Drug addiction and its associated consequences, such as long-term dependence, blood- borne illnesses, HIV, sexually transmitted diseases, social isolation, and criminal activity, are gradually being recognized as serious issues that need to be addressed, especially among displaced populations. Due to disputes and conflict in their country, around 1.44 million Afghan refugees (both registered and unregistered) are currently residing in Pakistan in a situation of protracted displacement and significant uncertainty, even though around 4 million Afghan refugees have been repatriated back to Afghanistan since 2002. There is a growing awareness that Afghan refugees, who are living in such humanitarian settings as long-term (protracted) displacement, may be subjected to the negative effects of substance use, which are like those experienced by other Pakistanis, due to socioeconomic disparities Since it is widely acknowledged that problematic substance use, and the harms associated with it are largely situational in nature, understanding and evaluating various localised factors and reasons should help policymakers develop interventions that are specifically tailored to the situation and through evidence-based practices. This qualitative research study used key informant interviews with service providers to critically interpret the widespread usage of cannabis, opiates, and tranquillizers among Afghan refugees in Pakistan. The study also highlighted that crystal methamphetamine (CMA) use is on the rise and is a worrying trend in major cities including Islamabad, Peshawar, Karachi, and Lahore. Numerous local factors, such as stress, depression, anxiety, unemployment, gender inequality, and future insecurity, have contributed to the rise of addictive behaviour among Afghan refugees.

Northumbria University Geography and Environmental Sciences Newcastle Upon Tyne UK

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