FIELD WORK REPORT

The Role Of Dost Welfare Foundation in Rehabilitation of Drug Addicts

Noor Ahmed M.A Sociology (Final) Session 2010-12

Institute Of Social Work, Sociology and Gender Studies (ISSG) University of Peshawar
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APPROVAL SHEET
The field work report title The Role of Dost Welfare Foundation in Rehabilitation of Drug Addicts submitted by Noor Ahmed is up to the requirements of M.A Sociology degree.

Researcher:

_________________________ Noor Ahmed __________________________ Mr. Syed Owais Assistant Professor Institute of Social work, Sociology and Gender Studies. University of Peshawar __________________________ Dr. Anwar Alam Associate Professor Institute of Social work, Sociology and Gender Studies. University of Peshawar __________________________ Professor Dr. Johar Ali Director Institute of Social work, Sociology and Gender Studies. University of Peshawar __________________

Supervisor:

Coordinator:

Approved by:

External Examiner:

_________________________________________________________________

Institute of Social Work, Sociology and Gender Studies (ISSG) University of Peshawar

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TABLE OF CONTENTS:
Acknowledgements
IV

1. INTRODUCTION
Introduction Common Typed of Drugs Causes of Drug Addiction Origin of Drugs Objective of the Study Methodology Chapterization 1 1 2 2 3 3 4

2. DRUG ADDICTION EXCLUSION

Drug Addiction and Rehabilitation a Review of Literature

The past Drug use around the world Drug addiction in Pakistan Rehabilitation of Drug Addicts 3. ORGANIZATIONAL PROFILE OF DOST WELFARE FOUNDATION Introduction Partners Of Dost Welfare Foundation The Staff Of Dost Welfare Foundation Drug Addiction Treatment and Rehabilitation Programmes Drop-In Centre and Outreach Services for Street Drug Addicts In Peshawar

5 5 5 8 9

10 10 11 11

12

Faith-Based Drug Demand Reduction Services in Fata Regions of Pakistan 12

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Drug Demand Reduction Services and Community Organizations in Afghanistan

Strengthening

Local 12 13

Community-Based Drug Demand Reduction Centre, Khazana

HIV Awareness and Voluntary Counselling Testing Services for Drugs Addicts 13 Fieldwork and Internship Programme For University Students and Graduates 13 Training Programme for National and International Government Organizations and NGOs 14 Treatment Centre for Adults Shahi Bala Day Care Centre for Children Haji Camp 15 16

4. DATA ANALYSIS AND INTERPRETATION

Case histories 18

5. CONCLUSIONS
The Conclusion 22

6. BIBLIOGRAPHY

23

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ACKNOWLEDGEMENT
First of all I am thankful to Allah to have given me the opportunity to study Master of Arts in Sociology at university of Peshawar and work in Dost Foundation. Thanks to my supervisor, Mr. Syed Owais. The supervision and support that he gave helped in the progression filed work report. My thanks also go to Mr. Shamsuddin Vocational and Rehabilitation Coordinator, Shahi Bala Treatment Center and Mr. Azmatullah Focal Person of Drop in Center (DIC) Haji camp. A big contribution and hard work from both of you during the field work was great indeed. All work during the program would be nothing without the enthusiasm and imagination from both of you. Besides, this field work made me realize the value of working together as a team and as a new experience in work environment, which provided opportunity to learn. Great appreciation go to the rest of the staff of DOST Foundation who help me from time to time during the field work. The whole program really brought us together to appreciate the true value of friendship and respect of each other. I would also like to thank the Coordinator Sociology at Institute of social work, sociology and Gender Studies (ISSG), Dr. Anwar Alam, Director of ISSG, Professor Dr. Johar Ali and all my group members Atta-ur-Rehman, Sahirullah, Sher Zada and Zahid Akram in helping me complete this filed work. Special thanks to my brothers, Dr. Yaqoob Khan and Dr. Baber Khan, who are waiting for my bright future.

Noor Ahmed

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CHAPTER NO 1 INTRODUCTION
Mans desire to employ substances that provide pleasurable stimulation or narcotic effects upon the central nervous system has been expressed universally in ancient as well as in modern civilization. With the passage of time, excessive indulgence, in them, came to be considering as deprived or criminal behavior. In recent years, however, it has been recognized that drug addiction are psychiatric and social problems. This initially staggering cost to individual and society socially, psychologically and economically (Ramzan, 2007). The very word drug means different things for different people. For some people, drugs are those substances, which are illegal and socially disapproved of associated with stereotypes images of junkies or solvent snuffers and not wish every day substances that ordinary people use, on other hand manly people increasingly refer to all medicinal preparations as drugs. Some useful definitions are (Dixon & Oro, 1987). A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function (World Health Organization, 1969). In pharmacology, a drug is "a chemical substance used in the treatment, cure, prevention, or diagnosis of disease or used to otherwise enhance physical or mental well-being (Middle English Drogges, 2007). Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around them. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge a persons self-control and ability to resist intense impulses urging them to take drugs (National Institute on Drug Abuse, 2011). Some common types of drug are:

Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone (Dilaudid), and oxycodone (Oxycontin).
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Central

nervous

system (CNS)

stimulants

include

amphetamines,

cocaine,

dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance).

Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety-reducing effect, which can lead to dependence.

Hallucinogens include Lysergic Acid Diethylamide (LSD), mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence.

Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish (Arrestee Drug Abuse Monitoring Medical Encyclopedia, 2010).

Causes of drug addiction Drug addiction is an overwhelming, uncontrollable need for drugs or alcohol despite the negative consequences that may follow. It can affect people of any age, sex or economic status, and while no exact cause has been determined, a variety of risk factors have been identified. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors. Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, post-traumatic stress disorder, or another mental health problem (Arrestee Drug Abuse Monitoring Medical Encyclopedia, 2010). Origin of drugs No one really knows the history of drugs, and drug use for the origins of the association of humans and drugs are shrouded in the mists of time. Not much is known about early drug use no one knows who was the first person to smoke a joint or get high on the magic mushrooms or opiates (History of Drugs, 2011).

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It has long been suspected that humans have an ancient history of drug use, but there has been a lack of proof to support the theory. Now, however, researchers have found equipment used to prepare hallucinogenic drugs for sniffing, and dated them back to prehistoric South American tribes. Quetta Kaye, of University College London, and Scott Fitzpatrick, an archeologist from North Carolina State University, made the breakthrough on the Caribbean island of Carriacou. They found ceramic bowls, as well as tubes for inhaling drug fumes or powders, which appear to have originated in South America between 100BC and 400BC and were then carried 400 miles to the islands (Jones, 2008). Nevertheless, what we do know about the history of drugs is that no known society, culture or civilization has been entirely drug-free. In fact, every society has used some drug, usually many. Some commentators suggest that it is an intrinsic characteristic (may be even a need) of human beings to experience an altered state of consciousness (History of Drugs, 2011). Objective of the Study 1. To investigate the factors of drug addicts based on age, sex, marital status, occupation, education, income, types of family, reason of using drugs. 2. To describe the type of reduction services provided by DOST Foundation to street drug users. 3. To understand the training and capacity building of DOST welfare foundation for serving the drug addicts. Methodology The following methodology was adopted for the completion of the field work. Universe DOST is a not-for-profit organization that was formed in 1992 in Peshawar, Pakistan. Since its inception, it has been reaching out to people living on the margins of society, and bringing them back into the mainstream. DOST works with street children, drug addicts, destitute women, prisoners, refugees, youth and the general public.

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DOST has four Treatment centers for drug addicts treatment and rehabilitation and two Day Care Centers. The centers which were easily reachable for field work study were selected, i.e., Shahi Bala Treatment Centre (TC) and Day Care Center (DCC) Haji Camp. Sampling In Shahi Bala TC, there were one hundred and twenty (120) drug patients in which seven were randomly selected for data collection. And in DCC Haji Camp there were more than twenty-five children in which four of them were drug addicts and selected for data collection. Tools of Data Collection The respondents participated in this study were the drug addicted patients of Shahi Bala TC and DCC Haji Camp. General questions were asked about the life and drug history of the responders. The medium of communication was generally Urdu. This study was conducted in May-June 2012. Duration of the study The duration of the study was one month (15.05.2012 to 15.06.2012). Chapterization The report is divided into five chapters the current chapter focus on the definition of drug, drug categories, drug use and drug factors where the word is left to be discussed which is important to understand the term drug because term drug is the center point of the field work report and many time used in report. And the objectives of the study and research method described for the field work report. CHAPTER 2 DRUG ADDICTION AND REHABILITATION In Chapter Two previous studies and research on the drug addicts and rehabilitation programs for drug addicts in the world countries discussed. Because a good literature review places a research project in a context and demonstrates its relevance by making connections to a body of knowledge.

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CHAPTER 3 ORGANIZATIONAL PROFILE Chapter three show the Introduction to DOST Welfare Foundation, Donors of DOST Welfare Foundation, The staff of DOST Welfare Foundation, The programs of DOST Welfare Foundation and The details about Shahi Bala Treatment Center and Day care center Haji Camp. The research study was conducted in Shahi Bala TC and DCC Haji camp which are the two main centers of DOST Foundation in the area. For a good research study its important to know the organizational profile. CHAPTER 4 DATA ANALYSIS AND INTERPRETATION In chapter four the collected data during the field work in Shahi Bala TC and DCC Haji Camp is analyzed. By so doing help in understand the role of DOST Foundation in the drug addicts treatment and rehabilitation in Shahi Bala TC and DCC Haji camp. CHAPTER 5 CONCLUSIONS Conclusions of the field work report based on objectives are described in Chapter Five.

