KARACHI: More than one million Pakistanis are estimated to be regular opiate (heroin or opium) users with a majority of them hooked on heroin, according to a survey report launched on Thursday.

The report on Drug Use in Pakistan 2013 survey, which was launched by the United Nations Office on Drugs and Crime (UNODC) at a hotel, stated: “An estimated 860,000 people are regular heroin users and 320,000 are opium users. Combined, 1.18 million people aged between 15 and 64 years use opiates.”

Opium users were slightly older (mean age 38.2 years) than heroin users (mean age 33.8 years) and more likely to live in rural environment whereas heroin users tended to live in cities, said the report that was also supported by the federal ministry of interior and narcotics control.

Also read: KP has highest number of drug users: report

A majority of drug users in the study aged between 25 and 39 years. Cannabis use was the highest among 30- to 34-year-old people and heroin use was the highest among 35 to 39-year-old people.

There were 430,000 estimated number of people who injected drug and 73pc of them reported sharing syringes, while claiming lack of access to sterile injecting equipment. Only 1pc of injecting drug users accessed needle and syringe supply, it was found.

Around 80pc of people who inject drugs (PWID) in Punjab shared syringes regularly. Half of the users in Khyber Pakhtunkhwa and 66 per cent in Sindh and Balochistan shared syringes, according to the study.

Cocaine use in AJK

While cocaine use is negligible in most parts of the country, its use was reported in Azad Jammu and Kashmir where around 2,300 people had used cocaine last year.“Almost 100,000 drug users in Sindh are estimated to be injecting drugs, primarily opiates. Prevalence estimate for the use of tranquilisers and sedatives in the province is comparable with that of Punjab while the use of ATS (amphetamine type stimulants) is not as high as in other provinces,” said UNODC representative Cesar Guedes.

The highest prevalence of opiate users was found in Balochistan, where 1.6pc of the population used heroin or opium or both.

“The National Drug Use Survey 2013 is for the first time conducted in Pakistan at provincial levels and it provides a comprehensive data on drug use and its implications on HIV transmission,” said Mr Guedes.

He said the information provided in the report would form the baseline for future planning and designing of drug prevention and treatment programmes in Pakistan.

Speaking about the situation in Sindh, he said 1.7 million people used illicit substances in the province in the past year whereas 96,000 drug users were estimated to be injecting drugs.

He said 42pc of the PWIDs in Karachi had HIV, while it was 19.2pc in Sukkur, 18.6pc in Larkana and 16pc in Dadu.

He said with 4.3pc of the population using cannabis last year, Sindh had the second highest prevalence rate for cannabis use in the country. An estimated 570,000 people in Sindh used opioids (any chemical that resembles morphine or other opiates in its pharmacological effect). Of them, 66pc people used prescribed opioids (painkillers) and 34pc used heroin, opium or both.

In Punjab, which comprises more than half of the country’s population, 4.7pc population or 2.9 million people were estimated to have used drugs last year. “Punjab alone has approximately 480,000 heroin users and 86,000 opium users,” the survey said. Around one quarter of a million people in Punjab were estimated to be injecting drug users.

The survey report revealed how Pakistan’s population aged between 15 and 64 suffered from the devastating consequences of substance abuse. The report estimated that 6pc or 6.7 million adults in the country used drugs over the past 12 months.

Treatment

“Although 4.25 million individuals are thought to be drug dependent, treatment and specialist interventions are in short supply, available to less than 30,000 drug users a year,” it added.

The report said that not all structured treatment was free of charge. “In a country where almost a quarter of the population is estimated to be living on less than US$ 1.25 a day, barriers preventing access to structured treatment are exceptionally high.”

In addition to drug use, there were warning signs for a rapid expansion of the HIV epidemic, it said. The survey results detected a very high prevalence of HIV-risk behaviours among people who injected drugs. “Because the majority of HIV positive people who inject drugs are not aware of their status, they are also not taking precautions to prevent further transmission. Because knowledge of how HIV is transmitted is extremely low in the general population, opportunities to prevent infection are being missed,” it added.

It said despite extensive efforts, prevalence estimates reported were likely to underestimate drug use among women. While men were found to use more drugs than women for most drug types; women were more likely to misuse tranquilisers and sedatives as well as amphetamines. Among dependent users, women were less likely to have received treatment than men.

Dr Khalid Shaikh, the provincial special secretary who formally launched the survey, said his department was collaborating with the UNODC for the prevention of HIV among the drug injecting users and would continue its support to the UNODC in its efforts for drug use prevention in Sindh.

Published in Dawn, December 12th, 2014