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

DRUG ABUSE IN PAKISTAN
reported occasional clean<strong>in</strong>g and nearly half regularly
clean<strong>in</strong>g their <strong>in</strong>ject<strong>in</strong>g equipment before use.
Methods used for clean<strong>in</strong>g <strong>in</strong>cluded the use of
spirit (25%), bleach (3%), boil<strong>in</strong>g water (22%), and
cold water (49%). The actual efficacy of the procedures
used is not known and is very probably
questionable. The use of cold water <strong>in</strong> particular is
not likely to be effective.
Most <strong>in</strong>jectors (68%) reported that they usually used
drugs with other <strong>in</strong>jectors. In the 12 months prior to
<strong>in</strong>terview (or, where appropriate, enter<strong>in</strong>g prison or
treatment) over half (53%) of <strong>in</strong>jectors reported shar<strong>in</strong>g
a needle/syr<strong>in</strong>ge after someone else had used it.
This figure rose to 69% for those <strong>in</strong> the street sample.
For many, us<strong>in</strong>g others’ equipment was not an
isolated <strong>in</strong>cident. Nearly a quarter reported (23%)
that they had done so 20 times or more, and this
figure was aga<strong>in</strong> higher (40%) for <strong>in</strong>jectors <strong>in</strong> the
street sample. Admitt<strong>in</strong>g shar<strong>in</strong>g equipment after
somebody else has used it is often difficult for drug
<strong>in</strong>jectors. A subsequent question therefore asked
about the risk behaviour of other <strong>in</strong>jectors by ask<strong>in</strong>g
how often they had passed on a needle or
syr<strong>in</strong>ge they had used to another <strong>in</strong>jector.
Worry<strong>in</strong>gly, on this question shar<strong>in</strong>g rates were
higher yet. Under a third of the sample reported
never pass<strong>in</strong>g on a needle or syr<strong>in</strong>ge (28%), and
slightly under half (42%) report<strong>in</strong>g do<strong>in</strong>g so 20 times
or more (the highest category on the scale used).
These data can be found <strong>in</strong> table 19.
Karachi profile
Patterns of <strong>in</strong>jection risk behaviour differed between
the cities studied. In Karachi almost two thirds of
<strong>in</strong>jectors <strong>in</strong>jected drugs <strong>in</strong> the company of others,
and 80% did not use new needles every time they
<strong>in</strong>jected. Although 60% said they “very often” cleaned
their needles before use, a significant m<strong>in</strong>ority of
<strong>in</strong>jectors (22%) had never cleaned equipment and
17% had only occasionally cleaned their needles
before <strong>in</strong>ject<strong>in</strong>g. More than half (58%) of the <strong>in</strong>jectors
<strong>in</strong> Karachi cleaned their needles with cold or
warm water whereas 26% cleaned them by boil<strong>in</strong>g.
With regard to needle and syr<strong>in</strong>ge shar<strong>in</strong>g it is
<strong>in</strong>terest<strong>in</strong>g to note that 45% said they never used
others’ needles while almost 31% said they had
used needles used by others for more than 20 times
<strong>in</strong> the past 12 months. On the other hand, more than
half (57%) said that others had used their needles
or syr<strong>in</strong>ges more than 20 times and only 22% said
that other <strong>in</strong>jectors had never used their needles.
Table 19.
Shar<strong>in</strong>g of needles and syr<strong>in</strong>ges <strong>in</strong> the last year (percentage)
Us<strong>in</strong>g equipment after Treatment Street Prison
another <strong>in</strong>jector sample sample sample All <strong>in</strong>jectors
Never 54 31 53 47
Once or twice 20 9 4 11
3-5 times 3 7 10 7
6-10 times 2 7 15 8
11-20 times 3 6 4 4
20 times + 18 40 14 23
Pass<strong>in</strong>g on equipment
to another <strong>in</strong>jector
Never 41 27 17 28
Once or twice 22 7 4 11
3-5 times 2 6 12 7
6-10 times 7 2 15 8
11-20 times 2 5 5 4
20 times + 26 53 47 42
Note: Percentages based on those report<strong>in</strong>g “ever <strong>in</strong>ject<strong>in</strong>g”—lifetime prevalence measure.
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