Issue 12
Afghanistan’s Drug Problem
By Jeremy KellyPhotos By Travis Beard
Illustration By Ryan Santos
Some smoke it with dried scorpions and snakeheads. Others use it in place of medicine. Afghanistan has a burgeoning local opium and heroin problem—and the war torn country is working to arrest this surge in drug use.
Maqsoud missed his infant daughter’s funeral. He was using some of the 800 afghanis ($16 dollars) his father gave him for the ceremonial cloth and bought heroin. When he woke from his drug-induced slumber, he returned to his family’s home. “There was nobody there. They had buried her,” he says. It was the wake-up call he needed. “That is why I am here.”
Maqsoud is one of 10 residential patients at Kabul’s Nejat Center, one of the few drug treatment centers in Afghanistan. Despite the heart-wrenching circumstances that led him to seek help, he is one of the luckier ones. There are 1,700 people on the waiting list for a bed at the Nejat Center. The United Nations Office of Drugs and Crime (UNODC) estimates there are one million drug users in the country. This is about four percent of the population.
Of these, about 150,000 are estimated to be using opium or heroin. Conditions are ripe for drug use in Afghanistan: the country is swelled by the return of refugees from Pakistan and Iran, where opium use is endemic. Afghanistan’s unemployment is high and of course, there is no shortage of drugs. Afghanistan has long been the world’s biggest producer of opium—the raw ingredient of heroin. About 92 percent of the world’s supply comes from this war-ravaged nation. A joint U.S.- U.K. funded eradication program is costing hundreds of millions of dollars, yet so far it has not made a dent. Last year was a record crop. This year is expected to be even bigger.
Afghan and Western efforts to curb production have been stymied by an insurgency—most ferocious in Helmand province, which on its own produces a quarter of the world’s heroin—and the government’s inability to stamp out corruption. Perhaps unsurprising when the president-appointed corruption-buster, Izatullah Wasifi, spent nearly four years in a Nevada prison for heroin trafficking and you can be offered hashish at a wedding from a Ministry of Counter Narcotics official you’ve just met.
“This is a battle in Afghanistan that will be won,” Public Health Minister Amin Fatimie says optimistically. “I think the international community has realized the importance of this issue.” The country is almost wholly dependent on foreign aid. Enforcing a policy of prevention before cure is somewhat tricky—getting the message across is difficult in a country where illiteracy is as high as 90 percent in some districts.
A recent initiative has been to print 20,000 anti-drug booklets for mullahs to use during Friday prayers. On the streets, billboards portray the devil dancing around opium fields. Government-produced matchboxes show a smiling man among 10-foot sunflowers, and on the reverse side, the same man cowering under giant poppy bulbs.
Fatimie’s immediate concern is intravenous drug use—a relatively new phenomenon in Afghanistan, arriving after the fall of the Taliban in late 2001. This has spawned a spike in HIV. There are only 69 registered cases, but the real figure could be as high as 2,500.
The government-run Drug Demand Reduction Department now covers 17 of the country’s 34 provinces, providing specialized help within hospitals. The task of treating Afghanistan’s growing drug problem, however, is the domain of the United Nations and non-governmental organizations (NGOs).
The Nejat Center is in the pockmarked southern suburbs of Kabul. Set up in 2002, it is the oldest drug treatment facility in Afghanistan. Funded by a group of NGOs, this facility has worked with some success in Pakistan since the mid-1990s.
The demand is high to get into Nejat Center, so prospective patients are required to complete up to three months of voluntary daily counseling to assess their commitment to kicking the habit. On the day I visit, I sit with a group of 25 men who are listening to a former user talk about how he weaned himself off heroin. The group ranges in age from late teenagers to long-bearded grandfathers. One has brought his young son. Another is a policeman, in uniform but not on duty.
