Exploring Drug Use Trends in Pakistani Youth: A Systematic Synthesis of Risk Factors and Societal Impact

Substance use among Pakistani youth has become a critical public health and social issue, exacerbated by the country's proximity to major drug-producing regions and ongoing socioeconomic challenges.This systematic review synthesizes existing literature on the prevalence, risk factors, and social consequences of drug use among individuals aged 12 to 29 in Pakistan, while drawing comparisons with global trends.A systematic search was conducted across Google Scholar, PubMed, and ResearchGate using keywords such as "Pakistani youth substance use" and "Opioid Pakistani teenagers."Peer-reviewed qualitative and quantitative studies were screened based on age relevance, study design, and thematic focus.Data were extracted on psychological drivers, family dynamics, substance types, and broader social impacts, followed by thematic synthesis.Twenty eligible studies were reviewed.Rehabilitation center surveys reported heroin (48%) and cannabis (28%) as the most abused substances, with 35% initiating use in adolescence.Comorbid depression was present in 46% of cases.Among medical undergraduates, tobacco (76%), benzodiazepines (32%), cannabis (27%), alcohol (16%), and naswar (28%) were commonly used.Peer pressure was identified in 96% of cases, along with academic stress and family conflict.Street-based youth studies (N = 443) showed drug use linked with age >16 (OR 2.3), homelessness (OR 2.4), peer use (OR 5), and drug sales (OR 10.3).Qualitative findings highlighted poor parental control and collective social pressure.Compared to other LMICs, Pakistan reported similar alcohol and cannabis use but significantly higher opioid misuse due to Afghanistan's proximity.Adverse effects include mental illness, school dropout, and legal issues.Youth substance use in Pakistan is driven by multifaceted socioecological factors.Effective intervention must include mental health, family-based, and structural strategies aligned with global prevention models, particularly to address the rising threat of opioid exposure.