In Pakistan the first known case of heroin addiction was recorded in 1980. In 1981, there were only 25 cases recorded. By 1986 there were half a million cases. Now it is estimated the Lhercarebetween 1-1.5 million cases in a population of 95 million. The rate of growth of narcotic addiction in Pakistan is higher than that of USA. In addition to heroin addicts, there are about 1 million opium and hashish users, and 300,000 tranquillizer abusers. The actual number of alcoholics is difficult to determine, since they usually don't seek treatment. There are only 26 rehabilitation centers and 10,000 trained social workers.

By comparison, in the USA with a population of 220 million, there are 15 milllion alcoholics, 2 million heroin addicts, 5.5 million cocaine users, 6 million tranquilizer abusers and 18 million regularly use marijuana. There are 700 treatment centers. There are 10,000 kids (children born to cocaine mothers).

The cost of drug treatment to the nation (USA) is $117 billion per year. In 1986 congress allotted only $2.5 billion to control drug traffic, a $110 billion industry. The value of cocaine seized at the borders in 1985 was $70 million (5 million in 1981) and marijuana $70 million (2 million in 1981). Next to Columbia, the USA is the second biggest producer of marijuana.

In addition to morbidity, the alcohol and drug scene is closely connected to the crime rate. In 1985 alone 800,000 arrests were made for drug violations (compared to 400,000 in 1973). Of the 523,000 inmates in the U.S. prisons, one-third admitted drinking alcohol before committing the felony. Of the 50,000 auto accidents deaths annually, 23,000 are related to acute alcoholism, 5,000 being teenagers. In addition about 1500,000 arrests occur annually in traffic violation due to alcoholism. In addition great man made disasters have taken place due to one man's alcohol indulgence i.e. the captain of the Exxon tanker in Alaska. No wonder, the ethics committee in US congress was so careful in choosing the Defence Secretary. One third of all 75,000 AIDS cases are occurring in IV drug abusers or their partners. 54%,of drug related AIDS are in heterosexual men, 16% in women, 20% in homosexual men, 8% in partners of drug users and 3% in children born to mothers with drug abuse or whose partner was drug abuser. The alcohol and drug abuse in children as young as 5 is increasing at an alarming rate.

In addition to alcohol, marijuana, heroin and cocaine, the other drugs abused are an angel dust (PCP), speed, MDMA (estacy), china white, MPTP, tranquilizers and anabolic steroids. Let us discuss some of the medical aspects of these drugs in brief.

Marijuana: Has 400 known chemicals, 61 of them affect the brain, the THC or delta 9 Tetrahydro Cannabinol is the most active ingredient. Marijuana impairs memory, concentration and reading capacity. Increases anxiety, apprehension and fear. It damages heart and lung. It lowers testosterone (male hormone) and sperm count and affects the outcome of pregnancy. It is more carcinogenic than cigarettes.

Cocaine: A potent brain stimulant, was initially thought to be harmless, thus added to the soft drink (coke) in 1900. When given intravenously, it produces intense high and intense low (depression), hallucination, convulsion, cardiac arrest and death.

Heroin: (Opium) morphine derivative. Usually injected by needle, but can be snorted or smoked. It is highly addictive with intensely withdrawal. Overdose results in death.

Amphetamines: Are "pep pills" to fight fatigue and stay awake, suppress appetite, and stimulates heart and central nervous system. Dangerous in large doses and can cause psychological addiction.

Barbiturates: Are used to overcome intense high and produce sleep. It can be fatal when used with alcohol.

LSD (Acid): It is a powerful hallucinogen, can cause psychotic reaction and mental breakdown.

New Drugs: MDMA (estacy) is LSD + Cocaine, causes disorientation initially but leads to permanent brain damage. China White is 1,000 times more potent than heroin. MPTP causes Parkinsonism (brain damage).

Alcohol: Alcohol damages all organs of the body in due course. It damages liver (cirrhosis), causes stomach bleeding (ulcer), heart (cardiomyopathy), sex hormones and the immune system. Its effect on the brain can be acute (intoxication, delirium) or chronic (ataxia, memory loss, coordination). It is linked to breast cancer and fetal damage in women. But it is violence, homicide, suicide and drunk driving which takes most lives.

Prorile of An Alcoholic And Drug Abuser:
Instead of writing at length the problems of drugs and alcohol in youths of America, which cost the nation billions of dollars, and cost mothers their sons and dauqhters (MADD), I think it will be bette if I print an autobiography of one of my patients (19 years old, white female, upper class, name withheld). She writes ...

