The nature of drug abuse in Nepal’s remote Karnali province is changing. Substances traditionally associated with addiction, such as heroin, brown sugar, hashish and cannabis, are no longer the only concern for authorities. Increasingly, young people are misusing prescription medicines intended for treatment, turning easily available drugs into a new source of addiction.

Police and health officials say the misuse of easily accessible prescription medicines, including sedatives, painkillers and other drugs prescribed for specific medical conditions, is becoming a growing concern across the province.

The abuse of medicines such as norethisterone, drugs prescribed for epilepsy, clozem, nitrazepam, tramadol and buprenorphine has raised alarm among law enforcement agencies. Police say many young people who cannot afford expensive illegal drugs are turning to pharmaceutical medicines because they are cheaper and easier to obtain.

The trend has created a new challenge for authorities because many of these substances are legally manufactured and sold for medical purposes, but can become addictive when consumed without medical supervision.

The Mugu District Police Office recently arrested 22-year-old Kamal Malla of Chhayanath Rara Municipality-1 with medicines used to delay menstruation and drugs prescribed for epilepsy treatment.

Police Inspector Nabin Shahi said Malla admitted to purchasing the medicines from pharmacies and consuming them for a long time. According to Shahi, Malla told police that he used the drugs because they made him feel “drowsy and intoxicated”.

Earlier, the Surkhet District Police Office arrested 28-year-old Kamal Karki and 21-year-old Dhwanil Malla from Birendranagar-3 with 232 tablets of nitrazepam. Police say the misuse of prescription medicines, ranging from sleeping pills to strong painkillers, is becoming increasingly common.

Shahi attributed the rise in prescription drug abuse to a combination of social and economic factors, including poverty, unemployment, psychological stress and easy access to medicines.

“Drug abuse has emerged as a new challenge for peace and security in Karnali,” he said. “Cannabis and hashish are also easily available in Mugu, contributing to the growing number of young people being trapped in addiction.”

Dr KN Poudel, a senior consultant physician at Karnali Provincial Hospital, said medicines such as nitrazepam and tramadol have legitimate medical uses but can become harmful when misused.

Nitrazepam is prescribed for patients suffering from insomnia for limited periods, while tramadol is used to manage severe pain, including pain experienced by cancer patients. When used in the prescribed dose and duration under medical supervision, these medicines are considered safe. However, excessive consumption outside medical purposes can affect brain function and gradually lead to dependency, he said.

“Recently, we have seen cases where people obtain these medicines from hospitals and pharmacies under various pretexts and misuse them,” Dr Poudel said. “Young people abusing such medicines often suffer from loss of appetite, weight loss, malnutrition, memory problems, reduced decision-making ability and mental health issues.”

He said families also need to be more cautious because medicines prescribed for patients are sometimes secretly taken by other household members, particularly young people, and consumed in unsafe quantities.

Deputy Inspector General Jaya Raj Sapkota, chief of the Karnali Province Police, said the misuse of prescription medicines should be treated as a serious emerging threat.

He called for stricter monitoring of medicine sales and distribution, regular inspections of pharmacies, awareness programmes targeting young people and improved access to mental health services.

“The drug network in Karnali appears to have expanded significantly. Police need to remain active across all districts,” Sapkota said. “Effective use of drug detection tests could also help identify users and strengthen prevention efforts.”