Programme development of drug abuse control in Baluchistan, Pakistan
Fact-finding mission to Zhob
Production of cannabis resin
Preventive treatment and rehabilitation programmes
Support by the authorities
Author: S. M. H. ZAIDI, S. M. ASHRAF, A. A. AFRIDI
Pages: 23 to 26
Creation Date: 1982/01/01
Regional Director, Pakistan Narcotics Control Board, Quetta, Baluchistan, Pakistan S. M. ASHRAF
Former Deputy Director (Agriculture), Pakistan Narcotics Control Board, Islamabad, Pakistan A. A. AFRIDI
Former Head of the Department of Psychiatry, Bolan Medical College, Quetta, Baluchistan, Pakistan
The drug abuse control programme in Baluchistan is inter-disciplinary and progressive. Its main thrust consists of constant vigilance on border check-points by law enforcement agencies, developing in-patient and out-patient facilities for treatment and rehabilitation of addicted persons, and a preventive education programme using the mass media and students from higher eductional institutions.
The province of Baluchistan is a vast area. It has boundaries with Afghanistan, Iran and all the other provinces of Pakistan, and has approximately 300 miles of coastline on the Arabian Sea. It is the home of the Sulaiman range of mountains, sparsely populated with tribes having affinities with those in Afghan tribal areas and Iranian Baluchistan; smuggling of all types of goods is common.
Cannabis reportedly grows wild in the northern area of Baluchistan. The Government of Pakistan classified the substance as a manufactured drug in the dangerous drugs laws (see the Gazette of Pakistan (extraordinary), dated 29 April 1975). In 1977 the Government initiated fact-finding studies at Qila Saifullah, in the political department of Zhob, with the object of determining the extent of cultivation as well as possible patterns and consequences of addiction to cannabis resin. Zhob is on the main link road of the province and is an important inter-provincial and international route of illicit trafficking.
A fact-finding mission visited Qila Saifullah, which is centrally located between Zhob and Quetta, where cannabis cultivation had first been detected. The local chiefs showed concern and awareness of the problem and were prepared to ensure that no cannabis would be planted in the area in the following year. However, they were reluctant to disclose any information regarding the villages and the history of cannabis cultivation.
The mission also visited the villages of Dera Qassam and Navi, on the main road from Khanowzai and Kafartoi. In a small hamlet known as Kangh Kafartoi, the owner of a field was busy harvesting seven acres of cannabis growing in three different fields. The cultivator said that he had planted cannabis for the first time in order to repay his debts. In another village called Shagi, approximately two acres had already been harvested, and the ashes of burned crops were found in two fields. None of the cultivators or inhabitants of the village were available for questioning, while information concerning the mission's activities had been circulated to adjoining areas so quickly that, during the night, flames from burning plantations could be seen on the deserted hillocks and slopes. The next day the mission proceeded towards Loralai where the main road extended into the sub-mountains. In a village of seven houses with approximately 18 acres planted with orchards and crops, three acres of cannabis were found spread over seven small fields. No-one was present in the village although one and a half acres of crops were being harvested, the rest having been burned a day earlier. During the night, flames were once again seen at various places.
The next day the mission was approached by a delegation of chiefs and asked to stop the operation in the interests of tribal peace.
It is the common practice to plant cannabis in apple orchards so as to enable the farmer to obtain two crops from the same field. Harvesting starts from the middle of October, and only the female plants which form flowers and seeds are gathered (the male plants having been gathered earlier from the fields). After harvesting, the plants are partly dried in the shade and partly in the sun. When the leaves become brittle they are removed from the stem and the flowering and seed-bearing parts of the plant are separated on the threshing floor or on to a large coarse sheet. The produce is rubbed over two grades of cloth or gauze one after the other, starting with the finer, leaving a coarse, powdery residue. Initially, the finest powder is graded as first quality and sells at approximately Rs 400 per kilogram. The second and third quality powders are sold at approximately Rs 250 and Rs 150 per kilogram. Later, these three qualities of powder are used to produce charas, or cannabis resin, which is moulded into rectangular slabs weighing 200 to 250 grams each.
Drug addiction among the people of this region had not been determined previously when a preliminary survey of 50 persons who abused drugs was carried out in 1977 by the Drug Abuse Advisory Centre attached to the Sandeman civil hospital, Quetta, with the support of the Pakistan Narcotics Control Board, Quetta.
Quetta, the capital of Baluchistan, is the largest city of the province and is situated near the borders with Afghanistan and Iran. This enables easy access for the inflow and outflow of illicit drugs.
