Research Study: Factors Causing Cannabis Use

Factors Leading towards cannabis use and what can be done about them: A study carried out in local transport drivers of district Peshawar, Pakistan.

The problem of drug trafficking represents a crippling facet of reality in Pakistan that is affecting 34% of the country’s population in terms of having problems with drug usage, and or abuse. The district of Peshawar, which lies near the Khyber Pass access to Afghanistan, places that region at the centre of trafficking activity that has made illicit drugs readily available to the populace at highly affordable prices due to the proximity of heavy drug activity. Drug use is an international problem, one that increasingly is focusing on Pakistan as a result of it being in the center of the most active drug producing regions in the world. As such, the country has developed a serious internal problem in that its citizens have become swept up in the production, trafficking as well as use of drugs. The preceding are activities that undermine the nation’s economy as the money flows are black market, and one which is costing the country its most valuable resource, is people, who are in ever increasing numbers being wasted as well as suffering from the ravages of drug use, and addiction.

The purpose, and role of government represent a complex issue that in its own right deserves a study onto itself. In the context of the examination thus identified, a summary of this complex relationship shall be put forth as it is an integral aspect of the preceding. Reus-Smit (1999, p. 129) tells us that:

“The moral purpose of the modern state thus entailed a new principle of procedural justice—legislative justice. This principle prescribes two precepts of rule determination: first, that only those subject to the rules have the right to define them and, second, that the rules of society must apply equally to all citizens, in all like cases. Both precepts were enshrined in the French Declaration of the Rights of Man and Citizen, which states that “[l]aw is the expression of the general will; all citizens have the right to concur personally, or through their representatives, in its formation; it must be the same for all, whether it protects or punishes.””

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Rousseau provides further amplification of the purpose of government as he held “…that the laws legislated by the people or their representatives must apply equally to all citizens in all like cases. “Every authentic act of the general will,” he writes, “favors all citizens equally, so that the sovereign, knows only the body of the nation and makes no distinctions between any of those who compose it” (Reus-Smit (1999, p. 130). Schmidtz (1991, p. 10) cites Hume (1978, p. 539) who states:

“…the beauty of the state is not that it results from a collective decision but rather that it makes collective decisions unnecessary. People no longer need to come to an agreement about what is in their collective interest, for magistrates “need consult no body but themselves to form any scheme for the promoting of that interest…. Thus, bridges are built; harbours open’d; ramparts rais’d; canals form’d; fleets equip’d; and armies disciplin’d; every where, by the care o government , which, tho’ compos’d of men subject to all human infirmities, becomes, by one of the finest and most subtle inventions imaginable, a composition, that is, in some measure, exempted from all these infirmities”

The foregoing tells us that government exists to look after, and for our best interests for the collective good. Thus the drug problem represents an issue that is not in the best interests of the people, and is government’s responsibility to confront and resolve. Thus, the reduction of drug use, and the reduction of drug production, and trafficking are priorities that the country needs to address in order to safeguard the future of its citizens, as well as return the country’s economic healths and vitality. This examination shall delve into the forgoing in the context of the “Factors Leading towards cannabis use and what can be done about them: A study carried out in local transport drivers of district Peshawar, Pakistan.”

The problem of drug use is a global phenomenon, one that is especially pervasive in Pakistan. The country’s proximity to Afghanistan, which ranks as one of the top drug producing nations on the globe, coupled with the high drug productive capabilities of Pakistan, and the high poverty levels in the Peshawar region, makes for the perfect breeding grounds for addiction. With in excess of 4 million drug users in Pakistan, representing one of the highest per user percentages internationally, the scope of the problem with respect to production, trafficking, and addiction represent a triple edged sword that few countries are faced with. The foregoing, has been aided by corruption in governmental posts as well as the infiltration of regional tribal leaders who either traffic in, or have interests in this trade, into political positions further complicating the task of control and reduction.

