An estimated 130 tons of illegal drugs is consumed every year in Pakistan. Islamic law forbids all intoxicants. Even so Pakistan has a local tradition of drug use. Several million people are believed to be heavy hashish users. Heroin addiction is a problem thanks in part to record opium harvests in nearby Afghanistan. Opium drinks mixed with milk and almonds are available. There is some debate in Muslims community as to whether the Muslim ban alcohol applies to just alcohol or whether it applies to intoxicants, and includes drugs such as opium, hashish, and marijuana.

Hookahs are popular in Pakistan. Mostly men who use them. Generally they don’t smoke hashish or cannabis in them rather. Usually the pipe contains a couple pieces of charcoal and black tobacco. Cannabis and hashish is widely used by students — something that shocked many parents when they found put about it.

According to the 2013 national survey on "Drug Use in Pakistan", 4.25 million people are considered dependent on substances and require structured treatment for their drug use disorder Survey findings show that cannabis is the most commonly used drug, with around 4 million users nationwide. Around 860,000 people used heroin regularly, approximately 19,000 people reported they had used methamphetamine and nearly 1.6 million people reported misuse of prescription opioids (painkillers) for non-medical use. [Source: United Nations Office on Drugs and Crime]

Cannabis use: percentage of the population aged 15–64: 3.9 percent (compared to 27 percent in Israel, 16.2 percent in the United States and .3 percent in Japan) [Source: World Drug reports of 2011 and 2006 by the United Nations Office on Drugs and Crime (UNODC), Wikipedia Wikipedia ]

Opiates use: percentage of the population aged 15–64: 1.0 percent, 9th out of 130 countries, (compared to 3.31 percent in Iran, 1.04 percent in the United States and .004 percent in Singapore. [Source: World Drug reports of 2011 and 2006 by the United Nations Office on Drugs and Crime (UNODC), Wikipedia Wikipedia ]

Cocaine use: percentage of the population aged 15–64: .01 percent (compared to 2.2 percent in Spain, 2.1 percent in the United States and .0002 percent in Singapore. [Source: World Drug reports of 2011 and 2006 by the United Nations Office on Drugs and Crime (UNODC), Wikipedia Wikipedia ]

Drug use deaths (per 100,000 people): 0.75 (compared to 15.93 in Ukraine and 0.30 in Japan. [Source: World Health Organization, World Life Expectancy ]

“Paan” — a mild stimulant — is widely consumed in Pakistan. It is made of betel nuts and fragrant syrup wrapped in a betel leaf. It comes in variety of tastes and fragrances, Ordinary people often chew it after meals. Habitual users consume it all day long, spit out the red juice and have red-stained teeth

Drug Use in Pakistan

According to a study by Royal Society for Public Health: “In Pakistan, the prevalence of drug addiction is increasing at an alarming rate. However, the risk factors, which are increasing vulnerability towards addiction, remain largely elusive. In this study, 102 male addicted patients admitted to drug rehabilitation centres of the Islamabad/Rawalpindi...were interviewed with the help of a structured questionnaire. [Source: The Royal Society for Public Health, Public Health, January 4, 2019]

“Participants mean age was 28.4 years (±9.8), whereas 14 percent were aged between 15 and 20 years. A large number of respondents (35 percent) initiated drug abuse in the teenage years. Majority of the subjects were skilled (60 percent) and had secondary education (47 percent), whereas 8 percent of the patients were students. Heroin was the most abused substance (48 percent) followed by cannabis (28 percent). The mean duration of substance abuse was between 1 and 5 years, whereas a significant fraction of subjects (8 percent) had more than 16 years of duration of abuse. Family disputes and peer pressure were the most common reasons for initiation of substance abuse. A significant fraction of patients (46 percent) reported to suffer from comorbid depression.

