When is a drug not a drug?

Drug addiction knows no boundaries of class, wealth, race, age. It eats at the fiber of society at every level.

Thirty years ago, the Russian invasion of Afghanistan caused not only an influx of refugees to Pakistan, but also opium as Kabul became the opium capital of the world.

Marijuana is classified as a gateway drug and the stage was well set in Pakistan. Morphine is obtained from opium and the cheaply available acetic anhydride is used to convert morphine into heroin. Almost overnight, intravenous heroin and cocaine users mushroomed all over Pakistan. The 2006 National Report on Drug Use in Pakistan estimates that there are 628,000 opiate users in Pakistan, of which 77 per cent are heroin users. According to the report, the prevalence of opiate use is 0.4 per cent in Punjab and Sindh, 0.7 per cent in Khyber-Pakhtunkhwa and 1.1 per cent in Balochistan; the higher prevalence in the last two is due to a common border with Afghanistan.

Serious health issues are common among opiate users: HIV infection, hepatitis C and tuberculosis. Most opiate users use other substances on a daily basis. As naturally derived drugs such as marijuana and opiates became entrenched in Pakistan, synthetic or designer drugs made their entrance.

Amphetamine-like substances such as ecstasy or MDMA, crystal-meth or methamphetamine and MDA are synthesised from ephedrine in meth-labs. Ecstasy and crystal-meth increase alertness, reduce fatigue, lead to feelings of increased physical and mental powers and induce euphoria. MDA is also known as the ‘love drug’ because of the feelings of intense euphoria and desire to be with others that it produces.

Besides their addictive nature, these amphetamine-like designer drugs can cause severe agitation, life-threatening increases in heart rate and blood pressure, as well as bleeding in the brain, heart attacks, tearing of the aorta, irregular heart rhythms, seizures and death.

Chronic use of ecstasy in typical recreational doses can lead to a paranoid psychosis that is clinically indistinguishable from schizophrenia. A recent important study reveals that MDMA use (possibly in conjunction with marijuana) can lead to cognitive decline in otherwise healthy young people.

According to the 2006 National Report on Drug Use in Pakistan, amphetamine-like synthetic drug use was low; ecstasy was most common and it was imported into Pakistan from various countries.

The Anti-Narcotics Force (ANF) seized 13 tablets of ecstasy in 2005 and, get this, 8,326 tablets in 2006! It’s difficult to wrap one’s mind around these statistics; was it truly a dramatic increase in the abuse of ecstasy or did the ANF get a shot in the arm or both?

Ecstasy is more expensive than other drugs of abuse in Pakistan and is used largely in parties by young people, aged 16 to 25 belonging to upper-class families. These young people, high on ecstasy, also indulge in risk-taking behaviour such as car and motor-bike racing, among a host of other activities.

Drug addiction knows no boundaries of class, wealth, race, age, profession or education. Like the chronic relapsing disease that it is, it eats at the fiber of society at every level.

All that an addict worries about is his next fix and all means to that end seem justified –– be it cheating, lying, robbery, prostitution or murder. With widespread unemployment and economic decline, the last thing that Pakistan could have afforded was its large addicted population. That the powerful and privileged of Pakistan would become wealthy through such actions is bad enough; to think that those billions have the stench of deaths and destruction is a travesty.

Published in The Express Tribune, April 13^th, 2012.