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

DRUG TREATMENT IN PAKISTAN
No major changes are evident from earlier studies
on the pattern of service provision <strong>in</strong> respect to
Government and non-government facilities. NGO’s
appeared to be prov<strong>in</strong>g the broadest range of care
and where Government treatment centres were provid<strong>in</strong>g
services this tended to be only on a detoxification
basis.
Some diversification and improvement is suggested
<strong>in</strong> respect to the range of services offered by some
private and NGO managed facilities. They have
developed programmes that provide a range of treatment
and rehabilitation services, and have made
<strong>in</strong>novations <strong>in</strong> their <strong>in</strong>terventions to meet the chang<strong>in</strong>g
requirements of their clients. A few organizations
have experimented with concepts of therapeutic
communities as well as of community based rehabilitation
of clients. This area is not addressed <strong>in</strong>
detail by this current study but the results do suggest
the need for a more <strong>in</strong>-depth assessment of the
k<strong>in</strong>ds of treatment provision available for those with
drug problems <strong>in</strong> <strong>Pakistan</strong>, the development of good
practice standards, and the identification of tra<strong>in</strong><strong>in</strong>g
and other developmental needs.
All but one of the treatment facilities <strong>in</strong>dicated that
they kept records of age, gender, education, occupation,
primary drug, <strong>in</strong>jection status, marital status
and treatment history of their clients for monitor<strong>in</strong>g
purposes. However, most of these records are not
summarized <strong>in</strong> a form that would allow easy analysis
and storage facilities often mean that data
retrieval would be problematic. Currently some periodic
reviews do take place with<strong>in</strong> agencies but periodically,
no actual analysis of trends over time is
attempted. Nonetheless, the fact that agencies collect
this <strong>in</strong>formation means that develop<strong>in</strong>g a treatment
report<strong>in</strong>g system is a realistic aspiration. As
the <strong>in</strong>formation currently collected is poorly utilized
at present, such a system could supply the treatment
services themselves with a useful review of
their own clients. This data could also provide a
valuable national <strong>in</strong>dicator of patterns and trends <strong>in</strong>
illicit drug <strong>abuse</strong> <strong>in</strong> <strong>Pakistan</strong>.
Table 22. Comparison of drug treatment services available <strong>in</strong> 1994/1995 and 2000
1994/1995 2000
Total provision identified
Number of treatment centres identified was 203 <strong>in</strong>
89 cities and towns
Centres provid<strong>in</strong>g:
Outpatient services only = 35 (17%)
Inpatient services only = 61 (30%)
Inpatient and outpatient services = 97 (48%)
Organization:
Government hospitals = 67 (33%)*
Private (for profit), = 93 (46%)
NGO = 43 (21%)
Almost all provide detoxification services, nearly all
claimed to be provid<strong>in</strong>g counsell<strong>in</strong>g
Over 66% reported to be provid<strong>in</strong>g relapse prevention
therapy services
Total provision identified
Number of treatment centres identified was 73 from
18 major urban centres of the country. Thirty-eight
of these facilities were also listed <strong>in</strong> the 1994/1995
survey whereas 35 facilities were newly established
or not identified <strong>in</strong> the previous exercise.
Centres provid<strong>in</strong>g:
Outpatient services only = 3 (4%)
Inpatient services only = 43 (59%)
Inpatient and outpatient services = 27 (37%)
Organization:
Government hospitals = 28 (38%),
Private (for profit), = 20 (27%)
NGO = 25 (34%)
All provide detoxification and over 90% counsell<strong>in</strong>g
services
Relapse prevention and aftercare services provided
by over 80% of services
*Government hospitals <strong>in</strong>clud<strong>in</strong>g teach<strong>in</strong>g hospital, district headquarter hospitals or Tehsil headquarter hospitals.
47