Substance related and addiction disorders

Statistics of Substance Abuse in Pakistan

  • Cannabis is the most commonly used drug in Pakistan. About 3.6 percent of the adult population or four million people are listed as cannabis users.
  • The use of opiates is higher than the global estimates in Pakistan. Among opiates, heroine and opium are used by one percent of drug users.
  • 8 percent Adults or 4.6 million people use drugs in 2013 in Pakistan.
  • According to an estimate, about 8.9 million people in Pakistan are drug dependent and only 30,000 individuals annually receive treatment due to short supply of treatment and special interventions.
  • Nationwide, there is a high prevalence of non-medical use of prescribed medicines (opioid-based painkillers, and to a lesser extent tranquillizers and sedatives) particularly among women.

Substance use disorder (SUD)

Substance misuse is not a personality or character problem; it is a health related problem. Substance use disorder (SUD) refers to a chronic and relapsing brain disease in which an individual continues the use of substance despite its harmful consequences and spends most of the time seeking the substance. When the desired substance is not available, the individual starts having some signs and symptoms of craving and withdrawal that is a clear indication of dependence. Addiction causes metabolic changes in the brain. Genetic factors, environmental factors and life styles are important etiological factors of ADDICTION.

Psychoactive substance

Any chemical substance can produce a physical or psychological reaction. Similarly, psychoactive substances affect our central nervous system (CNS) and alter the perception, mood, cognition, behavior, thinking process and motor functions of the user.

CNS is a part of nervous system that is consists of Brain and Spinal Cord. Our brain is covered with a protective membrane called Blood Brain Barrier. Only specific chemical substances that have small molecules can cross this membrane. Psychoactive substances can easily cross the blood brain barrier and therefore these substances directly affect the brain. These effects might be positive or negative and it depends on the type and use of substance. These substances can also alter the metabolism and chemical processes of the body.

Psychoactive substances include licit and illicit substances and some medicines. Medicines are used to cure diseases but psychoactive substances can lead to dependence and some harmful effects. These substances have short term and long term effects that can damage organs of the body. The use of psycho active substances often results in consequences central to individual, familial and community level.

Commonly used Methods of Substance Abuse

The specific effects of any substance depend on the method and amount of use of the choose substance. 

  • The study of different methods of substance use is important as different methods have different speed of action.
  • Smoking is the most common and fastest route of substance administration as it takes 7 to 10 second to reach to the receptors in brain. Taking psychoactive drugs through smoking can cause damage to heart and throat and can also cause cancer.
  • Intravenous injecting takes 5 to 3 seconds and intramuscular or subcutaneous injecting takes 3 to 5 minutes to directly reach the blood stream. It is one of the dangerous routes of administration. Individuals who take drugs through injecting are at greater risk of Addiction as the substance directly reaches to blood stream and delivers a greater amount of substance uses to the brain in a very short time period.
  • Swallowing is the simplest and safest route of taking drugs as by this way the drug slowly gets absorbed in the stomach lining and then slowly reaches the blood stream that makes it less dangerous.
  • Snorting will enter the bloodstream through the mucus membrane in the nose. The rest is then swallowed and moves down to the stomach where it finally reaches the blood. In general, the high is experienced within about 15 minutes from the time of snorting.
  • One of the riskier methods of drug intake is the use of suppositories where the substance is absorbed through the mucus membrane in the rectum. This is not a typical method of drug administration, though some drugs like ecstasy and cocaine are taken in this way. This is very risky method as drug can burn the lining of rectum that can result in a number of conditions and even it can cause death.