Muhammad Qasim wrote in The News:“Youngsters in Pakistan are the most affected by drugs and alcohol and the number of these addicts is increasing at the rate of 40,000 per year making Pakistan one of the most drug affected countries in the world while the most disturbing fact is that majority of heroin addicts are under the age of 24. According to one survey, one out of every 10 college/university students is a drug addict and almost 50 per cent students of different educational institutions particularly elite schools/colleges in Islamabad/Lahore are addicted to drugs, and majority of these students belong to elite class, having no issue of affordability. [Source: Muhammad Qasim, thenews.compk, June 26, 2018

“Head of Community Medicine at CMH Lahore Medical College Professor Dr. Muhammad Ashraf Chaudhry said the drug abuse jeopardises students’ health, both physically and mentally, because of which they cannot concentrate on their studies. “The widespread availability of drugs in Pakistan is making souls of youth lifeless and it is need of the hour to come up with effective measures to curb this menace.”

“Dr. Ashraf said majority of drug addicts usually start with soft drugs like chhaliya, gutka and pan (all betel nut preparation) , and then move to hard drugs like heroin, opium and cocaine, etc. The purchase of drugs or alcohol by young people is usually through dealers or ‘agents’, who are just a phone call away and their numbers are easily exchanged from one person to another, he said. There are evidences that the contact numbers of drugs dealers and agents are also widely distributed throughout hostels, hotels and other places that are generally hidden from the eyes of law enforcing agencies, he said.

Hashish and Cannabis in Pakistan

Pakistani hashish has a reputation for being cheap and dark green. Better quality black stuff comes from Afghanistan. In the 1970s, hashish was sold in blocks, about the size of two wallets laid end to end, that were often embossed with a golden seal. A half pound of hashish was sold for about US$US20.00 in the Peshawar area. Some tribesmen laced their cigarettes with hashsih and opium. [Source: Mike W. Edwards, January 1977]

Cannabis grows wild throughout much of Pakistan, particularly in the north. Most of the wild plants have low in THC. Better quality plants grow in Afghanistan. The people of what is now Pakistan have been cultivating and using cannabis for centuries. It predates the arrival of Islam and was described in ancient Hindu texts, which discuss its use as a medicine and in sacred rituals. Today, Muslim Sufis regularly smoke hashish and do so when they do their dances and rituals. At sufi festival such as the one at 1,400-year-old Abdullah Shah Gazi Shrine, hashish smoke permeates the air. Cannabis is important to Sufis. They believe that it provides deep relaxation and awakens the mind. Not all Pakistani Muslims share this view. Sufi shrines have been attacked by Taliban-linked and Islamic State militants. [Source: Sensi Seeds, June 16, 2020]

In the 1960s and 1970s, Pakistan was a stop on ‘hippy’ traveler trail. Peshawar was famous for it hashish markets and cannabis was not illegal until the 1980s when the Pakistani leader at that time, General Zia ul Haq, is said to have bowed to U.S. pressure during President Ronald Reagan’s global ‘war on drugs’. Some local people smoke with a chillum. Cannabis is also a yoghurt-like drink called bhang.

Cannabis possession is illegal in Pakistan but for the most part the Pakistani police look the other way to use by casual smokers. Recreational cannabis use is relatively common, especially among students and in the tribal areas of the northwest. Hashish is easily available and widely consumed in Pakistan’s largely lawless northern tribal region. The enforcement of the law varies considerably from region to region. In some parts of the north-west there are large cannabis plantations and hashish is sold openly. In other parts of the country, say, the capital Islamabad, laws may be more strictly applied.

According to Sensi Seeds: “If found selling 100 grams or less of cannabis, you could be sentenced to up to two years in prison. You may also be given a fine. If the amount of cannabis is between 100 grams and a kilogram, the prison sentence increases to seven years (with a fine too). If you’re caught selling over a kilogram, then you run the risk of being imprisoned for life or given the death penalty. Additionally, you may be fined up to one million rupees.”

