abih*, 29, was once quite successful in his career. Now, his friends say he is no longer the man they once knew. A lively, well-dressed, educated and bright professional employed in an international organisation, Sabih has become “unrecognisable” due to deteriorating health, both physical and mental. Having once been a regular gym-going 80 kg weight person, he now weighs only 45 kg. Instead of the two-bedroom posh apartment he used to live in four years ago, he now lives in a filthy room in a shabby locality in Islamabad.

His health took a downturn after he decided to try crystal meth, commonly known as ice, to fit into the city’s party scene. There was no turning back for him. Soon, he started experiencing anxiety, panic and hallucinations due to excessive use of crystal meth. At night, he would complain of snakes and insects crawling all over his body. He became fearful. He would complain constantly that he was being stalked and that someone wanted to kill him. His friends began avoiding him as most of the times they felt he was not in his senses.

“We avoid him; if he insists on visiting us, we keep a safe distance and stay alert because, you never know if he could attack you. Such people need money to buy drugs and for that, they can go to any extent. We try to make sure that he is not carrying any sharp objects when he is with us,” says one of his friends.

Unfortunately, Sabih is not the only one who suffers from addiction to crystal meth, a “fashion drug”. Due to its easy accessibility, the use of this drug among the youth is rising in schools, colleges and universities, even and in some slums.

In a stunning revelation at a seminar in 2018, Hammad Dogar, the then Anti-Narcotics Force director, said that 67 percent of university students in Pakistan were using illicit drugs. The figure was also quoted by former prime minister Imran Khan in an address to the nation.

Though the authenticity of these figures has been contested, the general impression The News on Sunday got from interviewing people is that the accessibility and consumption of the drug is dangerously high among several sections of the society, especially the youth.

A research study, Youth at Risk: An Alarming Issue of Drug Addiction in Academic Institutions in Pakistan, published by Science Direct in November 2020, says that the most common causes of students falling into drug abuse are social and family stress, exam-related anxiety, availability of drugs and peer-pressure.

A research study on the taboo subject of sexualised drug use, The Hidden Crisis, says that the use of sexualised drugs, mainly crystal meth, badly impacts its users with mental illness and sexually transmitted infections (STIs), including the HIV virus.

The study says that recent years have witnessed a steady rise in the use of crystal meth around the world. Pakistan has an important role in this regard both as a key nodal point in its trade – with much of the supply coming in from Afghanistan – and hosting a growing number of consumers.

While talking to TNS, one of the researchers for the study, Shahbaz* says that crystal meth is easily accessible in the market. “Ranging between Rs 400 and Rs 2,000 per gram, the drug is not too expensive for any section of the society.”

Shahbaz says the drug makes a person feel “high” for 48 hours. “During that time, the addict doesn’t sleep or feel hungry. They are not in their senses. There have been cases when some addicts went live online while naked or came out on the street in unacceptable ways,” he says. “Having a simple discussion with them when they are high on drugs can lead to a shocking outcome, even murder. This phase is followed by three to four days of downtime, which the addicts enjoy the most. During this time, the addicts sleep, stay numb, and remain oblivious to what is happening around them.”

Listing red flags for families and friends, he says some of the indicators include excessive weight loss, anxiety, fear, social isolation, irritability and aggression. He says that in many cases, the drug is used as a “fashionable and quick way to lose weight”.

Naila*, an activist from the transgender community, says that the use of crystal meth is very common among the transgender community, especially those engaged in sex work. “Some customers demand that sex workers take ice. In fact, they pay more for those agreeing to this demand as they believe that this enhances the desire in the sex worker.”

She says that to enhance their profits, some suppliers mix alum in the drug. “This is a very dangerous combination. It can kill a user within a few months. We have seen transgender community members getting mad and losing their lives – even committing suicide due to this addiction. We couldn’t do anything as our community members are not even welcomed in health facilities, what to talk about rehabilitation centres.”

The report, The Hidden Crisis: Causes and Consequences of Sexualised Drug Use among Key Populations in Pakistan, says that out of 100 users they spoke to, 70.4 percent said that crystal methamphetamine has negatively impacted their mental health. The report also revealed that 54.1 percent users wanted to stop the addiction. “Only 17 percent wanted to continue it because of the efficiency they believed the drug stimulates,” says the study.

Almost 35 percent of respondents said during the study that they were raped or sexually assaulted after its use. It also revealed that 74 percent of the users suffered poor physical health, including weight loss. It says that the risk of sexual violence and sexually transmitted infections was higher as its use blurs the lines of consent.

Most respondents said that they didn’t have access to psychological support due to the stigma attached to drug use and the transgender community. They said that the service providers at government health facilities were not trained to understand their situation and the rehabilitation process that requires specialised psychological counselling for a long time.

A majority of respondents didn’t even have knowledge of the existence of any support mechanism. “Those who had the information preferred not to approach such a facility because ‘it would be of no use’ and they feared getting caught by law enforcement agencies,” the report mentions.

Experts says that there is no specialised rehabilitation facility available for drug addicts at the government level whereas private facilities are expensive for a majority of addicts. Most of these resemble jails. Most addicts restart taking drugs as soon as they leave the facilities.

Talking to TNS, Malika Zafar, executive director of the Nai Zindagi Drug Rehabilitation Centre, says that in many private facilities, ethical standards are not sustained. “International standards call for voluntary admission of clients – once a client is convinced for rehabilitation. In our country, the family decides and people who use drugs are forcibly admitted to rehab centres. When a person is forcibly admitted in an involuntary rehabilitation centre, the person ends up scarred and goes back to drugs whenever they get a chance.”

Shahbaz says that family and friends play a critical role in identifying and helping people addicted to drugs. “Unfortunately, though, many fail to understand the helplessness of the addict and don’t have the patience to cope with the long rehabilitation.” He stresses the need for a well-thought-out strategy for the rehabilitation of drug users available to all sections of society. He says that the strategy should focus on “reducing harm” instead of “criminalisation” so that those who want to come out of the addiction can approach rehabilitation facilities without the fear of ending up in jail.

*Names have been changed to protect identities

The writer is a reporter for The News International