Each year I return to this subject, not because it is fashionable, but because the crisis rarely receives the space it deserves in our national debate.
Pakistan faces a deepening emergency of youth drug abuse and suicide. The data is incomplete and often obscured by stigma, yet what is available is alarming. A 2024 survey cited at Karachi University reported that 44 per cent of university and college students admitted to drug use, 53 per cent of males and 31 per cent of females, with online procurement increasingly common. A 2025 systematic review of rehabilitation cases found heroin accounting for 48 per cent and cannabis 28 per cent among young users. Thirty five per cent had initiated use in adolescence, and 46 per cent presented with comorbid depression.
Suicide has reportedly become the fourth leading cause of death among Pakistanis under 30. Late adolescence, between 15 and 18 years, appears particularly vulnerable, with poisoning and hanging the dominant methods. There are no reliable monthly official statistics, partly because suicide remains criminalised and heavily stigmatised. The Anti Narcotics Force has warned that millions between 18 and 31 are at risk. Even allowing for methodological gaps, the direction of travel is clear.
This is not confined to the young. Adults shoulder the heavier documented burden. A 2025 longitudinal clinical analysis spanning fifteen years recorded rising drug positivity rates, with cannabis frequently exceeding 20 to 30 per cent of tested samples, followed by opioids and benzodiazepines. More than 70 per cent of identified addicts were over 35. Economic strain, easy availability of Afghan sourced cannabis and heroin, and untreated mental illness form a combustible mix.
The United Nations Office on Drugs and Crime has estimated between 6.7 and 7.6 million users nationwide, roughly six percent of the population. Around four million require structured treatment. Khyber-Pakhtunkhwa has been reported at 11 per cent prevalence. Suicide rates, using WHO data from 2019 and 2021, hover near 8.9 per 100,000, with male rates more than triple female rates. Estimates suggest 15 to 35 deaths per day.
In Punjab between 2016 and 2020, young adults aged 19 to 39 accounted for nearly 39 per cent of reported cases, with poisoning and strangulation common and poverty and domestic conflict frequently cited triggers. Adults dominate both addiction statistics and suicide counts, which means economic and emotional fractures are transmitted across generations.
Consider the damage wrought primarily by poverty, family strife and accumulated hurt. Societies and families are meant to make life easier. When they become pressure cookers, they turn into engines of suffering. We prepare for hostile forces and visible enemies, but much of the injury we sustain comes from those closest to us, often without conscious malice. By the time the pain is visible, the damage is deep. Poverty is not easily abolished, but certain forms of harm are within our control.
Families and communities can learn to respect individuality, to refrain from intrusive control, and to resist the urge to turn collective honour into a weapon. The instinct to dominate may be rooted in evolutionary history, but we are not living in caves. A society rests on the assumption of safety and trust. Why seek to dominate someone you claim as your own?
The idea that you always know better than another person is a convenient fiction. It blocks perspective. Even a child, even a dependent, is an individual entitled to error. To deny that is to deny their humanity. The art of letting go is not abdication of care. It is recognition that autonomy reduces resentment, and that resentment, when chronic, mutates into despair or self-destruction. Healthier cultures are built less on control and more on boundaries.
There is also the structural failure. Accessible mental health care remains scarce. Outside a few urban centres and private clinics, public provision is thin. Psychiatric wards are often conflated with containment. We deploy hammers where chisels are required. Early intervention, counselling, school based support systems and community clinics are not luxuries. They are preventive infrastructure. The absence of such infrastructure leaves families improvising, often clumsily, sometimes cruelly.
If you are someone whose mental health is under strain, you must stand by the one ally who has never abandoned you, yourself. That is not a slogan. It is a discipline. Learn the early signs of exhaustion, humiliation and abuse. Name them. If you find them, adjust your exposure. Boundaries are not hostility. They are maintenance. Strengthening your inner shell does not mean becoming callous. It means withdrawing permission for casual harm. The insight that no one can control your internal response without your consent is not new, but it remains powerful. Viktor Frankl articulated it with clarity in Man’s Search for Meaning. Agency can survive even in constraint.
If you do not reclaim that agency, others may test the vacancy. Some will press advantages you did not know you had granted. You may discover that those you never wished to harm can still wish to harm you. Being incapable of hate does not grant immunity from it. You may find that even those you fought for found ways to injure you, sometimes more efficiently than your declared opponents. At times, being right intensifies opposition. A tougher shell cannot prevent physical injury or systemic injustice, but it can reduce emotional haemorrhage. It allows you to continue functioning without surrendering your core.
This is not an argument for isolation. It is an argument for discernment. Not everyone deserves intimate access to your vulnerabilities. Not every critic deserves your energy. We live in a time when honesty is often filtered through suspicion and outrage is monetised. Yet clarity about your own intentions provides stability. You do not need to invent shortcuts or dramatic exits. You need continuity. Keep going. Seek help where it is competent and humane. Offer others the dignity you expect for yourself.
The quiet emergency in Pakistan is not only statistical. It is cultural. It resides in how we speak to our children, how we measure success, how we treat failure, and how quickly we label vulnerability as weakness. Until we address those foundations, the numbers will continue to rise, sporadically recorded and inadequately debated. Mental health is not an imported preoccupation. It is the difference between a society and a jungle.