INTRODUCTION

It is estimated that nearly five million regular drug users are living in Pakistan. 40% belongs to urban areas and 60% are lived in rural areas. It is reported that Chars users children were 7,700,000 and they belonged in 10 to 12 years age category. Total number of heroin addicts is eighty million in the world and every year twenty billion rupees are used up on deal of horoin in the world (Anonymous, 2000).

Obnoxious youthful actions are extensive in Nigeria and all over Africa, to the extent that they have been giving a lot of apprehension 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 warning to lives and property. A lot of ritual killings are taking place Outside the campuses (Aluede 2000). Social and economic factors are responsible for risk behavior and the health of drug users. The health of drug users is affected by these factors indirectly by forming individual drug-use behavior; they affect health directly by affecting the available 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 disparity in health among drug users. Public health interventions designed at improving the health of drug users must address the social factors that accompany and intensify the health consequences of illegitimate drug use, (Galea, S., and Vlahov, D., 2002)

Recently, the use of illicit drugs has increased all over the world. It is further reported that a main world tendency is the increasing of many kinds of available drugs to an ever widening socio-economic variety of consumer. The use of illicit drugs has increased throughout the world in recent years. The report further states that. The report argues that the main difficulty drugs at global level continue to be opiates followed by cocaine. For example, opiates continued to be the main problem drugs for most of Europe and Asia, accounting for 62 percent of total treatment in 2003 and reports from a total of 95 countries showed that drug seizures amplified four-fold in 2003, and more than half of these were of cannabis, (World Drug Report 2005).

Drug addiction is a major problem throughout the world. Pakistan is a developing country and is located in South Asia, its total population is Pakistan is located in South Asia a million approx. Majority of the people is Muslim which is approximately ninety seven percent of the population. The remaining three percent of the population include Christians, Hindus, Sikhs and Parsis. Pakistan is quite a religious country and religion plays an important role in peoples lifestyle. Therefore, any kind of drugs, alcohol or addictive substances are detested generally by the society and religion is used as a tool to prohibit the use of the substances of abuse. On the other hand, alcohol has new acceptance in our society due to increasing influence of western culture in some cities of Pakistan Lahore, Karachi and Islamabad both by the wealthiest and the poor people. (Niaz, U et al., 2005) The use of legal and illicit drugs has long time history in Pakistan. This study was conducted to investigate the socioeconomic and cultural aspects of female addicts in Lahore. The sample was consisted of 50 females aged 25 - 35 years by random sampling technique. Open and closed-ended questions were prepared. Pre-testing of the study was carried out with ten respondents to examine the workability and suitability of measuring instruments. To draw conclusion, descriptive and inferential statistics were used to explore the data. It was concluded that socioeconomic characteristics in tenure of womens education, family income and demographic factors have bearing upon the drug addiction. It is also suggested that people should be made aware of advantages and disadvantages of drug addiction. If people

have taken the knowledge about the merits and demerits of drug use, then the percentage of drug users can be substantially decreased, (Mubeen, C. and Sharif,M. 2007) To make Pakistan a drug free country into a state with a large concentration of heroin addicts since1980, drug abuse has considered as frightening magnitude in Pakistan. When there were some 315,000 addicts who were mostly dependent upon oral use of less harmful substances like opium and marijuana or hashish, Pakistan was free from addiction of harmful drugs, including heroin till 1979. But a number of factors including immediate ban forced 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). 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 cannot take place except the individual attends for treatment. The drug addict must come to discover with the possibility of a life without drug taking. Usually, drug takers, have tiny or no motivation to suffer treatment. Alcoholics want to contradict that their consumption is abnormal; others openly protect their habits. By treating the drug addicts, the cooperation of psychologists and sociologists is also needed. 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 situation requires the same value 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 especially universities of Pakistan. Recently researches explored the different aspects of drug abuse and reported the percentage of drug use in students. There are more problems to knock out drug abuse which are notwithstanding, however one can and must bridge that informational gap, if one truly wants to be successful in controlling drug addiction. This situation claimed that there is a need of science and facts 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)

In developing countries and developed countries, drug addiction is highest growing difficulty among youth. This study revealed the increasing rate of drug addiction among youth of Kashmir due to conflicts and unemployment in this region. Regarding the objective of this study, the researcher has conducted interview schedule to collect the data from respondents. Most of the respondents said that problems of drug addiction among youth are due to conflicts and unemployment. Whereas 158 respondents also revealed that girls also take drugs. 143 respondents explored that member from their family take drugs at their homes. Majority of respondents also showed that educational anxiety is one reason for youth to take drugs. It is definitely going to have the pits contact on society, if our youth is indulged in drug addiction. Drug addiction causes the economic, cultural and moral degradation particularly to drug user and family in general. This study shows how our youth look to the problem of drug addiction. This study reveals the bad impact of drug addiction on youth. And this study also reveals the impact of drug addiction on girls, (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 individual 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 common phenomenon throughout the world. People have been found using different kinds of drugs, and they have somehow been abided by the society. The drug user knows that the society did not respect them but they still used drugs. How the current position of drug abuse in Pakistan is serious and has major consequences. The drug named, heroin has been seen since late seventies, and its abuse has been on the peek level. Traditional estimates of heroin addicts alone in the country put a figure around 2 Mn. The impact of this drug has severe health risks, 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 increased spread and pursue the means of positioning a stop to its production and undertake rehabilitation exercises.

Saeed, M.T., AND Zafar, M.I., (2003) defined 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 aid 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 have surples side effects. Drug became more toxic if dose is taken in large amount. Some drugs cause unhealthy effects on physiological and behavioral factors of addicts. 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.

Khan, M.H et al., (2004) said it is important for policy makers and research communities to try to control 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 of drug depend on the amount, method and frequency of usage of drugs. Heroin is most addictive from other drugs. 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 they stop taking drugs, they experiences physical withdrawal indications and a craving for the drug. Hernandez, M., et al., (2005) said that drug abuse has become one of major social problems throughtout the world despite education on prevention and rehabilitation of illicit drugs. Anesthesiologists should have awareness about this problem and the most likely effects and potential risks associated with the abuse of prohibited drugs. Some of these patients may present at preadmission testing, emergency situations or in the obstetric suite for anesthesia or analgesia. It is very important to investigate in a nonjudgmental way about addiction and drug 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 important to reduce postoperative hazards from inadequate analgesia. Due to the various clinical presentations that may arise from drug 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 addiction is endemic; on the other hand it is quickly dispersing 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 substance use. There is an urgent need to assess the risk that injecting drugs will increase and the need to institute appropriate publichealth- 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, 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 illegal substance among young adults and teens 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 are 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 are 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. Firstly they discussed 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. Secondly, they described the recent advances in the comorbid relationship between alcoholism and two movement disorders: essential tremor and myoclonus-dystonia. Lastly, they investigate 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 means of administering the drugs indicates various difficulties for the drug dependent specially the intravenous direction causes an important and severe 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 revealed a marked rise of drug abuse because of close territorial contacts with Afghanistan which is the largest producer of opium in the world. Some factors like, socioeconomic status, associated society, family history and others also play a spectacular role in promoting drug 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 behaviour of drug use is different in males and females. More males than females use multiple substances, about 55 percent of men are multiple users 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 is a major public health problem in Pakistan. To identify the socioeconomic profile and beliefs and practices of 500 drug users, a descriptive questionnaire survey in Karachi city was made. The result indicated that 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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