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

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<strong>Drug</strong> treatment <strong>in</strong> <strong>Pakistan</strong>:
the national treatment register update
Updat<strong>in</strong>g the register of drug treatment <strong>in</strong> <strong>Pakistan</strong>
The provision of therapeutic <strong>in</strong>terventions for <strong>in</strong>dividuals with drug problems is a core component
of a comprehensive demand reduction approach and the provision of drug treatment
is one of the central issues addressed <strong>in</strong> the Declaration on the Guid<strong>in</strong>g Pr<strong>in</strong>ciples of <strong>Drug</strong>
Demand Reduction. A number of studies have shown that drug treatment, when delivered
appropriately, is a cost-effective component of a drug control strategy. One aspect of the 2000
assessment study was therefore to update an earlier register of agencies offer<strong>in</strong>g drug treatment
<strong>in</strong> <strong>Pakistan</strong>. Such a register is a valuable resource for conduct<strong>in</strong>g future tra<strong>in</strong><strong>in</strong>g, network<strong>in</strong>g
and development activities to improve the quality and delivery of services for those
with drug problems <strong>in</strong> <strong>Pakistan</strong>. Furthermore, this <strong>in</strong>formation is important for consider<strong>in</strong>g the
coverage and availability of services and also for beg<strong>in</strong>n<strong>in</strong>g a debate on their most effective
configuration. A wide range of activities and therapeutic regimes can fall under this general
head<strong>in</strong>g. The need exists <strong>in</strong> most countries to ensure that a range of appropriate <strong>in</strong>terventions
is available, that they reflect client needs, and that they are evaluated to demonstrate effectiveness.
UNDCP is currently work<strong>in</strong>g with the Government of <strong>Pakistan</strong> to help ensure that
services meet these objectives.
Data on treatment attendance, usually collected <strong>in</strong> an anonymous register, is also the central
component <strong>in</strong> many ongo<strong>in</strong>g drug <strong>abuse</strong> surveillance systems. This source of <strong>in</strong>formation can
provide a valuable trend <strong>in</strong>dicator. Treatment registers are also low cost, can provide useful
<strong>in</strong>formation to those deliver<strong>in</strong>g services and can also <strong>in</strong>form government plann<strong>in</strong>g.
A special questionnaire was developed for the purpose of updat<strong>in</strong>g the earlier treatment agency
list. As well as audit<strong>in</strong>g what provisions existed, this form also collected <strong>in</strong>formation on current
activities, patient mix, average occupancy rates and other services provided. This <strong>in</strong>formation
is discussed below.
Overview and history of drug treatment <strong>in</strong> <strong>Pakistan</strong>
<strong>Drug</strong> treatment programmes <strong>in</strong> <strong>Pakistan</strong> formally began with the proclamation of Hadd (Religious
Injunctions) <strong>in</strong> 1979, which saw scores of opium addicts who could not get their daily dosage
of opium from the traditional opium vend system, com<strong>in</strong>g to government hospitals for “help”.
Most of the hospitals and the staff available at that time were ill equipped and did not have
the necessary tra<strong>in</strong><strong>in</strong>g to deal with such cases. Thus the onus of treat<strong>in</strong>g those with drug problems
fell on the departments of Psychiatry with<strong>in</strong> the Government hospitals. With the emergence
of hero<strong>in</strong> epidemic <strong>in</strong> the early 1980s, aga<strong>in</strong> the demand for treatment services grew. At
this time there was an <strong>in</strong>crease <strong>in</strong> provision, with Government agencies, hospitals, NGOs and
private facilities all expand<strong>in</strong>g <strong>in</strong> size. The focus of much of this activity was detoxification
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