Of Pakistan’s many social ills, perhaps one of the most intractable problems the country faces has to do with hard drugs – not only is Pakistan the principal hub for heroin smuggled out of neighboring Afghanistan, the country is also a massive consumer of narcotics itself.

Last year, the United Nations Office on Drugs and Crime (UNODC) warned that Pakistanis consume heroin valued at $1.2 billion every year.

While Pakistanis abuse a vast cornucopia of drugs, including cannabis, cocaine and amphetamines, the UN estimated that there are at least 500,000 hard-core heroin addicts in the country -- a direct result of the fact that Afghanistan produces 90 percent of the global opium and heroin, almost half of which is trafficked through Pakistan.

“Pakistan is particularly vulnerable to the trafficking of Afghan opiates and this poses a burden on public health, criminal justice and security systems,” said Jeremy Douglas, UNODC representative in Pakistan in a statement.

In fact, the three Afghan provinces which grow the most poppy (the source of opium and heroin) -- Helmand, Kandahar and Farah – all border Pakistan. The two countries share a porous border that is about 1,500 miles long and virtually impossible to monitor.

Sher Ali Arbab, the national research development program officer at UNODC, told China’s Xinhua news agency: "The drug traffickers have… succeeded in forming a mini-market of heroin in Pakistan due to lawlessness in the [northwestern] tribal area which provides them an easy opportunity to transport drugs due to less influence of law enforcement agencies in the semi- autonomous tribal area.”

These drugs are designed for markets in Europe, Russia, Australia and the U.S. – however, much of it is left behind and used by people in Pakistan, Afghanistan as well as Iran, thereby creating a huge social problem that none of these nations are prepared to deal with. *For example, NPR reported that one-twelfth of Afghanistan’s population – about 3 million people -- is estimated to abuse drugs).

Iftikhar Ahmed, an official with Pakistan’s Narcotics Control, lamented: “These drugs… benefit criminal groups along drug trafficking routes. Afghan opium production has resulted in negative social, health and economic consequences for Pakistan – we are a victim country.”

Pakistan media reported that of the 580 tonnes of heroin produced in Afghanistan last year, 260 tonnes reached global markets through Pakistan. Only about 1 tonne was seized by Pakistani customs officials.

Muhammad Shahid, the Director General of the Planning and Monitoring Unit in the Ministry of Narcotics Control, told Xinhua that Pakistani drug lords work in tandem with Africans and Europeans to move the product to the far-flung corners of the earth.

Shahid explained that heroin is widely available in Pakistan and very cheap – it can be bought locally at a price of $4 per gram (in contrast, once the drug reaches Europe, the piece mushrooms to $100 per gram and as much as $200 per gram in the U.S.)

Drugs proliferate in Pakistan despite harsh laws against trafficking – courts in the country have handed out more than 100 death sentences to convicted drug dealers and well over 1,000 life sentences in prison.

Moreover, the nation’s health care system is ill-equipped to handle the huge pool of heroin abusers – there exist only three state-run rehabilitation facilities and about 200 private centers (some of which can be costly).

Consequently, many addicts end up in jail.

Karachi, the huge Pakistani city on the Arabian Sea, is a major drug trans-shipment point and also has hundreds of thousands of heroin addicts among its teeming population.

Dr. Ayaz Memom, who runs a free rehabilitation clinic in Karachi, complained to BBC: "We don't have the resources or the funds for things like methadone. Instead the centre provides a drug-free environment."

In the absence of adequate treatments, many addicts must endure the horrors of “cold turkey” withdrawal in an attempt to cease their addiction.

However, despite the cheap price of heroin, addiction in Pakistan is not restricted to the poor and destitute.

Indeed, quite the contrary, according to Dr Mohammad Ali Rai, a health care expert.

In an opinion piece for the Pakistan Tribune newspaper, Rai indicated that 60 percent of drug addicts belong to the “educated class,” with a majority of them being university students.

Even more worrying, the practice of injecting drugs has skyrocketed in Pakistan, raising fears of an attendant HIV/AIDS epidemic as addicts share dirty needles.

“This [is] even [a] more precarious direction that the drug addicts are taking only helps to already stretch an over-stretched and ill-equipped health-care system,” he wrote.

“Therefore, there is an urgent and critical need for a comprehensive strategy to combat heroin drug use in Pakistan… Wooing students off drugs means providing other avenues of fun and opportunity… the specter of unemployment and lack of job opportunities also needs to be brought into the equation, as they are also crucial factors that force educated youth into the pit of drug abuse.”