INTRODUCTION

Prior to partition opium was cultivated and sold under a licensing policy of the government. After independence in 1947, the same laws were followed by the government until February, 1979 when the Hadood Ordinance was imposed. This ordinance placed a ban on the cultivation, production, sale and use of narcotics within Pakistan. Although the ban closed down legal outlets for drugs, illegal availability and use continued. Until this period, the issue of drug abuse had not become a social policy consideration or a national concern. The dramatic increase in opium production in Afghanistan made Pakistan an important transit gateway for illegal drugs, especially heroin. As a result, drug abuse within Pakistan became a more pronounced problem. Since that time, the problem of drug abuse has not only persisted but has continuously increased. This growing use of legal and illegal drugs compelled the authorities to take the issue of drug abuse more seriously. Various measures were adopted by the government of Pakistan to address the issue and conducting nation-wide research and surveys was one of them. The first National Survey on Drug Abuse (NSDA) was conducted in 1982 by the Pakistan Narcotics Control Board (PNCB). The results showed that heroin use was expanding on a signification scale and it was predicted that heroin consumption would continue to rise. Similar NSDAs were conducted in 1984 and 1986. Both these subsequent surveys indicated a rapid growth pattern of drug abuse in Pakistan (NSDA, 1986).

If a person is surrounded or is in an environment where drug abuse is common then in that case his ability to make his own decision depends on various exogenous factors. These exogenous factors may include political, social and cultural indicators. This presence and influence of exogenous factors on the drug abusing behavior of young people can be closely related to the class issue as class can also be a factor in influencing the use of drugs, (Rafiq, 1995). According to an estimate nearly 5 million regular drug users are living in Pakistan. 40% live in urban areas and 60% are living in rural areas. According to a report the number of Chars users children at the age 10 to 12 years were 7,700,000. In the world the total

number of heroin addicts is eighty million and twenty billion rupees are spent on trade of horoin in the world every year (Anonymous, 2000).

Unpleasant youthful activities are widespread in Nigeria and all over Africa, to the extent that they have been giving a lot of concern to the government and general public. In primary schools, peers engage in organized crimes and disrupt normal academic programmes. In secondary schools and most Nigerian universities, the activities of secret cults are known to have been source of threat to lives and property. Outside the campuses, a lot of ritual killings are taking place. (Aluede 2000). Social and economic factors shape risk behavior and the health of drug users. They affect health indirectly by shaping individual drug-use behavior; they affect health directly by affecting the availability of resources, access to social welfare systems, marginalization, and compliance with medication. Minority groups experience a disproportionately high level of the social factors that adversely affect health, factors that contribute to disparities in health among drug users. Public health interventions aimed at improving the health of drug users must address the social factors that accompany and exacerbate the health consequences of illicit drug use, (Galea, S., and Vlahov, D., 2002) The use of illicit drugs has increased throughout the world in recent years. The report further states that a major world trend is the increasing availability of many kinds of drugs to an ever widening socio-economic spectrum of consumers. The report argues that the main problem drugs at global level continue to be opiates (notably heroine) followed by cocaine. For example, for most of Europe and Asia, opiates continued to be the main problem drugs, accounting for 62 percent of all treatment in 2003. Reports from a total of 95 countries indicated that drug seizures increased four-fold in 2003, and more than half of these were of cannabis, (World Drug Report 2005).

Drug abuse is a global distress. Pakistan is located in South Asia and is a developing country which comprises of a population of 160 million. Majority of the population is Muslim which approximately ninety seven percent of the population is. The rest three percent of the population include Christians, Hindus, Sikhs and Parsis. Pakistan is relatively a