1. Justification for the study

The international initiative to reduce drug user, and availability in all countries, with emphasis on the nations of the United States, European Union member states, and other destination points has been undertaken to lessen the potential exposure to drugs on the part of adolescents, and young adults as well as to reduce crime. The flow of drugs fuels the coffers of organized crime amounting to sums in the billions of euros that is fed by the commission of petty crimes, murders, and other societal acts resulting from addiction, procurement, and supply at all levels in the matrix. The costs in terms of humanity, resources, and suffering are almost incalculable. The reduction of drug flow as well as usage represents a solution that benefits all but those who are reaping huge profits from its movement, and sale.

2. Problem Identification

In equating the problem as well as ramifications of the factors leading toward the use of cannabis, and what actions can be taken to reduce the foregoing, various approaches, and methodologies have been put forth by nations, and international organizations such as the United Nations to address this issue. The two main schools of thought in attempting to resolve this conundrum are the curtailing of supply as a means to limit drug availability along with punitive measures for suppliers and users, and the education of users, and potential users to the dangers of drug use, and providing them with a means to obtain treatment. The foregoing represents the tactics of the two main destination points, the United States, and the member states of the European Union, respectively. These are the external forces acting upon Pakistan in addition to the drug supply passing through the country from Afghanistan as well as the growth, and production of drugs within the country that makes heroin, cocaine and cannabis freely and readily available to the residents of Peshawar. It is one of the main through routes for the distribution of drugs.

The preceding has created an immense problem for the government of Pakistan to implement methods to resolve these issues, and address the needs of its populace in treating as well as stemming drug usage for their own well being.

3. Aim of the dissertation

The aim of this examination is to explore as well as uncover the factors leading to drug usage in the Peshawar district, its effects on the populace, and what steps, methodologies, and procedures can or should be implemented to stem its growth, and effect a reduction that is sustainable.

4. Specific Objectives

The objectives are represented by the following:

1. To identify factors leading to the use of cannabis by local transport drivers in district Peshawar.
2. To identify ways to tackle factors that lead towards cannabis use by local transport drivers.
3. To provide recommendations to deal with the issue of cannabis use by local transport drivers of district Peshawar.

5. Output of the study

This facet of the study is to provide a background of information on the issue that provides an informational basis via which to better understand the forces acting on drug usage in Peshawar from an internal as well as external perspective to reach a recommendation that provides a means to reduce drug usage.

6. Stakeholders/target audience

The stakeholders in this examination are represented by the destination states for the illicit drugs grown, cultivated, and produced in the region that is trafficked as well as the local residents who have been impacted directly by this activity to the point whereby Pakistan has one of the highest percentage rates of drug users in the international community. The concentration of drug activity in Peshawar has thus directly affected its residents, and is taking the future away from an entire generation that is caught in the web of illicit drugs. The target audiences represented by this examination are those parties involved in seeking a means to reduce drug use in the district, on a national as well as international level.

7. Methodology

The methodology to be utilized in this examination shall be based upon secondary sources utilizing a broad cross section of ideas, studies, approaches, and actual drug reduction strategies taken from key countries, and regions internationally. The sources will utilise books, journals, articles, and the Internet to gain as broad a perspective as possible that is limited by the amount of data as well as time constraints. The limitations are a result of the preceding as some potentially enlightening information could possibility be overlooked, and or not obtained as a result of the amount of data available. Research forms the core of this examination as it will provide the information from which specific aspects will be gleaned that relate to the study. Anderson (1998, p. 27) states that.

“Researchis a dynamic activity that travels a long and winding trail from start to finish. It is not a single event, rather, the act of doing research is a process. And like instructional design, evaluation, decision-making and planning, the research cycle has a set of basic elements that interrelate and interact with each other”

He adds that (Anderson, 1998, p. 27):

“All research involves certain common elements such as defining the questions, reviewing the literature, planning the methodology, collecting and analyzing data, and disseminating findings. At first glance, this may seem like a rather logical, straightforward process, but it is not. Research is dynamic, it evolves as activities unfold and the elements of the research process interact and impact on one another. Time is required to allow research questions to develop, literature to be searched, data to be collected, interpreted and analyzed, and findings disseminated.”

