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

NATIONAL DRUG CONTOUR MAPPING
Figures for each prov<strong>in</strong>ce separately are presented
<strong>in</strong> the annex tables A.III.1 to A.III.5 <strong>in</strong> an identical
fashion.
Table 25 constructs a demographic profile of the four
cities locales and the rema<strong>in</strong><strong>in</strong>g locales, us<strong>in</strong>g data
from the National Census.
Table 26 constructs the relevant target population of
males between 15 and 45 years of age, us<strong>in</strong>g data
on age and sex from the National Census. The
national age ratios are presumed to apply across all
locales.
Table 27 presents a profile of specialist cl<strong>in</strong>ic access,
<strong>in</strong> terms of <strong>in</strong>patient beds provided, the number of
admission episodes <strong>in</strong> the year, the number of
patients admitted <strong>in</strong> the year, and the number of
these that are male hero<strong>in</strong> addicts or <strong>in</strong>jectors <strong>in</strong> the
target age range.
Table 28 presents the estimates from the key <strong>in</strong>formant
study of the likely proportion of addicts who have
been treated <strong>in</strong> the identified specialist cl<strong>in</strong>ic, and
the associated multipliers. The number of addicts <strong>in</strong>
each locale is estimated, us<strong>in</strong>g a correction factor of
90% to allow for addicts who are treated but come
from outside the locale. In addition to the median
estimate, a likely maximum value and a likely m<strong>in</strong>imum
value are shown, derived from the extent of variability
<strong>in</strong> key <strong>in</strong>formant report<strong>in</strong>g <strong>in</strong> each locale.
Table 29 shows the estimated prevalence rate (estimated
from those locales with specialist cl<strong>in</strong>ics, and
assumed to apply also to locales without identified
cl<strong>in</strong>ics), the number of addicts <strong>in</strong> the locales with
cl<strong>in</strong>ics, and the estimated number of addicts <strong>in</strong> the
prov<strong>in</strong>ce, assum<strong>in</strong>g the same prevalence rate applies
throughout the prov<strong>in</strong>ce.
Improv<strong>in</strong>g the <strong>in</strong>itial estimates
The present report uses the simplest and most direct
of possible assumptions. Subsequent ref<strong>in</strong><strong>in</strong>g of the
estimates can be carried out <strong>in</strong> phases that <strong>in</strong>troduce
more sophisticated use of available data at
each of stages reported above. The relationship—if
any—of drug use to these features is exploited to
repeatedly ref<strong>in</strong>e the estimates of prevalence made
by extrapolation. These data are:
Relationship of drug use to more detailed
breakdown of age distribution;
Relationship of drug use to more detailed
description of the rural/urban dist<strong>in</strong>ction;
Relationship of drug use to more detailed breakdown
of the catchment areas of the cl<strong>in</strong>ics;
Relationship of drug use to numbers of household
or implied household size;
Relationship of drug use to other measures of
social structure such as poverty, literacy.
The <strong>in</strong>itial estimates provided here use:
(a) the broad age-groups of 15 to 45 years of
age, where most drug addiction occurs;
(b) the dist<strong>in</strong>ction between the four major
cities selected from each of the four prov<strong>in</strong>ces
and the rest of the locale (district)
<strong>in</strong> which they are located;
(c) the assumption that the catchment area for
the cl<strong>in</strong>ics is essentially the locale (district)
<strong>in</strong> which it is located—key <strong>in</strong>formant <strong>in</strong>formation
suggests that about 10% of addicts
are treated from outside the locale;
(d) the characterization of each local as either
“rural” or “urban”, as described <strong>in</strong> the study
design section of the report.
A subsequent wave of analysis ref<strong>in</strong><strong>in</strong>g these <strong>in</strong>itial
estimates can take recognition of
(a)
(b)
(c)
(d)
a greater treatment attendance by those
addicts over 25 years of age;
the urban and rural male population ratios
with<strong>in</strong> each city’s district;
the differential treatment attendance from
the city rather than the district where the
cl<strong>in</strong>ic is located;
the extent of the rural versus urban populations
difference with<strong>in</strong> <strong>in</strong> each of the rural
or urban locales.
The procedures used <strong>in</strong> this report give rise to a range
of likely estimates of overall prevalence and overall
numbers of hero<strong>in</strong> addict or <strong>in</strong>jectors. In an analytical
exercise of this sort, where the procedures are not, nor
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