Drug abuse in Pakistan - United Nations Office on Drugs and Crime

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Figures Pages I. Percentage of key <strong>in</strong>formants that reported drug use as common <strong>in</strong> their locale . . . . . . 15 II. Cumulative long term trend <strong>in</strong>dex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 III. Cumulative problems aris<strong>in</strong>g from drug <strong>abuse</strong> <strong>in</strong>dex, reported by key <strong>in</strong>formants <strong>in</strong> each state . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 IV. Age distribution of sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 V. Usual route of hero<strong>in</strong> adm<strong>in</strong>istration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 VI. Severity of dependence: all respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 VII. Percentage of sample who <strong>in</strong>ject . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 A.II.1. Severity of dependence scores—by sample group . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 viii
Executive summary The <strong>Pakistan</strong> National Assessment Study comprises of a set of surveys that each <strong>in</strong> its own right provides vital <strong>in</strong>formation on drug use <strong>in</strong> <strong>Pakistan</strong>; and which, when taken together, also provides a prevalence estimate of drug <strong>abuse</strong>. The surveys consist of (a) a national contour mapp<strong>in</strong>g exercise—to produce an overview of patterns and trends, (b) Four prov<strong>in</strong>cial city studies of the hard-core hero<strong>in</strong> us<strong>in</strong>g and <strong>in</strong>ject<strong>in</strong>g population, (c) An audit and update of the <strong>in</strong>formation on drug treatment facilities <strong>in</strong> <strong>Pakistan</strong>, (d) An estimation exercise (based on data collected <strong>in</strong> (a)-(c) for the number of hard-core hero<strong>in</strong> <strong>abuse</strong>rs and drug <strong>in</strong>jectors <strong>in</strong> <strong>Pakistan</strong>. Key <strong>in</strong>formants Key <strong>in</strong>formants were asked to report on drug <strong>abuse</strong> patterns and trends <strong>in</strong> their local areas. A total of 36 sampl<strong>in</strong>g sites (locales) were selected to allow a broadly representative national picture of the drug <strong>abuse</strong>. The sample was structured to <strong>in</strong>clude 18 matched pairs of rural and urban areas. In total, 283 key <strong>in</strong>formants were <strong>in</strong>terviewed for this study. Key <strong>in</strong>formants were selected on the basis that they had an <strong>in</strong>formed understand<strong>in</strong>g of drug <strong>abuse</strong> patterns <strong>in</strong> their particular locale. Cannabis type drugs (hashish and charas) were the drug type most often reported to “be commonly used” <strong>in</strong> the locales. Only 5% of respondents reported hashish or charas to be “rarely” used <strong>in</strong> their locales. These data <strong>in</strong>dicate that <strong>in</strong> terms of the number of consumers, cannabis represents the major illicit drug <strong>abuse</strong>d <strong>in</strong> <strong>Pakistan</strong>. This is <strong>in</strong> contrast with the f<strong>in</strong>d<strong>in</strong>gs of the 1993 survey, which suggested that hero<strong>in</strong> was the most commonly used drug. Hero<strong>in</strong> and alcohol are reported, after cannabis, as the next two most commonly used substances. Both drugs receive high “commonly used” rat<strong>in</strong>gs (46% and 45%), suggest<strong>in</strong>g that the consumption of both substances is relatively widespread <strong>in</strong> <strong>Pakistan</strong>. The high reported use of cannabis, hero<strong>in</strong>, and alcohol should not distract from the fact that worry<strong>in</strong>gly high levels of other types of drug <strong>abuse</strong> were also reported. In particular, it is a cause for concern that 9% of respondents are report<strong>in</strong>g the use of “other opiates” as common, that 20% report psychotropics as “commonly used”, and 12% report drug <strong>in</strong>jection as “common” <strong>in</strong> their locale. When hashish and charas are considered, little variation is found across <strong>Pakistan</strong> either <strong>in</strong> terms of rural versus urban comparisons or with respect to a prov<strong>in</strong>cial breakdown. Rural areas do report slightly higher overall figures, as do the prov<strong>in</strong>ces of Balochistan, and North-West Frontier Prov<strong>in</strong>ce (NWFP); lowest prov<strong>in</strong>cial figures were from S<strong>in</strong>dh. Hero<strong>in</strong> <strong>abuse</strong> is reported as a more urban phenomenon (54% of those <strong>in</strong> urban locales report<strong>in</strong>g common use as opposed to 32% of those <strong>in</strong> rural areas). Dist<strong>in</strong>ct prov<strong>in</strong>cial differences are also observable, with hero<strong>in</strong> <strong>abuse</strong> most commonly reported <strong>in</strong> Balochistan, then Punjab. NWFP had the lowest rat<strong>in</strong>g for reported hero<strong>in</strong> use with only 12% of key <strong>in</strong>formants report<strong>in</strong>g use that was “common” <strong>in</strong> their locale. <strong>Drug</strong> <strong>in</strong>jection appears least common <strong>in</strong> NWFP, where no key <strong>in</strong>formants report <strong>in</strong>jection as common <strong>in</strong> their locale. When long-term trends (last 5 years) for hero<strong>in</strong> use are considered, prov<strong>in</strong>cial differences are observable. Data from Punjab, the prov<strong>in</strong>ce with the highest population and high reported hero<strong>in</strong> prevalence, suggest a stable or even slightly decreas<strong>in</strong>g trend. This can be contrasted with data from S<strong>in</strong>dh and ix
Page 1 and 2: Supported by the UNDCP Global Asses
Page 3 and 4: UNITED NATIONS OFFICE FOR DRUG CONT
Page 5 and 6: Acknowledgements The National <stro
Page 7 and 8: Contents Acknowledgements . . . . .
Page 9: 3. Respondents’ perceptions of th
Page 13 and 14: EXECUTIVE SUMMARY About half of tho
Page 15: EXECUTIVE SUMMARY on these groups c
Page 18 and 19: DRUG ABUSE IN PAKISTAN data are to
Page 20 and 21: DRUG ABUSE IN PAKISTAN at the time
Page 22 and 23: DRUG ABUSE IN PAKISTAN Act also all
Page 25: 2 Rationale, methods and sampl<stro
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DRUG ABUSE IN PAKISTAN procedures f
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DRUG ABUSE IN PAKISTAN National tre
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8 National drug contour mapp<strong
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NATIONAL DRUG CONTOUR MAPPING Table
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NATIONAL DRUG CONTOUR MAPPING Figur
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9 Drug abu
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IMPLICATIONS OF THE NATIONAL ASSESS
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IMPLICATIONS OF THE NATIONAL ASSESS
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DRUG ABUSE IN PAKISTAN different as
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DRUG ABUSE IN PAKISTAN offences for
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DRUG ABUSE IN PAKISTAN This approac
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DRUG ABUSE IN PAKISTAN Table A.II.1
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Annex III. Tables supplemental to p
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ANNEX III. TABLES SUPPLEMENTAL TO P
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ANNEX III. TABLES SUPPLEMENTAL TO P
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Drug abuse in Pakistan - United Nations Office on Drugs and Crime

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