Received: 05-Jun-2022, Manuscript No. AMHSR-22-65913; Editor assigned: 08-Jun-2022, Pre QC No. AMHSR-22-65913(PQ); Reviewed: 22-Jun-2022 QC No. AMHSR-22-65913; Revised: 08-Aug-2022, Manuscript No. AMHSR-22-65913(R); Published: 15-Aug-2022

Citation: Chuadry MA, et al. Prevalence of Drug Use among University Students in Pakistan. Ann Med Health Sci Res. 2022;12:1-10.

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Abstract

Addiction to drugs is on the rise in Pakistan's educational institutions. Students in schools, colleges, and universities are becoming increasingly addicted to opioids, risking not just their own future but also the lives of those around them, including family and friends. Despite the considerable harm that drug and substance abuse cause in children's physical and mental health; neither the government nor educational institutions have taken meaningful action. To determine the prevalence rates of drug use within universities of Pakistan. The study will also try to provide feasible ideas and actionable suggestions to the government and relevant authorities to aid in the reduction of drug usage among university students. A quantitative, descriptive study was conducted to determine the prevalence rate of drug use within students of federally chartered universities of Islamabad. A total of 546 students enrolled in selected institutions were requested to complete a specially developed questionnaire. Perceived perception of the respondents was recorded and checked by using the likert scale. Data was entered, tabulated, summered, and analyzed by using SPSS version 21. A total of 490 questionnaires were received from students at targeted universities. The indings revealed that prevalence of drug use within educational institutions was high, and students were getting indulged into this scourge at an alarming rate. It was concluded from the findings of the study that the prevalence of drug use within institutions was high with boys and girls equally involved into this menace and university’s administration and concerning government authorities should take concrete steps to eradicate this menace from its roots.

Keywords

Prevalence; Drug addiction; Educational institutions; Pakistan

Introduction

Knowledge addiction is described in the gazette of Pakistan 1997 as "a person physically or psychologically dependent on any narcotic drug or psychotropic substance or an individual who habitually uses narcotic drugs or psychotropic substances." Drug addiction and its abuse is a global concern now and Pakistan, a South Asian developing country with a population of more than two hundred million, is not any exception. Drug abuse is already one of Pakistan's most significant social issues, affecting a sizable proportion of the country's population. As per United Nations Office on Drugs and Crimes (UNODC) World Drug Report (2020), in the year 2018, about 5.4 percent of the worldwide populace matured 16-64, have consumed drugs a minimum of once in their lifespan, illustrating almost one in every nineteen individuals. Likewise, in Pakistan, there are more than eight million drug users, and seven hundred deaths occur every day because of drug-associated intricacies.

Drugs are accessible in various structures the nation over, like cocaine, hashish, heroin, opium, cannabis, and crystal regardless of its perilous impacts and outcomes, the addicts are increasing at a crippling rate of forty thousand every year, as detailed by the Ministry of Narcotics Control (2009), furthermore, they likewise gave figures that about three million Pakistanis between the ages of 15 and 64 consume heroin daily, with nearly five million cannabis consumers dependent on charas. People of various ages use them however ladies’ consumers are nearly less because of their low and kept portability. The trend of teens turning to drugs for their guilty pleasure has reached alarming new heights.