Chapter 2 – Problem Analysis

The examination of the impact of cannabis use on local transport drivers of the Peshawar district in Pakistan immediately provides a visual as well as mental signal as to the potentially dangerous ramifications. Cannabis is a hypnotic drug derived from a plant which has intoxicant qualities that have some uses in medicine, but is better known for is use as a recreational drug where it generates a considerable range of side effects that impact differing people in varied manners. Mikuriya (1969, p. 904) listed the following potential therapeutic uses:

• analgesic and hypnotic,
• as an appetite stimulant,
• antiepileptic, antispasmodic,
• as an aid in the prevention as well as interruption of migraines and tic douloureux,
• as an antidepressant as well as tranquilizer,
• as a psychotherapeutic aid,
• antiasthmatic,
• in the acceleration of childbirth (oxytoxic),
• as a topical anesthetic,
• in certain uses as an agent that facilitates patient withdrawal from additions to opiates and alcohol, and
• as an antibiotic

In terms of the context of this examination concerning the factors that lead to the use of cannabis, and what can be done about the situation, utilizing the context of transport drivers in Peshawar Pakistan, the focus is thus on the user side of the equation in terms of cannabis as a recreational drug. In that context studies, and analysis by a broad number of researchers as well as the documentation found in journals, books, and articles clearly point out through conclusive as well as subjective findings that cannabis has a broad number of impairment qualities that can manifest themselves. Key to that understanding is the fact that these manifestations can occur in differing degrees of intensity as well as singular, and or multiple combinations in the user, who may or may not be aware of these effects. The preceding makes the use of this drug even more dangerous for individuals engaged in the operation of machinery, and in particular trucks.

The Center on International Cooperation (2004) provided an overview of the problem in stating that Pakistan is known for governmental corruption that plays a part in the drug trafficking that occurs within its borders. The proximity of Peshawar to the border of Afghanistan as well as its own growing. and related drug production activities makes that district a den for drug use as a result of its ease of availability. and low price. Contributing to the problem is the lack of employment opportunities that has created a large number of individuals living in poverty. The International Narcotics Control Strategy Report (2006) states that low income, lack of economic opportunities, and proximity to the availability of drugs makes for high usage. The forgoing, coupled with the fact that cannabis is a social, and or recreational drug that does not have the stigma of heroin, and cocaine, yet does have many of their same qualities, creates an environment ripe for addiction. The foregoing is demonstrated by the fact that after to Iran, Pakistan has the highest percentage of drugs users in the world (International Crisis Group, 2001).

Factors that lead to the use of cannabis, in addition to the broad circumstantial aspects thus far mentioned, are peer pressure, and use as well as social contexts (Ausubel, 1969, p. 17), and the lack of education, opportunities, and outlets for social and recreational pursuits, and information on the dangerous effects of cannabis use (Kahn, 2002). In terms of transport drivers, their jobs entail repetitive, monotonous, low paying work that leaves plenty of time for mental wandering, boredom, and association with individuals who are drug users as well as being young of age. That age group is therefore highly prone to peer pressure, thus throwing them into a circle of high potential usage (IRIN, 2006). All of the preceding represents unmistakable contributing factors that make it extremely difficult to escape falling into drug use.

In delving into the examination of the problem a ‘problem tree’ is a useful tool in analyzing situations as it aids in the identification of major problems in the examination, along with the causal relationships (Robertson, 2001. p. 32). In applying this methodology to the preceding examination, the following analysis of the factors equated with the problem become evident.

Figure 1 – Problem Tree Analysis of Factors Leading to

Cannabis Use and What Can be Done About Them:

A Study Carried Out in Local Transport Drivers

of the Peshawar District in Pakistan

The preceding analysis shall thus form the matrix upon which this examination will focus.

