DefinePK

Abstract

Introduction


Pakistan, along with Iran and Afghanistan, falls in the golden crescent, a region notorious for drug production and trafficking.1 According to the United Nations International Narcotic Control Board, the illicit cultivation, production and trafficking of narcotic drugs almost always result in drug use amongst local population. In this regard, Pakistan is quoted as a classic example.2 The National Health Survey of Pakistan 1993, reported approximately 2.7 million drug users in Pakistan.3The morbidity and mortality associated with psychoactive drug use have been recognized worldwide. Nevertheless, the statistics regarding the extent and prevalence of drug use are difficult to obtain, as drug users are mostly under-sampled in surveys.4 Globally, drug use poses significant health risk to an estimated 15 million people.4,5 Injecting is considered the worst route of drug use, accounted for 100,000 to 200,000 deaths per year worldwide. Studies have shown that drug users inject drugs in "shooting galleries"; a communal injection site located beside "Nalahs" (sewage water streams), on footpaths, or in abandoned buildings, where needles are usually borrowed for injections.6 In many countries such as Russia, Ukraine and India, the increasing scales of injecting drug use creates a potentially massive group of individuals at risk of acquiring blood borne pathogens such as Human Immunodeficiency Virus (HIV), and Hepatitis B and C.5,7In Pakistan, injecting drug use was not common until after the Afghan war, when a variety of drugs flooded from Afghanistan for transit.8 In 1993, 1.8% drug users were injecting drugs, however, in 1995 the proportion of drug users rose alarmingly to 25%. Moreover, a study by Baqi et al reported that about 52% IDUs were sharing needles to inject drugs.9 Further, half of those (1.52 million) IDUs were injecting heroin as narcotic drug.1,3,10The United Nations International Drug Control Programme (UNDCP) has indicated an increasing prevalence of IDUs in developing countries during the past decade.5 Studies have shown socio-economic and demographic factors, such as inadequate education11, homelessness12, depression13, and low income11, associated with injecting drug use in the developed world. However, there is a general dearth of scientific literature, especially regarding modes and determinants of drug use, in developing countries. As injecting drug use is associated with number of morbidities, therefore, exploring associated factors will help understand the nature of the problem and eventually address the hazards encountered by this high-risk group. Therefore, the objective of this study was to identify the socio-economic and demographic factors associated with the Injecting Drug Use among drug users in Karachi, Pakistan.