By Kamin Mohammadi
A small slim, small man
stands up, his dark eyes bright with emotion, a full moustache filling up his
face. 'My name is Shahram and I am an addict,' he says gently. He is greeted by
an enthusiastic response from the other men sitting around the room, the
standard opening of a Narcotics Anonymous meeting. Shahram proceeds to tell us
that he was addicted to heroin, opium and hash for 14 years and has been clean
'by the grace of God' for one year. Today is the celebration of this
anniversary and Shahram is presented with a cake set with a candle which he
blows out, laughing and choking back the tears as the other men applaud
him.
This may not be an unusual
scene but it is not taking place in your local church hall. We are standing in a
big hall in a park in Rey, in the deepest south of Tehran, the capital of the
Islamic Republic of Iran. This Narcotics Anonymous meeting is at one of two
types of NA centres this one is called a 'camp' because it is a purpose-built
compound in a park. The compound consists of tented buildings, the big hall
Shahram is being applauded in is half tent, half rough plaster walls, the roof a
vast sheet of tarpaulin with plastic windows letting in light which cuts through
plumes of cigarette smoke. This camp is for men only (there are separate camps
for women addicts) and, according to Iranian custom, the men have all shed their
shoes on entry and are sitting barefoot and cross-legged on the floor. It is
hard to guess their ages, so grizzled have they become after years of battling
heroin. But it is clear that the score of men here are from the poorest strata
of society, many are young and all are trying to remake their
lives.
Until one year ago today,
Shahram Khanalizadeh was one of Iran's estimated two million drug
addicts an official figure generally accepted to be much lower than the real
number of perhaps three to six million.
Despite the strict Sharia
laws which govern the country's Islamic system, according
to the UN World Drug Report for 2005, Iran has the highest proportion of
opiate addicts in the world 2.8 percent of the population over the age of 15.
The problem has reached epidemic proportions, with some 20 per cent of the
population thought to be involved in drug abuse in some
way.
As
a neighbour to Afghanistan,
the world's highest opium producer, Iran is the favoured route for drugs making their
way to Europe. The UNODC reported in 2005 that
60 per cent of the opiates produced in Afghanistan leave the country via
Iran, an increase of 20 per cent on
the year before. Much of the opium that washes out through Pakistan is later smuggled into
Iran over the south eastern
border, meaning that practically all the opiates produced in Afghanistan end up in Iran at some point of the 936 kilometre long
eastern border with Afghanistan and Pakistan, much
of it is either mountain or desert. And of this flood of drugs, much ends up
being consumed locally. Iranian officials have long said that their country is
paying the price for keeping heroin out of Europe, a fact confirmed by the
International Narcotics Control Strategy Report from the US State Department:
'There is overwhelming evidence of Iran's strong commitment to keep drugs
leaving Afghanistan from reaching its citizens
As Iran strives to
achieve this goal, it also prevents drugs from reaching markets in the West.'
The report goes on to comment that: 'The
latest opiate seizure statistics from Iran suggest Iran is
experiencing an epidemic of drug abuse, especially among its
youth.'
The
UN too has praised Iran's efforts in tackling its drug
problems. Roberto Arbitrio of the UN Office for Drug Control and Crime
Prevention (UNODC) in Tehran, referred to a
report of the UN body last March which said Iran had set a
world record in drug seizure and confiscation. The chief of Iran's national
police force, General Ismail Ahmadi-Moqaddam, has reported that the seizure of
145 tons of drugs nationwide between March and August of last year marks a
29-percent increase over the same period in 2005.
Iranian attempts
to control the flow from Afghanistan are an ongoing battle,
often the drug smugglers have more high tech equipment and better artillery than
the Iranian enforcement units
more than 4000 Iranian law enforcement forces have been killed in this
continuing war.
Opium has traditionally
been a panacea to the aches and pains of old age, but the new generation of drug
addicts have scorned opium for heroin. When the Taliban drastically cut opium
production in 2000/2001, prices soared making the cheap and widely available
heroin the natural option for addicts.
Shahram's story is typical.
Born 30 years ago into a poor family living in Rey, a suburb of Tehran's deprived southern
reaches, Shahram grew up with low expectations, he explains as we move out into
the open ground of the camp where a large urn dispenses tea and Shahram hands
out fresh pastries he has brought for the celebration. Behind him the outside
wall of the hall is painted with a large mural of a hand reaching down from
heaven to take another hand that is reaching up from below, an image repeated on
the sign announcing the camp, bearing the legend 'Society of the Delivered'. NA
has been delivering addicts to health in Iran for around
15 years now and there are numerous meetings in most towns in the country. In
Tehran alone
there are 40,000 NA members, both men and women and the society publishes a
newsletter and has a good website with details of meeting times and locations.
