Exploring landscape of drug abuse trends in Pakistan: A decade and a half of clinical laboratory big data analysis

The utilization of urine testing for drugs of abuse has emerged as a valuable tool in discerning the evolving landscape of drug abuse patterns. The objective of this study was to determine the patterns of drug of abuse within the Pakistani population, incorporating demographic factors such as age, gender, and location. This observational study was conducted at the Department of Pathology and Laboratory Medicine, Aga Khan University from January 2008 to December 2022. A review of drugs of abuse screening data extracted from laboratory information system was carried out. The panel includes screening of common drugs, amphetamine (AMP), benzodiazepine (BZO), barbiturates (BAR), cannabinoids (THC), cocaine (COC), and opioids (OPI) as well as blood alcohol (ALC) levels. Mean, standard deviation, percentage and frequency were calculated by using STATA version 13.Over a period of 15 years, a total of 130, 859 tests were performed, with 89.5% being male and mean age of 32.4 ± 11.3 years, while seventy-seven percent of the specimens (n = 101, 648) came from the province of Sindh. Of the total 6270 (4.8%) were screened positive for at least one drug, THC (n = 3626, 57.8%) was the most frequently positive test, followed by OPI (n = 1000, 16%), ALC (n = 671, 10.7%), COC (n = 31, 0.5%), AMP (n = 45, 0.7%), BAR (n = 35, 0.6%) and BZO (n = 862, 13.7%). Yearly trend analysis shows an increasing number of THC tests requested over time, with THC exhibiting the highest positivity rate, followed by BZO, OPI, and ALC.The 15-year patterns depict the rising prevalence of drug consumption which is subsequently increasing the demand for drug screening tests. The study highlights Pakistan's growing drug prevalence and calls for targeted policies to address its use, including strengthened prevention programs, improved regulation and better management and rehabilitation access.