The center’s director, Dr. Tariq Suliman, guides me through the clinic. Some users, he says, beat their addiction during the three-month counseling. But for most, it is a struggle. Five patients a week are selected for the residential program, which involves going two weeks cold turkey. Upon arrival, they are washed, their heads are shaved and they are given fresh, clean clothes. They are all taught personal hygiene during their initial counseling. Dr. Suliman says this helps them to reclaim respect for themselves and their bodies.
For the first few days, the patients will try to sleep as much as possible. When Dr. Suliman takes me to the detox room, all five patients are asleep. It is 11 a.m. One wakes to the sound of us talking softly. He raises, cracks a smile and shakes my hand. He gestures for me to sit on his bed. He tugs on the covers of the two beds next to his. My translator tells me that he is trying to wake them, telling them a foreigner is visiting.
His name is Mohammad Salim and he was introduced to opium in Pakistan. For the past nine years, he has been battling to stop. It is hard, he says, when there are few jobs and it is so easy to score. He is determined, however, not to go on being a junkie dad. “I was in a very dark place. Now I am trying to get my head in the light,” he says.
Dr. Suliman says war has—and still does— introduce many Afghans to drugs. “When you take drugs, you see the helicopter as a butterfly,” he says, recounting the description given to him by patients.
The center dispenses about 100 syringes a week and as many condoms. Some users will work their way down syringes of lessening milliliters; some will then work their way back up again. Suliman says the center’s success rate is “perhaps 30 to 35 percent.”
Outside of Kabul and the other cities, it is tougher to prevent and treat drug abuse. The northern region of Afghanistan is relatively peaceful. This is where many of the famed Afghan carpets are produced—as well as a new generation of drug users.
“When mothers are weaving carpets, they might not have the time to look after their children,” says the UNODC national project officer Mohammad Aqa Stanikzai. “So if the child starts crying, they make a solvent from opium [to pacify them].” Others use opium to relieve the aches produced by monotonous hours behind the loom.
In remote Badakhshan, the second highest opium producing province, the drug is used liberally in place of medicine, often with disastrous consequences. Recipients get a taste for it and before long they are hooked. Others seek to enhance their high by catching scorpions, killing and drying them and then crushing them into a powder that is mixed with either heroin or opium. Others use the heads of dead, dried snakes. This is said to produce hallucinogenic effects.
One family we meet in a village called Tokahi, near the Uzbek border, was so poor they had sold their weaving loom to pay for food and to support their opium habits. The father now works as a laborer with most of his $1 to $1.50 a day earnings spent on the family’s opium needs. The mother admits to getting her children hooked but said she knew no better and had no choice. “Until one month ago we had no services to buy medicine,” she says. “It is 60 kilometers to the nearest pharmacy and most of the opium is given to us, free. We didn’t know it was bad for them.”
In the western city of Herat a mother speaks openly about her and her daughter’s opium addiction. They have been using for about a year. The mother started drug use to combat depression after the death of her husband, who was a drug user for 25 years. She introduced the drug to her daughter to cure pain in her leg. The daughter’s habit keeps her revolving out of school and into rehab. In this Herat province, close to the Iranian border, 4,000 patients are on the waiting list for one of 20 beds at the Shahamat clinic, funded by the NGO Gesellschaft für Technische Zusammenarbeit—the German Technical Cooperation.
UNODC is seeking to find sustainable futures for many who have found drugs as a way to escape the seemingly endless chain of war and poverty. Together with its NGO partners, they use what are called “Demand Reduction Action Teams” to help addicts in remote regions, as well as women, who in this maledominated society cannot easily check in for treatment. UNODC provides tailoring classes for both women and men. Some patients have opened successful small businesses with the skills they learned.
Back in Kabul, the counseling class at the Nejat Centre has moved outdoors for daily exercises. The group runs on the spot, following the lead of their instructor. The son of one of the patients joins in. He looks too young to understand why his father is there, but at that moment, he just wants to be like dad. The Public Health Minister says saving this new generation from the drug menace will help all of Afghanistan. “We, all together, will be the winners.”