Shahram tries to trace the roots of his addiction for me. 'There are no jobs and
nothing to do with your time,' he tells me. 'I couldn't get along with my father
and I thought he didn't love me. We couldn't communicate so I spent less and
less time at home and more time with my friends who were smoking hash. We had
nothing else to do.'
The baby boom that took
place after the revolution of 1979 was encouraged by Ayatollah Khomeini, the
post-revolutionary Islamic leader, who demanded more children to expand the
revolution. Iranians duly obliged, and the population has jumped from 37 million
in 1979, to around 70 million. This is a particularly remarkable figure when
other factors are taken into account up to four million people left the
country at the time of the revolution and another million were killed in the
eight-year war with Iraq. Of the present population around 70 per cent are under
30 and these modern children of the revolution have very different needs and
desires to their parents, making the generation gap particularly
problematic.
Shahram's family problems
were exacerbated by the gaping social and economic divide between the south and
north of Tehran.
Old fashioned and underdeveloped, the south of Tehran is home to traditional and conservative
families, mostly poor while the north, nestling in the lap of the Alborz
mountains, is prosperous and developed, with the apartments and houses becoming
increasingly expensive as you head further north. The most elaborate villas
occupy areas that until recently were still villages in the foothills of the
mountains, and are sought out by Iran's richest ten per cent for the better air,
perched above Tehran's horrific pollution.
Shahram explains the
resentment that fed his sense of hopelessness. 'I saw the kids uptown and they
had everything. We had nothing and life was hard. I got more and more depressed
and eventually I started smoking hash. I was trying to erase my problems rather
than face them,' he says. As hash made him feel better 'and our basic human
nature is to want to enjoy ourselves' Shahram continued on to opium during his
two-year obligatory national service and despite cleaning up for a few months
when he was wooing his wife, at his wedding he was again slipping away to get
high.
By this time the price
hikes in opium, coupled with his rising tolerance to it, pushed Shahram into
trying heroin. He loved it. 'First of all, it was much more practical, it only
took 20 minutes to smoke,' he tells me in a fast staccato. 'I didn't get the
drowsiness of opium, and it was just better value.' He blushes and apologises to
me for what he is about to say, as discussing sex with a strange woman is
anathema to a Muslim man. 'Er, once I was married, I used more because, you
know, I wanted to enjoy my wife more. As I said, I think it is a human instinct
to want to take pleasure in your life.'
Shahram's habit soon became
the most important thing in his life. 'I lost my job as a builder and sold
whatever I could get my hands on to get money. I took the gold earrings out of
the ears of my two-year-old daughter so I could sell them to score. I sold all
our carpets, the furniture. I am ashamed of the things I did.' His wife hated
his heroin habit and tried to make him stop. She even sold her gold jewellery to
finance treatment, but despite several attempts, Shahram invariably returned to
heroin after a month or two. 'There are lots of different programmes and they
prescribe heroin substitutes but even if I beat the physical addiction, I never
lost the craving. I know people who have had complete blood transfusions who
still go back to using. You have to deal with the root of the problem, otherwise
the rest is useless.'
By the time Shahram was
introduced to NA, he had lost everything. His wife was living with her parents
with their two children, 'although because we loved each other we never
separated formally', and Shahram was living on the streets. He stole, lied, cheated and dealt drugs
himself to feed his habit because 'I was just using in order to keep alive. It
no longer made me high but my body couldn't function without it. Thank God I
never got to injecting because then I would have ended up in jail with HIV.' He
smiles broadly, 'I am just so happy that I survived to be given a second chance.
Today is marking my rebirth, my second chance.'
The love and understanding
he has found at NA has been key to Shahram's recovery. 'This is my refuge,' he
says as his friends come up to congratulate him, hugging and kissing him. 'I get
energy from the support I get here. If I have any problems, I go to a meeting
and people help me. Before I came here, I couldn't even say out loud that I was
an addict. Now I know myself.'
In keeping with NA policy,
the addicts have to go through the arduous process of detoxing without any
medicinal help, and they spend the first month living in the centre. They are
encouraged to donate around £25 to the running of the centre, otherwise
treatment is free. A few stops away on the metro line, I visit Persepolis, another NGO
which takes a different approach, having been the first non-governmental
organisation to be authorised to hand out methadone to addicts.
I enter a small courtyard
filled to bursting with men, queuing. The queue snakes up stairs leading to a
gallery where, from small window, methadone is handed out. I head up the steps,
turn instead into a small office, also packed to bursting with people, desks and
stacks of boxes. The boxes contain a package of syringes, clean needles, tape,
alcohol pads, condoms and distilled water, all handed out to addicts for free.