religious country and religion plays an important role in peoples lifestyle. Therefore, any kind of drugs, alcohol or addictive substances are despised generally by the society and religion is used as a tool to despise and prohibit the use of the substances of abuse. On the contrary, alcohol has found a new acceptance in the society with the increasing influence of western culture in the cities of Lahore, Karachi and Islamabad both by the wealthiest and the poor. (Niaz, U et al., 2005) The use of legal and illegal drugs has a long history in Pakistan. This study was conducted to explore the socioeconomic and cultural aspects of female addicts in Lahore. A random sample of 50 females aged 25 - 35 years was taken. A comprehensive questionnaire consisting of open and closed-ended questions was prepared. Pre-testing of the study was carried out with ten respondents to examine the workability and suitability of measuring instruments. Descriptive and inferential statistics were used to analyze the data for drawing conclusion. It was concluded that socioeconomic characteristics in term of womens education, family income and demographic factors have bearing upon the drug addiction. People should be made aware of its merits and demerits. If they do so, drug using percentage can be substantially decreased, (Mubeen, C. and Sharif,M. 2007) Drug abuse has assumed alarming proportions in Pakistan, turning a drug free country into a state with a large concentration of heroin addicts since 1980. Pakistan was free from addiction of harmful drugs, including heroin till 1979 when there were some 315,000 addicts who were mostly dependent upon oral use of less harmful substances like opium and marijuana or hashish. However a number of factors including abrupt ban imposed in 1979 on the sale, manufacture and consumption of narcotic drugs, concentration of efforts on curtailing the flow of drugs abroad without taking adequate measures to prevent their flow to the domestic market contributed to widespread addiction in the country, (Alam, I., et al., 2007). Regardless of the legal implications, a drug addict who is otherwise a respectable member of the dominant culture cannot be regarded as a criminal, simply because he uses drugs. He has an unfortunate personality defect. Treatment can not take place unless the individual attends for treatment. He must come to learn with the possibility of a life without

drug taking. Unfortunately, drug takers, as a rule, have little or no motivation to undergo treatment. Alcoholics tend to deny that their consumption is abnormal; others openly defend their habits. Long- term treatment is not only a medical problem, but needs the cooperation of psychologists and sociologists. Strong family support, social rehabilitation and training for gainful employment are the most important components after weaning addicts away from drug dependency to prevent relapses. It is a disease and not a character defect. A person being treated for this condition requires the same respect as a person with any other medical condition, (Mahanta, P., 2011).

The Influence of Drugs on the Performance of Students is describing the affects of drug abuse on the students in nationally representative institutions especially universities of Pakistan. Current research is elaborating the different aspects of drug abuse searches by institutions and reported drug usage by students. There are difficulties in the eradication of drug abuse which are notwithstanding, but one can and must bridge that informational gap, if one really wants to be successful in controlling drug addiction. It is the demand of time to bring science and facts before the ideology to make our youth strong and healthy from physical and mental point of view. It is important that early findings must be validated by high-level evidence studies, (Khattak, M.A., et al., 2012)

Drug addiction is fastest growing problem among youth in developing countries and also in developed countries. This study looks at the impact of conflict and unemployment in increase of drug addiction among youth in Kashmir. A study on youth was conducted using interview schedule method to collect data from respondents so that answer to the objectives can be found. The study results make some interesting revelations. It reveals that most of the respondents feel that conflict and unemployment both has added to the problem of drug addiction among youth. Whereas 158 respondents also revealed that girls also take drugs. 143 respondents revealed that member from their family take gateway drugs. Many respondents also revealed that educational stress is one reason for youth to indulge in drug addiction. Youth are the future of nation if they indulge in drug addiction it is surely going to have worst impact on society. It also brings economic, cultural and moral degradation to individual in particular and family in general. This study shows how our youth look to the

problem of drug addiction. This study looks to awareness among youth about drug addictions evil impact. And it also finds that girls also had impact of drug addiction, (Naqshbandi, M.M., 2012).