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CHAPTER NO 2
DRUG ADDICTION AND REHABILITATION A REVIEW OF LITERATURE
The Past Addiction has historically been considered a disease of weak will or moral turpitude. However, advances in brain imaging technology and the ability to accurately measure neurotransmitters over the past two decades has significantly improved our understanding of the neurobiology of addiction. Complex animal and human studies have led to evidence-based science that recognizes addiction as a disease. This is a dramatic change from the long-standing misperception that the addicted patient is afflicted with the illness due to a lack of willpower. In 1997, National Institute on Drug Abuse (NIDA) published Addiction is a Brain Disease and It Matters, by Dr. Alan Leshner, the then Director. This publication served a pivotal role in the introduction of the disease model of addiction based on emerging new research. In 2007, Dr. Nora Volkow, as the current NIDA Director, presented The Neurobiology of Free Will at the American Psychiatric Associations annual conference further enhancing the medical research communitys understanding of the drive of active addiction overriding individual personal needs. Consequently, the public is becoming better informed that the epidemic of addiction is the result of a disease. Public information of this disease is being disseminated by the media via educational programs and publications such as the 1998 PBS special Moyers on Addiction: Close to Home, the 2005 special issue of the journal Nature on addiction, the 2007 HBO special, Addiction: Why Cant They Just Stop? And Time Magazines 2007 cover story, How We Get Addicted. Viewing addiction as a chronic medical illness makes the longstanding stigmatization no longer acceptable (Hall, Scott, & Hakinberry, 2010). Drug Use around the World Drug use is a worldwide phenomenon, and drug use occurs in almost every country. The specific drug or drugs used varies from country to country and from region to region. Worldwide, the three main drugs of use are cannabis (such as marijuana), opiates (such as heroin), and cocaine. Although individual countries have their own drug laws, in general, drug possession, sale, and

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use are illegal. Unfortunately, laws are not always equally enforced in countries around the world. Current Global Trends in Drug Use throughout the 1990s, the use of amphetamine-type stimulants (ATS) increased dramatically worldwide. The main regions of use of ATS are in North America, Western Europe, and Asia. By the end of the 1990s, ATS use had stabilized or declined in North America and Western Europe. By contrast, use has continued to increase in Asia. Asia is the leading region for use and manufacture of ATS, and the potential for spreading the problem to other regions continues. Worldwide, cocaine use has been reported in more than two thirds of all countries. Although the use of cocaine is declining in North America, the rate of use still leads the world. In Western Europe, cocaine use has continued to rise since 1980. The lowest rates of cocaine use are found in Asia. Law-enforcement efforts have brought down the rate of production in cocaine-producing nations in recent years. The use of opiates has been increasing worldwide at an alarming rate, with more than two-thirds of the countries in the world reporting increases. Opiate use is highest in developing nations and nations in transition, while use in developed nations is stable or declining. One possible reason for the increase in use worldwide is that production of opium has increased dramatically. Production of opium has been shifting from Southeast Asia to Southwest Asia. Afghanistan leads the world in opium production, producing 79 percent of the total. Cannabis remains the most widespread drug in use worldwide. The use of cannabis is increasing overall, but in some regions, notably North America, Russia, China, and parts of Asia, use has stabilized or decreased in recent years. Cannabis will probably remain the most widely used drug because the crop is easily grown in many different climates and requires no processing for use as drugs. Opium and opiate drugs are most widely used in Asia. Opiate use is much lower in North America, Central America, South America, and Europe than it is in Asia. However, there is still enough use to consider opium a problem drug in those regions. Cocaine use is highest in the United States, but use is also high in other countries throughout the Americas and Europe. In general, rates of cocaine use are higher in more affluent countries. The use of amphetamine-type stimulants is highest in Europe and significant in selected other countries in the Americas. Africa has the lowest overall use of opium, and African rates of cocaine use are low. African countries

