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

DRUG ABUSE IN PAKISTAN
with treatment of addicts were asked how many
addicts they had contact with <strong>in</strong> the past 12 months,
and how many of these had received treatment <strong>in</strong> the
past 12 months. In us<strong>in</strong>g this <strong>in</strong>formation to produce
an estimate of the proportion of addicts treated <strong>in</strong>
the year, account was taken of the <strong>in</strong>formants’ experience
and suitability <strong>in</strong> provid<strong>in</strong>g a valid estimate.
These studies produce a range of likely estimates of
the proportion of addicts treated and the associated
appropriate multiplier factors that are used <strong>in</strong> the
calculation of the total number of addicts. The relevant
<strong>in</strong>formation is presented <strong>in</strong> table 28 below. This
is a difficult estimation exercise and considerable
levels of variability are likely to be <strong>in</strong>troduced <strong>in</strong>to
the estimation, although <strong>in</strong> methodological terms it
is probably smaller than likely errors produced by
other non-multiplier methods. Reliance on a s<strong>in</strong>gle
multiplier value is likely to be hazardous <strong>in</strong> terms of
accuracy of the result<strong>in</strong>g estimates and figures are
presented <strong>in</strong> table 28 for a likely m<strong>in</strong>imum and maximum
value of the appropriate multiplier.
Method of estimation:
geographical coverage
Estimation of the prevalence of drug addiction
through a treatment multiplier benefits from tak<strong>in</strong>g
account of geographically local variation both <strong>in</strong>
treatment facilities and <strong>in</strong> the proportion of addicts
treated. Data have been collected <strong>in</strong> four cities and
<strong>in</strong> 36 locales spread across the four prov<strong>in</strong>ces of
S<strong>in</strong>dh, Punjab, NWFP and Balochistan. The FATA
were <strong>in</strong>cluded with NWFP for purposes of the prevalence
estimation exercise. With the exception of
Balochistan, it has been possible to estimate drug
addiction prevalence on a prov<strong>in</strong>ce-by-prov<strong>in</strong>ce
basis. In Balochistan, <strong>in</strong>formation was too sparse to
allow satisfactory estimation of the prevalence level.
With<strong>in</strong> the prov<strong>in</strong>ces, all locales provided <strong>in</strong>formation
on the proportion of addicts treated over the preced<strong>in</strong>g
year (for step (b) of the estimation procedure).
Enumeration of the number of addicts <strong>in</strong>
treatment over the preced<strong>in</strong>g year (step (a) of the
estimation procedure) can be carried out <strong>in</strong> the subset
of locales where specialist treatment cl<strong>in</strong>ics have
been identified. With<strong>in</strong> each prov<strong>in</strong>ce two levels of
extrapolation are required to produce an estimate.
The first level requires extrapolation of the prevalence
estimates from the locales with identified specialist
treatment cl<strong>in</strong>ics to other locales <strong>in</strong> the
prov<strong>in</strong>ce that have none. The second level requires
an extrapolation from the locales selected for the
study to the prov<strong>in</strong>ce as a whole. The estimates for
<strong>Pakistan</strong> as a whole then are calculated as a comb<strong>in</strong>ation
of the four prov<strong>in</strong>cial figures.
Extrapolation at each stage described above can be
made by a variety of methods, and requires simple
assumptions to be made. In this report the reasonable
assumption is made that prevalence rates that
are estimated for the population <strong>in</strong> the cl<strong>in</strong>ic catchment
areas with<strong>in</strong> a prov<strong>in</strong>ce—that is, <strong>in</strong> those locales
with identified specialist drug treatment cl<strong>in</strong>ics—
can be applied to the rema<strong>in</strong>der of the population
<strong>in</strong> the prov<strong>in</strong>ce.
Estimation of prevalence
To focus the estimation and reduce the potential for
sampl<strong>in</strong>g variation and error, the estimation exercise
has been carried out on a target population of males
aged 15-45 years. For many reasons, discussed <strong>in</strong> the
report, estimat<strong>in</strong>g drug addiction prevalence amongst
women has not proven possible. Restrict<strong>in</strong>g the
prevalence to the age band of 15 years to 45 years
of age covers the vast number of addicts <strong>in</strong> the
population; select<strong>in</strong>g this age band where addicts
are most densely found allows a more accurate estimate
to be made than would be possible if the less
densely found, very young and very old were <strong>in</strong>cluded
<strong>in</strong> the prevalence denom<strong>in</strong>ator. Choos<strong>in</strong>g this
age band is justified both from previous <strong>Pakistan</strong>
studies and from the present four cities study of
<strong>in</strong>terviewed addicts.
Figures are presented <strong>in</strong> tables 25 to 29 for:
❏ The locales <strong>in</strong> which the four cities study
was carried out, where the most detailed
<strong>in</strong>formation is available;
❏ The rema<strong>in</strong><strong>in</strong>g locales, <strong>in</strong>corporat<strong>in</strong>g an
extrapolation from cl<strong>in</strong>ics with treatment
cl<strong>in</strong>ics to those without cl<strong>in</strong>ics;
❏ All locales studied <strong>in</strong> the survey.
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