Neurobiological Underpinnings of NDPS Drug Dependence and Their Role in Antisocial and Criminal Behaviour: A Multidisciplinary Review

Substance use disorders, specifically drug abuse/dependence involving controlled substances covered under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985, have become one of the primary issues of public health and forensic importance in India due to accumulating scientific evidence indicating a poorly understood connection between addiction and criminality in the context of forensic neuroscience. The present paper is dedicated to conducting a comprehensive review of neurobiological, pharmacological and criminal psychological evidence supporting a link between NDPS drug addiction and an increased tendency toward criminal behaviour. A systematic analysis of published literature was performed using popular scientific databases, namely PubMed/MEDLINE, Scopus, PsycINFO, Embase, Cochrane Library and IndMED, in addition to national surveillance and epidemiological information from the National Crime Records Bureau, Narcotics Control Bureau and AIIMS-NDDTC National Survey on the Extent and Pattern of Substance Use in India. It was established that repeated consumption of NDPS-scheduled drugs causes substantial changes in neurobiology, particularly prefrontal hypo-frontality, impaired function of the dopaminergic reward pathway and serotoninergic neurotransmission, disturbance in hypothalamic-pituitary-adrenal (HPA) axis, neuroinflammation and epigenetic effects. Altogether, such neurological changes result in deficient executive functioning, poor impulse control and weakened morality, increasing predisposition to violence, impulsive tendencies and risky behaviour related to crime. Moreover, pharmacodynamics of NDPS drugs along with social environmental factors contribute to the development of addiction-criminality association. As a conclusion, NDPS substance use disorder should be recognized as a neuropsychiatric disorder, implying necessary shifts in the paradigm of forensic medicine in India by replacing the punitive model of criminal justice with health-oriented rehabilitative practices involving compulsory neuropsychiatric evaluation and effective treatments.