New York                 By Dr. Cesar Chelala

A report just released by the United Nations Mission in Afghanistan (UNAMA) states that there were 2,754 civilian deaths and 4,805 civilian injuries in that country during 2012. Unmentioned in the report, however, is what may be considered a side effect of the conflict: the high number of opium-addicted children in Afghanistan.

The number of opium-addicted Afghan children has increased systematically in the last few years. The situation is not limited to Afghanistan. Children are being affected in Pakistan as well. In Karachi alone, there are tens of thousands of child addicts most of whom receive no care or support. New and more effective policies are needed to address this situation.

In a study conducted in Afghanistan, in 25 percent of homes where adult addicts lived, the children tested for drug addiction –some as young as 14 months old- showed signs of significant drug exposure. The children exhibited typical behavior of opium and heroin addicts: if the drug was withdrawn, they experienced withdrawal.

Not only were opium products found in indoor air samples but the concentrations were extremely high. This suggests that, as happens with secondhand cigarette smoke, contaminated indoor air and surfaces pose a serious risk to children's health.

The extent of health problems in children as a result of such exposure is not known. What is known is that the number of adult drug users has increased from 920,000 in 2005 to over 1.5 million in 2010, according to Zalmai Afzali, spokesman for the Ministry of Counter-Narcotics in Afghanistan. A quarter of those users are thought to be women and children. If current trends continue, Afghanistan could become the world's top drug-using nation on a per capita basis.

According to the U.N. Office on Drugs and Crime (UNDOC), no other country in the world produces as much heroin, opium and hashish as Afghanistan, a sad distinction for a country already ravaged by war. Control efforts so far have been concentrated on poppy eradication and interdiction to stem exports, while less attention has been paid to the rising domestic addiction problem among children.

Among the factors leading to increased levels of drug use in adults are the high unemployment rate throughout the country, the social upheavals caused by this war and those that preceded it, and the return of refugees from Iran and Pakistan who became addicts while abroad. In both of those countries, the high number of opium-addicted children is also a serious problem, particularly among street children.

Although the government has opened several shelters for street children in Tehran, many more centers are still needed to care for them. According to some estimates, there are between 35,000 and 50,000 children in that city who are forced by their parents or other adults to live and beg in the streets or to work in sweat shops for very low wages.

These children are subject to all kinds of abuse, and many among them end up in organized prostitution rings and become part of the sex trade. Children are often transported to other countries where they are obliged to work as prostitutes, while others simply disappear.

In Karachi alone, where there are tens of thousands of hashish-addicted children, children addicted to stronger drugs present other problems. Due to the increase in the number of street children, street crime is also on the rise as children become involved in drug trafficking in the city.

Those who inject drugs face the additional risk of HIV-infection by sharing contaminated syringes. "Drug addiction and HIV/AIDS are, together, Afghanistan's silent tsunami," declared Tariq Suliman, director of the Nejat's rehabilitation center to the U.N. Office for Humanitarian Affairs.

The distinction between producing and consuming countries has now changed.  “Traditionally, consuming countries have become producers of synthetic drugs. In turn, producing countries have become consumers. What remains is a shared international responsibility. No country should be left alone,” said Jean-Luc Lemahieu, the UNODC country representative.

There are about 90 drug treatment centers dispersed throughout the country, but most are small, poorly staffed and under-funded. The U.S. and its allies have the resources to rapidly expand and adequately fund and resource such treatment and rehabilitation centers throughout the country. The great number of opium-addicted children in Afghanistan is one of the darkest legacies of an ill-fated war.

César Chelala, M.D. Ph.D., is the foreign correspondent for The Middle East Times International (Australia).


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