At any given time, nearly half of these 2.5 million cancer patients are in advanced stages of the disease, and in severe pain. But even today, a majority of Indian states require hospitals, patients and their families to jump through several legal hoops to get to the drug. According to Rajagopal’s 2001 The Lancet article, “for a hospital (in one Indian state) to purchase morphine from another state… the procedure involves obtaining five licences from two different government bureaucracies in both states, each of which might have a different period of validity, but all of which must be valid at the same time. Inevitably, some licences expire before others can be obtained”.

All these restrictions seem to be in the wrong places. The United States’ 2007 International Narcotics Control Strategy observes that 20-30 per cent of India’s opium crop is diverted to illicit use. Even Indian brown sugar — based on morphine — is now available in neighbouring countries, it says.

Ravindra Ghooi, 57, from Pune, is angered by this. When Saral Ghooi, his mother, was diagnosed with advanced breast cancer in late 1996, she was 69. Ghooi’s mother refused surgery and chemotherapy, preferring instead to be “kept comfortable”. As Ghooi found out, this was easier said than done. “It took 130 days to get licences to purchase 10 tablets of morphine,” he says. He needed clearances from the Drugs Controller General of India (DCGI) in Delhi, the Narcotics Commissioner in Gwalior, and the excise departments of each state that the drug would pass through to reach Ghooi in Pune. “She suffered excruciating pain for 12 months due to non-availability [of the drugs],” he says in a petition to the Supreme Court. Saral Ghooi passed away in early 1998.