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

BACKGROUND
<strong>in</strong>jection of hero<strong>in</strong> was reported. The hero<strong>in</strong> addicts
came from various backgrounds rang<strong>in</strong>g from workers
with post-graduate qualifications to illiterate
women. Women were <strong>in</strong>troduced to hero<strong>in</strong> at an
average age of 22 years ma<strong>in</strong>ly through friends, husbands
and relatives. Peer pressure and a stressful
life were frequently mentioned as causes for hero<strong>in</strong>
<strong>abuse</strong>. Five out of the 32 hero<strong>in</strong> us<strong>in</strong>g women had
been arrested at least once. Women mentioned that
they found it difficult to receive treatment or counsell<strong>in</strong>g
on drug <strong>abuse</strong> as none of the established
treatment centres provide specialized services for
women.
Overall, drug addicts have little access to effective
treatment. With a few exceptions the services provided
by government-run drug treatment facilities
are limited to the management of acute withdrawal
symptoms of 7-10 days duration. Most of the drug
treatment facilities <strong>in</strong> the public sector are situated
with<strong>in</strong> the departments of psychiatry <strong>in</strong> teach<strong>in</strong>g or
district headquarters hospitals. The staff with<strong>in</strong>
these facilities are tra<strong>in</strong>ed <strong>in</strong> psychiatry and therefore
largely view addictive behaviour from this perspective.
Specialist tra<strong>in</strong><strong>in</strong>g <strong>in</strong> the management of
substance misuse problems is rare. NGOs differ <strong>in</strong>
levels of development and capacity <strong>in</strong> terms of provid<strong>in</strong>g
drug treatment. Generally, NGOs are more
receptive to develop<strong>in</strong>g new broader treatment
responses and provid<strong>in</strong>g a range of services beyond
medical <strong>in</strong>terventions to their clients. However,
aga<strong>in</strong> staff often are not specially tra<strong>in</strong>ed and there
is a need to develop a better understand<strong>in</strong>g of the
issues <strong>in</strong> offer<strong>in</strong>g <strong>in</strong>terventions such as social and
vocational rehabilitation. Only very few well established
NGO and private cl<strong>in</strong>ics offer comprehensive
treatment packages <strong>in</strong>clud<strong>in</strong>g rehabilitation and
social re<strong>in</strong>tegration services, but these services often
are too expensive for the average street addict to
access. Whilst no systematic follow-up is done on
the success of treatment, readmission of relapse
cases <strong>in</strong> public <strong>in</strong>stitutions are reported to be as
high as 90%.
It is estimated that approximately 20% of <strong>Pakistan</strong>’s
prison population has been <strong>in</strong>carcerated because of
drug <strong>abuse</strong>, possession of drugs and other drugrelated
offences. Many young drug addicts f<strong>in</strong>d
themselves <strong>in</strong> prison because their family members
were unable to cope with their addiction and
arranged for their imprisonment. Treatment services
<strong>in</strong> prisons, if available, are limited to medical <strong>in</strong>tervention
to br<strong>in</strong>g relief from acute withdrawal symptoms.
Prison authorities admit that they do not have
the capacity to properly deal with the problem of
drug addicts.
Relatively little research has been done on the consequences
of drug <strong>abuse</strong> <strong>in</strong> the country. There are
no official statistics or reliable reports available on
the socio-economic impact of drug <strong>abuse</strong>, drugrelated
deaths or drug-related violence. Very recent
reports <strong>in</strong>dicate the availability of high purity
hero<strong>in</strong> <strong>in</strong> some of <strong>Pakistan</strong>’s drug-markets, which
has caused several deaths among drug users.
Generally, however, the purity of hero<strong>in</strong> available to
street addicts <strong>in</strong> <strong>Pakistan</strong> is believed to be quite low.
However considerable geographical and temporal
variation may exist <strong>in</strong> the composition of hero<strong>in</strong>
available on the illicit market. As this factor may
directly <strong>in</strong>fluence the nature of drug <strong>abuse</strong> problems
<strong>Pakistan</strong> is faced with, there is a need to develop
methods for monitor<strong>in</strong>g the composition of drugs
on the illicit market. This topic is returned to <strong>in</strong> a
later part of this report.
Status of convention adherence
<strong>Pakistan</strong> is a signatory to the <strong>United</strong> <strong>Nations</strong> S<strong>in</strong>gle
Convention on Narcotic <strong>Drug</strong>s, 1961, the 1971
Convention on Psychotropic Substances and the
1988 <strong>United</strong> <strong>Nations</strong> Convention aga<strong>in</strong>st Illicit
Traffic <strong>in</strong> Narcotic <strong>Drug</strong>s and Psychotropic Substances.
In February 1999, the Government agreed
to ratify the 1972 Protocol, which amends the 1961
Convention.
Legislation
The Control of Narcotic Substances (CNS) Act, 1997,
aris<strong>in</strong>g from an ord<strong>in</strong>ance bear<strong>in</strong>g the same name
and promulgated <strong>in</strong> 1995, effectively covers all
aspects of <strong>Pakistan</strong>’s drug control efforts. It deals
with cultivation, manufacture, production, traffick<strong>in</strong>g
and possession offences as well as with treatment
and rehabilitation of drug addicts (see below). The
5