Opioid Epidemiology in Pakistan

Nationwide, one per cent of the population –over one million people– were estimated to be regular opiate (heroin or opium) users. The majority (80 per cent) use heroin, while one-third (33 per cent) use opium. Opium users were slightly older (mean age 38.2, standard deviation 10.1 years) than heroin users (mean age 33.8, standard deviation 9.4 years), and more likely to live in rural environments whereas heroin users live in cities. Two-thirds of opium users and one- third of heroin users were married, and while opium users mostly live in a home (84 per cent), nearly forty per cent of heroin users living in a park/road, shrine, or a location other than a home.

A daily heroin habit in Pakistan is estimated to cost between 1.50 and 3.00 USD, yet only 6.5 per cent of heroin users are employed full time. To earn money, one-third report donating/selling blood, and forty per cent report exchanging sex for drugs or money. Opiate users also often beg for money in the streets or perform tasks for daily wages such as selling rubbish. A small number (7 out of 3,330) reported working as professional injectors who inject other users, and one-quarter of users receive financial support from family or friends.

The average number of years of opiate use among respondents was 16 (15 among heroin users and nineteen for opium users), evidence of the long-term nature common for opioid use. Poly-drug use is also quite common among opiate users, whereas 74 per cent also used other psychotropic substances in the past year. The majority also use cannabis (67 per cent), but a considerable proportion also uses tranquillizers or sedatives (26 per cent) and various other substances such as prescription opiates (7 per cent) and/or cough syrups (4 per cent).