Hashish and Production

Cannabis and hashish production is widespread and Pakistan is one of the largest cannabis producers in the world. According to Sensi Seeds: “ Most of Pakistan’s cannabis is grown in the north-west of the country, in the federally administered Tribal Areas. This fertile, hilly terrain is ideal for both cultivating cannabis and opium poppy. Tirah Valley (in the Khyber Agency region) is famous for its large cannabis fields and harvest yields. With its warm climate and rainfall most evenings, the plants thrive, and it’s not uncommon to see them grow as tall as 15 feet high. Jamrud, which is a small town by the Khyber Pass, has around 250 currently-operational cannabis shops. Foreigners are not permitted to enter the tribal areas without armed bodyguards, due to the threat of kidnapping and violence. These regions are also home to some militias (some of whom receive funding from the cannabis industry). [Source: Sensi Seeds, June 16, 2020]

“Many of today’s cannabis strains have roots in the Kush region in Pakistan. This mountainous zone provides optimal conditions for growing potent cannabis; though farmers must harvest it carefully to ensure it maintains its quality. The cannabis grown in this area is distinctive in appearance. It can be purple-grey in color and sometimes grows to an exceptionally tall height.

“There are many methods Pakistani hash producers apply to make their hash products. In most instances, the dried plants are first threshed over a thin woven cloth. This separates the ‘garda’ (dried resin) from the rest of the plant matter. One large-scale commercial method then places the garda in a metal pan with a small amount of water. This is gently heated, and a large stone is used to knead and bond the pollen. Some adulterants, such as ghee or henna, may be added at this stage to increase the weight and the scent.

“Another, more traditional approach places the garda into a goatskin, where it is stored for several months. The subdermal fat of the skin enables the bonding process, turning the garda into a sticky, green-brown mass. Pakistani cannabis farmers claim that leaving the garda in the skin for longer improves the quality of the final product. Notably, in the tribal regions, some cultivators allow the cannabis plants to be covered in snow. This turns the green buds red, and locals believe it produces a more potent hashish.

Pakistan's Black, Sticky Goatskin-Matured Hashish

Not all Pakistani hashish is green, crumbly and lower in quality than Afghan varieties. Abubakar Siddique wrote for Radio Free Europe: “For Noor Muhammad Afridi, dealing in "Awal Namber Garda" is more than just his life's work. By providing the black, sticky hashish that keeps his customers very happy, he's keeping up a long family tradition. Just like his forefathers in the Afridi clan, the 32-year-old from Pakistan's tribal areas along the Pakistan-Afghan border has become a connoisseur of the local delicacy, aged to perfection with a centuries-old technique. "If you put [freshly prepared] hash resin into a goatskin or a sheepskin, it matures into something very good," he says. "It is well-preserved inside the skin, which also adds oil to it." [Source: Abubakar Siddique, Radio Free Europe, June 2, 2012]

“The technique is believed to greatly enhance the hashish's quality and, more importantly for its users, its effect. If the end product makes the cut, it earns the right to join the prize sheepskins hanging from the rafters of Afridi's hash shop in Jamrud, gateway to the Khyber Pass. To obtain Awal Namber Garda, Pashto for "top-grade dust," Afridi must travel from the plains of Jamrud to his clan's ancestral lands in the nearby mountains of Tirah Maidan. There, a moderate climate, red soil, and locals skilled in the craft of cannabis combine to produce what is renowned as the region's best hashish. It is an arduous journey made by way of rides in open pickup trucks and steep hikes, but it can yield huge revenues. Every gram guarantees profit — Afridi can fetch up to US$500 a kilogram for Awal Namber Garda — and, if all goes well, Afridi has plenty to stock his shop.

“The process begins once carefully cultivated marijuana plants have been cut and hung upside down. After they have dried, a thin cloth is used to carefully thresh the plants to collect the glistening, hairlike resin glands protruding from the buds and upper leaves. The residue is crushed into a fine, malleable powder — the main ingredient for making what, for Afridi, is black gold. The next step involves goats and sheep that locals slaughter in celebration of a good cannabis harvest. The longer the hashish is kept inside the skin of a freshly slaughtered animal, the better — three months at least, says Afridi. The process works best during the hot summer months, but direct sunlight must be avoided.

