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Thursday, July 09, 2026

COLD TURKEY

Many chronic pain patients can reduce opioid use with slow, voluntary taper



Slow tapering reduces opioid use




Stanford Medicine





More than 50 million Americans live with chronic pain; among them, approximately one in 10 take prescription opioids regularly. A new large-scale study led by Stanford Medicine suggests that — with the right approach — many people may be able to reduce their opioid use long term without increasing their pain.

The key is a gradual approach to tapering opioid doses that puts the patient in the driver’s seat.

“So much of the fear of opioid tapering is about losing control,” said Beth Darnall, PhD, a professor of anesthesiology, perioperative and pain medicine and lead author of the study published July 7 in the Annals of Internal Medicine. “We tested a patient-centered methodology where we really focused on the individual patient and developed methods to ensure that they had maximal control in the process.”

The study enrolled more than 500 adult patients who had pain for at least six months and taken prescription opioids for at least three months. (On average, the participants had taken opioids for 12.4 years.) Patients worked with their clinicians to create a personalized opioid tapering plan with the goal of achieving their lowest comfortable opioid dose over 12 months. Doses were reduced no more than 10% per month, and patients could control the pace of their taper and pause the taper in collaboration with their clinician.

After 12 months, about half of patients achieved a successful response, defined as cutting their opioid dose by at least 50% without increased pain or staying at the same dose with significantly less pain.

“For patients, I think the data are reassuring that if opioids are tapered the right way, meaning a patient-centered approach, people can significantly reduce their opioid doses without having increased pain long term,” Darnall said.

The tapering program is not designed for people who have an addiction to opioids, she added, and patients with moderate or severe opioid use disorder were excluded from the study. Many people who take opioids long-term develop physiological dependence to the medications — and experience withdrawal symptoms when the medication is reduced — but do not meet other criteria for addiction, which include taking more than prescribed, drug-seeking behavior, and negative impacts on work and social life.

The study also compared the impact of two behavioral supportive therapies for pain management offered on top of the patient-centered tapering plan. One-third of participants were randomly assigned to receive eight weekly sessions of cognitive behavioral therapy for chronic pain, which focused on psychological skills to understand and ease pain. Another third were randomly assigned to receive six weekly sessions of a peer-led chronic pain self-management program, which included education on pain management, nutrition and communication with clinicians. Another third received only the patient-centered tapering plan.

The researchers found that the addition of supportive therapies did not boost the success rate of opioid tapering, but cognitive behavioral therapy for chronic pain seemed to lessen opioid withdrawal symptoms.

Tapering too fast

The patient-centered approach to opioid tapering is in line with current recommendations from the Centers for Disease Control and Prevention, but that was not always the case.

Through the late 1990s and 2000s, a surge in opioid prescribing for chronic pain contributed to a rise in addiction, overdose and other health complications. In response, in 2016, the CDC released opioid prescribing guidelines that emphasized the need to reduce opioid doses but without clear guidance on how to taper.

“What ended up happening was that after the publication of the 2016 guidelines, there was rapid deprescribing, meaning there were people who had been taking opioids for a long time who were tapered too fast,” Darnall said.

Some patients were cut off abruptly and without their consent. For some, the ensuing mental distress and severe opioid withdrawal symptoms led to suicidal behavior or overdose from illicit drugs.

“Ironically, in the name of reducing their risk, we were creating new risks by reducing opioids in the wrong way,” Darnall said. “The data told us that there are risks when you go up on doses, but there are risks when you go on down on doses, too.”

Patient-centered approach

At the time, most studies on opioid tapering focused on inpatient settings, but as a pain psychologist, Darnall had long heard from her chronic pain patients that many wanted to reduce their opioid dose but didn’t know how. In 2018, she and her collaborators published a small, four-month study showing that a slow, individually designed taper could help many patients at a community pain clinic lower their opioid dose.

The new study expands on that work, recruiting patients from 11 primary care and pain clinic sites in five states. Patients met with their clinician every three to four weeks, either in person or online. Integral to the patient-centered approach was an electronic platform, called CHOIR, developed by Sean Mackey, MD, PhD, the Redlich Professor, chief of the Division of Pain Medicine and member of the study’s executive research team. It automated weekly and monthly check-ins with the patients and responded with recommendations and compassionate messages.

“If they reported having major distress or major symptoms, that would get escalated to the clinic so the doctor would know and be communicating with the patient quickly,” Darnall said.

The platform also included an opioid tapering calculator that recalibrated the personalized plan based on tapering decisions made throughout the year.

The researchers hope that these electronic tools can help more clinicians implement patient-centered opioid tapering.

“We’re making available to the public our opioid tapering calculator, which we developed as part of this study, and the entire CHOIR informatics platform, which can monitor patients and provide automated support,” Darnall said. “We’re making it available for free, but it still requires that health care systems dedicate resources to integrate it into their system.”

Easing withdrawal symptoms

The CDC updated its opioid prescribing guidelines in 2022 to encourage more individualized care and shared decision-making with the patient, and to warn against rapid tapering. It also suggests that integrating behavioral support therapies into the tapering process could improve outcomes.

The new study is the first to compare tapering programs with and without behavioral support therapies, though the results were not what the researchers expected.

“When we originally conceptualized this study, we thought that if we apply these two behavioral interventions, maybe patients will reduce their doses more and have less pain, and we didn’t find that,” Darnall said. In fact, the groups assigned the supportive therapies had slightly lower rates of tapering success — 48.6% for the cognitive behavioral therapy for pain group and 44.5% for the chronic pain self-management program, compared with 50.9% for the taper-only group.

Participation in the supportive therapies was relatively low, with only about 60% of participants attending any of their assigned sessions, perhaps because the tapering program was already time intensive.

But when the team analyzed the results, they found that patients in supportive therapy groups experienced fewer opioid withdrawal symptoms. In particular, those assigned to cognitive behavioral therapy for chronic pain reported about half as many withdrawal symptoms as those in the taper-only group.

