Program. The agenda included discussions and working groups on both supply and demand reduction. The United States, acting as an observer country, sent an INL representative to the conference to provide input on international efforts for demand reduction. Despite the obvious need for narcotics supply reduction efforts across South Asia, the Colombo Plan emphasizes demand reduction, specifically addiction treatment.

There are still many barriers to U.S. involvement in counter-narcotics in India. The lack of government cooperation is perhaps the largest impediment as U.S. supply reduction programs might expose corruption and political connections in India. Transparency International rates India 38 out of 100 on the Corruption Perception Index, putting India in the list of highly corrupt countries.

The scope of narcotics trafficking from India to the United States is not well-understood. India’s pharmaceutical and precursor chemical trafficking certainly plays a large role in drug abuse in the United States, and an increasing concern with the domestic CPD overdose epidemic. India’s government is making progress in its acknowledgement of the country’s drug problem and is devoting increasing resources towards counter-narcotics efforts. The combination of narcotics production, government and corporate corruption, and increasing demand means India will likely remain a source of illicit production and narcotics trafficking. As a result, the United States should evaluate how and where to allocate more resources toward counter-narcotics efforts in India.

Ms. Natalie Tecimer is a Program Coordinator and Research Assistant with the Wadhwani Chair in U.S.-India Policy Studies at CSIS.