Objectives of The Study:

My study is based on the following objectives:

To explore the effects of drug addiction on the personality and family life of addicts. To measure some suggestions to reduce drug addiction To determine the prevalence of substance abuse among adult

REVIEW OF LITERATURE
Rafiq, M., (1995) said that drug abuse has never been an uncommon phenomenon in this part of the world. People have been found using or abusing different kinds of drugs, and they have somehow been tolerated by the society. The drug abusers, nevertheless, have been largely looked down upon by the society, but the practice has been continuing. The present situation of the drug abuse in Pakistan, however, is somewhat serious, and has grave consequences. Since late seventies, a new drug, namely Heroin has come to the scene and its abuse has been on the increase. Conservative estimates of heroin addicts alone in the country put a figure around 2 Mn. The fact that its abuse has serious health hazards, and almost cripples the lives of the addicts, is sufficient to concern workers in human development and welfare, to look into the causes of its raped spread and seek the ways and means of putting a stop to its production and undertake rehabilitation exercises.

Saeed, M.T., AND Zafar, M.I., (2003) said that in medical terms, a drug is any substance that may modify one or more of functions of a living organism. Drugs can provide temporary relief from unhealthy symptoms and/or permanently supply the body with a necessary substance which the body can no longer make it. Almost all the drugs produce unwanted side effects. In large doses, all drugs are toxic. Some drugs lead to an unhealthy dependency that may be physiological and behavioral. Whether a person is genetically or bio-chemically predisposed to addiction or alcoholism is a controversy that has been debated for years within the scientific community. One school of thought advocates the disease concept, embracing the notion that addiction is an inherited disease, and that the individual is permanently ill at a genetic level, even for those experiencing long periods of sobriety.

Khan, M.H et al., (2004) said it is important for policy makers and research communities to try to determine how the drug problem is likely to change, so that policies and programs can be altered accordingly. Research-based drug abuse community prevention approach has recently surfaced-up with new hope. Here first step is to assess prevalence of risk factors associated with drug users. The next step is assessing the community readiness

for launching prevention program. The final step is involving parents, educators and community leaders to carefully plan how, when and where to carry out each program.

United Nations Organization for Drug Control (2005), in the recent times, the cases of risks related to drug and substance abuse have increased the risks situations which include many negative physiological health effects, ranging from minor issues like digestion problems or respiratory infections, to potentially fatal diseases, like AIDS and hepatitis C. The effects depend on the drug and on the amount, method and frequency of use. Some drugs are very addictive, like heroin, while others are less addictive. But the upshot is that regular drug abuse or sustained exposure to a drug - even for a short period of time can cause physiological dependence, which means that when the person stops taking drugs, he/she experiences physical withdrawal symptoms and a craving for the drug. Hernandez, M., et al., 2005. substance abuse remains one of the biggest societal problems around the world despite education on prevention and rehabilitation of illicit drugs. Anesthesiologists should be aware of this problem and the most likely effects and potential risks associated with the abuse of illicit substances. Some of these patients may present at preadmission testing, emergency situations (even critical care) or in the obstetric suite for anesthesia or analgesia. It is very important to enquire in a nonjudgmental way about addiction and substance abuse, obtain toxicology screens, and identify these patients in order to minimize the adverse effects of anesthetic agents and other drugs provided while in care. It is equally important to minimize postoperative risks from inadequate analgesia. Due to the diverse clinical presentations that may arise from substance or polysubstance abuse, the anesthetic management should be tailored to each individual and universal Emmanuel, F., and Attarad, A., (2006) said that Pakistan is among the countries where drug injecting is endemic, but is rapidly spreading to new population groups. The patterns of drug use are not different to those seen in other parts of Asia, indicating that the rapidly increasing IDU can fuel the hitherto quiescent HIV epidemic in the country. The prevention of injecting is possible as injecting is not an inevitable consequence of drug use. There is an urgent need to assess the risk that injecting drugs will increase and the need to institute appropriate public health- based HIV intervention activities before the problem

