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

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<strong>Drug</strong> <strong>abuse</strong> <strong>in</strong> <strong>Pakistan</strong>: the implications of
the <strong>Pakistan</strong> national assessment study
Comparisons with the earlier national assessment studies
Comparisons of the data presented here can be made with the f<strong>in</strong>d<strong>in</strong>gs of the earlier assessment
studies but caution is required as the earlier work tended not always to differentiate
between drug types (<strong>in</strong>clud<strong>in</strong>g alcohol) and the sampl<strong>in</strong>g strategy varies between these studies.
Nonetheless, sufficient comparable <strong>in</strong>formation is available to draw some conclusions on
changes <strong>in</strong> patterns and trends <strong>in</strong> drug <strong>abuse</strong> <strong>in</strong> <strong>Pakistan</strong>.
With respect to the overall pattern of drug <strong>abuse</strong> <strong>in</strong> the country, <strong>in</strong> 1982 hashish and charas,
which we will refer to here for convenience as cannabis, was estimated to be the most commonly
consumed illicit substance. The 1982 study estimated that 3.4% of the adult male population
was us<strong>in</strong>g this drug. The later surveys suggest that hero<strong>in</strong> use overtook cannabis use
around 1986. Cannabis <strong>abuse</strong> was reported to have decl<strong>in</strong>ed between 1982 and 1986 but subsequently
to have slowly risen after this date, although rema<strong>in</strong><strong>in</strong>g at a lower consumption level
than for hero<strong>in</strong>. The current study does not stand <strong>in</strong> conflict with this analysis, neither does
it necessarily support it: with respect to the direction of trends it may well be that cannabis
use decl<strong>in</strong>ed slightly dur<strong>in</strong>g the mid 1980s and then subsequently <strong>in</strong>creased.
Equally difficult to resolve are questions concern<strong>in</strong>g the relative consumption levels of cannabis
and hero<strong>in</strong> <strong>in</strong> <strong>Pakistan</strong>. Did cannabis <strong>abuse</strong> actually fall lower, as reported, than hero<strong>in</strong> <strong>abuse</strong>
or was this f<strong>in</strong>d<strong>in</strong>g due to estimation errors? The present data do not allow us to determ<strong>in</strong>e
the truth of this matter, as either scenario would be consistent with the current f<strong>in</strong>d<strong>in</strong>gs.
Relevant, though, is that although the results presented here give no def<strong>in</strong>ite answer, they do
raise the question as to what extent earlier estimates of hero<strong>in</strong> <strong>abuse</strong> might have been <strong>in</strong>flated.
Address<strong>in</strong>g these issues cogently is greatly complicated by the time <strong>in</strong>tervals between the
assessments exercises, a fact which serves to emphasise that the accurate identification of
consumption trends over time relies on the development of a cont<strong>in</strong>uous surveillance mechanism.
This issue is discussed <strong>in</strong> detail below.
The key <strong>in</strong>formant data <strong>in</strong> the 2000 exercise strongly suggest that cannabis <strong>in</strong> one form or
another (marijuana, charas, etc) is the most commonly used drug <strong>in</strong> the country <strong>in</strong> terms of
lifetime use and prevalence over the last year. Whilst this study was not designed to give an
estimate of the number of cannabis consumers <strong>in</strong> <strong>Pakistan</strong>, it can be posited that this figure
is likely to be considerable. Any estimate will depend specifically on the period prevalence
measure used (lifetime, last year, last month etc). However, if period prevalence for either lifetime
or last year is considered, the total numbers of <strong>in</strong>dividuals is likely to be higher than a
million. For a po<strong>in</strong>t of reference, if the 1982 prevalence estimate is taken <strong>in</strong> conjunction with
today's figures it would suggest there would be around 1.3 million current users. The general
op<strong>in</strong>ion would be that consumption today is probably considerably higher than <strong>in</strong> 1982, so
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