Globally pandemic, locally endemic: Pak’s lacks regular epidemiology on drug abuse

Shazia Mehboob

ISLAMABAD: Countries around the world, including Pakistan, observe June 26 as “International Day against Drug Abuse and Illicit Trafficking”.

In Pakistan, the Day is supported by individuals, communities and various organizations to raise awareness of the major problems that illicit drugs create in our society.

A rapid increase in drug addiction amongst young people, particularly in educational institutions, has become a serious social and health hazard thus placing our youth, a large portion of our total population, at risk.

Despite the existence of multiple institutions working separately with separate budget allocations at national and provincial levels, drug abuse and illicit trafficking in this country has risen to an alarming level.

Exposure to drugs at such a young age is not uncommon in this country. But while the other drugs have been around for a while, Ice is a relatively new phenomenon that seems to have taken off among young people.

Ice comes as small clear chunky crystals. Its variants include a brownish crystal-like powder with a stronger smell and bitter taste.

Methamphetamine users may suffer a number of permanent neurological and cognitive effects. Health experts

For Nikash Khan*, a 12-year-old resident of the tribal areas, it all started as fun with a friend at the wedding ceremony of his sister. However, it did not stop there.

Nikash* was in class sixth when he fell victim to hashish and now at the age of 18, the young man has become addicted to Ice which is relatively a more hazardous drug. He wants to escape the addiction but the availability of drugs with ease and the peer pressure forces him to remain in the den of drug addicts.

Young people without enough money use hashish, says the teenager while others prefer ice. Nikash* is currently under treatment at a private rehabilitation centre in Islamabad as he attempts to rediscover part of his childhood that went to waste with ice.

Similar is the tale of Abbottabad-based Usman*, now 20. He was in class 10 when he fell victim to drug abuse.

No regular epidemiology on the drug abused in Pakistan: MD PsychAid Farman Ali

The abuse of recreational drugs leads to long-term effects that impact on a person’s personality and behaviour. Individuals who use methamphetamine for a significant period may suffer a number of permanent neurological and cognitive effects.

“Becoming happy in life was a driving factor behind my use of drugs,” says Nikash*. In his experience, such attitudes create insecurity and undue pressure on students.

Recent times have seen an alarming rise in the number of cases of ice abuse on campuses. Perhaps most saddening are the cases where young people feel that Ice can alleviate depression and help them to perform better in exams.

Students with perhaps less ability are more vulnerable to drugs, says Nikash*. For him, studies-related stress was a main contributing factor.

In the exuberance of youth, young people such as Nikash* have taken to Ice as a method of putting their minds at ease.

Nearly 200 million people are using illicit drugs worldwide: UNODC

Pakistan is a signatory to the United Nations charter committing it to eliminate drug abuse and illicit trafficking from the country. Likewise the rest of the world, it also celebrates Anti-drug Day every year on June 26. Despite drug trafficking and usage seem to revolve around educational institutions, the majority of drug users are under the age of 35.

According to the UNODC, nearly 200 million people are using illicit drugs such as cocaine, cannabis, hallucinogens, opiates, and sedative-hypnotics worldwide, said Mehwish Tariq, CEO of Hometwon Community Foundation, an Islamabad-based non-development organization working for the eradication of drugs and illicit trafficking.

An expected number of active drug users in Pakistan exceed 10 million: HCF chief Mehwish Tariq

An expected number of active drug users in Pakistan exceed 10 million, adding that even schools are badly affected by the menace of drugs, Mehwish informed.

The government and other agencies are working against substance abuse but lack effective rehabilitation programs at the grassroots level which require active involvement of all stakeholders at all levels, says Mehwish. HCF has been working in this area and trying to bring all the relevant stakeholders on the same platform for a joint fight against this deeply rooted social ill.

Farman Ali MD PsychAid Hospital Islamabad said SUD’s is primarily a chronic and relapsing disease. Approximately 2 percent of our total population is are dependent on different kinds of drugs. However, a lack of coordination and not being a priority of the relevant actors towards treatment and rehabilitation “Globally, it is pandemic and locally is an epidemic”, Ali deplored.

Our national capacity to provide treatment is limited to no more than 30,000 slots annually as only 0.75 per cent have access to the treatment while 99 per cent have access to buy and use the drugs, he pointed out while talking to ThePenPK.com.

Our national capacity to provide treatment is approximately 30,000 slots annually as only 0.75% have access to treatment while 99% have access to buy and use the drugs: Farman Ali

The PsychAid Hospital director said that our annual drug sale cost is estimated at more than 2 trillion. He said SUDs patients don’t have access and can’t afford the treatment cost, adding an average cost per patient per month by Rs35,000. He pointed out that the Public sector hospitals don’t provide SUDs treatment.

It should be mandatory for federal and provincial ministries as well as departments of health to include narcotics-related treatment in their policies. Moreover, every government hospital at the provincial and federal level must establish a dedicated ward for drug abuse patients with psychiatrists or ensure the treatment of drug-addicted patients at already dedicated wards in DHQs and THQs and doctors specializing in drug treatment and rehabilitation. At the present, there is no regular epidemiology on drug abuse in Pakistan.

In December 1987, the UN General Assembly decided to observe June 26 as the International Day against Drug Abuse and Illicit Trafficking. The UN was determined to help create an international society free of drug abuse. This resolution recommended further action with regard to the report and conclusions of the 1987 International Conference on Drug Abuse and Illicit Trafficking.

Following the resolution, the years 1991 to 2000 were heralded as the “United Nations Decade Against Drug Abuse”. In 1998 the UN General Assembly adopted a political declaration to address the global drug problem. The declaration expresses UN members’ commitment to fight the problem.

The Way Forward

1. Govt hospitals should accommodate more SUDS for early Detox
2. Federal and provincial health should maintain 10 beds for SUD’s treatment
3. Teaching hospitals should assign House job officers to rehab centers as mandatory
4. Like other national health issues, DAT may be included in the NIH control program
5. International donors should provide funds for rehab centers to ensure maximum accommodation and quality of services
6. Govt to recognize the ICAP license and provide jobs to the addiction professionals.
7. IHRA should enroll all the HCEs in Islamabad

Names of the quoted children have been changed to hide their identity.