“Shah Mahmud, 55, is the type of farmer who Afridi has watched since childhood tending to cannabis on the tiny terraced fields of the Tirah Maidan. Mahmud says the resin powder is stitched into the skins, which each hold six to 10 kilograms of hashish. Drawing on his experience of decades of hash use, Mahmud claims that when the process is completed, Awal Namber Garda is beyond compare. "Its outstanding quality is that the oil has enhanced its effect," he says. "If it's dry, it loses its effect and smoking it even causes headaches. The [summer] heat is like an enemy of Garda. If you protect it from the heat properly, nothing can harm it."

“While hashish available outside Khyber is often adulterated with henna, chewing gum, or even chemicals, Mahmud maintains that the hashish prepared in the Tirah Maidan is the real deal. "Hashish is not a bad addiction even if you smoke it for 50 or 60 years," he says. "Cigarettes are more dangerous because each one you smoke reduces your age by a minute. Garda doesn't dry out your mind. A charsi (hashish smoker) is always straightforward." Afridi seconds the notion and says that locals use hashish to treat many diseases. He insists that few of his regular customers ever get sick. "Awal Namber Garda is very good," he says. "The second- and third-rate hashish is considered very bad because its effect is similar to your brain being squeezed very hard."

Heroin Use in Pakistan

Pakistan has more heroin users than another country. By some estimates there are 4 million heroin users in Pakistan (more than 2 percent of the population), with more than 1 million in Karachi. If the figures are correct there are as many heroin users in Pakistan are there are Christians. Heroin typically sells for between US$2 and US$5 a gram, a fraction of what it costs in the West, where prices of US$100 or more for less pure heroin are not uncommon. In the early 2000s, Pakistan, Thailand, Iran and China accounted for most of the world's heroin consumption. In these places prices are low and totals sales is probably less than US$10 billion.

Heroin use was virtually unknown in Pakistan before the war in Afghanistan in 1979. Supplies of heroin from Afghanistan dramatically increased in Pakistan after the Aghan War began and prices dropped dramatically. By 1985, there were an estimated 150,000 addicts. In the 1990s, the number of heroin addicts doubled, primarily among teenagers. The Pakistan Narcotics Control Board estimates that although there were no known heroin addicts in Pakistan in 1980, the figure had reached 1.2 million by 1989; there were more than 2 million drug addicts of all types in the country in 1991. This dramatic increase is attributed the ready availability of drugs She returned to broader concerns. Today, around 80 per cent of the global opiates come from Afghanistan. The border between Afghanistan and Pakistan is very porous and its had to keep drugs from coming into Pakistan. [Source: Peter Blood, Library of Congress, 1994 *]

Many people who have only recently started have jobs and dress well. Most users in Pakistan inhale vaporizing heroin with a straw or metal pipette off of a piece of flame-heated aluminum foil, often from a cigarette pack. In the West this is called "chasing the dragon." In Pakistan it is called “panni”. A dose of heroin, known as a token, sells for about US$1, a tenth of the cost on the streets of a U.S. city, but the quality of the cheaper varieties is bad,. It is often cut with barbiturates. [Source: Barry Bearak, New York Times, April 19, 2000]

Heroin users rarely inject heroin and when they do they often die because the better quality varieties aren’t cut like they are the West.. Syringes sell for 10 ten cents but addicts tend to use them over and again until the needle is painfully blunt even though they known about the AIDS risk. Some mix the heroin with lemon juice to make it soluble.

There are still many who shoot up. Describing one addict Barry Bearak wrote in the New York Times, "Mr. Kahn" empties "a tiny bag of heroin into a plastic bottle cap, adding water and heating it on a small flame, drawing the hypnotic broth into a syringe...Mr Khan, 30, and a helpmate search his arms, hands, feet and groin before settling on faint line in his right biceps...The shot was transporting. His head lowered sideways as he if he was laying it on a platter."