Chapter 3 – Literature Review

Cannabis sativa was labeled by Linnaeus in 1753 is known by many names, the most popular, and universally understood being marihuana, and weed (Grinspoon, 1971, p. 1). Known for medicinal as well as being a euphoriant, the first recorded use of cannabis is “…found in the Herbal, an ancient equivalent of the U.S. Pharmacopoeia, written about 400 to 500 B.C. “ (Grinspoon, 1971, p. 1). Also known as ‘Indian Hemp’, it is a stout, bushy, branching plant whose height varies from 5 to 15 feet in height, and is an old crop that has been grown in China as well as Asia for centuries (Hill, 1952, p. 28). In terms of products, Indian hemp is utilized “…for ropes, twine, carpets, sailcloth, yacht cordage, binder twine, sacks, bags, and webbing” as well as “Hemp waste, and the woody fibers of the stem are sometimes used in making paper” (Hill, 1952, p. 29). In addition “The seeds contain an oil that is useful in the soap and paint industries as a substitute for linseed oil” (Hill, 1952, p. 29).

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Medicinally, “Cannabis has long been used as an indigenous medicine in the south of Africa, South America, Turkey, Egypt, and many areas of Asia including India, the Malays, Burma, and Siam” (Grinspoon, 1971, p. 218). Despite the Western notion of cannabis as simply an intoxicant, there is documented evidence of its beneficial use in medicinal remedies. There is a large body of evidence from the Orient on the use of cannabis in medical applications (Grinspoon, 1971, p. 219). In studies conducted by Dr, W.B. O’Shaughnessy in 1839, who at the time was thirty-three and an “… assistant surgeon and professor of chemistry at the Medical College of Calcutta …”, he experimented on “…patients suffering from rabies, rheumatism, epilepsy, and tetanus” (Grinspoon, 1971, p. 219). O’Shaughnessy reported “ … anticonvulsant properties of the previously untried materia medica, expressed his “belief that in Hemp the profession has gained an anti-convulsive remedy of the greatest value” (Grinspoon, 1971, p. 219). O’Shaughnessy’s research led further investigation by Dr. R. M’Meens for “…tetanus, neuralgia, the arrest of uterine hemorrhage, as an analgesic during labor, in dysmenorrhoea, convulsions, the pain of rheumatism, asthma, postpartum psychoses, gonorrhea, and chronic bronchitis” (Grinspoon, 1971, p. 219). Dr. M’Meens studies and reports resulted in cannabis being assigned (M’Meens, 1860, pp. 94-95):

“a place among the so called hypnotic medicines next to opium; its effects are less intense, and the secretions are not so much suppressed by it. Digestion is not disturbed; the appetite rather increased; . . . The whole effect of hemp being less violent, and producing a more natural sleep, without interfering with the actions of the internal organs, it is certainly often preferable to opium, although it is not equal to that drug in strength and reliability.”

M’Meens also found that cannabis had use as a sedative among other medicinal purposes (Grinspoon, 1971, p. 220). Dr. Hare in 1887 noted that the use of cannabis “…quieting restlessness and anxiety, and by turning the mind of the patient to other channels. . . . Under these circumstances, the patient, whose most painful symptom has been mental trepidation, may become more happy or even hilarious” (Hare, 1887, p. 225-226). However, the Tax Act of 1937 “…completed its medical demise, and it was removed from the U.S. Pharmacopoeia and National Formulary in 1941” (Grinspoon, 1971, p. 218).

