In a first ever study conducted on the use of drugs in Afghanistan, the UN has brought to light the little known problem of drug abuse within Afghanistan. Having suffered incessant conflict for over twenty years, many Afghans face chronic health problems such as anxiety, depression, post-trauma stress disorder and insomnia. For them, resort to drug use was a natural way to cope with their problems and bereavement. The study, conducted in February-March 2003, revealed that in a population of 2.5 million, 23,995 were hashish, 10,774 opium and 7008 heroin users.

The report also exposed the link between refugees and drug addiction. 38 percent of all opium addicts and 45 percent of heroin users began using drugs while they were refugees in Iran and Pakistan. Among opium users, 29 percent were women. Kabul alone had about 300 women addicts. According to Stanekzai, the program officer of the Nejat rehabilitation centre, addicts spend as much as $1 per day (a day’s pay for civil servants) on their drug habit, despite their cash-strapped existence. Some women addicts spent nearly twenty percent of their meager monthly income on their drug habit.

Opium, though addictive, has been part of the traditional Afghan medicine for cold and curbing hunger, which probably explains the high incidence of its use among children. According to aid workers, the situation is much worse in the northern provinces where many women employed in carpet weaving regularly administer opium to their children to keep them quiet while they work. In the northern province of Badakshan, there are an estimated 5000 opium addicts. The worst hit cities are Kabul, Kandahar, Jalalabad, Herat, Mazar-e-Sharif and Faizabad. The UN drug agency, along with the Afghan Counter-Narcotics Division, is set to launch a demand-reduction programme in these cities.

A worrisome development is the increase in intravenous drug users; traditionally, drug users only smoked using improvised pipes or chewed the drug. In Gardez, UN workers found many intravenous users. This has raised apprehensions in health officials as intravenous drug usage raises the risk of the spread of HIV/AIDS and other blood-borne diseases, which the war-torn country’s nascent heath infrastructure cannot handle.

A related problem is the lack of adequate de-addiction centers. A few centers that operated prior to the war have been destroyed. Inadequate de-addiction centers have a bearing on treatment of addicts; patients on the detoxification program that normally lasts a month are discharged much before their scheduled departure for want of resources and logistics. The Nejat rehabilitation centre in Kabul is probably the only non-governmental aid agency in the capital catering to drug-addicts. With only 10 beds, it already has a waitlist of 130 patients. The government runs a Drug Dependence Treatment Centre with 20 beds adjoining a mental health care unit. However, much more is required to tackle the problem satisfactorily.

Though Afghan opium production primarily caters to addicts in the West, neighbouring countries, through which the banned substance is transited, have also registered a growing number of drug addicts. Tajikistan is officially reported to have 9000 addicts, though the actual number is about 55,000. Pakistan too has an incredible 3.5 million drug addicts and plans to open five new rehabilitation centers across the country. Uzbekistan has over 24,000 registered addicts, though admittedly, this is not the final figure.

The high incidence of HIV/AIDS in the Central Asian republics is reported to be a direct fallout of the easy availability of drugs in transit through these countries The number of registered cases of AIDS in Tajikistan, which until few years back had four patients, now stands at 92. In its report, Opium Economy in Afghanistan: An International Problem, the UN has highlighted that HIV/AIDS infection is increasing at the fastest pace in Central Asia, and drew a direct link between the regional HIV/AIDS crisis and the Afghan drug trade. Between 1994 and 2001, there has been a 600 fold increase in AIDS cases in Central Asia, approximately 88 percent of which were related to intravenous drug abuse.