As teenage years are the times of crucial transitions. It’s the period of development, both physically and mentally, as well as cognitive and emotional maturation. For a few, it is likewise a period where they are more vulnerable to the commencement of drugs. Youthfulness is the basic danger time frame for drug use initiation. According to the United Nations Office on Drugs and Crime (UNODC) World Drug Report (2020), the highest rate of drug use was shown in those aged 18–25 inside the populace aged 15-64, and these findings are applied to the youth of Pakistan also. Nearly a quarter of the youth population of Pakistan is involved in some sort of substance abuse and consumption of cannabis is by far most common among young people. Another emerging trend is the use of 'Sheesha' in conjunction with cannabis (charas) and other drugs, which are being abused by both young men and women, mostly from the upper socioeconomic strata who live in the most opulent areas of cities. The accessibility of drugs like cannabis is linked to culture. Society and state have a say in how the supply of drugs will be managed and monitored. As indicated by the law of Pakistan, vending drugs including cigarettes to individuals younger than 18 is prohibited, notwithstanding, individuals skillfully some way or another go around the guideline. As a result, drug use is becoming widespread among the youth of Pakistan even though law and religion restrict it and it isn't ethically appropriate to use drugs within families. The reality that Afghanistan lies to Pakistan's northwest, and maintains nearly 70% of the world's narcotics supply, is the primary explanation for fast and easy drug accessibility in Pakistan. Owing to Pakistan's precarious location, the region isn't just utilized for illegal foreign drug dealing, yet it likewise has made the country a hotbed of drug consumption multidimensional variables can be held liable for placing students at a high risk of drug initiation during their university life. Few worth mentioning issues in mental and emotional wellbeing, societal economic and social disparities, troubled and unfortunate backgrounds, parent's carelessness, habitual smoking, and susceptible campus environment. Peers influence is also a significant variable because it can potentially become a trigger for becoming interested in drugs during the academic period. Young people try it out of fascination or for enjoyment at first, but it quickly becomes risky, leading to an increased frequency of drug abuse. The misplaced "coolness" synonymous with drug use often promoted by the media is another reason for the indulgence of many young people in this menace. Shisha is a hot new trend among young people these days, and they do it simply to look more fashionable. Even though Shisha is much more toxic than tobacco and can be highly lethal. Smoking has become exceptionally normal among young boys, with girls likewise getting reveled in it. They do not consider smoking something major however a smoker has a lot higher propensity of mishandling drugs than non-smokers. Hostel-dwelling male students are also found to be more likely to use drugs. According to a study conducted by Sarkar, Roy and Singh, the prevalence of drug abuse among hostellers was found to be higher than that of nonhostellers in Indian Universities. Their study also proposes that cannabis and cigarettes were the most widely consumed substances in hostels by students. Drug misuse has a wide range of harmful consequences for the person who uses it. It has a detrimental effect on one's physical and mental health, and the outcomes of misuse can be felt at various levels, from the person to society. Young people initiate the use of drugs out of curiosity, trying light drugs first, then intakes become frequent, with light drugs substituting hard ones and within no time they become addicted to them. Drugs being synthetic agents can harm the human body's work as they can incite infections like HIV and hepatitis. Likewise, drugs have a detrimental impact on brain development too, resulting in a variety of psychiatric conditions. Neurological impairment can be induced by drug misuse, impairing the brain's ability to function normally. The effects of drugs destroying thousands of neurons are fatal, and its overdose has claimed the lives of hundreds of students. Drug usage by students hinders their ability to think properly, and academics become less meaningful to them. As a result, they do not attend school constantly and eventually drop out. A few of the immediate impacts of drug misuse on students' lives include poor judgment, lack of imaginative thinking, and inability to develop essential life and social skills. Furthermore, keeping students unaware of their inner talents left them with no ambitions for the future. Some of the detrimental consequences of drug abuse on physical wellbeing are impaired sleep, hunger issues, elevated heart rate and body temperature, higher risk of hepatitis and HIV/AIDS infection, loss of life, varying forms of tumors, and ulcers. Although drugs have far-reaching repercussions, a substantial percentage of young adults continue to use them. Therefore, taking urgent and appropriate measures to mitigate the increasing rates of drug usage on university campuses has become essential. Therefore, our study seeks to establish preventative approaches as well. According to WHO and UNICEF (2016), the easiest way to understand prevention is to look at it holistically, which necessitates three stages of prevention: primary, secondary, and tertiary. Delaying the onset or initiation of drug use altogether is primary prevention. Secondary avoidance is a strategy for preventing people who are only getting started with drugs from being addicts so that they can be saved before they do serious harm to themselves. The goal of tertiary avoidance is to help narcotics users recover their lives by eliminating their addiction to drugs, thus also called rehabilitation prevention. So, a plan or strategy must be designed in such a manner that it encompasses all three types of prevention to effectively address the problem of substance addiction. As a signatory to several international drug treaties, Pakistan is obligated to take all reasonable and necessary steps to monitor and track all facets of drug production and trade, as well as to ensure public health prevention, care and rehabilitation. The federal government is aware of the increasing drug crisis on college campuses and has taken several steps to resolve it, but failures in execution have left the issue unaddressed. Identifying and filling loopholes in the development and enforcement of new narcotic policies, reinforcing the bodies accountable for narcotics control, devising a robust panning and surveillance mechanism, and maintaining youth and academic institutions' interest in eradicating drugs from their campuses has become critical in solving the continuing problem of drug addiction on campuses. Considering the use of the rising narcotic on university campuses, this study proposes to find the prevalence rates of drug use within university students of Pakistan. The study will be undertaken in Pakistan's public and private universities to determine the prevalence rates of drug use within universities so that a clear picture could help in devising proper strategies to curb this menace from society. The focus of the study will be to investigate prevalence of drug use within university campuses so that specific anti-drug abuse strategies could be devised that can be enforced quickly. As we feel it is critical to determine the prevalence of drug usage, it will aid in assessing the severity of the issue and strategies may then be designed accordingly [1-5].