The researchers also noted that a patient’s self-rated “readiness” to taper at the start of the study was a good predictor of taper success, underscoring the importance of allaying patients’ fears and giving them a sense of control.

Before embarking on the study, Darnall’s team surveyed hundreds of patients and found that 68% of patients on prescription opioids had tried tapering without success. Most had attempted on their own, sometimes cold turkey.

“If they stop abruptly, it’s probably going to be a horrible experience,” Darnall said. “So that’s the experience they have and they think, ‘I need to stay on my dose; I can’t taper opioids.’ But often that’s not true — it was a flawed experiment.”

Researchers from the University of Arizona College of Medicine, Vi Palo Alto, Jonathan M. Wainwright Memorial Veterans Affairs Medical Center, University of the Pacific, University of Maryland School of Nursing, Kaiser Permanente, MedNOW Clinics, Lehigh Valley Physician Group, Intermountain Health and Stieg Clinics also contributed to the work.

The study was supported by funding from the Patient-Centered Outcomes Research Institute (PCORI).

 

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About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.




Sustained availability of dedicated high school health courses and adolescent substance use



JAMA Network Open



About The Study:

In this cohort study of California public high schools, sustained availability of a dedicated health course was associated with modestly lower prevalence in several common forms of adolescent substance use. These findings suggest that sustained, dedicated health coursework may be a scalable component of school-based substance use prevention.


Corresponding Author: To contact the corresponding author, Brennan Davis, PhD, email bdavis39@calpoly.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2026.22676)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time

  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2026.22676?guestAccessKey=1b34668e-afe8-4888-aa3d-dd05b3b83eff&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=070926

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.


 

Could acupuncture to the ear help to relieve migraines?




Federation of European Neuroscience Societies

Could acupuncture to the ear help to relieve migraines? 

image: 

Auriculotherapy for a migraine patient

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Credit: Please credit Fernanda Belle





Barcelona, Spain: Acupuncture to the ear may help to lessen pain from migraines and their impact on daily life, according to new research presented today (Friday) at the Federation of European Neuroscience Societies (FENS) Forum 2026 [1].

A randomised clinical trial of the treatment, called auriculotherapy, found that migraines were less painful immediately after the treatment and 30 days later, compared with the pain experienced before treatment. The impact of migraines on daily life also improved.

In addition, the researchers, led by Fernanda Belle, a physiotherapist in the Experimental Neuroscience laboratory at the University of Southern Santa Catarina (UNISUL), Palhoça, Brazil, observed changes in oxygenation levels in the prefrontal cortex of the brain over the course of the study, as measured by hemoencephalography (HEG®), which is a non-invasive technology using near-infrared spectroscopy to measure blood flow in the brain, and is an indirect measure of neural activity.

However, although these were all statistically significant improvements when comparing the 68 women in the trial before and after the treatment, there was no statistically significant difference between the 34 women receiving auriculotherapy and the 34 who received the sham treatment.

Ms Belle said: “Both groups improved over time, which may suggest that auricular stimulation, even when non-specific, can influence pain-related outcomes. However, at this stage, we cannot conclude that auriculotherapy was superior to the sham procedure.

“In the HEG® assessment, we identified changes in the average oxygenation levels of the prefrontal cortex over the course of the study, as well as differences between the groups, but the pattern of change over time was not clearly distinct between the two groups. However, the results are important because they show that it is possible to objectively monitor aspects of brain function in women with chronic migraine.

“Overall, these results are encouraging, especially because we observed improvement in clinical outcomes during follow-up, with a more consistent effect on pain in the group that received auriculotherapy. This suggests that auriculotherapy may be an interesting complementary strategy in the care of chronic migraine. We are reassessing these preliminary results in a larger group of women.”

Ms Belle has personal experience of migraines as she and members of her family suffer from them. So she wanted to explore options for improving the care for other people facing the same problem.

“Migraine is a highly prevalent and disabling condition, and many patients do not achieve adequate symptom control with conventional treatments alone. It also affects women approximately three times more often than men, probably due in part to hormonal influences, and it represents an important cause of disability,” she said.

Ms Belle recruited 68 women to her study who had had a clinical diagnosis of migraine for at least one year. All the patients experienced migraines on 15 or more days a month. Migraines were characterised by recurrent moderate to severe headaches, accompanied by other symptoms such as nausea, sensitivity to light and sound, and sometimes aura – a neurological symptom that can include visual disturbances such as flashing lights or zigzag lines.

The researchers assessed pain via the McGill Pain Questionnaire, and the impact on daily life using the Headache Impact Test (HIT-6) at three time points: before the patients started treatment, immediately after the treatment, and 30 days later.

The patients were randomly assigned to receive eight sessions of auriculotherapy or the sham treatment over eight weeks. Auriculotherapy involved the use of semi-permanent needles to stimulate specific points on the ear selected according to the protocol for migraine. Afterwards, mustard seeds were applied to the same points to maintain the stimulation until the next session. The sham procedure involved the application of semi-permanent needles to ear points that were not related to migraine, but corresponded to the fingers, wrist, knee, arm, shoulder, lung, lower limbs and spine. Mustard seeds were also applied to these points.

Patients did not know which procedure they were having, the therapist did, but the outcome assessors and those conducting the statistical analysis were blinded as to which group the women had been allocated. The researchers carried out physiological assessments in the brain using HEG®, which involves having small sensors attached to the patients’ heads to measure blood flow and oxygenation.

In the auriculotherapy group, the average pain score decreased from 50.5 before the sessions, to 44.7 immediately after the sessions, and to 41 after 30 days. This represented a reduction in pain of approximately 11% at the end of the treatment and 18% at the 30-day follow-up.

In the group receiving the sham procedure, the pain scores also decreased from 50.2 before the sessions to 44.3 immediately after the sessions and to 43.9 after 30 days, representing reductions of approximately 12% and 13%, respectively. At the 30-day follow-up, pain scores were significantly lower than before treatment in both groups. However, there was no statistically significant difference between the groups, meaning that the study could not show that auriculotherapy was superior to the sham procedure.