overtakes the response. Although a few harm reduction and needle exchange programs have been functional but the interventions need to be scaled up. Ecological factors e.g., changes in the local drug market have shown to play a leading role and practical steps to combat these situations need to be taken. Effective efforts to reduce heroin supply probably leads to an inflation in the price and low availability of the drug. This might lead to an increase in the injection use of other synthetic drugs readily available in the country. It is strongly suggested that any supply reduction efforts should be accompanied with an expansion of prevention as well as detoxification facilities in Pakistan, to avoid this emerging public health problem. Omage, E., and Omage, M.I., (2008) said that the use of illicit drugs among young adults and teens in Oredo L.G.A is attributed to many factors. Among which are lack of proper parental care, attention and love, proper monitoring of the teen child and young adult, peer pressure which in many cases influences or the necessity to act what you are not originally, to feel high among frustration level, social economic situation among reasons. The NDLEA and other law enforcement Agencies are trying what they can do to stem the tide but enough seem not to be done because drug traffickers and users are smarter developing varied and more sophisticated methods used for the business. Alcohol happens to be most abused. To stem the unwholesome tide, tactical contributions from stakeholders individually and collectively should be ascertained.

Winters, K.C., (2008) said that adolescence is a time when a young person forges a sense of self, experiments with independence and seeks new experiences. This developmental period is also likely to be the years when we observe behaviors that reflect how social pressures and thrill-seeking can override common sense. The adolescent brain responds more quickly and more intensively to excitement, arousal and rewards. Channeling this exuberance toward healthy and growth-enriching experiences is among the important tasks for parents as they raise their teenager and for youth-serving professionals who work with young people. Benyamin, R., et al., (2008) said that common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Physical dependence and addiction are clinical concerns that may

prevent proper prescribing and in turn inadequate pain management. Less common side effects may include delayed gastric emptying, hyperalgesia, immunologic and hormonal dysfunction, muscle rigidity, and myoclonus. The most common side effects of opioid usage are constipation (which has a very high incidence) and nausea. These 2 side effects can be difficult to manage and frequently tolerance to them does not develop; this is especially true for constipation. They may be severe enough to require opioid discontinuation, and contribute to under-dosing and inadequate analgesia. Several clinical trials are underway to identify adjunct therapies that may mitigate these side effects. Switching opioids and/or routes of administration may also provide benefits for patients. Proper patient screening, education, and preemptive treatment of potential side effects may aid in maximizing effectiveness while reducing the severity of side effects and adverse events. Opioids can be considered broad spectrum analgesic agents, affecting a wide number of organ systems and influencing a large number of body functions. Luciano, M.S., and Pullman, S.R., (2009) said that the complex relation between movement disorders and substance abuse is reviewed. First, we discuss the wide variety of movement disorders that occur as a direct consequence of acute use or withdrawal of drugs of abuse, such as alcohol, cocaine, heroin, amphetamine and methcathinone. Second, we describe the recent advances in the comorbid relationship between alcoholism and two movement disorders: essential tremor and myoclonus-dystonia. Lastly, we discuss the abuse potential of the dopaminergic agents, apomorphine and levodopa, in patients with Parkinsons disease. Mansha, I., et al., (2010) said that addiction is a psychological and physical dependence on substance which leads to detrimental effects to the person as well as to the society. Different modes of administering the substance leads to various problems for the drug dependent specially the intravenous route causes a significant and drastic rise in the number of patients with hepatitis as it is a viral disease and is spread by the contaminated needles and accessories shared by infected person with normal one. Statistics have showed a marked rise of substance abuse because of close territorial contacts with Afghanistan which is the largest producer of opium in the world. Different factors including socioeconomic status, associated society, family history and others also play a spectacular role in promoting

