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DRUG ABUSE in PAKISTAN Results from the Year 2000 National Assessment Supported by the UNDCP Global Assessment Programme on Drug Abuse

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DRUG ABUSE in PAKISTAN Results from the Year 2000 National Assessment Supported by the UNDCP Global Assessment Programme on Drug Abuse Supported by the UNDCP Global Assessment Programme on Drug Abuse Conducted in partnership with the Narcotics Control Division, Anti-Narcotics Force Government of Pakistan DRUG ABUSE IN PAKISTAN Results from the year 2000 National Assessment Supported by the UNDCP Global Assessment Programme on Drug Abuse Conducted in partnership with the Pakistan Anti-Narcotics Force The Global Assessment Programme on Drug Abuse (GAP) improves the global information base on patterns and trends in drug consumption through supporting Member States to build the systems necessary for collecting reliable data to inform policy and action; encouraging sharing of experiences and technical developments through regional partnerships; and encouraging the adoption of sound methods to collect comparable data. UNITED NATIONS OFFICE FOR DRUG CONTROL AND CRIME PREVENTION DRUG ABUSE IN PAKISTAN Results from the year 2000 National Assessment Study Supported by the UNDCP Global Assessment Programme on Drug Abuse Conducted in partnership with the Narcotics Control Division, Anti-Narcotics Force Government of Pakistan UNITED NATIONS New York, 2002 The designations employed and the presentation of material in this publication do not imply the expres- sion of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. This publication has not been formally edited. Acknowledgements The National Drug Abuse Assessment Study in Pakistan This study was conducted under the auspices of the Pakistan Anti-Narcotics Force (ANF) and the Pakistan Regional Office of the United Nations International Drug Control Programme (UNDCP). However, the study was also reliant on the goodwill and hard efforts of a large number of individuals without whose participation this exercise would not have been possible. These include not only the research team but also those who facilitated and participated in the study. These include government functionaries and NGO representatives who made possible the access to treatment and prison facilities and provided other expert advice and support. We are also indebted to the large number of citizens who participated in the research exercise. We are grateful to the support of all those who contributed and in particular would like to acknowledge the contribution of the research and implementation team listed below. Government of Pakistan (Anti-Narcotics Force) Saiyed Mohib Asad, Deputy Director-General. Mr Mairaj. A. Arif, Deputy Director. UNDCP (Pakistan) Mr Bernard Frahi, Representative. Mr Thomas Zeindl Cronin, Programme Management Officer. Dr Nadeem-Ur-Rehman, Demand Reduction Consultant/Study Coordinator. UNDCP (Global Assessment Programme, GAP) Mr Paul Griffths, Senior Epidemiologist. Dr Kamran Niaz, Regional Epidemiological Adviser. Statistical and Research Consultant Mr Colin Taylor, National Addiction Centre (UK) Data Processing Khan Mohammad Kashif, Computer Programmer. Imran Zafar, Data Entry Operator. Khalid Siddique, Data Entry Operator. Field Work Supervisors Ms Beena Hassan, Sindh Province. Dr. Shahryar Aftab, Punjab Province. Mr. Edwin Arthur, Balochistan Province. Mr. Zakir Shoaib, N.W. Frontier Province. iii Interviewers Naushad Ahmed Malik, Mirza Akhtar Mughal, Maqbool Ahmed Mashori, Zeba Anjum, Sarfaraz Qutab, Javed Ali, Abdul Rauf, Wajid Ali, Dr. Qasim Brohi, Ms. Mehmooda Aftab, Mrs. Rukhsana Hussain, Bushra Saeed, Aratus Attarad, Shahid Bilal, Siraj Din Bhatti, Pious Bhatti, Dr. Khalida Bajwa, Muzaffar Hussain Khan, Mr. Asim Shahzad, Ommi Kalsoom Khalduna, Edward Arthur Iqbal, Nafeesa Sultana, Shaheena Fakhir, Muhammad Shafiq, Muhammad Hafeez Farooq, Iqbal Bano, Akbar Ali Durrani, Aftab Ali, Andrew Florence, Siqa Fateh, Abdul Waheed Khattak, Zulfiqar, Hilal Ahmed, Nosheen Sabhzada, Asad Haroon, Fawad Rizwan, Gull Haider, Babar Ahmed Bahar, Fazle Ghaffar, Hidayatullah Neak Akhtar, Gul Akbar Khan, Zahid Akhtar. iv Contents Pages Acknowledgements . iii Executive Summary . ix Introduction . 1 1. Background . 3 Pakistan in context . 3 Drug cultivation and production . 4 The drug abuse problem . 4 Status of convention adherence . 5 Legislation . 5 National drug control policies, priorities and plans . 6 National institutional framework and capacity . 6 Socio-economic characteristics of Pakistan . 6 2. Rationale, methods and sampling . 9 3. Mapping the national contours of drug abuse: the key informant interviews . 11 Key informant interviews sample description . 11 Perceptions of drug use in the locale . 13 Trends in drug abuse . 17 Perceptions of problems arising from drug abuse . 20 Attitude questions . 21 4. Interviews with drug abusers . 23 Data collection . 23 Demographics—age distribution . 23 Prison contact . 24 Prison history . 24 Demographics—education and employment . 25 Treatment contact . 25 First treatment . 26 Need for treatment . 27 Drug abuse history . 28 Current drug use . 28 Dependence and problems . 30 5. Drug injecting . 33 Drug injection among the sample . 33 Drug injecting amongst women . 34 Age, education and employment . 34 Patterns of use . 35 v Pages Injection risk behaviour . 35 Karachi profile . 36 Lahore profile . 37 Quetta profile . 37 Peshawar Profile . 37 Drug treatment history . 37 Arrest and imprisonment history . 37 Living and support status . 38 6. Data on prisons activity in the four cities . 41 Prison data collection . 41 Overview: drug charges in Pakistan . 42 7. Drug treatment in Pakistan: the national treatment register update . 43 Updating the register of drug treatment in Pakistan . 43 Overview and history of drug treatment in Pakistan . 43 UNFDAC funded treatment facilities . 44 Integrated drug demand reduction project . 44 Past assessments of drug treatment programmes . 45 National survey of drug treatment and rehabilitation services in Pakistan . 45 National treatment registry update 2000 . 46 8. National drug contour mapping: estimating the prevalence of hard-core heroin use in Pakistan . 49 Data structures of the contour mapping exercise . 49 Method of estimation: treatment multiplier method . 49 Method of estimation: geographical coverage . 52 Estimation of prevalence . 52 Improving the initial estimates . 53 Refinements to initial multipliers for estimating the number of addicts . 55 Interpretation of the initial estimates and their extrapolations . 56 9. Drug abuse in Pakistan: the implications of the Pakistan national assessment study . 59 Comparisons with the earlier national assessment studies ..
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