“We also observed a reduction in the impact of migraine on daily life,” said Ms Belle. “In the auriculotherapy group, the average HIT-6 score decreased from 66.1 before the sessions to 60.7 immediately after the sessions and to 59.5 at 30 days. In the sham group, the average score decreased from 65.8 to 59.2 after the sessions and was 59.3 at 30 days. Across both groups, this represents reductions of approximately 8% to 10%.

“Both groups improved over time, which may suggest that auricular stimulation, even when non-specific, can influence pain-related outcomes. However, at this stage, we cannot conclude that the auriculotherapy protocol was superior to the sham procedure. As this is a preliminary analysis from an ongoing study, the findings should be interpreted with caution and will be reassessed in a larger sample.”

In addition to studying auriculotherapy in a larger group of women, Ms Belle and her colleagues are also investigating the mechanisms that may explain how auriculotherapy acts in the body.

“Migraine is a complex condition involving neurovascular, autonomic and neuroinflammatory changes. The ear has strong links to networks of nerve cells, including connections with the vagus nerve, the trigeminal nerve and cervical nerves, which are involved in pain regulation, autonomic activity and inflammatory responses,” she said. “One of our hypotheses is that auriculotherapy may influence the so-called neuroimmune axis – a two-way communication system between the nervous and immune systems, modulating processes related to pain sensitisation and inflammation.”

Professor Christina Dalla from the National and Kapodistrian University of Athens, Greece, is chair of the FENS Forum communication committee and was not involved in the research. she said: “Migraine is a debilitating condition that can have a major impact on people’s lives, especially women’s lives. Well-conducted, randomised controlled trials of the condition are rare so, as a neuropsychopharmacologist, I am pleased that this study is being presented at the FENS Forum, as it has a rigorous methodology and careful assessment of the participants throughout the follow-up period. I look forward to seeing the results of auriculotherapy in a larger number of participants. It is important to emphasise that this a potential treatment that is complementary to existing migraine therapies, and not a replacement for them.”

(ends)

Notes

[1] “Auriculotherapy modulates cerebral hemodynamics and pain in women with migraine: a randomized double-blind trial”, by Fernanda Belle, Poster session 07 – Late breaking abstracts, 9:30-13:00 hrs CEST, Friday 10 July, poster area: https://fens2026.abstractserver.com/program/#/details/presentations/5399

 

Dreamer, Rebel or Zigzagger? Research reveals nine types of procrastinators and how to help them all





University of Cambridge

Solving Procrastination book by Itamar Shatz 

image: 

Front cover of Solving Procrastination: The Science of Why We Put Things Off and How to (Finally!) Stop, by Itamar Shatz, published by Tarcher (Penguin Random House) on 25th August 2026.

 

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Credit: Penguin Random House





Procrastination is on the rise, partly because of digital distractions and modern work, a new book warns. Working out which types of procrastinators we are is crucial to overcoming a problem that harms our finances, health and relationships.

 

Worrier, Pessimist, Perfectionist, Dreamer, Zigzagger, Rebel, Thrill seeker, Hedonist, Burnoutthese are the 9 types of procrastinators identified by Cambridge University’s Dr Itamar Shatz in Solving Procrastination: The Science of Why We Put Things Off and How to (Finally!) Stop, published by Tarcher (Penguin Random House) on 25th August.

Rebel procrastinators, Shatz argues, feel they don’t have enough control over what happens in their life, so they procrastinate to assert their autonomy and get back at authority figures they resent. Shatz advises them to find their own reasons for taking action and focus on their own standards (rather than on perfectionistic ones set by others), while prioritizing taking care of themselves and switching their environment so authority figures feel less prominent.

Zigzagger procrastinators constantly shift between whatever has their attention one moment to whatever happens to catch their eye the next. Shatz recommends they add structure and concreteness to their plans by setting specific goals and unpacking the steps needed to achieve them. They should also engineer their environment to reduce temptations and distractions, also ride the waves of their productivity rhythms, and seek support from an ‘accountability buddy’.

 

Whether it’s putting off a tax return, taking an essay to the wire, or delaying a difficult email, everyone procrastinates but few understand the problem or how to solve it. Dr Itamar Shatz, a social scientist at Cambridge, explains how procrastination works and the serious harm it does. He then offers a toolkit to help every kind of procrastinator overcome the problem.

 

An old problem in a fast-changing world

 

“Procrastination isn’t just a matter of motivation or bad time management,” Dr Shatz says. “These are really unhelpful misconceptions. Procrastination revolves around the tug-of-war between helpful elements of our drive to act and harmful elements of our drive to delay.”

Shatz draws on insights from hundreds of studies in psychology, behavioural economics, neuroscience, and related fields. He emphasises that procrastinators come from a wide variety of backgrounds, and that we can embody more than one type of procrastinator at once.

“Procrastination is an ancient human problem but the increasing bombardment of digital distractions in our lives may be making it worse,” Shatz says. “It can be hard to tear ourselves away from the various apps, platforms and games that provide an endless torrent of content that’s been ruthlessly optimized to capture our attention.”

Modern work is also encouraging procrastination, Shatz argues, partly because many tasks are “hard to care about at a basic psychological level”. “Long ago,” he says “people mostly needed to do things that had fairly clear and immediate consequences, like hunt food (or starve). People were unlikely to procrastinate on those tasks because the drive to not starve is powerful in a visceral way. Today, we regularly have to do nebulous things with amorphous future consequences, like email tax forms to our accountant.”

 

Harm caused by procrastination

 

Shatz demonstrates that procrastination causes serious harm to lives and careers, and also to entire organisations and national economies.

For many people, procrastination bites at university. Leaving assignments and revision to the last minute leads to worse grades and sometimes outright failure. Half of students have been found to procrastinate chronically and while adults in employment fare better, Shatz points out that one-in-five still procrastinate chronically, contributing to unemployment and lower salaries. He points to one large-scale study which found a $21,000 drop in average salary for every point decrease on a five-point procrastination scale.

Procrastination has been found to cost employers an estimated $20,000 per employee per year in the US, from the roughly two hours per day that employees spend procrastinating on average.