Literature Review

A drug is defined by the World Health Organization (WHO) as any substance which, introduced into the living organism can modify one or more of its functions. Over the last two decades, the globe has seen a significant increase in the prevalence rates of drug use across all age categories, with an alarming surge among young people, as well as the fatal consequences of its use, resulting in drug usage becoming a worldwide problem. According to an estimate of the United Nations Office on Drugs and Crime (UNODC), worldwide drug usage increased by 28% between 2009 and 2018 with cannabis being the most abused substance. Previously, it was assumed that the drug problem was limited to the use of illegal substances such as heroin. However, there has been a shift, with licit drugs (alcohol, cigarettes) bridging the gap and serving as a conduit for the consumption of illicit substances, particularly cannabis and cocaine, which are now more prevalent. Consuming alcohol or cigarettes increases the likelihood of drug usage (cocaine, marijuana) several times since they have a pre-existing tolerance that leads to drug dependency. Drug usage is deadly; 500,000 individuals died because of addiction and 18 million years of healthy living were lost because of drug misuse, particularly opioids. Injection drug use endangers people's lives, with many contracting HIV and Hepatitis as a result. Despite the known vulnerabilities and dangers associated with drugs, their usage remains and is even rising on a large scale. According to a recent study published by UNODC, drug usage has risen by 22% since 2010, with an estimated 275 million individuals abusing drugs in the preceding year. Furthermore, based on demographic characteristics, the study predicts that worldwide drug usage would rise by 11% more by 2030. Even though the increase is expected for all countries, the greatest obvious effects are likely to be seen in low-income or developing countries since they have a big youthful population, and youngsters' indulgence in this scourge is substantially greater than adult indulgence. Thus, it is imperative that comprehensive and efficient monitoring and response systems, as well as prevention programs, should be developed to assist these countries in safeguarding their young population from the projected rise in drug use [6].