substance abuse; thus mounting number of patients with HBV and HCV in Pakistan is observed specially in the last decade. Podhisita, C., et al., (2011) said that males and females have different use behaviors. More males than females use multiple substances, about 55 percent of men are multiple users (using two or more) compared to just 11 percent of women. Drinking and smoking tend to be tried at the same age while drug tends to come later. Base on the findings for male use behavior, we believe that drinking and smoking are co-factors in the sense that a user of one is likely to be a user of the other. If adolescent males are drinkers, they are more like to smoke; and if they are smokers, they are more likely to drink. This, however, is not the same as saying that drinking leads to or causes smoking, or vice versa. In practice drinking and smoking seem go hand-in-hand. For further understanding of use behavior, it is important to find out why this is the case. Investigation may look at social, psychological and clinical aspects of this. Ali, H., et al., (2011) said that drug use has been identified as a major public health issue in Pakistan. A descriptive questionnaire survey in Karachi city was made to identify the socioeconomic profile and beliefs and practices of 500 drug users. The most commonly used drugs were cocaine (19.0%) and crack-cocaine (15.0%), followed by amphetamines (11.0%), alcohol, caffeine, barbiturates and benzodiazepines (10.0% each). Key psychological factors leading to drug use were problems with parental or marital relations or break-up of a relationship (45.0%). Drugs were seen as an escape from stressful life events (28.0%) or feelings of failure (18.2%). Many drug users blamed the origins of their drug use on bad social influences (47.0%) or socioeconomic problems (23.4%). Preventive measures are needed to decrease the rate of drug addiction in Karachi. Tahir,K., (2011) said that Pakistan is today notorious for many things, but in the last 20 years, drug production and addiction has increasingly become one of them. The use of legal and illegal drugs has a long history in Pakistan. Today, Pakistan is not only one of the main exporters of heroin; it has also become a net importer of drugs. It is estimated that about 50 tons of opium are smuggled into Pakistan for processing heroin for domestic use. The current trend of substance abuse among youth and especially school age children is troubling.

This terrible trend is growing in women also. Many fingers have been pointed at the youth themselves while at the same time ignoring the very people who support the youths drug habits, and wantonly purvey rot among the youth. The height of societal breakdown and decadence comes when the older generation fails to live up to their responsibility and duty of guiding the younger generation. Drug peddlers and barons are increasingly targeting the youth, a symbol of freshness and revolution, for money and for their mental derangement. It is pitiful that drug peddlers lead the youth into temptations through advertisement and glamour. They totally ruin the physical and mental skill of the young people. These drug peddlers have no regard for the consequences of their bloodied actions. Many youths have committed suicide in the malicious tents of pathological drug abuse, and not being able to distinguish the concords of life from the discords. Currently, drugs ranging from alcohol, cigarettes, marijuana, cocaine, heroin to hashish and many others are readily available to young children and the youth among the university and college in Pakistan. These portend a great economic problem to the majority of the third world where development aspirations are generally pegged on manpower and expertise, which is currently wanted in these countries. Our youth are dying morally, socially, psychologically and physically from drug abuse and addiction. The duty of parents in looking after their youth has also come into serious focus here. Before anything else, parental care is the most important control and preventive measure against drug abuse and addiction. The parents should do enough to guide and be with their children at all times. Slamberova, R., (2012) said that drug abuse during pregnancy is a growing problem in all developed countries all over the world. The drugs easily cross the placental barrier into the fetal body and are present also in the maternal milk. Therefore, it may affect the development of the child pre- as well as postnatally. The effects of prenatal drug exposure are long-lasting and persist until adulthood. The present review summarizes the clinical and experimental evidence showing how opioids and psychostimulants can affect maternal behavior of drug-abusing mother and the development of their offspring. Hanan, F., Ullah, A., and Shah, M., (2012) said that various drug rehabilitators have divided the drug addiction process into four main stages. In experimentation stage the drug is used for fun or escape from problem, without experiencing any negative legal or social

consequences. Regular use stage is characterized by use of drug without becoming dependent on it, at this stage complexity in behavior of individual starts to emerge. There is thin line between regular use and risky use/abuse, but generally it is a continued use of drugs of severe social and legal consequences. As a temporary form of escape it can lead to more serious problems. In addiction stage Physical dependence on a drug is often mixed. Drug addiction and dependence Characteristics include withdrawal symptoms and compulsive use of the drug despite severe negative consequences to his or her relationships, physical and mental health, personal finances, job security and criminal record. A.A.Malik., et al., (2012) said that significant proportions of the users were spread almost evenly between the low and the lower middle classes. Awareness among the nonusers was much higher as compared to the users and the users continued to rely on drugs despite knowing that doing so would cause them serious health consequences. To tackle this problem, core issues like social instability, injustice and economic disparity need to be addressed.

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