Modern day medical findings see its proponents suggesting the legalisation of marijuana in terms of its medicinal uses (Earlywine, 2002, p. 167). Naturally, the preceding views have sparked a number of debates. It has been found that “Smoked cannabis clearly helps some problems and may cost less than other medications”, and that “Synthetic cannabinoids can also alleviate symptoms of many disorders” (Earlywine, 2002, p. 167). G.T. Stockings, a medical researcher, administered a synthetic cannabis preparation to fifty depressive patients, and thirty-six showed definitive improvement (Stockings, 1947, pp. 918-922). Mikuriya (1969, p. 904) in reviewing the medical evidence as well as literature listed the potential and possible therapeutic uses of cannabis:

• analgesic and hypnotic,
• as an appetite stimulant,
• antiepileptic, antispasmodic,
• as an aid in the prevention as well as interruption of migraines and tic douloureux,
• as an antidepressant as well as tranquilizer,
• as a psychotherapeutic aid,
• antiasthmatic,
• in the acceleration of childbirth (oxytoxic),
• as a topical anesthetic,
• in certain uses as an agent that facilitates patient withdrawal from additions to opiates and alcohol, and
• as an antibiotic

The current position of organized medicine in the United States is that cannabis has been condemned as medically worthless, and even dangerous (Grinspoon, 1971, p. 226). In fact the members of the Committee on Legislative Activities of the American Medical Association in 1937, in protesting the Marihuana Tax Act, stated (Cary, 1937, pp. 2214-2215):

“There is positively no evidence to indicate the abuse of cannabis as a medicinal agent or to show that its medicinal use is leading to the development of cannabis addiction. Cannabis at the present time is slightly used for medicinal purposes, but it would seem worthwhile to maintain its status as a medicinal agent for such purposes as it now has. There is a possibility that a restudy of the drug by modern means may show other advantages to be derived from its medicinal use. “Your committee also recognizes that in the Border States the extensive use of the marihuana weed by a certain type of people would be hard to control that in the Border States the extensive use of the marihuana weed by a certain type of people would be hard to control”

In 1967 a position paper written in the Journal of the American Medical Association stated “Cannabis (marihuana) has no known use in medical practice in most countries of the world, including the United States” (Council on Mental Health and Committee on Legislative Activities and Drug Dependence, 1967, p. 1181). The factual evidence however points to otherwise as a classified undertaking by the United States Department of Defence in the United States that suggests the utilisation of cannabis compounds might be useful for (Culliton, 1970, p. 105):

1. analgesics
2. blood pressure reduction, and
3. psychopharmacotherapeutic agents

The limited utilization position of the United States in the uses of marijuana for medical purposes is outdated, according to global practices. The only uses legally approved in the United States are in California, and Arizona for medical purposes as approved by a physician, primarily for glaucoma, and high blood pressure (Christenson, 2004). Research conducted at the Complutense University in Madrid revealed that components contained in marijuana that were derived from the plant inhibited the growth of cancerous brain tumours (Annie Appleseed Project, 2007). The findings of that study were published in the journal of the American Association of Cancer Research. Other research and studies have also found that “…cannabis restricts the blood supply to Gliobastoma multiforme tumours …”, which is an aggressive brain tumour (Annie Appleseed Project, 2007). The foregoing study which was initiated in the United States in 1974, and then subsequent left unfounded was picked up by the Complutense University Department of Biochemistry and Molecular Biology in 1998 were it was “…discovered that THC could selectively induce programme cell death in brain tumours without affecting healthy cells” (Annie Appleseed Project, 2007).

In addition, new research and studies have uncovered what other cultures, notably Asian, have known for decades, that marijuana in certain uses does have value as a medicine. In a recent study conducted at the University of California, it was “…found that smoked marijuana was effective at relieving the extreme pain of a debilitating condition known as peripheral neuropathy … (as well as potentially beneficial uses for) … cancer, AIDS, multiple sclerosis, arthritis and other debilitating illnesses.” (International Herald Tribune, 2007). The foregoing positive uses of cannabis as well as the wide spread use in Asia on an historical basis for medical purposes underlines the rationales for providing the broad based background information which was utilized to set the context that the initial foundational uses of cannabis in that region on an historical basis served a different purpose from its present. That background is important in understanding that the mental, and historical context in terms of cannabis in the Asian region differed greatly from the policy, and views of the United States, and Europe that impose criminal penalties that have spread to other regions, including Asia as the over riding policy that deals with usage today.