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generally show more amphetamine-type stimulant use than use of opium and cocaine (Drug Use Around the World, 2012). Drug Addiction in Pakistan The number of drug users in Pakistan has gone up from 50,000 in 1980 to 8.1 million in 2011. Every year at least 50,000 more people get addicted to different kinds of drugs. On average, an addict spends between Rs3, 000 and Rs3, 300 on drugs in Pakistan. These figures were quoted by Syed Zulfiqar Hussain, a consultant working with the Youth Council for Anti-Narcotics (YOCFAN) Campaign, at a seminar held on 12 May, 2011 to mark the International Day against Drug Abuse and Illicit Trafficking. Hussain said that according to the National Survey of Drug Abuse hashish 2009 was the most common drug in the country. He said drug use in Pakistan should be understood in reference to its location next to Afghanistan which is the biggest producer and exporter of opium. He said the quantity of opium consumed in Pakistan had gone up to 80 million tons. This, he said, was more than the quantity consumed in India (67 million tons). He said more than 80 per cent of addicts confined in Italy were Pakistanis. The seminar was organized jointly by the YOCFAN, the Pakistan Girl Guide Association (PGGA) and Save the Life (from Drugs) London. Hussain said most people living in povertystricken areas of the country got addicted to drugs because some of their elders had been addicts throughout their lives. Most people get the habit by watching their elders while growing up, he said. He said nowadays even A-class (without any impurity) drugs were easily available in lowincome areas. He said market had no role in determining the use of drug in the country. There is an extensive supply of drugs such as opium and hashish in the country. Apparently, police and drug mafias are colluding, he said. The organizers later announced that a Drug Abuse Information and Resource Centre would soon be set up as part of a campaign against drug use. Some people in the audience questioned the effectiveness of such initiatives and said that the government had taken several such initiatives in

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the past. They said it had been six months since the launch of Lahore Drug Free City campaign but no progress was visible (Raza, 2011). Rehabilitation of Drug Addicts United Nations Office on Drugs and Crime (UNODC) is a global leader in the fight against illicit drugs and international crime. Established in 1997 through a merger between the United Nations Drug Control Program and the Centre for International Crime Prevention, UNODC operates in all regions of the world through an extensive network of field offices. UNODC relies on voluntary contributions, mainly from Governments, for 90 per cent of its budget. UNODC is mandated to assist Member States in their struggle against illicit drugs, crime and terrorism. In the Millennium Declaration, Member States also resolved to intensify efforts to fight transnational crime in all its dimensions, to redouble the efforts to implement the commitment to counter the world drug problem and to take concerted action against international terrorism. (EMCDDA, 2012) We now have the results from a series of well-designed randomized clinical trials, from Europe and Canada, which have been peer reviewed and published in high-impact scientific journals, as well as steadily accumulating clinical experience of the development and provision of supervised injectable drugs treatment. All of the available findings from randomized controlled trials (RCTs) published in academic papers and project reports have been examined in order to gauge the efficacy (against a range of outcomes) as well as the cost and cost utility of supervised injectable heroin (SIH) and other illicit drugs treatment. Thus, this Insights gives a historical overview of SIH and illicit drugs, including the international policy and legislation regarding this treatment, before moving on to examine the research evidence and clinical and policy experience with this new treatment. (John, Teodora, & Nicola, 2012)

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CHAPTER NO 3
ORGANIZATIONAL PROFILE OF DOST WELFARE FOUNDATION
Introduction DOST is a not-for-profit organisation that was formed in 1992 in Peshawar, Pakistan. Since its inception, it has been reaching out to people living on the margins of society, and bringing them back into the mainstream. DOST works with street children, drug addicts, destitute women, prisoners, refugees, youth and the general public. It strives to restore to them their lives, their dignity, and their humanity, and to bring them back as contributing members of society (Dost Foundation, 2012). DOST is not an abbreviation of some other terms but DOST is an Urdu word which means friend. Or we can say that this agency is a friend in need. The Full name of the organization is Dost Welfare Foundation just calling it DOST Foundation is not correct (Sajid, 2008). With a staff of over 100, DOST provides a continuum of care and quality services through its programs for drug abuse prevention, treatment and rehabilitation, drug harm reduction, HIV/AIDS prevention, vocational skills training, research, advocacy and networking. All DOST programs are based on human rights protection of marginalized groups such as drug users, street children, juvenile offenders, women and minor children in prisons. DOST enables these vulnerable persons to explore the underlying factors of their drug misuse and imprisonment, to come to terms with past traumatic experiences, examine attitudes and behavior patterns, receive training in life and social skills and re-integrate into the community and society (Sajid, 2008). Partners of Dost Welfare Foundation The international partners of DOST Foundation are The Royal Netherlands Embassy Islamabad, British High Commission Islamabad, Australian Government Overseas Aid (AusAID), United Nations International Children's Emergency Fund (UNICEF), Department For International Development (DFID), United Nation Office on Drugs and Crime(UNODC),Catholic Relief Services(CRS), German Technical Cooperation (GTZ) and Save the Children.
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There are national partners as well in which INFAQ Foundation, Pakistan Bait-ul-mal, Marie stopes society, National AIDS Control Programme (NACP) Pakistan and Government of Khyber Pakhtunkhwa (KPK). Theses all national and international partners supporting the DOST Foundation in various welfare projects in which the rehabilitation of drug addicts is major project. (Dost Foundation, 2012). The Staff of Dost Welfare Foundation The President of DOST Foundation is Dr. Parveen Azam Khan and there are eight directors (Dost Foundation, BOD, 2012). In the team of DOST Foundation there are 198 full-time workers, 240 volunteers and internees, 10 projects / donors, 04 residential treatment centres, 14 community-based centres,14 mobile teams and 04 prison-based centres (Dost Foundation, 2012). Drug Addiction Treatment and Rehabilitation Programmes Drug addiction treatment services are operational since 1993, which include residential and community-based services. Clients in treatment are provided detoxification, behavioural change counselling, family and social interventions, religious and spiritual groups, relapse prevention skills, vocational skills development and aftercare services. Currently with a total capacity of 200-beds six residential treatment centres are operational, which are:

