The alarming surge in numbers across the board in Bihar — from drug arrests to seizures to addicts to cases — frame a story about a new crisis gripping the state in the wake of prohibition, as revealed by The Indian Express on Thursday. Each number is also a harsh and poignant reminder of a life deeply affected, or cut short.Listen to this government employee from a village in Bihar’s Saharsa, a district in the Kosi police range that has seen almost a four-fold jump in NDPS cases in the last four years. For him, the crisis hits home.“Our only hope is that my 28-year-old brother stays alive. And he can stay alive only if he does not use drugs,” he said, recalling fears of a family that has watched a good student lose his routine, work and happiness to drugs.Also Read | How ‘Kota’ drug smuggled in via Myanmar is spreading in a dry Bihar“He cleared the Central Teacher Eligibility Test, worked as a medical representative and earned Rs 25,000 to Rs 30,000 a month. In 2023, he appeared for the state public service commission examination on his first attempt. He did not clear it and was briefly depressed,” he said.The family does not know when or how he began using drugs. “He stopped going to work, stayed awake late into the night, skipped meals and slept during the day. If we asked him to bathe or eat, he became aggressive. His health began to deteriorate,” the brother said.Since late 2023, the family estimates, it has spent Rs 3-4 lakh on his treatment. The first attempt, at a private centre in Patna, ended on the 76th day; he collapsed the next day. This year, they tried a facility closer to home, where he stayed four months. He came home at the beginning of October.There is no clear sign of a relapse, but the family is wary and has kept him away from the village and his social circle. “He thinks we are trying to harm him when we are actually trying to save him. Until that feeling changes, I do not know how he will improve,” the elder brother said.Story continues below this adThe long road back: ‘30 days not enough’The nearest measure of substance use in Bihar is a 2023 Parliament report, which estimated about 12.05 lakh cannabis users and 1.71 lakh opioid users across the age band of 10-75. The latest snapshot of this crisis can be seen at Chetna, a Patna centre run by the NGO Jagran, which tries to rebuild the structure of an ordinary day. Here, residents wake at 5-5.30 am for yoga, followed by counselling, exercise and medication before lights-out. The routine is deliberately repetitive, meant to make other habits possible again.These residents include a 23-year-old whose dependence, counsellors say, began with curiosity and peer pressure, a 31-year-old unemployed graduate dependent on opioids, and a 19-year-old from a rural background dependent on injected drugs.Vinay Kumar Sinha, director of Jagran, has worked in drug-abuse prevention and care since 1988. The centre has 15 beds and has run since 2000 with support from the Union Ministry of Social Justice and Empowerment. The mandatory stay is 30 days, and residents must be discharged at the end of it. “Thirty days is not enough now. With synthetic drugs, withdrawal can be much more severe. A person may begin to stabilise, but that does not mean the dependence has been addressed or that he is ready to return to the same environment,” Sinha said.What worries him is what waits outside: the same friends who introduced them to drugs, a household struggling to pay its bills, a village with little to fill the day. Some older users, he says, recruit newer ones to fund their own habit. He estimates that 10-12 per cent of school-going children are addicted to some form of narcotic.Story continues below this adRead | Bihar’s heroin menace: Rs 69 lakh seizure exposes interstate network200 patients a month, many don’t returnAt the Patna Medical College and Hospital and the Indira Gandhi Institute of Medical Sciences (IGIMS), doctors say around 200 patients have visited every month for consultation on drug dependence over the past six to seven years, many of whom don’t return. A doctor at AIIMS Patna, which has a 30-bed de-addiction facility, said they have been seeing “similar numbers recently”.“Most of them hardly attend the first one to three sessions before discontinuing treatment,” says Dr Rajesh Kumar, head of psychiatry at IGIMS. “Many patients do not even start treatment, thinking about what others would say if they found out that they use drugs. There is also fear of law enforcement. Because of these fears, many people never seek treatment at all,” he said.Dr Kumar says the answer lies partly in how society and hospitals treat users. “Addiction is a mental health condition that often co-occurs with anxiety and depression. So we have to embrace them as patients, not as outcasts or criminals,” he said.Explained in graphics | From bottle to vial, how drugs took hold in a dry BiharCentral Government-supported dedicated treatment remains geographically concentrated, covering less than one-third of the state’s districts. As of March 2026, Parliamentary records listed NGO-run centres supported under the National Action Plan for Drug Demand Reduction in 11 districts, three of them in Patna. Two government hospital facilities, at Sadar Hospital in Bhojpur and AIIMS Patna, were also listed. Beyond this, the state depends on private facilities, district-level services and NGO-led programmes.Story continues below this adNational Crime Records Bureau (NCRB) data records the extreme cost: since prohibition came into force in 2016, Bihar has recorded 132 suicides under the “drug abuse/ alcoholic addiction” category.There’s tension in the villageBack in Saharsa, the government employee sees his family’s ordeal as part of a larger rural problem. Drug use is widespread in his village, he says, yet many families do not know where to turn; some cannot afford treatment, others cannot keep it up. “Treatment alone cannot solve everything if the person comes back to the same place, has nothing to do and meets the same people,” the brother said. He wants support and awareness at the ward and block level, so that families can seek help before a crisis.A social worker in Purnia says the market has become more visible in the past three to five years: “Smack and brown sugar are no longer confined to cities. They have become commodities that are available even in villages.” A primary-school teacher in Madhepura says children in Classes II and III have casually told her how ganja is smoked in cigarettes.Also Read | West Bengal writes to Bihar and UP governments about makers of spurious drugs, seek cooperationSocial workers warn it is not only users who suffer. “A young person’s life is being destroyed, but other people can lose their lives too,” a schoolteacher from Saharsa said.Story continues below this adThe teacher recounts the recent shooting of a young man who, he says, resisted an attempted robbery for money or a mobile phone by a man he believed was drug-dependent. The teacher describes how dependent users stop meeting friends, talking to family, eating properly, bathing or working; they spend their own money, then ask parents, relatives, friends or strangers, and when that fails, some turn to theft, robbery, even murder.Three cases from the past three months illustrate these fears:lIn July, an alleged addict in Jehanabad was arrested for beheading his 25-year-old sister-in-law after a quarrel over delay in serving him food.lIn August, a 23-year-old in East Champaran was arrested for allegedly slitting his mother’s throat to take the Rs 83,000 she had withdrawn from self-help group funds to pay for his addiction.lLast month, a 25-year-old in Samastipur allegedly hacked his father to death with an axe after he refused to give him money for drugs.Story continues below this adA senior police officer estimates that around a quarter of young people aged 15-29 are not in education, employment or training, and calls this mix “a demographic disaster in the making”.According to the Ministry of Statistics and Programme Implementation’s Periodic Labour Force Survey (PLFS), Bihar has the highest overall NEET concentration: over 81 per cent of its districts reported a youth share of more than 25 per cent. The state-level NEET rate is 32.1 per cent, significantly outpacing the national average of 25 per cent.“If we want to prevent young people from entering this cycle, we have to work at the root — in their homes, schools and communities — while making help available when someone is already using drugs,” the officer said.