Heroin Addicts in Pakistan

Pakistan has more heroin addicts than almost another country and one the highest addiction rates in the world. Drug addiction is behind incidences of poverty for individuals and families and crime. A shift to injecting heroin from smoking or sniffing it was linked with higher incidences of HIV/AIDS. [Source: “Worldmark Encyclopedia of National Economies”, The Gale Group Inc., 2002]

The cheap prices allows almost anyone to become addicts, most of whom are males. Long-term users look like the homeless people they are. They support their habits by begging, shoplifting, working odd jobs, and selling drugs. Describing one addict in Karachi, Bearak wrote, " Jan Sher, 29...lives beneath the girders of a walkway. Dirt is on him like plaster...but he handles a syringe so deftly that it may as well be an extra finger." [Source: Barry Bearak, New York Times, April 19, 2000]

Describing the situation in Karachi in the early 2000s, Bearak wrote, "Addicts are everywhere and nowhere, easy to overlook from a car but impossible to miss on foot. They are huddled together on the sidewalk, under the bridge, behind the truck, against the fence, along the prime begging space beside the shrine." Shop owner near places where addicts hang out are not a happy lot. One told the New York Times, "We have had some of these people beaten, to the point of almost killing. But they get up as if nothing had happened. Beating them is of no use. They will have to die on their own."

Heroin addicts can found sleeping on median strips and near drainage ditches filled with raw sewage. They often hang out in large groups in parks or among piles of rubbish with stray dogs, that the addicts say are hooked. Many started with hashish before graduating to heroin.

Child Heroin Addicts and Scorpion Venom Smokers in Pakistan

Drugs are easily available from places like the Ilyas Goth shantytown, where are large percentage of the residents — including women, children and entre families — are addicts. One mother told the New York Times as she watched her daughter snort heroin through a ballpoint pen, "I did not forced her into addiction. It was her own decision." [Source: Barry Bearak, New York Times, April 19, 2000]

Over 70 percent of the addicts are under 35, including 200,000 children. Many addicts have no illusions about their future. One 14-year-old addict told AFP, "I am a hero chasing heroin for death." He begs from minibuses by reading passages from the Quran. He told AFP, "I earn 150 to 200 rupees (three to four dollars) a day then take the medicine. If I don not take it, then I sweat badly and my body aches. For the last six years, I have been living for this heroin." The boy was introduced to drugs by his father, a former taxi driver and longtime addict. He broke a vow to his dying mother that he would not become an addict and prevent his brothers from becoming addicts.

Many of the child addicts are boys who sleep on the streets and hit tables at roadside restaurants for leftover food. Many started with hashish and graduated to glue and solvents and then heroin. Many hang out in groups with a leader. Some support their habit through prostitution and are exploited by the mafia..

Some junkies in Quetta smoke scorpion venom. One young man told Reuters he dries the stingers on the sun and grinds them and smokes the powder. When asked if he gets high, he said, “Oh yes. When I smoke them the heroin is like nothing to me.” He said he started smoking scorpions after finding lots of scorpions n the place he was getting high with his friends They collected them from underneath stones at ruined buildings.

Drug Enforcement and Treatment in Pakistan

Drug enforcement is the job of the Anti-Narcotics Force, a largely military operation. The police are only nuisance, often only interested in collecting bribes. "You can drop your pants in a police station and shoot up, and no one would care," the addict Jan Sher told the New York Times in 2000. Some policemen are addicts.

The ban on alcohol is often blamed for exacerbating the drug problem. At one time drinking alcohol was quite common. In 1977, drinking was banned. After that many people stopped drinking began taking drugs as a substitute.