Drugs and youth

A large proportion of the world's population is under the age of 30. Research on general population drug usage repeatedly reveals that drug usage among youth is higher compared to older people. Persons aged 18-25 had the highest rates of drug usage, according to the statistics. This is a problem that exists in all countries and for all substance types. Several factors impact young people's drug sensitivity. These variables manifest themselves in the lives of young people at multiple levels, beginning with personal issues (personality, genetics), then interpersonal factors such as youth contact with family, schoolmates, and peers, and finally macroenvironmental factors such as the economic and social environment to which young people are exposed. A substantial body of evidence shows that the adolescent years are the most vulnerable for young people to become involved in drug use because they are subjected to a variety of social and mental stresses. According to the UNODC's World Drug Report, the most prevalent trend among youths, aside from tobacco smoking and drinking alcoholic beverages, is their consistent and pervasive use of cannabis. According to the study's findings, globally 14 million young people aged 15 to 16, or 5.6 percent of the global population, consumed cannabis at least once in the previous year. These findings are like the UNODC World Drug Report, but with an increase in the number of cannabis users among young people. The study also shows that many cannabis products are becoming stronger with time, while the number of young people who feel cannabis is not dangerous is growing, posing a significant threat to future generations. Cannabis usage in youngsters begins in late adolescence and peaks in early adulthood. Using cannabis before the age of 16 exposes the young population to greater risk and increases the likelihood of getting addicted, as well as the formation of psychiatric problems, according to medical research. According to the UNODC research, 9% of cannabis users develop usage issues and 1 in 6 users who started using it in youth becomes dependent later. According to Hyman and Sinha, the proclivity of young people to use cannabis makes them more sensitive to other drugs, and even if other factors such as environment or heredity could be avoided, a cannabis user has a very high probability of consuming other substances. Contact between teenage cannabis users and their friends who are also cannabis users’ produces a vulnerable atmosphere in which the risk of abusing other substances is multiplied several times. According to, over 25% of Pakistani adolescent drug users are under the age of 18, with many consuming drugs before the age of 18 or between the ages of 18 and 25. Similar results were observed in a study in which 92.9 percent of individuals admitted to taking drugs or alcohol before the age of 25. As evidenced by the literature, drug addiction is becoming increasingly prevalent in Pakistan, with our youth, who account for around 64 percent of our population, bearing the brunt of the burden. And the issue appears to be worsening in the future, with the number of young drug users growing at a rate of 40,000 each year, rendering Pakistan one of the most afflicted countries by drug usage. These numbers necessitate the development of fast and effective measures, as well as their actual implementation, to protect the nation's young, the country's most important resource [7].

Situation of drug use in Pakistan

As per the findings of the last survey done in Pakistan in 2013 to evaluate the prevalence rates of drug use, which was conducted with the assistance of UNODC, around seven million Pakistanis aged 15 to 64 were taking drugs. Over four million people were believed to be sufferers of drug misuse, with cannabis being the most widely consumed substance and heroin being the product getting used on regular basis among Pakistanis. These were the results in 2013, and the statistics are now far higher than those indicated above. According to the most recent Anti Narcotic Force (ANF) data, twenty-seven million people in Pakistan are currently victims of drug abuse, with a sizable proportion of the youth population participating in this scourge with every passing day. Since 1979, the prevalence of drug usage in Pakistan has increased. There were no heroin addicts in the nation before 1979, but because of the post-soviet scenario in Afghanistan, Pakistan, as the former's neighbor, became exposed to the threat of drug use. The turmoil in Afghanistan at that period had a significant influence on Pakistan, which saw a significant increase in poppy growth and drug manufacturing. Pakistan has long been plagued by drug related problems because of its perilous location and closeness to Afghanistan to the west. According to a UNODC report, Afghanistan has "continued to be the world's top farmer of opium poppy and the world's greatest producer of opium." The report also indicates the country's persistent tendency of increasing opium output. Such discoveries from a neighboring nation put Pakistan in danger and increase the likelihood of drug problems in its land and people. Pakistan is in a precarious situation, with a lengthy border with Afghanistan, the majority of which is porous, and many portions of the border remain unprotected due to tough terrain, despite the government's efforts to control it. Drug traffickers have historically utilized Pakistan's geographical location to their advantage, and the country's soil has traditionally been used as a supply route for drug trafficking. As per UNODC research, 40% of narcotics manufactured in Afghanistan are exported to the rest of the globe via Pakistan, resulting in a massive supply of drugs within the nation and therefore for use by its people. Given the preceding discussion about Pakistan's proximity to Afghanistan, which makes it a passageway for global drug transport, drug availability within the country is a lot easier, and as a result, these substances also reach local people in the country, making it one of the major drivers of rising domestic drug use in the country. This increased access to drugs has made our youth vulnerable to the usage of drugs. Recently, young people have become increasingly interested in drug use, and drug mafias have specifically targeted students, and drug use has spread across many higher education institutions in Pakistan [8,9].

