Pubdate: Sat, 18 Aug 2001 Source: New York Times (NY) Copyright: 2001 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Neil MacFarquhar IRAN SHIFTS WAR AGAINST DRUGS, ADMITTING IT HAS HUGE PROBLEM Six addicts were milling around in the corridor of an unusual clinic here, waiting for the start of their third day of treatment, when a young patient suddenly emitted a deep bestial groan and collapsed to the floor, writhing. "He must have epilepsy," said Dr. Mohsen Kianpour, the unflappable psychiatrist who founded the place, stepping over to help restrain the young man until the seizure subsided. "You know, a lot of epileptics use opium to treat their symptoms. But he didn't tell us. Maybe he was afraid he wouldn't be admitted." Fear has been the guiding principle behind the approach to the treatment of drug addicts in Iran for almost 20 years, with addiction a crime that brought at least jail and occasionally even a death sentence. But given the alarming wave of addicts that is swamping the prisons, clogging the justice system and taxing hospitals, the Islamic Republic is shifting tactics. It is slowly recognizing that addiction is a disease, and that treatment might slow the flood of drugs into the country. This year, the new Outpatient Clinic for the Treatment of Addictive Behavior at the Zahedan Psychiatric Hospital has taken the unusual step of experimenting with methadone treatments. "As long as people don't want to change, nothing will work," Iran's drug czar, Mohammad Fallah, said in an interview in Tehran. "That is fundamental. But we have begun to revise our past policies. Maybe in the future we will change the prison law as well." Official estimates, generally deemed accurate, count 1.2 million addicts in a population of 63 million, with at least one million more casual users. In view of the fear tied to admitting to addiction, however, other groups say there may be more than three million addicts, as much as 5 percent of the population. By comparison, Britain, with a similar population, has 200,000 addicts. For years Iran tried to hide drug abuse, the standard reaction to social problems in a country that promotes Islamic government as the key to an earthly Eden. "They said we are Islamic, so we don't have any addiction, we don't have any prostitution, it is all good," said Fatimeh Farangkhah, a social worker at one of the few private groups that work with addicts. The difficulty of initiating an honest social discussion has been compounded by the fact that addiction, like much else here, has become a political football between reformists and conservatives. The conservatives argue that the problem stems from exposing the young to the West, thus diluting Islamic principles. Reformists say the young, starved for any form of public entertainment, turn to drugs. Everyone agrees that drugs are readily available largely because of the accident of geography: Iran is the major land route for much of the heroin and opium smuggled to Western Europe from Afghanistan and Pakistan, as well as hashish. Iran itself was a major producer under the shah. Now, according to United Nations figures, Iran leads the world in seizures of opium and its derivatives. The extent of smuggling puts drug prices on a par with cigarettes, especially in cities like Zahedan, 30 miles from where the three nations converge. The city is the provincial capital of Sistan va Baluchistan, one of Iran's poorest provinces, where the anemic economy has long made smuggling a hallowed tradition. "This province is a paradise for addicts, because it is a gateway for drugs," Dr. Kianpour said. "People move here from all over Iran because the opium is cheaper." For years the government has been trying and failing to stem the flow of drugs by sealing the border. The costs in money and manpower are enormous. Almost half the 3,000 police officers killed in the war on drugs in the last 20 years have died in this province. Throughout Iran last year, there were more than 1,500 firefights with heavily armed drug smugglers. In that effort, Sistan va Baluchistan constitutes the Wild East. In a six-hour gun battle in 1999, 33 officers died. "Every corner of the desert around here is the site of clashes between the Iranian security forces and drug smugglers," said Danial Mollaee, political and security deputy to the provincial governor. Aside from the craggy terrain, Mr. Mollaee said, the problem is compounded by the fact that Baluchi tribesmen inhabit all three countries and consider the border a fiction. Some even keep one wife and family on the Iranian side and one across the border, officials said, and the border no man's land is reportedly so untamed that an arms bazaar there offers tanks for sale. "The government accepted that Zahedan is a special case," Dr. Kianpour said as he told how he won his argument to use methadone despite the suspicion that surrounds it. Abstinence remains the cure of choice. The government has long been concerned that making methadone legal would only feed the drug market. Even to this day, a Health Ministry official is at the clinic to supervise the distribution of each painful injection. Iran has yet to seek the syrup used elsewhere. "If we didn't use methadone, nobody would come to us to seek a cure, because drugs are so cheap here," Dr. Kianpour said. It cost less than $90 a kilogram until this spring, when the price shot up to $375 a kilo after the Taliban government in Afghanistan had banned poppy cultivation. The jump pushed many people to seek treatment. Dr. Kianpour can treat a maximum 20 patients in each two-week program, because methadone is expensive and Iran, despite its frontline status, receives little foreign aid to combat the scourge. He said he thought that he was doing well, with 15 percent of his patients staying clean. On the surface, the patients' lives seem perfectly ordinary, if difficult. One is an overworked fifth-grade schoolteacher. Another is a veteran who is nursing shrapnel wounds from the Iran-Iraq war. A third is a homemaker who seeks solace over her shiftless husband. They each turned to drugs, they said, to try to ease their problems because they were so easy to buy. Parvis, the teacher, who only wants his first name used to protect his job, turned to opium to try to gather more energy. His salary was too meager to feed four children, he said, and he took on private students until 10 p.m. every day and drove a taxicab during the summers. "It took me three years to become an addict," said the teacher, gaunt at 125 pounds and looking far older than his 35 years. "Eventually I didn't even have time to smoke. So I just ate the extract." Most of the young men in the Zahedan clinic complained of boredom. The town, with 600,000 residents, has two decrepit theaters, endlessly repeating movies made 10 years ago. Satellite television is rare. Internet connections are almost nonexistent. The best job is working as a guard on a drug-smuggling caravan. "There are no factories, no stadiums, and the agriculture is kaput, so we have nothing to do except either take drugs or deal drugs," said Abed Zeinalabadine, 34, a war veteran from nearby Zabol. "There is only one park, and it has something like four trees." The schoolteacher interjected, saying, "Instead of trees in our parks, all you find are drug dealers." - --- MAP posted-by: Derek