“Overcoming procrastination will become even more important as use of AI grows,” Shatz argues, because “personal productivity is expected to be one of the skills that remains essential for most types of work—including deploying AI.”

Beyond the workplace, procrastination causes other serious financial harm, including when we delay paying bills or saving for retirement.

Procrastination can also interfere with our relationships, Shatz argues. “It can make colleagues resent us, if they have to pick up our slack. At home, it can cause fights with our family, if we don’t do the chores we promised to. It can get in the way of making friends and finding romance. All of this can make procrastination a very isolating problem, which hurts us when we need other people the most.”

Procrastination can inflict serious harm on our emotional wellbeing and even physical health, Shatz says. This is partly because of the stress, shame, guilt and regret it generates, but also because it leads to unhealthy behaviours such as going to sleep too late, exercising too little, or postponing going to medical screenings.

 

Psychological mechanism

 

Shatz explains the main psychological mechanism behind procrastination:

“We are naturally wired to try to increase the pleasure that we experience and decrease our pain, a phenomenon called the hedonic principle. This leads us to pursue activities that we hope will make us feel good and avoid ones that we worry will make us feel bad, like when we watch funny videos to forget about an unpleasant task on our to-do list.”

In the meantime, the task lurks in the back of our mind, draining our energy, filling us with stress, and getting in the way of our enjoyment.

Shatz says: “The reason we procrastinate despite this heavy cost is that we’re also naturally wired to focus on what’s immediately in front of us. When this immediacy principle combines with the hedonic principle, they push us to do whatever will make us feel better right now, instead of what will be better for us in the long term.”

 

Solving procrastination

 

Shatz’s toolkit for overcoming procrastination includes calling out catastrophizing; planning how to handle potential obstacles; eliminating distractions; adding friction between you and temptations; engineering your environment in your favour; unpacking overwhelming tasks into manageable steps; starting with easy wins; rejecting perfectionism for good enough; and riding the waves of your productivity rhythms.

Shatz advises perfectionist procrastinators to avoid an all-or-nothing mentality and remind themselves that “imperfect progress is still progress, and is much better than getting stuck waiting for perfection.” Perfectionists should also set aside other people’s unrealistic expectations when deciding on their goals and avoid comparing themselves to others in ways that make you afraid of being imperfect. Carefully curated public highlight reels are, Shatz argues, making this pitfall particularly easy to stumble into.

Shatz offers specific advice to people with ADHD, emphasising that they might need to work in a place with lots of background noise, and retain certain temptations, such as video games, which people without ADHD might find distracting. The book also offers guidance for helping friends, loved ones, colleagues and employees, to stop procrastinating.

Shatz acknowledges that some high-functioning procrastinators, including Steve Jobs and Douglas Adams, can be extremely successful, but warns: “These procrastinators gain a false sense of security, which causes them to keep procrastinating and leaves them vulnerable to things going wrong in the future.”

“Solving procrastination isn’t about squeezing every possible drop of productivity out of your day,” Shatz emphasises. “It’s about helping you do the things you want to, when you want to, without guilt or stress. The key point is that you can choose how you spend your time, rather than have this choice stolen from you by procrastination.”

 

Reference

 

Itamar Shatz, Solving Procrastination: The Science of Why We Put Things Off and How to (Finally!) Stop (Tarcher, 25th August 2026). Hardcover: ISBN: 9798217047406

We will decide its future: A socialist voice from Pakistan-administered Kashmir

Kashmir protest

First published at Alternative Viewpoint.

Pakistan-Administered Jammu and Kashmir (PAJK) is passing through one of the harshest phases of confrontation it has seen in years. The wave of mobilisation led by the Joint Awami Action Committee (JAAC) — which grew out of grievances over electricity, taxation, and the question of seats reserved for refugees settled in Pakistan — has met a sharply escalated state response. In June 2026, the authorities outlawed the JAAC under anti-terrorism legislation, even as protests, shutter-downs, and clashes left more than twenty people dead, filled the prisons, and brought internet shutdowns, curfews, and shortages of food and medicine across the region. All of this unfolds against the clock of assembly elections set for late July, and the still-unresolved dispute over the twelve reserved seats.

In this conversation, Alternative Viewpoint speaks with Umair Khurshid, of the Jammu Kashmir National Students Federation (JKNSF), founded in 1966, one of the oldest socialist student organisations in the region and, by its own account, among the forces that helped build the JAAC from the first day. The interview takes up what has changed since the proscription: how a movement built on mass participation and restraint survives being branded a terrorist threat; how it keeps organising under surveillance and detention without surrendering its public, disciplined character; and why, after a familiar cycle of agreements announced and then abandoned, the rank and file are increasingly demanding accountability from their own leadership.

The discussion ranges across the human cost of the shutdown, the debate over whether to boycott or contest the coming elections, the re-emergence of women in the movement against conservative pressure, the role of the diaspora in breaking the state’s information blockade, and the question of solidarity with Gilgit-Baltistan and across the Line of Control. Throughout, the JKNSF’s voice is a distinctive one: defending the movement against the state’s propaganda while insisting, from within, that immediate demands must be carried toward a deeper programme of popular sovereignty, democratic control from below, and socialist transformation. It is a reminder that the sharpest critics of a movement’s limits are often those who have given the most to build it.

How did you first get involved in this struggle, what keeps you in it now that the risks have grown, and how do you see the movement, especially aspects not always covered in the media?

The Jammu Kashmir National Students Federation, or JKNSF, was founded in 1966 and is one of the oldest socialist student organisations in Pakistani-administered Jammu Kashmir (PAJK). I joined JKNSF in 2016, and my involvement in this struggle grew out of that political tradition. From the beginning, JKNSF has stood with students, workers, and the oppressed masses, linking their immediate struggles to the broader fight against capitalism, exploitation, and the class rule that shapes their everyday lives.