Sakoon Kor 1 Sakoon Kor 2 for adult drug addicts Sakoon Kor 3 for child drug addicts Sakoon Kor 4 for drug addicts in jail

Total numbers of clients in the end of 2010 were 4701 in Sakoon Kor-I, 4559 in Sakoon Kor-II, 263 in Sakoon Kor-III and 3305 in Sakoon Kor-IV given drug treatment. In the end of 2010 total clients in Sakoon Kor-I were 1183, Sakoon Kor-II 1848, and Sakoon Kor-IV 821 which were inducted into primary rehabilitation. The total numbers of families

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involved in the rehabilitation of clients in the end of 2010 were in Sakoon Kor-I 2447, Sakoon Kor-II 2315, and Sakoon Kor-III 211 (Dost Foundation, 2012). Drop-In Centre and Outreach Services for Street Drug Addicts in Peshawar Outreach and drop-in center-based services are available to the street drug users of Peshawar since 1994. Services include psycho-social support, healthcare, drug awareness, pre-treatment counseling and HIV prevention services. DOST currently provides these services through two static drop-in centers, three outreach teams and one mobile drop-in Centre reaching to more than 3000 street drug addicts every month. In the end of 2010, 8338 IDUs were registered, to the same year services were provided to 2311 clients, 2610 were tested for HIV. 2100 clients were guided through the process of removing toxic (Dost Foundation, 2012). Faith-Based Drug Demand Reduction Services in Fata Regions of Pakistan In 2006, Faith-based drug demand reduction services were established in four FATA/PATA regions of Pakistan. Presently Dar-ul-Falah faith-based centres are operational in four agencies namely Mohmand, Malakand, Khyber and Kurram. These centres mainly work to mobilize religious leaders and community influential, provide pre and post treatment interventions with drug users and their families and create general mass awareness. By the end of 2010, 7862 clients were counselled and provided other services in Dar-ul_Falah centres, 2088 clients referred for treatment and 4815 religious leader were sensitized and mobilized (Dost Foundation, 2012). Drug Demand Reduction Services and Strengthening Local Community Organizations in Afghanistan DOST established drug demand reduction services for Afghanistan in 2007. Presently two residential treatment and two outreach drop-in centres are operational in Bamyan and Daikundi Provinces of Afghanistan through partnerships with local organizations. Moreover, a training and resource centre is working in Peshawar to enhance the capacity Pakistan. In 2007 pretreatment services provided to 48 drug addicts, 33 families of clients were reached and 37 community elders were reached to DOST Foundation centres (Dost Foundation, 2012).

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Community-Based Drug Demand Reduction Centre, Khazana Khazana community-based drug demand reduction centre was established in 2005. The centre provides general community awareness, sensitization and mobilization of community elders, outreach and drop-in centre services for drug addicts, family interventions, referral of drug addicts for treatment, home-based treatment and follow-up services. Up to 2010 1346 clients were counselled and provided other services in Drop in Centres (DIC), 426 were referred for treatment to DOST Foundation and 3028 families of drug addicts were counselled and advised (Dost Foundation, 2012). HIV Awareness and Voluntary Counselling Testing Services for Drugs Addicts In 2001 DOST commenced HIV prevention and STI management services for drug addicts in addition to the outreach and residential treatment services. These services, which mainly include HIV awareness, Voluntary Counselling and Testing, management of STIs and condom education and provision, are offered through outreach teams, drop-in centres and residential treatment centres. By the end of 2010 the number of drug addicts were 27768 which were provided HIV awareness, 4257 were provided VCT services and 1928 clients were provided STI treatment (Dost Foundation, 2012). Fieldwork and Internship Programme for University Students and Graduates In 1996, DOST commenced the fieldwork and internship programme for the new university graduates and students of different disciplines including social work, psychology, sociology, medicine and management sciences from various universities and colleges of Peshawar. Presently, DOST offers internships and fieldwork opportunities in different service delivery areas including drug abuse prevention and treatment, HIV prevention, rights protection, management areas including monitoring and evaluation, finance and human resource management. By the end of 2010, for 569 students from different departments of Peshawar University held training sessions and 2010 graduates joined internship program in DOST Foundation (Dost Foundation, 2012).

