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Cultural diversity in India has nurtured the use of mind-altering substances over centuries, with-out causing any great alarm about drug abuse. This paper, using research conducted by the authors and other secondary data, attempts to present socio-cultural-religious, functional patterns of drug use in the country and examines some of the factors responsible for the drastic changes that have occurred since the 1980s. Specifically, it points out that the Narcotics Drugs and Psychotropic Substances (NDPS) Act, 1985, took the responsibility of drug abuse control away from the community to the near-defunct legal establishment; that by criminalising socio-religious-cultural-recreational use of opium and cannabis, it has promoted the pro-liferation of alcohol, heroin, and other moreharmful pharmaceutical drugs; that it has given a new lease of life to organised crime syndicates; and that denial of access to low cost, accessible health care at the hands of traditional healers is an unintended consequence needing immediate rectification. It makes certain policy recommendations to the UN bodies, their member states and to policy makers in India in particular.