Unlike some organisations that focus almost entirely on the national question while pushing local economic struggles into the background, JKNSF has always treated these questions as interconnected. We organise around the immediate problems that students and ordinary people face, including fee hikes, unemployment, inflation, state repression, and the everyday denial of their democratic rights. For us, these are not secondary issues. They are part of the same structure of exploitation and domination that shapes life in PAJK.

JKNSF was part of this movement from the first day. In fact, I would say it played a crucial, and in some ways foundational, role in helping build the movement and the Jammu Kashmir Joint Awami Action Committee, or JAAC. Our comrades were involved in shaping the initial charter of demands, organising on the ground, mobilising students and young people, and taking the risks that came with this work. Some of our comrades also faced arrest and injury during this process.

At the same time, it is important to be honest about the internal dynamics of the movement. There have been repeated attempts by some forces to sideline left-wing, socialist, and progressive voices, although these forces played a central role in building the movement from the beginning. There has often been a tendency to present the movement as the achievement of a few individuals while downplaying the contributions of students, workers, and progressive organisations that helped lay its foundations. We have disagreed with those tendencies and have argued consistently for a broader, more democratic, and more inclusive movement.

We support the committee as a front around shared demands, but we are not tailists. We neither blindly follow the committee leadership’s adopted position nor dissolve our organisation into it. JKNSF maintains its own political identity, programme, and analysis. We participate in common struggles where unity is necessary, but we also retain the right to raise criticisms, express disagreements, and argue for a different direction when we believe it is needed.

In particular, we believe that the movement cannot be reduced to negotiations over a few immediate demands alone. Those demands are important and worth fighting for, but the more profound questions of neocolonialism, class structure, democratic rights, and political power must also be addressed. On these questions, we have sometimes had differences with other forces within the movement, and we have never hidden those differences.

What keeps us in this movement, despite the risks, is that this is the struggle we have stood for from the very beginning. It is rooted in the real lives of the people, and it did not appear from nowhere. It was built through years of anger, organisation, and sacrifice.

From where we stand, what often does not make it into the wider coverage is the actual social character of this movement. It is often portrayed by the state and state-backed media as foreign-funded, Indian-backed, or driven by some hidden agenda. Alongside these efforts, there has been a wider smear campaign against the people of Jammu and Kashmir. Furthermore, there have been attempts to assign the movement an ethnic colour, to invoke divisions among people, and to present a struggle rooted in democratic rights, livelihood, dignity, and popular anger as if it were hostility toward some community.

This narrative does not stand up to even the most basic facts. People involved in this struggle, including JKNSF, have repeatedly condemned Indian occupation, military repression, and the violence faced by people in Indian-administered Jammu Kashmir (IAJK). A movement that has consistently opposed oppression on both sides of the Line of Control cannot honestly be reduced to the propaganda label of being Indian-backed. This movement belongs to the people who have come out despite curfews, bullets, arrests, propaganda, and fear.

That is why JKNSF has been part of it since the formation of JAAC in September 2023, and we will remain part of it. At the same time, we will remain part of it as an independent socialist organisation, defending the role of progressive forces and continuing to argue that lasting change requires not only resistance but also a clear political vision rooted in the interests of workers, students, and ordinary people.

The JAAC has now been outlawed under anti-terrorism legislation. How has this designation practically changed the perception of a movement that has prided itself on restraint? Has it weakened you, or widened sympathy in ways the authorities may not have anticipated?

The outlawing has changed things in two ways. Practically, it has increased the legal and physical risks for everyone associated with the movement. It gives the state a wider excuse for arrests, raids, intimidation, surveillance, and the criminalisation of even ordinary political activity. A person attending a meeting, helping organise a protest, sharing a statement, or raising their voice for the demands can now be treated as if they were part of something criminal. That is the immediate purpose of such a designation. It is meant to frighten people away from public participation.

But politically, we do not think it has had the effect the authorities hoped for. This movement has not been known for armed actions or adventurism. It has been known for mass mobilisation, shutdowns, sit-ins, negotiations, public demands, and restraint, even in the face of provocation and violence. When a movement with that character is suddenly called a terrorist threat, people can see the contradiction. They know who has been firing, who has imposed curfews, who has shut down the internet, who has arrested people, and who has used force against unarmed protesters.

So yes, there may be an immediate chilling effect. Some people may become more careful. Local organisers may have to think harder about how they move, speak, and gather, but I do not think the designation has weakened the movement in a deeper political sense. In many ways, it has widened sympathy, because it has exposed the state’s fear of even peaceful mass politics.

Hundreds have been detained, and there’s a heavy security and intelligence presence. How does a movement keep functioning under those conditions, guarding against infiltration and attempts to provoke it into violence?

The first thing that changes is the atmosphere. Fear becomes part of daily life. People become careful about whom they meet, what they say, where they gather, and how they organise. Local activists understand that authorities may view a normal political conversation as suspicious, but a people’s movement operates beyond formal structures. The movement endures due to the widespread sharing of grievances; while a state can detain individuals, it cannot suppress the conditions that fuel the anger.

It is also important to understand that the masses in Jammu and Kashmir are highly politically conscious. People here have a long history of political engagement and collective struggle. They have learned from past experiences, including periods of repression, co-optation, and attempts to divide popular movements. Because of this history, many people understand the importance of organisation, discipline, and maintaining broad public support. The movement is not sustained by a handful of leaders alone; it is sustained by a politically aware population that understands the issues at stake and has developed its own collective memory of struggle.

Of course, repression creates real dangers. One danger is infiltration; another is provocation. The state often wants a restrained movement to lose its discipline, because once it can present the movement as violent, it becomes easier to isolate it, criminalise it, and justify further force. This is why political clarity matters so much. The movement has to keep reminding people that its strength lies in mass participation, public legitimacy, and restraint. It should not allow anger, however justified, to be turned into actions that help the state’s narrative.

From our perspective, the answer is not secrecy for its own sake or adventurism. The answer is political discipline; decisions should remain collective, demands should remain clear, and the movement should keep its public character.

There’s now a pattern of agreements announced and then left unfulfilled. What motivates the movement to return to the negotiating table, and what factors would lend credibility to any new agreement this time?