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Training Programme For National and International Government Organizations and NGOs In 1999, DOST launch the training programme for GOs and NGOs working in Pakistan and Afghanistan in the fields of drug demand reduction, HIV prevention and protection of women and child rights. Presently, DOST is working in collaboration with the Ministry of Public Health and Ministry of Counter Narcotics Gov. of Afghanistan and the Home Department and Civil Defence Department of Pakistan for training their staff. Trainees include doctors, counsellors, social workers, police officials, prison health personnel and prison management staff and probation officers. DOSTs own staff, working in different programmes also receive regular trainings and capacity building. Training is also offered to various NGOs working in Pakistan and Afghanistan. In the end of year 2010, 321 drug abuse awareness sessions held with police official at civil defence and3903 police officials were trained (Dost Foundation, 2012). The field work study was on drug addicts exclusion. The centres for the drug addiction selected; I. II. Treatment Centre for adults Shahi Bala Day Care Centre for Children Haji Camp

1- TREATMENT CENTRE FOR ADULTS SHAHI BALA The treatment which is offered in DOST welfare foundation is called classical-systematic-and lifetime treatment. Classical in the sense that it is a multidimensional treatment. It involves new scientific, faith based, and traditional Approach. When we combine these three approaches then we call it the classical treatment. Systematic in the sense that there is a complete system of treatment. All the process goes stepwise, rather than haphazardly. Life time it is life time treatment because drug addiction is the life time problem. The treatment plan in Dost Welfare Foundation is divided into three phases; I. II. III. Pre-treatment phase Treatment phase Post-treatment phase
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15 I. PRE-TREATMENT PHASE

This phase starts before the treatment and before the patient enters the TC. It includes various steps which are awareness lectures, harm reduction, individual motivational counseling sessions, family contacts, client registration, and enquiry session. The objectives of this session are the awareness, motivation and make the client ready for treatment.
II. TREATMENT PHASE

In pre-treatment phase there are future three steps of rehabilitation which are detoxification, primary rehabilitation and secondary rehabilitation. Intake Interviews Medical Checkup is before detoxification. a) Detoxification Period: This is the first phase in the treatment process, and lasts for 10 to 15 days. During this period the physical withdrawal of the drug takes place. The main features of therapy include: 1. Symptomatic medical treatment 2. No substitute drugs 3. Bath therapy 4. Open door policy 5. Individual counseling 6. Peer support 7. Handing over of client to Supervisor/psychologist/ counselor 8. Data Sessions 9. Brief History of the Client b) Primary Rehabilitation: This period last for up to 45 days i.e. 8 weeks and it is a 30 days period after detoxification. It includes the following features; 1. Life story in written form 2. Client profile 3. Lectures 4. Groups of the clients

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5. Dars 6. Individual Counseling Sessions (ICS) 7. Different Therapeutic Techniques are started 8. Behavior Shaping Tools are applied 9. Assigning of Therapeutic Duties 10. Family Therapeutic Sessions 11. Need Based Assessment for Vocational Skills c) Secondary Rehabilitation/ Vocational Skill Development: This phase may be residential or out-patient and includes vocational training in automotive/electrical repair, welding, carpentry, handicrafts, sewing, food preparation etc. Main features of this phase include: 1. Some duties and responsibilities are assigned to the client and he is held responsible for it. 2. Social reintegration 3. Vocational Rehabilitation 4. Internship 5. Job Placement (if available) III. POST TREATMENT PHASE Follow-Up and Aftercare

This phase of treatment last up to 90 days i.e. 45 days period after the first 2 phases. These phases include follow up and After Care, Narcotic Anonymous Meetings, RPP-Relapse Prevention Programs, Letters and Telephone Calls, Home Visits of Ex-Clients and Social Gathering for drug addict patients (Sajid, 2008). 2- DAY CARE CENTRE FOR CHILDREN HAJI CAMP DCC mean day care center which is called DIC which means Drop in Centre. Dost Foundation drop in center for children located near haji camp Peshawar in which street children are guided, provided facilities like medical, educational, food and in near future the Day Care Center haji camp will provide shelter for homeless children.

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DCC Haji Camp not only working for street children but also for drug addicts children in the area and later when they are getting positive change referred to Hayatabad main office in which 90 days complete treatment is provided to drug addict children. The DCC of Haji camp was established on 11th September 2009. It is the sub section of Dost Welfare In DCC Haji Camp food, medical facilities available for children and psychologists for counseling the children in center. In the building of DIC Haji camp there is one meeting office, one staff room, one counseling room , one activity room, one sports room, one kitchen, one bath room, one vocational room, one manager office, one shelter home and one non- formal room. The project coordinator in DIC is Samiullah, Community mobilizer Azmathullah, outreach counselor Afzal Shah, office assistant Fayaz Daniel and Vocational trainer is Saima Hanif except these there is one watch man and one driver.

