
Pakistan, a country already tormented by regional insurgencies, is fighting a losing battle against a different kind of foe: drug addiction. In the country’s northwestern province of Khyber Pakhtunkhwa (KPK), an estimated 11 percent of residents use illicit substances – primarily heroin. Peshwar, the provincial capital of KPK, is a city rife with homeless addicts and dirty needles.

“Pakistan’s illegal drug trade is believed to generate $2 billion a year [making] Pakistan the most heroin-addicted country, per capita, in the world,” wrote David Browne, who covered the mujahideen insurgency in the 1980s, in a recent exposé for The Telegraph. “Peshawar is at the center of this phenomenon, in close proximity to extensive opium-poppy fields in the Afghan provinces of Badakhshan, Kunar and Nangarhar, and the rudimentary heroin-processing labs clustered around Landi Kotal in the adjoining Khyber tribal agency.”

The booming drug trade, which goes hand-in-hand with local Islamist groups, has transformed Peshwar from a city popular with tourists for its outdoor bazaars to a violence-ridden wasteland. Public offices are hidden behind extensive barricades and blast walls to protect from suicide bombers. Travelers have been replaced by derelicts, constantly in search of their next hit.

According to the United Nations Office on Drugs and Crime (UNODC) in a report titled “Drug Use in Pakistan 2013,” 6.7 million Pakistanis used drugs last year. A staggering 4.25 million are thought to be drug dependent. Drug rehabilitation programs and other treatments were provided for only 30,000 of the country’s addicts in 2013.

While cannabis was listed as the most commonly used drug in Pakistan, opiates (including opium and heroin) were a close second. It is estimated that 44 tons of processed heroin is smoked or injected in Pakistan each year – a figure that suggests a rate of use that is two or three times higher than in the U.S. An additional 110 tons of Afghani heroin is trafficked through Pakistan each year on its way to international drug markets.

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Oussama Tawil, UNAIDS country coordinator for Pakistan, noticed a sharp spike in the number of addicts in Pakistan who consume their drugs intravenously.

“In 2007, Pakistan had an estimated 90,000 [injecting drug users] and the number has now risen to around 500,000,” Tawil said. He blamed the rise on location, with the most-addicted areas bordering Afghanistan’s fertile poppy growing provinces.

Intravenous drug use is a popular conduit for the transmission of blood-borne disease if the needles are shared – another increasingly common practice.


“In one recent survey of regular injecting opiate users in Pakistan 73 percent of respondents reported sharing a syringe, and it is estimated that about a third of those are HIV-positive,” Browne added.

In 2005, only 11 percent of Pakistani drug users were HIV positive. That number rose to 40 percent in 2011, according to the latest study.

“A majority of the population doesn’t have any idea about the risk of sharing needles and women also entered prostitution to make money to buy drugs,” Cesar Guedes, a UNODC representative, told The Hindu.

UNODC has called on the Pakistani government to address the problem through wide-ranging policy changes, HIV prevention campaigns, and a support network for those struggling with addiction.

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If the case of Khadija Shah – a British drug mule arrested with 63 kilograms of heroin at Islamabad Airport in May 2012 – is any indication, Pakistan is willing to get tough on those involved in the drug trade. The 26-year-old woman, who gave birth while in prison, was sentenced to life behind bars last week.