Calcutta, India — Cancer was slowly killing an old man in his fourth-floor apartment, and as the disease spread from organ to bone, sharp pains stabbed at his very core.
A clear oblong patch was stuck to Shyam Sundar Nevatia's chest, just above his weakening heart, gradually releasing a 25-milligram dose of opium-based narcotic over three days. The medication was no match for the relentless pain as death drew near.
Nevatia's doctor had prescribed more powerful morphine pills, but the 74-year-old businessman's family checked at hospitals and pharmacies, and even on the black market, without finding any.
India is the world's largest producer of legal opium, the raw material for codeine, morphine and other painkillers. But corruption and red tape have left thousands of Indians such as Nevatia to die in agony.
And strict licensing hasn't stopped drug gangs from diverting opium meant for medicines to smuggling routes shared by heroin and morphine traffickers, gun-runners and Muslim militants, police say.
"Organized crime and politics join together in this to make life miserable," said A. Shankar Rao, zonal director of the Narcotics Control Bureau, a national police unit.
Mala Srivastava, the federal official who oversees the licensing system, denied that it had serious flaws.
"Whatever little diversion there is is internal," she said. "We have never heard of Indian opium, or Indian heroin, traveling abroad" illegally.
But the U.S. State Department's annual report on narcotics control strategy calls India "a modest but growing producer of heroin for the international market."
India has been an opium producer for centuries. During this year's winter season, more than 78,000 licensed farmers produced an estimated 483 tons of opium. About 84% of that was exported, mostly to pharmaceutical companies in the United States, the world's largest importer of opium.
In an effort to keep opium out of criminal hands, India's federal and state governments license every step of the process, from growing poppies to stocking and transporting the painkilling drugs they produce.
But officials who issue the permits often don't answer the phone, are away from their desks or let applications languish for weeks, doctors and pharmacists complain. Sometimes hospitals run out of morphine while waiting for permit applications to work their way through the bureaucratic labyrinth.
