Drugs are highly addictive and lead to physiological and psychological changes in the body. Addicts feel the need to get high during periods of low emotions.

A Little High, A Little Low - A Cautionary Tale

Introduction

We live in a hyperactive society, where we can get things done at our fingertips. That feeling of accomplishment can give you a dopamine rush. But, what happens when that feeling is taken away from you? You start finding other ways to satisfy your brain&rsquo;s hunger for that happiness and satisfaction. In many cases, people adopt hobbies to keep themselves busy. But in some cases, things may take a darker turn, making people resort to drugs. 
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In a fast-paced society, everyone is trying to get things done at their earliest. Exhausted from screens, work and education, we often find ourselves looking for a break. For some people blowing off steam could be as simple as going on a trip, but for others, it may mean going on a mental trip.

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For most of us using drugs seems like a simple question i.e. you can choose to do it or not do it. However, the case is very different for people who find drugs as their way of escape. The frustration mentioned above is just the tip of the iceberg. Societies across the globe are facing a myriad of issues. Cancel culture is rampant, as is creating and promoting superficial lifestyles on social media; the quest to be the best is no longer an option but rather a necessity, leading to increased frustration, hopelessness and <a href="https://merisehat.pk/disease/depression">depression</a>. These frustrations are further augmented in socially-closeted countries where men are met with hate when they express any emotions, while women deal with multiple unexplainable stigmas. This causes people to shut themselves in their own minds.&nbsp; 
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Drug abuse is becoming a growing concern in Pakistan, and is affecting all social classes. Various existing stigmas hinder people from seeking professional help for their mental health which contributes to pent-up frustrations, traumas, or experiences.&nbsp; 
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Hence, drugs provide a way for people to escape their harsh reality, experience a rush of happy chemicals, or numb themselves. In many cases of drug abuse, people are often victims of abuse, rape or some sort of traumatic experience. While this does not justify drug abuse, it identifies a crucial problem &ndash; the need for increasing mental health awareness in Pakistan.

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Understanding The Dangers of Drug Abuse

Pakistan&rsquo;s greatest tragic loss has been its youth to drugs in the early 90s. In 1989, heroin use became very common in Pakistan and Afghanistan<a href="#accordion">[1]</a>. However, the strict regulations imposed since then have aided in gaining good control over the situation<a href="#accordion">[2]</a>.&nbsp; 
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Some commonly abused drugs in Pakistan include:&nbsp; 
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Hashish: Hash, also known as chars, is by far the most commonly consumed drug by all classes of Pakistan.&nbsp;

Hash is a potent form of marijuana and is known to form several long-term and short-term side effects. These include: 
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<ul>
	<li>Lightheadedness&nbsp;</li>
	<li>Learning difficulties</li>
	<li>Difficulty in thinking, problem-solving and registering senses</li>
	<li>Paranoia</li>
	<li>Headaches</li>
	<li>Anxiety&nbsp;</li>
	<li>Panic attacks</li>
	<li>Respiratory issues involving bronchitis, pneumonia and lung cancer</li>
	<li>Cardiac arrhythmias&nbsp; 
	&nbsp;</li>
</ul>

Edibles: These are normal foods infused with drugs of any kind. In most cases, the drug is marijuana. Edibles are very common among the younger generation, often consumed as a recreational activity. However, edibles give a much stronger and heightened effect of the drug, and run a massive risk of overdosing<a href="#accordion">[3]</a>. The side effects of edible consumption include: 
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<ul>
	<li>Severe anxiety and panic attacks</li>
	<li>Excessive drowsiness</li>
	<li>Hallucinations</li>
	<li>Vomiting</li>
	<li>Paranoia</li>
	<li>Psychotic episodes</li>
	<li>Respiratory depression</li>
	<li>Agitation</li>
	<li>Impaired motor ability</li>
	<li>Psychosis 
	&nbsp;</li>
</ul>

