Written by Dr. Shahid Athar   

In Pakistan the first known case of heroin addiction was recorded in 1980. In 198 1, there were only 25 cases recorded. By 1986 there were half a million cases. Now it is estimated that there are between 1-1.5 million cases in a population of 95 million. The rate of growth of narcotic addiction in Pakistan is higher then that of the USA. In addition to heroin addicts, there are about I million opium and hashish users, and 300,000 tranquilizer abusers. The actual number of alcoholics is difficult to determine, since they usually do not 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 million alcoholics, 2 million heroin addicts, 5.5 million cocaine users, 6 million tranquilizer abusers and 18 million marijuana smokers. There are 700 treatment centers. (There are 10,000 cocaine kids (children bom 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 $1 10 billion industry. The value of cocaine seized at the borders in 1985 was $70 million (5 million in 198 1) 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 artests were made for drug violations (compared to 400,000 in 1973). Of the 523,000 inmates in U.S. prisons, one-third admitted drinking alcohol before committing the felony.

Of the 50,000 auto accident deaths annually, 23,000 are related to acute alcoholism, 5,000 being teenagers. About 1,500,000 arrests made annually for traffic violation are related to alcoholism. In addition great man made disasters have taken place due to one man's alcohol indulgence: the Captain of the Exxon tanker in Alaska. No wonder, the ethics committee in the US Congress was so careful in choosing the Defense Secretary. One-third of all 200,000 AIDS cases occur 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 bom to mothers with drug abuse or mothers whose partners were drug abusers. 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 angel dust (PCP), speed, MDMA (ecstasy), 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 Tetrahedra Cannabinol is the most active ingredient. Marijuana impairs memory, concentration and reading capacity. It increases anxiety, apprehension and fear. It damages the heart and the lungs. It lowers testosterone (male hormone) and sperm count and affects the outcome of pregnancy. It is more carcinogenic than cigarettes.


A potent brain stimulant cocaine was initially thought to be harmless. It was thus added to the soft drink (coke) in the 1900s. When given intravenously, it produces intensely high and intensely low (depression), hallucinations, convulsions, cardiac arrest and death.


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


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


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



LSD is a powerful hallucinogen. can cause psychotic reaction and mental breakdown.



MDMA (ecstasy) is LSD and cocaine. It causes disorientation initially but leads to permanent brain damage. China White is 1,000 times more potent than heroin. MPTP causes Parkinson's Disease (brain damage).


Alcohol damages all organs of the body in due course. It damages the liver (cirrhosis), the heart (cardiomyopathy), sex hormones and the immune system, and causes stomach bleeding (ulcer). 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. It is responsible for violence, homicide, suicide and drunk-driving which takes most lives.


Instead of writing at length the problems of drugs and alcohol in the youth of America, which cost the nation billions of dollars, and cost mothers their sons and daughters (MADD), I think it will be better if I print an autobiography of one of my patients (19 year 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 parents' 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. My 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 (produced) frightening images. But I could not do anything but lie in bed, waiting for the drug to wear off. I did not 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 that school year). But, I guess the stage was set 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 Shariah or Islamic Law seeks to protect 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 pathway and remove the restraint. Ability to make a judgment, to protect the body or honor, a quality for humans, is lost under the influence of drugs.

There are two main features of Islamic prohibitions.
Islam stops the wrong at the inception and not at the end. There is nothing like a safe drinking age or safe drugs to get high on. Most of the teenage alcoholics do not buy alcohol from the store but get it at home. Islamic law makes no distinction between children and parents. Total prohibition (or total abstinence), is required of all unlike the prevalent practice in Western society. This duality of standards (or double standard of judgment) has crippled Western societies in their ability to deal with the problems of drugs and alcohol.

Islam blocks all the avenues to wrong. Therefore not only is illicit sex prohibited, but the casual free mixing of sexes, obscenity and pomography is prohibited. In the same context, not only is drinking wine prohibited, but making it, serving it, selling it, keeping it, or even growing grapes for the sole purpose of selling it to a winery for making wine is prohibited by the Prophet. Some 1400 years ago, God, our Creator and Sustainer, Who cares for us, sent down following revelation in the following order, mentioned in the Quran, "They ask you concerning wine and gambling. Say: 'In them there is a great sin, and some profit, for men, but sin is greater than the profit... (2:219). "O you who believe! Approach not prayers, with a mind befogged, until you can understand all that you say" (4:43). "O you who believe! Intoxicants and gambling, (dedication of) stones, and (divination by) arrows, are an abomination of Satan's handiwork: Avoid such (abomination) that you may prosper" (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 God and from prayer Will you not then give up" (5:93).

The above verses were received over a period time. Muslim society was gradually prepared psychologically for the final prohibition so that when the last verse was received, they accepted it without any reluctance. When the prohibition was announced it had an electric effect. Anyone who happened to be drinking, threw away the glass and the cups raised to the lips were dashed to the ground. The streets of Madinah that day flowed with wine!


  • * "Every intoxicant is khamr, and every khamr is unlawful" (Reported by Muslim).
  • * "Of that which intoxicates if taken in large amounts, a small amount is (also) haram" (Ahmad, Abu-Dawaud and Al-Timidhi).
  • * "Intoxicants are the mother of all evils" (reported in Bukhari).


There are no easy solutions. In fact it is a multifaceted 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 the 1920s), it is difficult to achieve unless strict laws are made and enforced against drug producers, traffickers and offenders, without making any 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 safeguard peace, morality and health of individuals and society. While we are trying to do these, in the meantime, we should pay more attention to the needs of the victim by educating the masses, social workers, law enforcement agencies and physicians, while at the same time developing treatment and rehab centers to cope with ever increasing human sufferings, and to help some young men, women, sons, daughters, husbands and fathers from being lost forever. 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 be unable to look after himself, his family and serve his creator in the best possible manner.


      Declaration made this - day of                      , 19____   I, of sound mind,
willfully and voluntarily make known my desires that my dying shall not be
artificially prolonged under the circumstances set forth below, and I declare:
If at any time I have an incurable injury, disease or illness certified in
writing to be a tem-tinal condition by my attending physician, and my attending
physician has determined that my death will occur within a short period of time,
and the use of life-prolonging procedures would serve only to artificially prolong
the dying process, I direct that such procedures be withheld or withdrawn, and
that I be permitted to die naturally with only the provision of appropriate
nutrition and hydration and the administration of medication and the performances of
any medical procedure necessary to provide me with comfort care or to alleviate
In the absence of my ability to give direction regarding the use of
life-prolonging procedures, it is my intention that this declaration be honored by my
family and physician as the final expression of my legal right to refuse medical
or surgical treatment and accept the consequences of the refusal.
who is not a beneficiary of my will, is my case manager, if I am not able to give
direction. I do not pemiit autopsy of my body unless my death occurred in a
suspicious manner and is required by the court of law.

Signature Address

The declarant has been personally known to me and I believe (hinvher) to
be of sound niind. I did not sign the declarant's signature above for or at the
direction of the declarant. I am not a parent, spouse, or child of the declarant. I
am not entitled to any part of declarant's estate or directly financially responsi-
ble for the declarant's medical care. I am competent and at least eighteen (18)
years old.

Witness Date
Witness: Date