Reducing drug demand in Afghanistan

After 25 years of conflict and displacement, many Afghans now use a wide range of drugs, including alcohol, opium and tranquillisers, to cope with the stress of daily life.

In 2002, after a transitional government had replaced the Taliban, a priority of the new national Counter Narcotics Directorate (CND) was to establish a policy framework for drug control. In 2003, a National Drug Control Strategy was adopted that incorporated all aspects of demand reduction, including the provision of harm reduction services to injecting drug users to prevent the transmission of HIV and other blood borne viruses. This was followed in May 2005 by a National Harm Reduction Strategy for injecting drug use and HIV prevention signed by the Ministry of Public Health and the Ministry of Counter Narcotics, which replaced the CND.

This period of policy and service development in post-conflict Afghanistan highlighted a number of lessons:

• National Drug Control and Harm Reduction Strategies are required so that there is systematic coordination of policy at national, provincial and local levels to ensure the development of a rational comprehensive system. This reduces the risk of duplicating services and wasting scarce resources, and allows for mutual support and information sharing between service providers.
• Drug treatment guidelines that set minimum standards are needed for governmental and non-governmental agencies implementing services for drug users and their families.
• Recognising that different drug problems need different approaches and interventions made the rapid assessment of problem drug use a priority.
• A standard list of technical terms, such as 'problem drug use', 'drug dependency' and 'detoxification' in local languages encourages common understanding and discourse.
• The quality and support of staff is crucial. Staff are selected on merit, whilst their training aims to reduce reliance on external advisors or consultants. All those working with problem drug users receive basic skills training and systematic follow-up and evaluation.

Moving forward

With increased recognition of problem drug use in Afghanistan and its related health, social and economic problems at the individual, family and community levels, more resources are becoming available for demand reduction interventions. It is important to:

• ensure continuing coordination, networking and information sharing between demand reduction service providers
• scale-up harm reduction measures, including needle and syringe access and disposal programmes and work to prevent opium and heroin smokers switching to injecting
• regulate and control the illicit trade in pharmaceuticals, such as painkillers and tranquillisers
• ensure proper aftercare, follow-up and relapse prevention programmes for those undergoing treatment programmes
• develop culturally appropriate primary prevention materials and activities for the country's large youth population.

David Macdonald
Demand Reduction Advisor, Ministry of Counter Narcotics, Kabul
ds_macdonald@yahoo.co.uk

Mohammad Zafar
Director, Demand Reduction Directorate, Ministry of Counter Narcotics, Kabul
mohammad.zafar@mcn.gov.af

See also

Drugs in Afghanistan: Opium, Outlaws and Scorpion Tales, Pluto Press: London, by David Macdonald. January 2007

National Harm Reduction Strategy for IDU and the Prevention of HIV/AIDS, Ministry of Counter Narcotics and Ministry of Public Health, Islamic Republic of Afghanistan, Kabul, May 2005 (PDF)
www.ahrn.net/library_upload/uploadfile/file2495.pdf

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