The movement keeps returning to the table because it has never been afraid of negotiation. From the beginning, it has tried to show that its demands are public, reasonable, and rooted in the real conditions of the people. In that sense, going to the table is not a weakness; rather, it reveals whether the state is willing to resolve the crisis politically or is merely attempting to exhaust people through delay.

But there is now a clear pattern: agreements are announced, committees are formed, deadlines are given, and then implementation is delayed or abandoned. The state uses this process as a tactic which allows it to lower the temperature for a few days, divide the movement, create confusion among the people, and then return to repression once the pressure on the streets has been reduced.

This tactic means that any new agreement must be judged by its concrete steps, not by the words used in a press conference. It would need a written and public framework, clear timelines, legal and administrative guarantees, immediate implementation of the agreed points, release of detainees, withdrawal of cases, an end to the proscription of JAAC, justice for those martyred and injured, and a mechanism that the public can actually verify. Without that, an agreement is only another pause button for the state.

We also believe the movement must advance further. The demands raised so far are undeniably important, but if the movement remains only at the level of demands, the state always has room to respond with committees, partial concessions, technical delays, and promises of future reviews.

This is why we believe a proper political and economic programme is necessary. The movement should not only say what it rejects or what it wants. It should also say how it can be achieved and implemented and also address the question of political power.

This is where Bordiga’s argument in “Seize Power or Seize the Factory?” remains relevant. The point is not simply to win isolated concessions or occupy one limited space within the existing order. The real question is political power. So yes, the movement may return to the table, but it should do so with political clarity. Negotiation can be useful when it is backed by mass pressure, organisation, and a broader programme, but talks must not become a substitute for building a movement capable of forcing implementation and going beyond temporary concessions.

Have these repeated breakdowns changed how the rank and file view their own leadership’s readiness to settle?

Yes, they have changed how many people view the leadership’s readiness to settle. There is now a debate inside the movement, and it would be wrong to pretend otherwise. Many people still understand the pressure the leadership faces, but there is also frustration that, at several key moments, the leadership appeared too willing to accept assurances from the state without enough concrete guarantees.

This debate did not begin only with the latest agreement. Even during earlier marches and negotiations, many activists argued that the leadership went soft at crucial points. One major example was the failure to insist more strongly on action against those who opened fire on protesters, resulting in martyrdom. For the families of the martyred, for injured comrades, and for those who stood on the streets facing bullets, this was not a secondary issue. Justice for those attacked by the state is central to the movement’s moral and political legitimacy.

That is why many of us believe the movement needs stronger democratic accountability from below. We should not view decisions about settlement, retreat, escalation, and negotiation as the sole responsibility of a few leaders. The people who face repression must have a real say in what is accepted in their name.

The shutdown has produced real shortages of food and medicine. Who bears the heaviest burden, how does the movement weigh that hardship against its goals, and what do you say to residents who have publicly blamed the JAAC for the disruption and the deaths?

The heaviest burden is always carried by those who have the least cushion. Daily wagers suffer first because one closed day can mean no food at home. Similarly, small traders and poor households suffer the most.

So we should not romanticise hardship; the movement cannot treat people’s suffering as a small cost, but the central question is, who created this situation? The movement did not shut the internet, impose curfews or bring armed forces into villages and towns. The state created the crisis and then tried to blame the people for resisting it.

A large majority of people understand the situation, and they know that the same people who are now speaking about disruption ignored the suffering that existed before the shutdown.

That does not mean every criticism from residents should be dismissed. If someone says they are hungry, cannot obtain medicine, or that pain is real, it must be heard with seriousness, but there is a difference between genuine public distress and a manufactured campaign to blame the movement for violence and shortages caused by state repression.

As far as some of the public videos and statements blaming JAAC are concerned, many people locally do not see them as organic. In some cases, people appearing in such videos do not even reside in the state, leading to their mockery as rented propaganda. In other cases, they come from loyalists of mainstream parties who have always stood with the state structure. Some people are thought to be under pressure from old police cases or other vulnerabilities that can be used for blackmail. I would still avoid making it about personal abuse. The larger point is that the state amplifies these voices because it cannot answer the movement politically.

This is a coalition of traders, students, lawyers, nationalists, and the Left, and there’s been talk of currents pulling in different directions. Under this much pressure, what holds it together, where does it strain, and who is shaping its direction now?

What holds this coalition together is the charter of demands and the wider question of popular sovereignty. The movement, as you rightly said, includes people from different backgrounds, so naturally there are different political currents within it, but these forces are connected by a shared set of democratic and local demands that come from the lived conditions of the people.

There is also a rising “Kashmiri” anticolonial consciousness that has become very important in PAJK. In this part of Jammu Kashmir, this consciousness has not always rested on one common ethnic or linguistic identity. It has developed more through resistance, through shared political experience, and through the way people have been treated by the state. Every act of repression strengthens the feeling that people here are being denied dignity and political agency as a collective.

This situation involves not only sentiment but also a political idea that is evolving into a social force. Marx captures this relation between consciousness and material struggle in his Critique of Hegel’s Philosophy of Right, where he writes: “… but theory also becomes a material force as soon as it has gripped the masses. Theory is capable of gripping the masses as soon as it demonstrates ad hominem, and it demonstrates ad hominem as soon as it becomes radical. To be radical is to grasp the root of the matter. But, for man, the root is man himself.”

That is what we are seeing in PAJK. A consciousness formed through lived oppression, political memory, and collective struggle is no longer confined to small political circles. This consciousness may have existed earlier in different forms, but I think it has become much stronger in recent years. The internet has played a major role in that process. Before the internet, many people were less connected to each other across districts, and many were less exposed to the history of the region, to the political debates, and to the questions that had been suppressed for decades. The state often restricts or discourages books and narratives that challenge its official version of history. People may still not have access to everything, but discussions that were once limited to small political circles now reach young people, students, workers, traders, and ordinary households rapidly.

