Pubdate: Mon, 21 May 2007 Source: Montreal Gazette (CN QU) Copyright: 2007 The Gazette, a division of Southam Inc. Contact: http://www.canada.com/montreal/montrealgazette/ Details: http://www.mapinc.org/media/274 Author: Tom Blackwell, CanWest News Service Bookmark: http://www.mapinc.org/find?143 (Hepatitis) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) THE GRIP OF HEROIN The Abundant Supply Of Poppies In Afghanistan Has Taken A Terrible Toll At Home Brothers Abdul Jabar and Abdul Sitar crouch on the floor of their spartan Kabul living room, each light up a small heroin cigarette and draw deeply on the powerful drug. Nearby, several of their 11 small children watch impassively. For the kids, this is nothing unusual. Their fathers have been addicted to heroin, and largely incapacitated by it, since long before they were born. Two of the older boys, who look about 8 or 9, generate the family's only income by selling products off a cart after school. "Because of this thing, I can't work, I can't talk sometimes. I eat stones," said Abdul Jabar, who later illustrated his odd compulsion by swallowing three small rocks. He said he usually passes them without incident. "If I knew I would be in this condition, I wouldn't have used this drug. If they paid me $10 million, I wouldn't have used this drug," Jabar said. Yet the two brothers, and a third who successfully went through rehabilitation recently, are far from being alone in their plight. Although it is a strict Muslim country, held in the grip of a fundamentalist regime for five years until 2001, Afghanistan is suffering from a boom in heroin addiction. The international community has sought to crack down on the war-weary nation's record poppy crops, now serving 90 per cent of the world's demand, but the abundant supply of heroin's main raw ingredient has taken a terrible toll at home. An influx of Afghan refugees who became addicted in Iran and in Pakistan, the trauma and physical ravages of nearly 30 years of war, and grinding poverty are also blamed. "It is not only the rest of the world that is suffering. We are suffering; it is a big problem for us as well," said Tariq Suliman, the doctor who heads the Nejat Centre, a local rehab clinic. "Now on each and every street we have people who suffer from drug addiction. .. It is spreading fast and it is difficult to control." Meanwhile, injection of heroin - and sharing of needles - is becoming increasingly more common, helping fuel an HIV problem that threatens to spiral out of control. Surprisingly, a smaller part of the HIV outbreak is related to prostitution, an even more subterranean culture in the Muslim nation. There are foreign prostitutes working out of Chinese restaurants in Kabul, catering mainly to ex-pats, as well as home-grown sex workers, including young boys known as bachabozi, or playing boys, experts say. Authorities have confirmed 71 HIV cases in Afghanistan, but estimate there are really 1,500 to 2,000, said Miodrag Atanasijevic of the aid group Medecins du monde, which runs a street outreach program for Kabul addicts. A study by Catherine Todd, an epidemiologist from the University of California at San Diego who is working in the capital, found that high percentages of intravenous drug users shared needles and had Hepatitis C, seen as a precursor of HIV spread. The incidence of HIV among such addicts now sits at about three per cent, but if current trends continue it will reach concentrated epidemic status - five per cent of users - in at least one location within a year, with potentially devastating consequences. Once it hits 20 per cent, "we've lost the battle," Todd said. "The window of opportunity is open but it's in the process of closing. You can spend millions now, or billions later." A United Nations study in 2005 estimated there are a million Afghan drug addicts: 50,000 using heroin, 150,000 opium, 500,000 hashish and about 400,000 using other illicit drugs and pharmaceuticals. The number of heroin addicts doubled in Kabul between 2003 and 2005. And their ranks have undoubtedly swollen since then, said Suliman, of the Nejat clinic. Among them is Matiulah, who, like many Afghans, goes by just one name. He said he became hooked in 1993, when mujahedin factions were battling over Kabul, and his wife, caught in the cross fire, was killed. Two addicts for whom he played his flute introduced him to heroin smoking. He had told them how sad he felt. "When I used the drug, it really reduced my pain," he said. "The drug was the only thing that stopped me (from) thinking about my wife." He later moved north of Kabul but would come back to the city to buy heroin, even during the years of the Taliban, who took the Quran's ban on intoxicants so seriously, they made a public display of riding their tanks over beer cans. His dealer eventually gave it to him for free in exchange for his rounding up new customers. Finally, last year, he was discovered by the newly set-up Medecins du monde program, has now cut back to three heroin cigarettes a day and is convinced he will stop for good. Although a number of treatment programs have cropped up since the fall of the Taliban, waiting lists are still months long. The Abdul brothers have been trying for six months to get into Nejat, and worry their brother, who was treated successfully there and lives with them, could fall off the wagon. "If we were treated together, this problem would have been solved very soon," Abdul Jabar said. They developed their habit in Iran, where they went to get away from the war between the Soviets and mujahedin in the 1980s. They were frequenting prostitutes in the Islamic republic, and a friend told Abdul Jabar he could improve his stamina after smoking heroin. "I went for sex; I was doing it for two hours," he recalls. "But I wasn't aware that from the inside, I was dying." - --- MAP posted-by: Derek