In equating the use as well as regional context regarding Pakistan and cannabis, it is important to understand that the country borders China, Tajikistan, and Afghanistan. The preceding is important in that Afghanistan is “… the principle opium supplier to heroin and morphine base laboratories located in Pakistan …”, Tajikistan as well as Turkey (Center on International Cooperation, 2004). The drug industry provides a livelihood for many of the poor of Afghanistan as well as Tajikistan, and the Peshawar district (Center on International Cooperation, 2004). The governmental administration in Pakistan has corrupt elements, subject to the payment of funds to ease controls, and police interference, thus keeping the market fluid (Khan and Wadud, 2001). With Peshawar located extremely close to the Afghanistan border, and Khyber Pass, it is the center of drug trafficking, and thus also fosters a drug supportive culture. The significance of the preceding is that the underlying hard drug culture fosters softer drugs use, cannabis, as more acceptable and a lighter form of involvement (United States Department of State, 2006). Cannabis is cultivated as well as grows wild in the region, thus making its availability easy for any resident (United Nations Office on Drugs and Crime, 2007).

Figure 1 – Map of Pakistan

(unique-century, 2007)

The significance of the medicinal historical background as well as the drug industry trade, and the overall poverty of the region set the conditions for drug use among the populace as well, important factors in the understanding of motivations for use, and conditions that drag individuals into use. Important in this understanding is that Afghanistan’s drug trafficking represents an estimated one-third of the overall Gross Domestic Product, which is fostered by a corruption government administration (United States Department of State, 2006). The region itself is also subject to the drug trade as a result of the land expanses of land, and the huge number of individuals living at, and below the poverty line. In addition to the indicated countries, drugs form a big part of the economies of Bangladesh, India, Nepal, and Sri Lanka (Center on International Cooperation, 2004). The heavy undercurrent of drugs, opium, heroin, and thus cannabis represents a lure for a means out of poverty as well as a manner in which a large number of the populace are exposed to drugs at an early age.

Pakistan itself traffics in drugs as well as cultivates opium, and is a major transit country for hashish and opiates from Afghanistan (Center on International Cooperation, 2004). The country also has unconfirmed labs, and facilities along with an estimated 3 to 5 million addicts. Drug traffickers in Pakistan move product from Afghanistan to Turkey by land, through Iran as well as by sea. The foregoing is also an important consideration in the use of cannabis as a softer drug that is less addictive, and more importantly is affordable as a hard drug substitute in terms of poor economic opportunities as well as physical isolation for Pakistanis (International Narcotics Control Strategy Report, 2006). In the Asian region, cannabis is seen as an herb more than a drug. Unlike hard drugs such as heroin and cocaine, cannabis is seen as a social and recreational drug. It is easily grown in almost any type of conditions, and the climate in Pakistan is particularly suited to cultivation. It is important to mention that cannabis in today’s form differs from their culture of the 1960’s and 70’s in that it has been cross bred, and its potency has increased dramatically, estimated by 20 times (Drug Addiction & Advice Project, 2007). The last factor, increased potency has changed the dynamics of cannabis to one that borders on the additive qualities of cocaine.

Cannabis is a mood-altering drug, which represents one of the key rationales for its use among the improvised peoples of Peshawar as it provides an increased internal feeling of well being and happiness, increases laughter, and also heightens one’s appetite. The preceding are factors in the hard life of poorer Peshawar residents as they have little to be happy about. Cannabis, like alcohol helps people to relax, and in many instances aids them in thinking that it helps them to cope with their problems (Department of Human Services, 2002).

3.1 Actions Against Cannabis

The global drug problem has been the subject of immense study as well as policies. A key development that has influenced the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances has been the Inter-American Commission on Drug Policy (Smith, 1992, p. 16). After years of study, the Commission issued a policy report in 1991 that advised that the means to control, and thus reduce global drug use rested in understanding the following dy