That is also why the internet shutdown matters so much. It is not only a communication blackout but an attempt to break the social and political circulation through which people understand themselves as part of a common struggle. The state understands that the internet can amplify suffering, memory, and political clarity. A large section of the youth has become acquainted with this wider Kashmiri consciousness through these debates, videos, statements, histories, and experiences of collective struggle.

As for who is shaping its direction now, I think it is no longer only a matter of formal leadership. The JAAC leadership still matters, and different organisations inside the movement still matter, but the rank and file, local committees, youth, traders, student activists, and the families of those martyred and injured now carry enormous moral and political weight. The movement is being shaped from below as much as from above. That is one of its strengths, and also one of the reasons the leadership cannot simply settle everything behind closed doors without facing questions from the people who have paid the heaviest price.

How accountable is the central leadership to the local action committees that do the day-to-day organising?

As we mentioned earlier, understanding the movement requires looking beyond its formal leadership. The day-to-day strength of the movement comes from local action committees, district-level organisers, students and ordinary people who keep the struggle alive on the ground.

There have been real reservations about the structure of decision-making. JKNSF has expressed its own concerns, particularly regarding the core committee that oversees the broader JAAC and holds considerable influence in decision-making. We, along with individuals from other organisations and many members of the general public, have questioned their roles. These questions became sharper around the issue of elections, representation, negotiations, and who has the authority to settle or speak in the name of the movement.

So accountability is not perfect, and it would be wrong to pretend that there is no tension, but as discussed earlier, it would also be wrong to say that the central leadership or the core committee is completely unaccountable to the local level. The weight of the movement itself creates pressure. Even when leaders may want to avoid difficult questions, the scale of participation forces them to respond. The local committees, the rank and file, and the wider public have become too important to ignore.

In that sense, accountability exists, but pressure from below rather than a fully formal democratic structure produces it. That is both a strength and a weakness. It indicates that the movement is alive and rooted among the people, but it also shows the need for clearer mechanisms of consultation, representation, and decision-making, and our criticism should be understood in that spirit. We raise these questions because we want the movement to become more democratic, representative, and capable of carrying the struggle forward. This criticism is not the same as the propaganda of forces that want to weaken, discredit, or isolate the movement. We criticise from within the struggle, as part of it, and with the aim of strengthening it.

A very large share of families here depend on relatives abroad. Beyond remittances, what role is the diaspora playing — and has the movement managed to turn that overseas presence into real political pressure?

The diaspora has played an important role, and not only through remittances. Families abroad are connected to almost every town and village here, so when repression takes place, it is not contained locally. News travels through family networks, political networks, student circles, community organisations, and social media. That has helped break the silence around what is happening in PAJK.

The overseas presence has also created diplomatic and international pressure, especially in the UK, where a large part of the diaspora is based. The demonstration in London on June 13, which brought around 10,000 people onto the streets, was one of the clearest signs of the situation. There have also been protests and campaigns across Europe, the United States, and Canada. In many ways, the demonstration may be one of the largest diasporic mobilisations around PAJK in recent years. The fact that the issue was discussed in the UK Parliament also shows that the movement has begun to convert overseas presence into visible political pressure. We can see that from the way the state responds to them. When the authorities condemn these activities as foreign intervention or try to present them as part of some external conspiracy, it indicates that they feel the pressure. If these actions had no effect, the state would not be so anxious about them.

International solidarity is important, and we cannot emphasise it enough. When people abroad raise their voices, it instills confidence in people here and makes it harder for the state to bury everything under blackout, propaganda, and repression. It also challenges the state’s public relations machinery, which is very active, especially in moments like these. The state wants to control the story, and diaspora activism helps contest that control.

But from our perspective, we should also be clear about the limits. We do not have any illusions that the UN or any international organisation will come and solve this question for us. These bodies may carry symbolic and diplomatic weight, and their statements can affect how states manage their image, but they do not usually intervene in any meaningful way against the interests of powerful states. We have seen these dynamics clearly in IAJK, where India was able to abolish Article 370, impose a long curfew and communications blackout, and carry out widespread repression without any serious intervention from international institutions.

Elections to the assembly are scheduled for late July. What is the movement’s posture toward them — contest, boycott, disrupt — and can electoral politics deliver what years of street mobilisation have not?

The JAAC is divided on the question of elections. There is no single, fully settled position inside the movement. Officially, the stance of the JAAC has been that elections should be boycotted unless there are electoral reforms, especially the abolition of the 12 refugee or migrant seats and fresh delimitation. The argument is that elections under the existing structure only reproduce the same political engineering and keep power in the hands of the same mainstream parties.

But the issue is now a serious debate inside the movement. Some people still argue for a boycott; others believe the movement should contest. Public opinion is also divided. Many people understand the case for boycott, especially when the electoral system itself is considered manipulated, but many also worry that staying out of the election would leave the entire field open for the mainstream parties that have already failed the people.

From our perspective, the movement cannot simply abandon this arena. We do not believe that elections alone can resolve the questions raised by years of street mobilisation. The more profound issues of popular sovereignty, economic exploitation, representation, state repression, and democratic rights cannot be solved through the assembly as it currently exists, but leaving electoral politics entirely to the old parties also has a cost. It allows them to claim representation while the forces that built this mass movement remain outside the formal political field.

So the question is not just boycott or contest in the abstract. The real question is, with what program? If the movement enters the electoral field, it should not do so only to win seats or become another pressure group inside the same structure.

We think street mobilisation and electoral politics should not be treated as opposites. Without mass pressure, elections become a managed ritual, and without political organisation, street mobilisation can be pushed into repeated negotiations and delay tactics. These two questions are linked, and a movement that has built power in the streets should also think seriously about how that power is expressed politically, including through elections, without losing its independence or its programme.

Therefore, I would say electoral politics can deliver something only if it remains connected to the movement outside the assembly. It cannot replace struggle on the ground, but it can become another front, provided the movement enters it with clarity and a programme that goes beyond temporary concessions.

Participation by women was, candidly, limited in earlier phases. What’s changing — and what does a younger, more connected generation want that the older leadership may not yet represent?