Situation of drug use in universities of Pakistan

According to the 2017 nationwide census figures, Pakistan has a population of 207.7 million people, making it the sixth most populated state, with over 30 percent of the population aged 15 to 29. As a result, Pakistan's higher educational institutions have a key role to play in lowering the growing rates of drug usage among the young. Recent studies have indicated a worrisome increase in drug addiction among Pakistani students enrolled in higher education institutions. As a result of these findings, drug use at Pakistani universities has emerged as a serious societal concern for the country, which also happens to have one of the world's largest young populations. Every year, half a million people are added to Pakistan's drug addict list, with most of them aged 18 to 25. According to survey results, one out of every 10 university students in Pakistan uses drugs. The literature indicates that drug use is on the rise at universities, but a lack of reliable statistics makes determining the extent to which this plague has infiltrated these institutions difficult. Measuring the prevalence of drugs is crucial. As a result, the current study is critical since it will provide an accurate picture of drug consumption patterns in Pakistani educational institutions [10,11].

Objectives of the study

During this study our primary objectives are:

• To explore the demographic characteristics of drug users in universities.

• To determine the prevalence of drug use within university students of Pakistan.

Selection criteria of the study

This study includes only those participants who fulfilled the following criteria:

Inclusion criteria students were included in the study if they have:

• Students enrolled in university

• Both Male and Female gender

Exclusion criteria students were excluded from the study if they have:

• Persons not students

• Students other than target universities

Material and Methods

The study used a survey method to collect data, and the data were analyzed descriptively. Following procedural steps were adopted to accomplish the goal. Population of the study since the study was confined to Islamabad; only universities with campuses in the city were considered. The study was also limited to federally chartered universities with campuses in Islamabad, so federally chartered universities with campuses in Islamabad are given first preference. Islamabad has a total of 23 federally chartered universities. There are 16 public universities and 7 private universities among them. Target universities of the study were selected based on HEC University’s category wise ranking (Table 1) [12-16].

Sampling techniques

Researchers used stratified random sampling to recruit students from targeted universities that have certain inclusion criteria. The sample from every stratum was selected randomly [17,18] According to Gay (2009) “stratified random sampling is a way to guarantee desired representation of the relevant subgroup within the sample”. As a result, each university was treated as strata, and students were drawn from each stratum as a sample (Table 2).

Instruments: For data collection, questionnaires were developed after studying the relevant literature. Refer to a questionnaire as a valuable tool for gathering data and views from persons who are knowledgeable about the problem. The questionnaire consisted of 7 questions to determine the prevalence of drug use among university students. These questions were adapted from World Health Organization (WHO) methodology for student drug-use surveys (WHO 1980: 37-43). The questions were targeted at finding if they have used any drugs in their lifetime or within the past 12 months, the frequency with which they take drugs, the frequent product they use, mode of administering the drugs, and who first exposed them to drug usage. Liker’s method of summated rating scale was used. The respondent was provided with three options: “Agree”, “Neutral” and “Disagree” and they were asked to respond to the existing statements using any of these three responses. Main seven questions are inquired to determine prevalence rates of drug use. Researcher decided on a descriptive research strategy and designed a questionnaire survey to analyze the factors that could help in combatting drug use within universities of Pakistan [19-24].

Results

Table 3 shows that out of the sample size of 546, 490 students responded positively and returned the duly filled-out questionnaires.