Heroin: Most commonly used by the homeless, or people belonging to the lower class. Due to its extreme affordability, heroin is one of the most addictive drugs in the world. The opioid drug is made from morphine, and is often injected for maximum bioavailability. It is believed that even a single dose of heroin can get you addicted due to its high analgesic effects<a href="#accordion">[4]</a>.&nbsp;The side effects of heroin include: 
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<ul>
	<li>Insomnia</li>
	<li>Collapsed veins&nbsp;</li>
	<li>Damaged tissues</li>
	<li>Infection of heart valves and lining</li>
	<li>Abscesses</li>
	<li>Sexual dysfunction</li>
	<li>Depression and antisocial personality disorder</li>
	<li>Pneumonia</li>
	<li>Constipation and stomach cramps 
	&nbsp;</li>
</ul>

Psilocybin Mushrooms: Commonly known as magic mushrooms or shrooms, they are most commonly consumed in Karachi. The drug gives you a euphoric feeling, while making you hallucinate. So far, they are not considered addictive, but can cause permanent damage to the brain<a href="#accordion">[5]</a>. The long-term side effects may include: 
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<ul>
	<li>Change in personality</li>
	<li>Hallucinations</li>
	<li>Tolerance requiring the user to consume more every time</li>
	<li>Hallucinogen Persisting Perception Disorder (HPPD) also referred to as &lsquo;flashbacks&rsquo; 
	&nbsp;</li>
</ul>

Dipping tobacco: Also known as moist snuff, it is called &lsquo;naswar&rsquo; in Pakistan. Commonly used in KPK, this is grounded moist tobacco that is not for smoking purposes. It is administered by taking a small chunk out and stuffing it in a corner of your mouth<a href="#accordion">[5]</a>. Tobacco use, in general, has many side effects including: 
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<ul>
	<li>Oxidative stress</li>
	<li>Cardiovascular diseases</li>
	<li>Dyslipidemia</li>
	<li>High cholesterol 
	&nbsp;</li>
</ul>

Conclusion

Drug addiction is not a battle fought by individuals, but by societies as a whole. Drug addiction in general is deep-rooted by societal flaws.&nbsp;

Instead of shaming drug addicts or people who have been finding solace in substances, we need to create avenues for their rehabilitation.&nbsp;

Our primary responsibility in this war is to create dialogues, be more vocal about our thoughts and experiences, and help others cope with their issues in the healthiest way possible.

We as a society need to normalize discussing and seeking help for mental health and addictions issues.&nbsp; Alongside investing in avenues which allows for effective rehabilitation and re-integration of recovered addicts in society.&nbsp;

Our society needs to create more dialogue and awareness regarding drug use, along with providing better solutions for people to release their pent-up frustrations.

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Key Points

<ul><li>Pakistan has been battling street drugs and substance abuse for ages.</li><li>The most common types of drugs consumed in Pakistan include hashish, edibles of marijuana, heroin, naswar, and psilocybin mushrooms.</li><li>The solution lies in normalizing discussing and seeking help for mental health and addictions issues, alongside creating more dialogue and awareness regarding drug use.&nbsp;</li></ul>

[1].Haq, I., 1996. Pak-Afghan Drug Trade in Historical Perspective. Asian Survey, 36(10), pp. 945-963

[2].Gossop, M., 1989. The detoxification of high-dose heroin addicts in Pakistan. Drug Alcohol Depend, 2(1), pp. 43-50.

[3].Rehab After Work, 2020. The Dangers of Marijuana Edibles.

[4].National Institute on Drug Abuse, n.d. Heroin Drug Facts.

[5].Drug Policy Alliance, n.d. What are the long-term health impacts of psilocybin mushrooms?

[6].Faiza Sajid, S. B., 2015. Effects of smokeless dipping tobacco (Naswar) consumption on antioxidant enzymes and lipid profile in its users. Pak J Pharm Sci, 5(18), pp. 29-33.

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