New Therapy Attacks Soaring Drug Addiction

A methadone program for heroin addicts in Afghanistan is proving to be a success, according to local doctors and international health organizations. Until last year, detoxification was the only option for injection drug users (IDUs) seeking addiction treatment in the country.

"In a setting like Afghanistan, where there are no referrals possible to a social worker or a psychosocial counselor, and where you need to integrate everything in the same program, the results are quite impressive," said Dr. Zemaray Amin of Doctors of the World (DOTW), which heads the Kabul-based project. Amin is "completely optimistic" the program's success will lead to a wider local acceptance of substitution therapy.

DOTW estimates the number of heroin users in Afghanistan has increased by 140 percent, from 50,000 in 2005 to 120,000 in 2009. HIV prevalence among IDUs in three Afghanistan cities has grown from 3 percent in 2006 to 7 percent in 2009, the group estimates. Hepatitis C prevalence has risen too, from 36.6 percent in 2006 to 40.3 percent in 2009.

Six months into the trial, the client retention rate was 83 percent, compared to just over 75 percent for similar trials elsewhere. Crime and mental health outcomes among clients have also improved, researchers told the recent International Harm Reduction Association's annual conference in Beirut.

This first major Afghan trial of the intervention is backed by Afghanistan's health ministry and funded by the World Bank. Nonetheless, the program ran into problems importing methadone - though it had secured permission from Afghanistan's counter-narcotics ministry - months into the trial. The counter-narcotics ministry now is calling for an independent review, while a freeze has been placed on enrolling new patients.

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