Demographic characteristics of respondents

The university students’ demographic and responses to a structured questionnaire are presented here. Information regarding demographic characteristics of respondents in terms of age, gender, and family income, level of education, their family background, and living status is analyzed and presented in the following Table 4.

Results based on responses regarding prevalence

In this section, responses of students on questions regarding the prevalence of drugs are analyzed. Seven tables below are presented showing the responses of students. The tables present a comprehensive, quantitative analytical framework of prevalence rates of drug use within students belonging to federally chartered universities of Islamabad. The below table presents responses in the form of frequency and percentage (Tables 5-11) [25].

Discussion

According to the findings of this study, the prevalence of drug use on university campuses is rather high, with almost the same number of girls and boys abusing drugs, with hostelite being more involved in this scourge than day scholars. Students receiving unchecked financial support from the family were found to be more inclined into using drugs compared to the ones having financial constraints.

Conclusion

The results of findings from the student’s responses on seven questions related to prevalence of drug use have revealed that a significant proportion of students have been indulged into drug use.

Following were the major conclusions of the said study:

• Results revealed that a very significant proportion of students were habitual of taking drugs as 68% of students claimed that they take drugs often or sometimes while 41% were consuming within past 12 months and some were taking drugs every day. Therefore, it was clear that the prevalence of drug use within university campuses was high. The results were like the claims of with high rates of on-campus drug users in universities of Pakistan.

• It was evident from students’ responses that many of them fall prey to drugs during their transitional period of life while entering university from college as a very significant proportion of students reported their age of onset was 18-19 years. As the probability of becoming a drug addict is higher in the periods of transition from teenage to adulthood, because it’s considered a time of major physical changes and exploration most students claimed that they started using drugs after getting enrolled in the university. These findings also guarantee that the youngsters have easy access to the drugs which makes the situation worse.

• It was established from students’ responses that cannabis was the most consumed type of drug, and a very large majority of students were found to be addicted to cannabis. Opioid was found to be second to cannabis frequent use.

• Smoking was found to be the most common way for administering drugs in students, second to smoking was sniffing as 60% of respondents claimed that they use these two ways frequently for taking drugs. The increased use of smoking for drug administration is a critical public health problem because it can affect the physical and mental well-being of young people.

• It was established from student’s responses that seniors/ peers or friends were one of the main reasons behind their exposure to drugs as 74% of students claimed that they were exposed to drugs either because of their friends or peers/seniors.

Recommendations

The conclusions lead to the following recommendations:

• Prevalence rates need to be controlled by imparting health education and strictly enforcing legal restrictions. The university's code of conduct should also be strictly enforced so that students' easy access to narcotics can be limited. Strict management and oversight of the university's drug-use policies should be maintained

• Students' views about drug addiction must be modified by teaching them the long-term implications of drug use and providing them with healthy relaxation choices.

• Life skill training should be imparted to students so that they would be able to cope with stressful situations. Students must be taught that dedication on their part is required to remain substance-free.

• Active student participation in health education is also required through the establishment of anti-substance groups and student associations. Officials at the institution should also strengthen and support current student clubs and associations, as well as closely monitor their activities.

• Family members must be involved in the effort to prevent and control substance usage among students. Peer pressure can also be mitigated by health education and population decrease.

• There is a need to introduce recreational options for students in university so that students can get many alternate ways for refreshment instead of leaning towards drug use. Healthy and recreational activities for students at university campuses need to be introduced.

• There is a need to coordinate and harmonize the efforts by all stakeholders on controlling rates of drug abuse among students as it is imperative to gain synergistic results.

• According to the study's findings, Pakistan does not have a strong policy against drug misuse, or there is a lack of execution of current rules, which causes a gap in society, in general, allowing young, particularly university students, to become readily involved in drug usage. As a result, the relevant authorities should take sufficient efforts toward developing policies at the national level.

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