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

MAPPING THE NATIONAL CONTOURS OF DRUG ABUSE
of hero<strong>in</strong> use among women <strong>in</strong> <strong>Pakistan</strong>.
Interest<strong>in</strong>gly, unlike the male pattern of use, hashish
or charas is not commonly reported as the ma<strong>in</strong>
drug type used by women <strong>in</strong> most locales.
Among young people, hashish or charas is reported
to be the most common drug used by 65% of key
<strong>in</strong>formants, followed by hero<strong>in</strong> and alcohol (17% and
14% respectively). The <strong>abuse</strong> of solvents, which is
elsewhere commonly associated with younger ages
groups, or street children, was not reported as the
ma<strong>in</strong> drug used by young people by any <strong>in</strong>formant.
Trends <strong>in</strong> drug <strong>abuse</strong>
Key <strong>in</strong>formants were asked to reflect on trends <strong>in</strong>
drug <strong>abuse</strong> <strong>in</strong> their locales. Two time periods were
used for these questions. For each <strong>in</strong>dex drug,
respondents were asked whether use had “decreased
a lot”, “decreased a little”, “not changed”, “<strong>in</strong>creased
a little”, or “<strong>in</strong>creased a lot” <strong>in</strong> their locale. The first
time period respondents were asked to assess
changes over was “the last five years” (i.e. from
1995). This is long term measure approximat<strong>in</strong>g the
period s<strong>in</strong>ce the last national assessment exercise
was conducted (1993). “Five years” was selected as
the maximum reasonable long-term recall period.
The second set of questions covered the same topic
but asked for short-term trends. In this case a standard
“last year” report<strong>in</strong>g period was adopted.
Data on long term trends for the whole sample can
be found <strong>in</strong> table 6. In annex table A.II.3. urban
versus rural comparisons are given and <strong>in</strong> table A.II.4
a prov<strong>in</strong>cial breakdown is provided. As an aid to consider<strong>in</strong>g
the data as a whole an overall rat<strong>in</strong>g has
been computed, which can be found <strong>in</strong> table 7. In
the overall measure, negative values have been
placed <strong>in</strong> brackets and <strong>in</strong>dicate that key <strong>in</strong>formants
are report<strong>in</strong>g a decrease <strong>in</strong> use.
Some caution is required when reflect<strong>in</strong>g on perceived
trends over time, especially long time <strong>in</strong>tervals,
as memory effects and other factors may <strong>in</strong>fluence
perceived changes. It can be argued that when
social problems such as drug <strong>abuse</strong> or crime are
considered, respondents are often more <strong>in</strong>cl<strong>in</strong>ed to
report negative rather than positive changes. Nonetheless,
these data do provide a useful overview of
observed trends and have been used <strong>in</strong> the previous
national assessment exercises for quantify<strong>in</strong>g annual
<strong>in</strong>creases <strong>in</strong> prevalence rates. In <strong>in</strong>terpret<strong>in</strong>g the
data it is also important to look closely at the
prov<strong>in</strong>cial breakdown. Trends must be viewed with
respect to their population base. For example, a
small upwards or downwards trend <strong>in</strong> an area of high
prevalence will have far more impact, <strong>in</strong> terms of the
number of <strong>in</strong>dividuals affected, than a similar trend
<strong>in</strong> an area of low prevalence.
With this <strong>in</strong> m<strong>in</strong>d data on hero<strong>in</strong> trends <strong>in</strong> Punjab
is particular <strong>in</strong>terest<strong>in</strong>g as this prov<strong>in</strong>ce conta<strong>in</strong>s
some of the large cities where hero<strong>in</strong> problems are
most apparent and where the highest prov<strong>in</strong>cial
population rates are found. The overall rat<strong>in</strong>g is 0
for this prov<strong>in</strong>ce <strong>in</strong>dicat<strong>in</strong>g overall that responses
suggest<strong>in</strong>g <strong>in</strong>creases <strong>in</strong> use are balanced with those
suggest<strong>in</strong>g decreases.
Table 6.
Perceptions of long-term trends <strong>in</strong> drug use <strong>in</strong> the locales (last 5 years)
Decreased Decreased Increased Increased Don’t
<strong>Drug</strong> type a lot a little No change a little a lot know
Hashish and charas 7 (3%) 32 (12%) 34 (12%) 97 (35%) 102 (37%) 4 (1%)
Hero<strong>in</strong> 19 (7%) 57 (21%) 28 (10%) 77 (28%) 78 (29%) 13 (5%)
Opium 15 (6%) 38 (14%) 132 (50%) 36 (14%) 19 (7%) 25 (9%)
Other opiates 7 (3%) 8 (3%) 43 (17%) 41 (17%) 19 (8%) 128 (52%)
Cough syrups 7 (3%) 16 (7%) 27 (11%) 34 (14%) 26 (11%) 134 (55%)
Psychotropics 4 (2%) 12 (5%) 31 (12%) 101 (39%) 68 (26%) 44 (17%)
<strong>Drug</strong> <strong>in</strong>jection 3 (1%) 11 (4%) 31 (12%) 75 (30%) 37 (15%) 96 (38%)
Solvents 2 (1%) 5 (2%) 30 (13%) 59 (25%) 11 (5%) 130 (55%)
Alcohol 7 (3%) 26 (10%) 71 (26%) 85 (31%) 73 (27%) 9 (3%)
17