Substance Abuse in Kabul, Afghanistan: Clinical Patterns, Comorbidities, and Healthcare Challenges

Abstract

Background: Substance abuse represents a major public health problem in Afghanistan, with its high prevalence among adults aged 18 to 40 years. Besides social complications, there are physical and psychological complications. Consequently, it places a high burden on the healthcare system. Patterns, comorbidities, and healthcare challenges posed by substance use must be understood in order to intervene effectively.

Methods: A cross-sectional survey was conducted among 1,500 adults (aged 18–40 years) using convenience and snowball sampling in community and public settings across Kabul. Data were collected using a structured questionnaire adapted from previously published instruments and administered in local languages (Dari and Pashto). The questionnaire captured demographic characteristics, substance use patterns, clinical symptoms, and healthcare access. Descriptive statistics and cross-tabulations were performed using SPSS.

Results: 68% of men reported substance use, primarily opioids (35%) and methamphetamines (25%). Malnutrition accounted for 45% of physical complications, infections for 12%, and anxiety for 25% and depression for 48% of mental health issues. 42% of women reported using cannabis and opioids, with fewer health issues. Misconceptions regarding the dangers of drugs were widespread, and only 30% had access to healthcare services.

Conclusion: Substance misuse among Afghan adults constitutes a serious health problem in the 18-40-year-old age group, for whom access to healthcare itself is very challenging. Urgent interventions through community-based programs, awareness programs, and policy initiatives are required to reduce harms and improve public health outcomes.