In Afghanistan, drug rehab for children

Christian Science Monitor/ July 14, 2010

Najiba scrabbles through cupboards frantic for something sweet. She claws at her mother, urging her to help. Najiba, though only 13 years old, lives in the Sanga Amaj drug addiction rehab clinic in Kabul with her mother, Zainab – who is also an opium addict, a habit acquired from her husband and passed on to her daughter.
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.“When she was born, she kept crying, so after two months or so I started giving her opium to keep her quiet,” says Zainab. (Her and Najiba’s names have been changed to protect their privacy.)

The result is a drug dependency that Najiba is now desperately fighting.

Yet she is neither alone among Afghan children addicted to opium, nor among the worst affected. For starters, she’s one of a small minority getting professional help.

Opium as a pacifier
Opium is used in parts of Afghanistan to quiet babies and, in poorer households without access to medical help, to relieve pain – trends exacerbated by decades of conflict. Economic pressures and fragmented families have meant that women have less help at home and are more likely to give opium to cranky children, to free themselves up to do housework.

“Opium is sometimes used as a child-rearing method,” says Preeti Shah, a Narcotics Affairs Officer of the US Bureau of International Narcotics and Law Enforcement Affairs (INL) in Kabul.

The conflict has also left people with deep physical psychological wounds, which they try to numb with narcotics.

A two-year pilot study by the INL on drug addiction and household toxicity in Afghanistan found that babies as young as nine months were testing positive for narcotics, says Thom Browne, deputy director of the INL’s anticrime programs. It also found that in many cases, the level of toxicity in young children was several times higher than that in adult heroin users. The study, which looked at 30 households in three provinces, will be expanded to cover 2,000 households in 22 provinces next year.

While other countries also face cases of babies born with addiction, in Afghanistan the problem deepens as parents continue to administer drugs to their children. According to a recent report by the United Nations Office on Drugs and Crime (UNODC), up to half of drug users surveyed gave their children opium. The INL found in their study of Afghan drug users’ homes significant samples of opium in the air, bedding, eating utensils, toys, and other items that children come into contact with.

Treatment as taboo

Treating drug addiction is not easy anywhere, but is especially difficult in Afghanistan because of social and cultural stigmas against females going outside the home. Many families are reluctant to let women come and stay at Sanga Amaj for the 45-day treatment period, let alone the preferred 90-day period, says Latifa Hamidi, the doctor who oversees the clinic. Even surveying women proved near impossible – they constituted only 3 percent of the UNODC’s sample size.

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.Even more helpful would be treat the entire family, says Gilberto Gerra, the UNODC’s chief of drug prevention. Otherwise, “if a woman goes back to a home where her husband is using drugs, the risk of relapse is very high.”

Although cultural taboos prohibit men and women being treated together, the INL hopes to build treatment centers for men and women near one another, to allow family members to visit one another. Sanga Amaj, which opened in 2007, represents a step in that direction, by treating women and their children together.

The clinic’s 33 patients include 15 children, the youngest of whom is 3 years old. Zainab and Najiba have been here for two weeks. In addition to attending group therapy sessions and receiving medical treatment, during they day they exercise, sit in religion classes, and learn skills like sewing and embroidery. At the end of their time, they will go home to Zainab’s husband, who has already undergone treatment. If Zainab and Najiba stay clean, they will be entitled to free medicine from the clinic.

Facilities like Sanga Amaj are few. Kabul only has four, which can handle about 100 patients. Of Afghanistan’s 1 million drug users, at least 90 percent have no access to treatment, according to the UNODC.

Expanding treatment facilities would require considerable foreign aid and expertise, but does not rank high on donors’ list of priorities. These include instead ending the poppy farming and drug trade that make Afghanistan the supplier of 90 percent of the world’s opium.

“Afghanistan is known for being a supply country,” says Ms. Shah. “It is time to recognize it is a demand country as well.”