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USA TODAY
As soon as the social worker handed Khord Agha a clean needle, the 28-year-old heroin addict pulled out his packet of tinfoil and began searching for a vein.
After jabbing unsuccessfully several times, he finally found a spot. His shoulders slumped as the drug coursed through his bloodstream, and Agha began talking about how he became one of the surging number of heroin addicts in Afghanistan.
"It started when I was working for a family on their farm in Iran," said Agha, who left Kabul more than eight years ago to find a job. "Everyone was using it to relax. Now, I use it to get through the day, to tolerate the depression of my existence."
Afghanistan, besieged by decades of war, is fighting another battle — a spiraling epidemic of heroin addiction in the country that is the world's largest producer of opium, which is used to make heroin. Some Afghan officials worry these drug addicts could pose a threat to the country's security.
"This is a problem if we don't address it soon can affect all areas of life — even security," said Abdullah Wardak, a physician who heads the Afghan Health Ministry's drug demand reduction department. "If a drug addict is desperate enough for drugs, think what the Taliban could get him to do."
The number of addicts in Afghanistan is far greater than in the USA. A survey by the United Nations Office on Drugs and Crime (UNODC) in 2005 showed Afghanistan had 920,000 heroin addicts, or 3.8% of the population. In the USA, 282,000 people are dependent on heroin, or .2% of the population, according to the 2008 National Survey on Drug Use and Health.
Afghan and U.N. monitors say the problem has grown much worse as the war against Taliban insurgents continues to escalate. There may be more than 1.3 million addicts, says Afghanistan's counternarcotics minister, Col. Gen. Khudaidad, who goes by only one name.
'They all become hooked'
Khudaidad says a big part of the problem are Afghan refugees who picked up the habit while living in Iran or Pakistan and then returned home in recent years.
"They would go work in construction or on a farm, and their bosses would give it to them, so they would sleep well and have energy to work the next day," Khudaidad said. "But they all become hooked."
Jean-Luc Lemahieu of UNODC in Afghanistan said heroin addiction spreads far beyond the population of returning refugees.
Officials closed down a massive drug den in the bombed-out ruins of the old Russian Cultural Center this summer in central Kabul. Lemahieu said up to 1,600 heroin users a day would frequent the den, which he called "the McDonald's of opium addiction." Each day, two to four bodies would be found — victims of overdose, malnutrition or exposure related to drugs.
"We know, of course, what we saw in the Russian Culture Center is only the tip of the iceberg," Lemahieu said.
Before 2001, when U.S. forces toppled the ruling Taliban regime, Afghanistan had one drug treatment center.
Now there are about 45 clinics, and that's still not enough, said the Health Ministry's Wardak.
So six days a week, social workers from the Nejat Rehabilitation Center, fan out around Kabul to offer heroin addicts clean hypodermic needles to prevent the spread of HIV or hepatitis.
Shahzaman Sharifi, a physician and one of the social workers, said addicts' reasons for starting on heroin vary. Some were wounded in Afghanistan's civil war from 1992 to 1996 and turned to opium — then heroin — as a pain reliever. Others used it as an escape from crushing poverty and a sense of hopelessness.
Unending cycle
Sharifi said he sees the same men nearly every day. He always hands the gaunt Mohammed Javed, 37, a package of cookies, along with a clean needle. On a recent visit, Javed's left foot, where he usually injects his heroin, was swollen and oozing.
As Sharifi bandaged the wound, Javed said he had to kick the habit. He told Sharifi he planned to admit himself soon to the rehab center. "My wife told me she will wait for me to get better," said Javed, who hadn't seen his family in years. "I want to stop this, so I can save myself."
The next day, Sharifi checked on Javed. He was slumped in a heroin daze, barely able to speak, a few feet from where Sharifi had left him a day earlier.
Sharifi handed him a clean needle and a package of cookies, then went on with his rounds.
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