Women did have a role in the movement from the beginning, and comrades from our organisation were actively involved in it. For instance, our women comrades took the lead in organising a women’s march in Rawalakot. So it would not be correct to say that women were completely absent in the early phase.

But thereafter, we saw the influence of conservative forces increase inside the core committee and around the movement’s leadership. These forces tried not only to push women back but also to sideline progressive elements, left organisations, and others who wanted the movement to take a broader political direction. That had an effect, and women’s participation became more limited, and the public face of the movement became more male-dominated than it should have been.

Now, the pressure from the movement itself and the scale of repression have led to an increase in women’s participation again. The movement has created a situation where conservative forces have had to step back to some extent because much of the day-to-day organising is being done by people who have already been politically active through student organisations, political organisations, and local committees. In many of these spaces, women already have a presence, especially in progressive and student circles.

At the same time, we have to be honest about material reality. Jammu Kashmir, despite its history of political consciousness and resistance, is still in many ways a conservative mountainous society. Women do not receive the same space for political expression that men receive. Even in politically advanced circles, patriarchal thinking exists. Women are often expected to support politics from the background, while men speak, negotiate, lead, and represent. That has to be challenged within the movement itself.

If this movement continues, women’s participation can become one of its most important gains. Not only because it strengthens the movement numerically, but also because it challenges the conservative limits of politics in our society. A movement for dignity, democratic rights, and popular sovereignty cannot remain complete if half of society is kept at the margins.

Is there a shared cause with Gilgit-Baltistan, and how does this movement relate to Kashmir on the Indian side while keeping itself from being instrumentalised by outside powers?

There is certainly a shared cause with Gilgit-Baltistan, especially because the Gilgit-Baltistan Awami Action Committee also emerged around economic, democratic, and local demands. In that sense, there is a clear connection. People there have also raised questions about resources, representation, taxation, rights, and the decision-making process that affects their lives without their meaningful consent. These are not identical situations, but there is a shared structure of denial, dependency, and political control.

However, I think there has been some hesitation from parts of the leadership in PAJK in fully expanding solidarity with the movement in Gilgit-Baltistan and seeing it as part of a connected regional struggle. That hesitation is rooted in political and historical reasons, as well as fears about how the state might interpret such solidarity; however, we believe that democratic and economic struggles across the region should not be viewed in isolation. If ordinary people in Gilgit-Baltistan are fighting for control over their resources, dignity, and democratic rights, then that is a struggle we should recognise and support.

As far as IAJK is concerned, the movement is obvious against Indian occupation, military repression, and the denial of democratic rights to the people on that side. In fact, one of the most popular slogans of the movement roughly translates to “This land (Jammu Kashmir) is ours, and we (the people on both sides of LoC) will decide its future.”

There have also been voices from IAJK that have expressed support for this movement, and some of that support is genuine. People there understand what state repression, blackout, military presence, arrests, and political humiliation mean. They can see those patterns here, even if the political conditions on both sides of the Line of Control differ.

We should also be clear that some forces aligned with the Indian state try to use this movement to push their narrative. Such forces do not help the movement. They make things worse by allowing the Pakistani state and its supporters to present a genuine people’s struggle as some Indian-backed project. I wouldn’t call this a joint conspiracy, but it is an attempt to use our movement for their propaganda.

The Indian state lacks any moral superiority in this situation. People in PAJK are familiar with India’s holier-than-thou attitude, and they also know the record of the Indian state in Kashmir. More than one lakh people have died and endured mass repression, disappearances, arrests, curfews, and prolonged communications blackouts. A state with that record cannot present itself as a defender of the rights of people of Jammu and Kashmir.

We welcome genuine solidarity from people across the Line of Control, especially from those who understand repression through their own lived experience, but we reject any attempt by Indian state-aligned forces to appropriate this movement for their own nationalist propaganda.

What would genuine de-escalation require right now, what are your red lines in any settlement, and a year from now, what do you expect to be doing?

Genuine de-escalation right now would require the state to move first, because the state has the armed power, the prisons, the cases, the checkpoints, and the ability to impose or lift a siege. It would require the withdrawal of deployed forces from civilian areas, the lifting of curfews and restrictions, the restoration of internet and communications, and an immediate end to raids, arrests, and intimidation. It would also require the release of detained activists, workers, students, and ordinary protesters, along with the withdrawal of cases filed against people for taking part in the movement.

There also has to be urgent relief for ordinary people. Food and medicine must be allowed to move without obstruction. Hospitals must remain open and accessible. The injured must be treated without fear of arrest. Families of the martyred must be given justice, dignity, and the right to bury and mourn their loved ones without pressure. If the state is serious about de-escalation, it cannot speak the language of peace while keeping the machinery of repression in place.

At the same time, any agreement must acknowledge those who were martyred and injured. There can be no settlement that leaves detainees in prison or keeps cases hanging over people’s heads as a tool of future blackmail.

From the perspective of JKNSF, we also believe that even a good settlement cannot be the end of the struggle. The movement has shown the power of the people, but it has also shown the limits of raising demands without a broader political and economic programme. We need to build organisation, political education, student and worker participation, women’s participation, and democratic accountability from below. The struggle has to move from protest alone toward a clearer vision of power, resources, representation, and social transformation.

A year from now, JKNSF expects to remain actively engaged in this work. We will continue organising among students and youth, raising political awareness, defending democratic movements against repression and propaganda, and ensuring that the sacrifices made by the people are not reduced to a handful of temporary concessions. Whether the struggle takes place on the streets, in educational institutions, through local committees, public forums, elections, or political education initiatives, our commitment will remain the same: to help transform the courage, anger, and sacrifices of the people into lasting democratic organisation and a progressive political programme rooted in the interests of workers, students, youth, women, and the oppressed masses of Jammu and Kashmir. For us, this struggle cannot stop at temporary relief or administrative reforms. It must move toward socialist transformation, where resources, power, and decisions are placed under the democratic control of the working class.

Umair Khurshid is the Editor of Azam, the organ of the Jammu Kashmir National Students Federation (JKNSF).