Pharmacotherapy

Monday, March 10, 2008

Iran's addicts fall victim to geography

By, Anna Fifield (Tehran), Financial Times Deutschland, February 28, 2008

Iran shares a long border with Afghanistan, which produces 90 per cent of the world's opium, and as much as half of that is smuggled through Iran. The country's proximity to the world's biggest opium producer has led an estimated 5m into narcotics.

Three years ago things could hardly have been worse for Ali-Reza Fatehi. His family had disowned him, he had lost his profitable business selling socks in the Tehran bazaar and his television set was his only friend.

When he was not watching television he was rifling through rubbish bins to collect plastic that he could sell on to recycling companies.

"It was a very degrading job and completely out of character for me," says Mr Fatehi, looking down at his stained shaking hands through dark-ringed eyes. "But at the time I was doing crack and heroin and I wasn't myself."

Explosion in opium production since US-led invasion

Officially there are 1m drug addicts in Iran but international health workers estimate that the figure is much closer to 5m, in a country of 70m people. While much is known about the problem in neighbouring Afghanistan, and particularly about the explosion in opium production since the US-led invasion seven years ago, Iran's significant drug challenge is below the radar.

But Iran shares a long border with Afghanistan, which produces 90 per cent of the world's opium, and as much as half of that is smuggled through Iran, partly for export and partly for consumption by people such as Mr Fatehi.

Iran's addicts spend $3bn - the equivalent of 15 per cent of Iran's annual oil income - on drugs each year and their problem has led to a multitude of social ills, including an increase in HIV infections. There are about 70,000 HIV/Aids sufferers in Iran, about 60 per cent of whom were infected by sharing needles.

But just as Iran is a victim of its geography, Mr Fatehi, 37, was in some ways a victim of his success.

"I dropped out of school and started selling socks and stockings," he says at the Persepolis centre, a non-governmental treatment centre in southern Tehran where he goes every day for methadone, an opiate-replacement therapy.

"I was making very good money so I hired someone to run the business for me. I had a lot of free time to go to my friends' houses and have fun, but one of them introduced me to opium."

He progressed to heroin, crack cocaine and crystal meth and was an addict for more than a decade, until he finally sought help three years ago.

"Physically I'm clean now but mentally I'm not. I can't imagine not having any substances in my life," he says. "But this medicine has helped me a lot."

The Persepolis centre is one of a handful of pioneering institutions that treats drug users. It focuses on harm reduction - giving fresh syringes and condoms to addicts - and provides methadone to about 250 people a day, a fifth of whom are women.

Spread of HIV and AIDS

"Many addicts catch other diseases such as HIV or hepatitis so we teach them how to inject cleanly and to uphold healthy practices," says Gaila Darvishany, one of the centre's managers. Volunteer workers dole out plastic cups of methadone and change the dressings on the wounds of crack users who have accidentally burnt themselves.

Iran is a natural bridge between Afghanistan and Europe - ideal for smugglingThe government is trying to stem the flow of drugs into the country, a struggle that has led to the killing of more than 4,000 police officers in the course of drug control operations since the 1979 Islamic revolution.

Iran has built what Roberto Arbitrio, the head of the United Nations office on drugs and crime in Tehran, calls an "Iranian Great Wall" of ditches and fences along the border with Afghanistan and Pakistan.

Heroin trafficking on a huge scale


"Iran is a natural bridge between Afghanistan and the 'Balkan route' to Europe. Plus, to the north there is the Caspian Sea and the Russian market, and to the south is the Gulf, increasingly a route for hashish," Mr Arbitrio says.

"But this is not a situation where you've got a guy coming across the border with a suitcase containing 1kg of heroin," Mr Arbitrio says. Traffickers in 4WDs carry Kalashnikov machine guns and rocket-propelled grenade launchers, travelling "like an army" and using guerrilla warfare, he says.

After waging waging his own struggle, Mr Fatehi - who has now found himself a cleaner line of work, selling cigarettes from a sack on the pavement - has modest ambitions for the future.

"My life has already got a lot better," he says. "But now I'd like to get married and have kids. I'd like my mother to come and visit me more. I'd like for my dad to accept me. I'd like to be myself again."

Source: http://www.ftd.de/karriere_management/business_english/:Business%20English%20Iran/322896.html

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