Drug treatment facilities were virtually nonexistent in the early 1990s. At that time Karachi only had facilities to treat 500 addicts. One Karachi doctors left a lucrative practice to run a drug treatment he runs with his own money. There were only thirty drug treatment centers in Pakistan in 1991, with a reported cure rate of about 20 percent. [Source: Peter Blood, Library of Congress, 1994 *]

According to the 2013 national survey on "Drug Use in Pakistan", 4.25 million people are considered dependent on substances and require structured treatment for their drug use disorder Around 860,000 people used heroin regularly, approximately 19,000 people reported they had used methamphetamine and nearly 1.6 million people reported misuse of prescription opioids (painkillers) for non-medical use. [Source: United Nations Office on Drugs and Crime]

Treating Drug Addicts in Peshawar

Sharmeen Obaid-Chinoy, the best-known documentary filmmaker in Pakistan, and winner of two Oscars and three Emmys, made a film about heroin addicts in Pakistan. Alexis Okeowo wrote in The New Yorker: “One afternoon, Obaid-Chinoy visited an addiction clinic in Peshawar. Although it was situated in an alley off a busy main road, it was a serene place, with intricately tiled floors and an airy courtyard. In an empty office, she set up an audio recorder to interview a former patient of the clinic, a man in his fifties who now worked as a counsellor. Tall and thin, with a kind face, he told her that he had aspired to be a doctor, until, he said, “on the day of my wedding a friend gave me a cigarette with heroin in it.” As Obaid-Chinoy gently asked questions, he spoke with growing emotion. Every time his colleagues and relatives sent him to rehab, he relapsed. He got into debt, and ended up living on a riverbank with other addicts, fleeing across the water whenever the police showed up; some of his friends had drowned in the periodic raids, he said.” He began to cry. [Source: Alexis Okeowo, The New Yorker, April 9, 2018]

“On the afternoon that Obaid-Chinoy visited the addiction clinic in Peshawar, she joined Parveen Azam Khan, the doctor who opened the center, in 1993, as she travelled to another clinic. Today, she runs several facilities that provide free treatment. Khan, who is seventy-nine, has an elegant bearing and an assured manner of speaking that suggests that she is unaccustomed to being interrupted.

“In the interview with Khan, Obaid-Chinoy needed to elicit a scene that would personalize the issue of drug addiction...People often remain silent about drug use, even when it affects family and friends. This afternoon, Obaid-Chinoy had something particular in mind. She told me that Khan’s two sons had both died mysteriously at the age of twenty-nine, ten years apart. “Dr. Parveen,” Obaid-Chinoy said. “You’ve been doing this for a very long time. Is there anything in any of the clinics, any story, that has a very dramatic arc to it? You know, there was some addiction, recovery, and some sort of resolution.”

“Obaid-Chinoy reminded her of a boy, abandoned by his family because he was H.I.V.-positive, who left the clinic and became a drug dealer. “Oh, yes,” Khan said. “We tried to bring him back into treatment, but he refused. He said, ‘I have no life, anyhow, so, this way, I feel very important, and I’m looking after myself.’ We’re still working on him.”

“Obaid-Chinoy said. “But as somebody who has devoted her life to rehabilitating anyone who has been affected by drugs — this boy came in, he spent time, you tried to reconcile him with his family. Not only did he go back on the streets but he became a drug dealer. How does that make you feel? Does that make you feel a little hopeless?” “The fact that he was H.I.V.-positive made things more complicated,” Khan said, in the tone of a clinician consulting her notes. “But, again, we have so many like this.”

“The car turned onto a street densely edged with trees. In the dappled light, Khan suddenly began to talk about her sons. They were “handsome, brilliant,” she said softly. “My sons had everything in life — they had the best of education.” She was silent for a moment. “You can’t dwell on it, because it’s too painful. This work is the only way I can deal with life.”As we neared the clinic, another question occurred to Obaid-Chinoy. “Do you think that, while you’re saving people, they’re also saving you?” she asked. “You’re so right,” Khan said.

Image Sources: Wikimedia Commons

Text Sources: New York Times, Washington Post, Los Angeles Times, Lonely Planet Guides, Library of Congress, Pakistan Tourism Development Corporation (, Official Gateway to the Government of Pakistan (, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Reuters, Associated Press, AFP, Wikipedia and various books, websites and other publications.

Last updated February 2022

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