Muhammad Suhail Khan, Wu Zongyou, Abdur Rahman, Aman Khan, Shagufta Batool

Background: Women in Khyber Pakhtunkhwa face several barriers, including poverty, cultural stigma, intense social pressure and a lack of accessible services, which prevent them from addressing drug use and mental health issues. Aim: The study aimed to explore the impact of socio-economic and psychological factors on substance use among women aged 25-34. Setting: This study was conducted at community centres and private schools across several cities in Khyber Pakhtunkhwa, Pakistan, including Peshawar, Charsadda, Nowshera, Swabi and Mardan. Methods: A mixed-methods approach was employed, combining quantitative surveys from 120 participants to analyse drug use patterns and qualitative interviews with 20 participants to investigate personal and social challenges through in-depth interviews. Results: Quantitative data indicated that unemployment, financial hardship and low education significantly predicted drug use, whereas moderate depression, anxiety and stress exacerbated it. Perceived stigma serves as a protective role in this study. Qualitative findings highlight themes such as socioeconomic challenges, mental health issues, cultural pressures and barriers to treatment that exacerbate these problems. Conclusion: This study highlights the importance of rehabilitation centres and community counselling services tailored to women's specific needs, along with legislative measures to address gaps in support and resources for women facing drug use issues. Contribution: This study contributes to the understanding of the complex relationships between mental health, socioeconomic status and cultural factors influencing drug use among women and aims to inform public health policy and strategy.