Pubdate: Tue, 27 May 2008 Source: Toronto Star (CN ON) Copyright: 2008 The Toronto Star Contact: http://www.thestar.com/ Details: http://www.mapinc.org/media/456 Author: Rosie DiManno Bookmark: http://www.mapinc.org/youth.htm (Youth) Bookmark: http://www.mapinc.org/topic/opium (Opium) AFGHAN CHILDREN GET OPIUM AS CURE-ALL Country Is Becoming Internally Subsumed By Drugs MAZAR-I-SHARIF, AFGHANISTAN-Saliha is a recovering opium addict. He's 4 years old. His 10-year-old sister is an addict. His mother is an addict. Scratch Saliha's tummy and the wide-eyed child giggles. Press just a little harder and he bursts into tears. "It hurts," he wails. This is the soreness that occurs with opium addiction, along with the nausea, the cramping, the diarrhea, the listlessness. Somehow, the youngster has retained his baby fat, not yet taken on the skeletal appearance of a chronic opium user. But his growth has been stunted and Saliha looks more like a child half his age, lying on his mother's bed in the drug-recovery section of a local hospital. In Afghanistan, rehab - for the very lucky, the very few - can start as young as this. One patient on the ward, now gone back to his village, was a 6-month-old infant. They are only children. They never made a choice to use opium. It was put in their mouths - usually by their mothers - to still them, keep them quiet and docile. This is what parents had been instructed to do, by their families, by tribal elders, by well-intentioned but uneducated quacks who believed opium to be the benign cure-all, or at least helpful therapeutic intervention, for everything that ails a person, and so very handy. They just didn't know any better. Opium for colic. Opium for labour pains. Opium for women's troubles. And, routinely, opium as pacifier to soothe a baby fussing, as babies do. "They use it as a medicine for all kinds of illnesses," explains Dr. Mobien Sultani, 31, who runs the Counter-Narcotics Drug Recovery program at this 20-bed unit in northern Balkh province, one of only two such specialized hospital wards in the country. "The mothers of these children work very hard. Most of them are Turkmen carpet-weavers. In order to work, in their homes, they need the children to be relaxed, to sleep for a long time. So they put opium on their tongues." The problem, Sultani continues, is particularly rampant in northern Turkmen villages, where casual opium use has been common for decades. It was simply part of their culture. In one particular rural town, social workers from this hospital documented 3,500 opium addicts - nearly the entire population. It was their normal. "They were addicted. They just didn't know they were addicted," Sultani sighs. "We're seeing now more and more teenagers turning to heroin. They do this for the same reason that young people use drugs everywhere in the world - for the pleasant sensation it gives them, at first; because they're idle, they don't go to school, they can't find jobs. But this is killing our communities. With few people working, because everyone is sitting around smoking opium or heroin, the bottom falls out of the local economy. Families either hide their addicts in the home - especially the females - or sometimes throw them out on the street. Then these people become garbage. Men, teenage boys, have to steal, they will even kill, to support their addiction." Once a nation that merely produced and exported narcotics - cranking out some 93 per cent of the world's heroin last year - Afghanistan is now becoming internally subsumed by drugs: 920,000 users, according to the Afghanistan Independent Human Rights Commission, out of which 120,000 are women. According to a 2005 study, Balkh alone has 110,000 opium addicts - and this is a province that cultivated zero poppies last year, as concluded by a UN survey. In fact, says Sultani, cannabis use - hashish, primarily - is the top addiction in Balkh, followed by opium, alcohol (despite the fact Afghanistan is a formally dry Muslim country) and heroin, the chemically refined version of opium. "The communities tend to accept hashish use," says Sultani. "But heroin makes young people depressed, as well as useless. Heroin addiction is a big stigma for Afghans." Saliha's mother, Malika, 35, says she began taking opium following the birth of her first child 14 years ago. "This is the medicine that was given to me. I didn't know there would be side-effects for me and for my children." She entered the hospital with her two youngest kids a few weeks ago and, together, they have coped with the dreadful withdrawal symptoms. For most female addicts, however, there is tremendous shame attached to admitting addiction. So they hide in their homes, growing increasingly detached and isolated. There are only six female beds in this facility. Sultani has pleaded with the Ministry of Public Health to establish more such hospitals and increase his bed capacity to at least 50. In another bed by the window, Khurma tells the familiar story - addiction born from delivery of her five children. The youngest, 12-year-old Khudi Bardi, is also a patient. They share this narrow cot. "I was spending ($2) a day on opium," recalls Khurma, 45. That would buy about two grams of opium every 24 hours. Doesn't seem like much, in the way of cost, but the average yearly income in Afghanistan is only about $400. "My family could not afford it any more. I had to stop." Her son makes a ball with his fist, to express the agony of opium stomach pains. By age 10, he was stealing rice from the village to purchase the drug and also trafficking in narcotics - selling mostly to local women. "I can remember when opium made me feel happy. I liked that feeling. But then it made me feel sicker and sicker. I was sick when I took it; I was sick when I stopped. "But I'll never start again." The in-patient detox program lasts for up to 40 days. Before qualifying for the treatment, applicants must attend three times a week, on an out-patient basis, while tapering off their drugs. Follow-up supervision - the hospital employs five social workers - extends for a year. Sultani admits there is a 40 per cent relapse among those who complete the program. The Ministry of Counter-Narcotics operates 11 drug-education clinics in the province but this is the only facility with patient beds and detox capacity. Since it opened in December 2006, 376 patients have gone through the program. "It's not much but we do the best we can," says Sultani. "The most important thing, though, is education, getting into the communities and making people understand about the dangers of opium, about harm reduction. We go into the schools, talk to the elders, at the shuras and in the mosques. "It is a very big job, a major challenge. But on our side, we also have Islam, which forbids the use of narcotics. Our faith is our strongest weapon." - --- MAP posted-by: Jay Bergstrom