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

DRUG ABUSE IN PAKISTAN
Balochistan, which suggest an <strong>in</strong>crease <strong>in</strong> hero<strong>in</strong> <strong>abuse</strong> over this period. In NWFP, little change is reported
and, <strong>abuse</strong> levels are reported as low. These data would fit with the tentative suggestion that hero<strong>in</strong> use
is still diffus<strong>in</strong>g <strong>in</strong> <strong>Pakistan</strong> to new areas, <strong>in</strong>clud<strong>in</strong>g more rural areas, whilst at the same time stabiliz<strong>in</strong>g,
or even decl<strong>in</strong><strong>in</strong>g, <strong>in</strong> some of the larger urban centres where use has been longest established.
An upward trend <strong>in</strong> <strong>in</strong>ject<strong>in</strong>g is reported <strong>in</strong> all prov<strong>in</strong>ces although the <strong>in</strong>crease <strong>in</strong> NWFP is marg<strong>in</strong>al.
However, S<strong>in</strong>dh, Balochistan and Punjab all report a strong upward trend. Inject<strong>in</strong>g is reported to be
<strong>in</strong>creas<strong>in</strong>g more strongly <strong>in</strong> urban rather than rural locales, but for both the overall trends are up.
In all prov<strong>in</strong>ces, <strong>in</strong> both urban and rural locales, and regardless of the relative prevalence rate, hero<strong>in</strong>
was the drug most associated with caus<strong>in</strong>g problems. Eighty-one per cent of respondents reported that
hero<strong>in</strong> caused “major problems” <strong>in</strong> their locales. In Punjab prov<strong>in</strong>ce, 88% of respondents reported “major
problems” <strong>in</strong> their communities result<strong>in</strong>g from hero<strong>in</strong> <strong>abuse</strong>.
After hero<strong>in</strong>, alcohol received the second highest overall problem score <strong>in</strong> all prov<strong>in</strong>ces with the exception
of Balochistan, where hashish and charas problems received a higher rat<strong>in</strong>g. In Punjab, nearly half
(48%) of all key <strong>in</strong>formants reported that alcohol use was caus<strong>in</strong>g “major problems” <strong>in</strong> their community.
Overall, the key <strong>in</strong>formant data suggest that whilst drug <strong>abuse</strong> rema<strong>in</strong>s a more urban phenomena this
difference is not as pronounced as expected. Even <strong>in</strong> rural areas worry<strong>in</strong>g levels of drug problems were
reported. That said, if hashish and charas are excluded, NWFP, appears to be the prov<strong>in</strong>ce least effected
by drug problems.
This study cannot report comprehensively on the <strong>abuse</strong> of drugs by women <strong>in</strong> <strong>Pakistan</strong>. Key <strong>in</strong>formant
data suggest that, with the exception of psychotropics, for all drug types <strong>abuse</strong> levels among women are
far lower than those found among men. However, assess<strong>in</strong>g drug <strong>abuse</strong> among women <strong>in</strong> <strong>Pakistan</strong> is a
particularly difficult objective and problems may rema<strong>in</strong> hidden. Many key <strong>in</strong>formants did not feel able
to comment on this question. Even if prevalence levels are much lower the difficulties experienced by
women who <strong>abuse</strong> are likely to be particularly pronounced and their options for obta<strong>in</strong><strong>in</strong>g assistance
limited. The problems that accrue from psychotropic use among women rema<strong>in</strong> unknown. For all these
reasons, a conclusion of this study is that a further research exercise that focuses on substance <strong>abuse</strong>
among women is required. In any such exercise considerable attention will need to be played to select<strong>in</strong>g
the appropriate methods to collect <strong>in</strong>formation <strong>in</strong> this particularly sensitive area.
Addict <strong>in</strong>terviews
Samples of regular hero<strong>in</strong> users and/or <strong>in</strong>jectors were <strong>in</strong>terviewed <strong>in</strong> four cities; Karachi, Lahore, Quetta,
and Peshawar. In each city, a sample of drug <strong>abuse</strong>rs were recruited <strong>in</strong> street sett<strong>in</strong>gs, <strong>in</strong> treatment facilities
and <strong>in</strong> prisons. One thousand and forty-n<strong>in</strong>e <strong>in</strong>terviews were conducted <strong>in</strong> total. All but 12 of those
<strong>in</strong>terviewed were men. Subsequent analysis is restricted to the 1,037, male respondents only.
The hero<strong>in</strong> <strong>abuse</strong>rs <strong>in</strong>terviewed were older than <strong>in</strong> the 1993 exercise. This suggest that the demographics
of the hero<strong>in</strong> abus<strong>in</strong>g population <strong>in</strong> <strong>Pakistan</strong> has changed and is now more similar to age pattern
found elsewhere. The mean age of respondents was between 31 and 33, with 40% aged 25-35 years old.
The age distribution of the sample was similar regardless of the sett<strong>in</strong>g <strong>in</strong> which the <strong>in</strong>terview took place.
Only 5% of respondents were aged between 15 and 20 years old and less than half the sample (41%)
were aged under 30 years old. This contrast with the earlier study, where nearly a quarter of those <strong>in</strong>terviewed
were under 20 years old and nearly two thirds, under thirty years old.
Of the three sample groups street addicts were the most socially marg<strong>in</strong>alized; they had lower levels of
education, higher levels of homelessness, lower levels of employment and less family contact. They also
reported more previous prison experience than the treatment sample. Addicts <strong>in</strong>terviewed <strong>in</strong> treatment
were the most affluent, likely to be <strong>in</strong> employment and well educated. However, across the samples overall,
addicts appeared poorer and more socially marg<strong>in</strong>alized than <strong>in</strong> the 1993 exercise.
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