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CHAPTER NO 4 DATA ANALYSIS AND INTERPRETATION

The study was on the drug addiction treatment and rehabilitation of Dost Welfare Foundation Peshawar. Factors of drug addicts based on socio-economic and demographic These factors are identified in drug addiction. The mostly drug addicts age were below 30 years one of them was 52 years old, name Sabir Alam. All were male and some of them were married and some were unmarried. Most of drug addicts were unemployed. Shaheen Badsha said, I was unemployed and took loan from my uncle and I bought a taxi and driving a taxi but the income was not enough to support my family.I was taking hashish first and later I begun heroin Sahfeeq 24 years old lived in Sadar, Peshawar said; I used to sell candies in the streets. Sometimes I would steal, but mostly I would beg. For a little while I was with a gang. I used to sleep in an abandoned warehouse here. Lots of street homeless guys go there. We were sniffing heroin there but I do not go there anymore because of what happened. Nine months ago I was there sleeping. Two strangers came. It was 6:30 in the morning, and they came into the building where we were. They told all the others to get up and that they were going to search us for drugs. Then they took us to the bathroom and told us to take off all our clothes. At first, I refused. I told them they would not want this to happen to their own kids. But they threatened us all if we did not do as they said. When they didnt find any drugs they let the other guys go. Then one of them laughed in my face. They beat us badly and took the money we had. I escaped but they sexually abused one of my friend name kashif he is 20 years old

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Factors of drug addiction The education is important factor to understand the right and wrong. The drug addicts were uneducated and few of them were literate. In joint families there are more social problem then in nuclear and in the TC most of the families of drug addicts were joint and because of joint structure of the family they faced social and economic problems. Mudasar Ali said, my education is primary .I was smoking cigarettes with my school friends my family is jointone day I was tense and my cousin told me to smoke a cigarette which will relief me from all tensions... Unaware the bad effects... Because I was no sense to identify heroin and hashish Fasil was in was in Malaysia, he was using drugs because of his bad company he said: When I used, I would get into a panic then when the effect wore off, that thing would hit and youd want to use more. [..] Each time I us more I would get thinner, I wouldnt eat, and I was in bad health, coughing, with a lot of catarrh in my lungs Safi escaped from his home when he was 15 because of his violent stepmother. He lived in a Nowshera, became addicted to drugs and was sexually abused by a policeman. In 2010 he came to DCC Haji camp, receiving medical treatment, counseling and support. His dream is to be a Doctor. DOST Foundation have also challenged community attitudes, raising awareness and promoting acceptance through local meetings, workshops and events. As a result, leading members of the Peshawar community (professors, doctors, business people and religious leaders) have become a source of strength and support, advocating for reform of government policies and practices on child drug addiction and sexual exploitation. The success of the pilot project has allowed work to develop further and new services to be established at childrens request, including a 24-hour safe shelter will be open soon in DCC Haji Camp, offering basic healthcare, counseling, education, child-child support, family tracing, social integration and follow-up services.
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Causes of using drugs No exact cause has been determined, a variety of risk factors were identified. However, a persons genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors. The clients in TC and DCC using drug because of broken family, low economic status and peer pressure etc. Fahim was using drugs because of peer pressure, and Arshad was using it because of broken family and low economic status. Arshad said; I was depressed because of our low economic status and begun to steal cars that job made me more depressed .I was using heroin Sabir Alam said that he was unaware of the bad effects of drugs. Street children who participated in the study usually said they were forced onto the streets in search of work because of poverty and family breakdown (the former often precipitating the latter). Street working children reported they had been unable to continue their education and most children were illiterate. With employment opportunities scarce, street working children have little option but to accept dangerous and demeaning jobs such as selling drugs or alcohol, pushing carts or searching through rubbish dumps for materials to sell. As 12-year-old Ashraf said: We are born to work. This is our life. In this life I have nothing to do drug relief me from tensions Are the Services of Dost Foundation satisfactory? Clients in treatment are provided detoxification, behavioral change counseling, family and social interventions, religious and spiritual groups, relapse prevention skills, vocational skills development and aftercare services. Most of the clients were happy from DOSTs Services provided in the center. The satisfied Respondents identified different factors or reasons for their satisfaction. The most freqently identified positive aspect of DOSTs services were the provision of Food, Clothing, Shelter,

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medical and recreational facilities. Sokat a child drug addict in DCC Haji Camp said he came from broken family. DOST provided him medical, recreational, food and educational facilities. The client (Srfaraz 29 years) has started drug addiction in a very young age. He use to go to school but when he was in class 2nd he become a truant and he joined a group of addicts students. First he started from cigarette and then gradual proceeded to other dangerous substances. Due to his addiction habit he left the school in class two and now he has no ability to read or write. According to him he is self-motivated for treatment and he has come through Darul-Shafa TC in Industrial State Hayatabad. He is very happy and according to him the services provided him is very special. Another drug addict patient name Salim in TC said; I am happy here the facilities here are very special .. After recovery I wish to stay here and work in DOST Foundation and serve the humanity However, a few of the respondents did not show satisfaction about DOSTs services. For instance, there was accusation of pornography. A child named Asif was not satisfied with DOST services he said: In early days I was in Hayatabad and I was happy there..But after the treatment they send me here in DCC Haji camp but the environment is not good here..they are showing pornographic movies on TV and the behavior of the some staff members is not good with us. I want to go back to Hayatabad office.

