Public health: The slippery slope to drug addiction

Cannabis is the most commonly used drug in the 15-to-19 age bracket. One third of ‘regular cannabis users’are people aged 20 to 29, says the report.

Cannabis is the most commonly used drug in the 15-to-19 age bracket. One third of ‘regular cannabis users’are people aged 20 to 29, says the report.

LAHORE: “For some, doing drugs is a way to impose their superiority over their peers. For others it is a rebellion against social norms. But for me, it was about blending in with my peers, being able to relate to them,” says *Ahmed, a 21-year-old political science student who will be graduating this year.

Ahmed started smoking cigarettes at the age of 16. What started as an occasional activity with friends ultimately turned into a 30-to-60-a-day habit. “I made it a point to smoke in front of people,” he says. “That way they knew they could not mess with me.”

At 18, as he shifted to a local boys’ hostel for college, Ahmed started consuming alcohol and charas. But he claims he is not addicted to either. “It just helps me concentrate, keep my mind fresh and have a little fun,” he says.

Ahmed is one of 4 million people in Pakistan who use cannabis, according to Drug Use in Pakistan 2013, a report made by the United Nations Office on Drugs and Crime (UNODC) in collaboration with the Ministry of Narcotics Control and the Pakistan Bureau of Statistics.

According to the report, drug use is most prevalent in Khyber Pakhtunkhwa, where 11% of the population uses drugs, followed by Sindh (6.5%), Balochistan (almost 5%) and the Punjab (4.8%).

Cannabis, at 18%, is the most commonly used drug in the 15-to-19 age bracket, followed by amphetamines   a stimulant that increases focus and alertness – at 15%.

One third of ‘regular cannabis users’, says the report, are people aged 20 to 29. Forty per cent of them use cannabis in the form of charas and 31% use bhang. Almost 22% of opium users are aged 25 to 29.

The purchase of drugs or alcohol by young people is usually through dealers – or ‘agents’, as they are called by students – who are just a phone call away. Their numbers are distributed widely at hostels. The agents get the caller’s name, location and what drugs they want. Diverging from the script usually brings an abrupt end to the call.

For Rs1,400, users can get up to 20 charas cigarettes. A 23-year-old charas user said purchases were usually shared by a group. He showed off a freshly-bought packet of charas, around 4 grams of it, bought for Rs400. “I don’t smoke this except when with friends,” he said. He consumes around five charas cigarettes a month, he says, usually to ease academic pressure during exams.

But according to Ehtisham Zafar of the Drug Free Pakistan Foundation (DFPF), charas is “more harmful” than heroine. While withdrawal from heroine takes a week to 15 days, he says, withdrawal from charas lasts longer than a month.

Zafar says people usually start with “soft drugs”   chaaliya, gutka and paan – and move on to hard drugs. “There is a psychological limit to every drug and once the user reaches it, they move on to another, stronger addiction,” he says.

According to his research, drug users in Pakistan spend Rs150 to Rs175 daily on their hit. As per the DFPF, 20 to 25% of young people are involved in some form of drug abuse. He sees a link to crime too. “They commit crimes either for money to buy drugs or to show that they are invincible. They have the urge to prove that they can do anything,” he says.

Maria Ali, a drug demand reduction officer at the Punjab Anti-Narcotic Force, says social and psychological factors influence the use of drugs in young people. “Often at parties young people use all sorts of drugs,” says Ali, “from sheesha to charas and cocaine, everything is available.”

The use of intravenous drugs is more common in Sargodha, Dera Ismail Khan and Faisalabad. Ali says the use of injections greatly increases the risk of Hepatitis B and C and HIV-AIDS. “Drug usage is integrally linked to money   the more money the person has, the more expensive the drug at their disposal,” says Ali.

Muhammad Nadeem Ashraf, who has been running two treatment and rehabilitation centres in Lahore for 17 years, believes there is a great degree of ignorance regarding cigarettes and sheesha. “Generally speaking, no one considers these as addictions, including parents,” he says. “Once the drug users lose control of time, place and quantity, they turn into addicts.” In a social environment that encourages use, Ashraf says, the addiction grows stronger.

Tina Abid, a senior psychologist at the Ehsas Clinic for addiction treatment and rehabilitation, says peer pressure is one of the major motivators for drug abuse leading to addiction. “The greatest hurdle in drug treatment is overcoming denial,” says Abid.

Addiction is not just confined to chemicals (substances), she says. Non-chemical addictions are fast penetrating society, she says. Repeated restless behaviour, says Abid, constitutes non-chemical addiction. This could be racing cars, gambling, shopping or even sex, she says. “It has got a lot to do with challenging the social stigmas and that is where we need to keep communicating with young minds,” she says. As for Ahmed, while he claims to be able to stop his drug and alcohol use “on his own,

he strongly discourages his friends from starting their use. Why? “Because they are my friends. How can I let them?”

Published in The Express Tribune, May 25th, 2013.

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