"When I was in high school, my friends and I began to experiment with marijuana. After the excitement of smoking pot became "old hat", we began to try different drugs - such as hash and THC. Pretty soon cocaine and LSD were introduced to us and it was common place to go to any party "high" on one or more of these drugs. Several times, I had very frightening experiences. Specifically one night, after taking LSD I went home (to my parent's home) before my"high" was over. Usually, I stayed overnight with a friend who "tripped" with me. On this night, my boyfriend and I broke up right after I took the LSD, so I went home alone. Mv parents were asleep in the next room and I felt that I had to be very quiet, so as not to wake them. I was afraid to make any noise , plus I was upset over the breakup of my relationship with my boyfriend. When the LSD took effect, I was very frightened. The walls looked as though they were melting: I heard strange noises; I hallucinated, even after closing my eyes. The sights were very unpleasant and frightening images. But l couldn't do anything but lie in bed, waiting for the drug to wear off. I didn't think I could tell my parents, since I knew I had taken an illegal and dangerous drug- I was awake nearly all night, scared to death with no one to talk to. For days after this incident, I was nervous and jumpy and depressed. The incident was a major shock to my system and one that I would never want to repeat.

I stopped taking "drugs" immediately after my senior year in high school- (I had only discovered drugs at the beginning of the school year). But, I guess the stage was set off for my future reactions. Drugs did not help- they were just for fun at first - but then once the "high" was gone, there was a real "let down" feeling that followed. So we'd either do more drugs or drink a few beers to make that feeling go away. Even now, whenever I get down or "stressed out"- the first thing I do is have a few drinks. The day after is always unpleasant if I have had too many drinks - so the opportunity for a vicious cycle is there. I honestly believe that the "harmless" experiments with marijuana, several years ago, may have been the start of this tendency to turn to alcohol today. The bottom line is, I'd be a hundred times better off today - happier and wealthier if drugs had never entered my life years ago.

The Islamic Perspective:
The objectives of Islamic divine laws are the protection of faith (belief in one God), life ( abortion. suicide, homicide), property (ownership) and the mind (intoxicants). Normally in the brain there is an inhibitory control which tells us not to engage in shameful or wrongful acts. Any suppressant drug including alcohol will suppress this nerve pathways and take away such restraint. Ability to make a judgement, to protect the body or honor, a quality for humans is taken away under the influence of drugs.

There are two main features of Islamic prohibitions:
a) lslam stops the wrong at the inception and not at the end. There is nothing like safe drinking age, or safe drugs to get high. Most of the teenage alcoholics don't buy the alcohol from the store but get it at home. Islam makes equal laws for both children and parents by prohibiting completely (total abstinence), but the West does not. It is for this reason, the West has been crippled to handle the problem of drugs and alcohol, because it has made duel standards.

b) Islam blocks all the avenues to the wrong. Therefore not only illicit sex is prohibited, but casual mixing of sexes freely is prohibited, but obscenity and pornography is prohibited, and in the same context, not only drinking wine is prohibited, but making it , selling it, keeping it, or even growing grapes for the sole purpose of selling it to winery for making wine is prohibited by the Prophet (PBUH). Some 1400 years ago, Allah(swt), our creator and sustainer, who cares for us, sent down following revelation in the following order, mentioned in Quran.

Al Baqarah 2:219: "They ask you concerning wine and gambling." Say: "In them there is great sin, and some profit, for men, but sin is greater than the profit."

Al-Nisa 4:43: "O you who believe! Approach not prayers, with a mind befogged, until you can understand all that you say."

Al-Ma'idah 5:93: "O you who believe! Intoxicants and gambling, (dedication of) stones, and (divinations by) arrows, are an abomination of Satan's handiwork: Avoid such (abomination) that you may prosper."

Al-Ma'idah 5:93: "Satan's plan is to sow enmity and hatred among you with intoxicants and gambling, and to hinder you from the remembrance of Allah and from prayer. Will you not then give up."

The above verses came over period of years and when the last verse came, Muslims threw away all the wine into the streets and stopped completely in whatever state they were in, and streets of Medina were flowing with wine.

Sayings of Prophet Mohammed (PBUH) and about wine and other intoxicants.

1. "Every intoxicant is khamr, and every khamr is haram (unlawful)- reported by Muslim.

2. "Of that which intoxicates in a large amount, a small amount is haram" (Ahmad, Abu-Daud and Al-Tirrnizi,).

3. "Khamar (intoxicants) is the mother of all evils". Reported in Bukhari.

The solutions: There are no easy solutions. In fact it is a multifactorial problem and each aspect should be addressed individually, and seriously, both by the government and by the public. While the total ban on production, import and export is the ideal solution to create a drug free society, by experience (i.e. in the USA with total ban on alcohol in 1920's) it is difficult to achieve unless strict laws are made and enforced on drug producers, traffickers and offenders, a law, that sees distinction between the helpless victim and a powerful drug Lord. Our current system punishes the former and spares the latter. Islam offers such tough laws to influence our morality and health. While we are trying to do these, we in the mean time should pay more attention to the needs of the victim by the education of the masses, social workers, law enforcements agencies and the physicians at the same time developing treatment and rehab centers in large scale as human sufferings continues to grow and son, daughters, husbands and fathers are being lost daily. All these require motivation and commitment from all of us. It is beyond the dignity of a human being to become dependent on alcohol and drugs and not be able to serve himself, his family and his creator in the best possible manner.