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CHAPTER NO 5 CONCLUSIONS
Most of the drug addicts were aged below 30 years, all were male, mostly were unmarried, some of them were unemployed and other were farmers or blue-collar workers, the structure of the family of the drug addicts patients were joint, and the main reason for using drug were failure in love and broken families. The DOST foundation providing reduction services for children in Haji camp and Hayatabad. In Haji Camp the Day Care Center also called Drop In Center providing food, medical, education facilities and in near future the DCC Haji Camp will provide Shelter for street children. Most children who were drug addicts referred to Hayatabad center for treatment. And other who is not taking drugs referred to different government and private schools for education. The children in DCC are guided by counselor. The DOST Foundation is providing treatment facilities to drug addicts in the country especially for the KPK province. The treatment which is offered in DOST welfare foundation is called classical-systematic-and lifetime treatment. Classical in the sense that it is a multidimensional treatment. It involves new scientific, faith based, and traditional Approach. When we combine these three approaches then we call it the classical treatment. Systematic in the sense that there is a complete system of treatment. All the process goes stepwise, rather than haphazardly. Life time it is life time treatment because drug addiction is the life time problem. The treatment plan in DOST Welfare Foundation is divided into Pre-treatment phase, Treatment phase and Posttreatment phase. Except these DOST also providing job for the recovered drug patients in the centers.

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24 Dost Foundation. (2012). Faith-Based. Retrieved May 08, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=6&Itemid=2 0 Dost Foundation. (2012, May). Our Partners. Retrieved May 07, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=16&Itemid= 4 Dost Foundation. (2012, May). Our Team. Retrieved May 08, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=3&Itemid=1 4 Dost Foundation. (2012). Training Programme. Retrieved May 10, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=15&Itemid= 27 Dost Foundation. (2012, May). Treatment. Retrieved May 09, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=4&Itemid=1 8 Dost Foundation. (2012). VctIDu. Retrieved May 10, 2012, from Dost Foundation: http://home.dostfoundation.org/index.php?option=com_content&view=article&id=10&Itemid= 24 EMCDDA. (2012, May 04). UNODC. Retrieved May 17, 2012, from European Monitoring Centre for Drugs and Drugs Addiction: http://www.emcdda.europa.eu/about/partners/unodc Hall, B., Scott, P. M., & Hakinberry, D. (2010, July/August). Prescription Drug Abuse & Addiction. West Virginia Medical Journal, Vol.106(Special Issue). Retrieved May 18, 2012, from http://www.wvmphp.org/WVSMA-Special_Edition_Article-Final-Proof.pdf J. S., T. G., & N. M. (2012). EMCDDA INSIGHTS. Luxembourg: Publications Office of the European Union,. Jones, W. (2008, October 19). Stone age man took drugs. The Telegraph. Retrieved May 14, 2012, from http://www.telegraph.co.uk/news/newstopics/howaboutthat/3225729/Stone-Age-man-tookdrugs-say-scientists.html Middle English Drogges. (2007, September 20). Drug. Retrieved May 12, 2012, from Dictionary.com: http://dictionary.reference.com/browse/drug National Institute on Drug Abuse. (2011, March). DrugFacts. Retrieved May 14, 2012, from NIDA National Institute on Drug Abuse: http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction Ramzan, M. (2007). Downloads. Retrieved May 16, 2012, from National Social Forum: www.nsf.org.pk/downloads/Muhammad_Ramzan.pdf
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25 Raza, R. (2011, June 26). Day against Drug Abuse. The Express Tribune. Retrieved May 18, 2012, from http://tribune.com.pk/story/196455/day-against-drug-abuse-more-than-8-1-m-addicts-inpakistan-now/ Sajid, I. A. (2008). Drug addiction Treatment and Rehabilitation. ISSG, Social Work, Peshawar. Retrieved May 09, 2012 http://www.scribd.com/doc/28680237/Drug-Addiction-Treatment-andRehabilitation-Imran-Ahmad-Sajid World Health Organization. (1969). WHO Expert Committee on Drug Dependence. Geneva: World Health Organization. Retrieved May 10, 2012, from http://whqlibdoc.who.int/trs/WHO_TRS_407.pdf

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Noor Ahmed Master of Arts in Sociology Session 2010-12 University of Peshawar Email khan.sociology@gmail.com / yahoo.com / Hotmail.com

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