Associated Press - December 9, 2006
Mike Eckel

"I tried it, I liked it and it went from there," said the haggard, fidgety, out-of-work 24-year-old who got hooked on heroin in 2004. "If you have the money, you can find it anywhere, anytime."

This mountainous nation already was scarred by a civil war that ended just nine years ago. Now, wounds are being inflicted by a dramatic spike in the trafficking of drugs coming out of neighboring Afghanistan bound for Russia and Europe - and increasingly being used by Tajiks.

Makhkamov is one of 7,600 officially registered addicts in Tajikistan. But activists say the real number may be eight times higher and they warn that rising addiction and its related crime and disease are draining limited social resources in this desperately poor country.

"We're on the verge of a generalized epidemic," said Murtazokul Khidirov, a health activist involved in the fight against illegal drugs, AIDS and related diseases. "If that happens, there will be big problems."

The country's average annual per-capita income of $1,400 is the lowest in formerly Soviet Central Asia, according to the International Monetary Fund's data for 2005. As many as three-quarters of its 7 million people live in poverty, the United Nations says.

Tajikistan shares close cultural ties with Afghanistan as well as a porous, 830-mile border.

Russian guards patrolled the frontier for many years as both Afghanistan and Tajikistan were wracked by war. The Tajiks have taken over - with U.N. help - but doubts persist whether they can stem the tide, especially since Afghanistan's opium cultivation has reached record levels.

Officially, according to the Tajik Drug Control Agency, 7 to 8 tons of illegal drugs were seized last year, and the U.N. ranked Tajikistan fifth worldwide in heroin and morphine seizures and fourth for opium. Most experts, however, say the Tajik figures represent just a small fraction of the drugs transported through the nation.

Iran, Pakistan and other Central Asian nations are also conduits for drug smuggling from Afghanistan, but endemic corruption and poverty put Tajikistan in more danger, experts say.

"There is a problem and we are looking for help from the world community, from the United States," said Lt. Col. Avaz Uldashev, a spokesman for the Tajik Drug Control Agency.

Since the end of the 1992-97 civil war, the average age of Tajik addicts has crept downward from about 30 to 35 years old to between 20 and 29.

The proportion of female addicts, mainly prostitutes, has soared to around 30 percent of all users, increasing the likelihood that cases of infectious diseases like AIDS will jump in coming years, said Khidirov, the health activist.

Health workers and aid groups in Dushanbe, the capital, are allowed to distribute condoms and clean needles to help prevent the spread of AIDS, Khidirov said.

But critics say the government largely neglects the treatment side of the drug fight. AIDS cases have climbed markedly the past five years and a record three dozen fatal drug overdoses were recorded last year.

Efforts to treat addiction, like methadone replacement therapy, are largely ignored.

So are residential treatment clinics like the Drop-In Center - one of only two such places for addicts nationwide. Nine addicts, including Makhkamov, live at the small, nondescript house on Dushanbe's western outskirts, getting a free place to sleep, eat, wash clothes and receive counseling. Many others come and go sporadically.

On a recent evening, one woman slept on the floor in front of a blaring TV and under a flickering light bulb, while two other addicts, including a 42-year-old former doctor, played pingpong in the main room.

Posters in Tajik and Russian explaining how AIDS and hepatitis are contracted adorn the walls of cramped rooms where residents store their precious few belongings under narrow, uncomfortable beds.

Sergei Kozlov, the center's director, said the operation, which opened last spring, has received foreign funding of about $13,000 and nothing from the government.

"The government looks at us like 'let them do what they want so long as they don't bother us.' Tajik society isn't ready for us yet," he said.

Kozlov blamed the surge in addiction on the poor economy, which has turned drug trafficking into a semi-reliable source of income. In Dushanbe, it's almost as easy to buy drugs as it is to buy beer, he said.

"You have to fight the addiction. We have to do more, to fight it and to help (addicts)," he said. "If you leave them, they just become parasites on society."

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