The population of Quetta varies from 250,000 in the winter to 350,000 in the summer; the inhabitants of the city are predominantly Pashtoons, Baluch, Hazaras and settlers from the other provinces of the country. Five different languages are spoken and the community is divided into five residential areas. A great number of tourists, including foreigners, visit the city in the spring and the summer. Some foreigners carry with them illicit drugs not readily available in the country, such as LSD and amphetamines, to exchange for preparations of cannabis and raw opium. The object of the survey was to determine the ill-effects of the drugs on the individuals concerned.
The Social Welfare Department initially collected a sample of 250 subjects from suspected places of drug abuse located in the city centre. Only 50 of these subjects (45 males, 5 females), were selected for study in the Department of Psychiatry.
The subjects had been taking drugs for between 3 months and 30 years, with an average of 12.6 years. The types of drugs used were opium (46 per cent), cannabis preparations (8 per cent), barbiturates (6 per cent), and Mandrax (4 per cent). Multiple drug users represented 36 per cent of the cases studied. The average expenditure on drugs was Rs 9.60 a day, and the average income was Rs 573 per month. More than half of the subjects were in their teens and gang activities in this group were an influential factor. The tendency was to progress from soft to hard drugs and from single to multiple drug abuse. In contrast, the older age group had become dependent on drugs either following psychiatric illness or physical disability. Efforts were directed towards a consideration of these two age groups.
As far as the younger group was concerned, it was considered to be mainly the responsibility of parents and teachers to keep a vigilant eye on children to detect disturbed behavioural activities; for the older age group, it was recommended that general practitioners very carefully monitor their therapeutic approaches with psychoactive drugs.
When the survey began it was not expected that any female would come forward because of social and religious barriers, but the five females who attended did so of their own accord in response to a television and poster campaign.
There were more marital problems among the addicts than in the control group. The percentage of unmarried persons among the drug abusers was 28 per cent, while in the control group it was 20 per cent; a difference which was not significant. It was also interesting to note a high correlation of marital status to employment. Out of eight unemployed, six were unmarried.
Of the addicts, 36 per cent had lost their jobs because of poor work habits; 28 per cent were working normally and these subjects used drugs in more moderate amounts than those who had a poor work record. The crime rate among addicts (which ranged from offences such as petty theft to homicide) was found to be 20 per cent, compared to 4 per cent in the control group. The test and control groups were drawn from the local urban population of Quetta and were of low or average socio-economic status.
Acute psychotic breakdown provoked by heavy and prolonged use of cannabis preparations was relatively easy to treat; patients responded promptly to therapy with phenothiazine, either alone or combined with electro-convulsive therapy (ECT). The symptoms of acute psychotic breakdown were not usually found among the opium addicts. This might have been because of long use of opiates and might have been part of the personality of the addicts, but this aspect has yet to be confirmed. The opium addicts were treated with tricyclic anti-depressants such as tryptanol, one 75-mg tablet at night, along with a small dose of an anti-psychotic such as largactil, one 25-mg tablet three or four times a day. This treatment, following the ban on opium vendors in the country, was successful in easing the situation. Multiple drug abusers, however, were resistant to any kind of psychiatric help and it was thought that this might have been because of the development of a psychopathic personality.
General awareness of the problems of drug abuse had been created by the media in the province. Press, television and radio had all shown a keen interest in broadcasting news of seizures and of meetings, discussions and seminars and related approaches. These were designed to reduce drug abuse.
In an effort to stem illicit production and to prevent further trafficking in drugs, the Province implemented activities in both prevention and law enforcement. The Pakistan Narcotic Control Board established its regional office in Baluchistan in May 1975. In 1979-1980, approximately 11 tons of opium in seven trucks and one tanker were seized by the Customs, Levies and Frontier Corps, and a spectacular seizure of 250 kg of morphine base of over 70 per cent purity was the largest in the region. These seizures in 1979-1980 indicated an increase in the production of opium in the North West Frontier Province, as well as showing the direction that trafficking took towards Iran.
The Health Department established a drug abuse advisory centre in 1977 in the premises of the Sandeman civil hospital, Quetta, with the active support of the Pakistan Narcotics Control Board. The centre now has an in-patient treatment facility. The Social Welfare Department also embarked upon the construction of a rehabilitation centre, and counselling centres have been established in Baluchistan colleges. Social work students from Baluchistan University have undertaken field work in the Pakistan Narcotics Control Board, Quetta, to:
Assist in the organization of a community campaign seeking to develop community awareness of drug addiction and support for narcotics control;
Help drug addicts make effective use of the medical and psychiatric facilities, by providing them with guidance, counselling, referral and other supportive services;
Assist in conducting surveys and research.
The success of the programme depends on many factors, but most important of all are the efforts of the martial law authorities, the Excise and Taxation Department and the Department of Central Excise and Land Customs, all of which have reinforced their work in narcotics control. In addition, the Pakistan Narcotics Control Board has been actively advising, supervising and co-ordinating the activities of the related departments and agencies, and has provided information designed to create community awareness of the hazards of drug abuse.