As all those who drop in every day up to 600 people, mostly men but a handful
of women too are all homeless, the basic care the centre provide is vital,
giving out food, clean clothes and even a shower. There is always a GP on hand
to provide medical attention, including wound and abscess management many of
the addicts are suffering from diseases such as Hepatitis and HIV and have
weeping sores on their bodies from their diseases and the hardship of their
lifestyles. The care pack is designed to make sure those injecting at least do
so hygienically and safely. Those registered for the syringe package have to
bring back the used syringe before they can get another package. 'It's part of
the education,' he says, 'And we don't want the streets littered with used
needles.'
The team consists of
doctors, a psychiatrist and an outreach team that takes the same packages out
into the community one worker tells me that he gives 60 condoms a day to just
one prostitute working the park nearby. Although officially illegal in
Iran, poverty, addiction and the
disintegration of families forces many women into prostitution, and here in the
poverty-stricken south of the city, there are few other choices. The lack of
adequate social services has inspired many NGOs such as Persepolis to try to address the many inter-related social
problems in Iran.
Like NA, most of Persepolis's staff are
reformed junkies and often they just sit and listen. Despite the need for
sensitivity in safe sex education in the Islamic Republic where pre- and
extra-marital sex is illegal, teaching the addicts about condoms is essential.
Below the office there is a
day room where people can drink tea and talk; lunch is offered on alternate
days. 'There is such a need for what we are doing,' Dr Nassirimanesh, the
founder, says. 'We have enough people who want to work, enough people needing
treatment. What we don't have enough of is funding. Get me funding and we will
open a Persepolis in every district in every town.
What we do now is small in scale. We reach a very tiny percentage of the
population.'
Persepolis' work may be
frustratingly small scale, but the regime's new approach encompasses working
with NGOs like this one to battle the epidemic. At
a pre-sermon lecture at Friday Prayers last summer, Fada-Hossein Maleki,
Secretary General of Iran's Drug Control Headquarters said that Iran 'is at the
forefront of the campaign against narcotics throughout the globe' and described
the role of the government as working alongside the 500 non-governmental
organizations active in this field.
A
comment by Ayatollah Hassan Marashi, who previously served on the High Council
for Judicial Development and in the judiciary, illustrates the change of heart
of the regime. Talking of drug dealers, he told an Iranian newspaper that many
become dealers out of economic necessity, and that arresting and imprisoning
them proves counterproductive as families then sink deeper into poverty and
sometimes turn to prostitution. 'Punishment does not correct people's behavior,'
he said. 'We pay no attention to the causes and we merely pursue the
effects.'
Mehrdad
Ehterami, an official at Iran's state Welfare Organization's prevention
and addiction-treatment department has stated that Iran sees 90,000
new drug addicts every year, with more than 180,000 people treated for addiction
in the state or private sector. He listed 51 government facilities, 457 private
outpatient centers, and an additional 26 transition centers that all work
together to combat the problem.
I ask Dr Nassirimanesh
about the government's approach, which is one of the most enlightened in the
world. Recently addicts were invited to present themselves at police stations
and health care centres to undergo voluntary treatment and rehabilitation, in
return for amnesty from arrest and prosecution. About half of the annual budget
allotted to fighting drugs now goes towards harm reduction. 'The government is
taking the four pillar approach, same as countries such as Switzerland and the UK,' says Dr
Nassirimanesh. 'They are: harm reduction, treatment, prevention and then supply
reduction. Without all four pillars, government drug policy is like an orchestra
playing out of tune. Since we started our work, government policy has changed
dramatically and we no longer have problems with the law and red tape. What we
need now is more support for NGOs, and more NGOs willing to pull up their
sleeves and help.'
As an Iranian who has grown
up in the UK and regularly visits my homeland,
I have heard many people are doing synthetic recreational drugs. Even with
Iran's historical addiction to opium,
this is a departure from the norm. I ask Dr Nassirimanesh about this, and he
laughs: 'At Persepolis the people we treat are at the end
of the road. They don't know what "recreation" means, they are just trying to
survive.' But when I persist, he admits that 'anecdotally I have heard of the
use of recreational drugs such as cocaine has rocketed. There needs to be
research done to find out how to deal with the impact of recreational drug use
at this level. Doctors need to be educated on how to handle the health
consequences and the government needs to be prepared for the social
consequences.'
There is quiet consensus
among people working on the frontline of this problem that it has not yet
peaked. Talking to Hamid, one of the young addicts in the centre, he tells me:
'The kids up there in the north of Tehran can afford to buy beer and vodka. We
can't, so we take heroin cos it's cheap.' A shot of heroin can cost 80 cents,
less than a packet of foreign cigarettes (20 Kent will set you back $2) and I
have heard rumours that on university campuses drugs are more readily available
than books. $16 will buy one gram of good quality heroin, about 50 per cent
pure, which could last a novice addict about ten days, though a seasoned addict
like Shahram could get through two grams a day. Poorer quality heroin costs $8 a
gram. 'Opium is much more expensive,' says Shahram, 'So it's just not as
popular. Crack is cheap too and I have seen kids start with crack, not even
bothering with hash.' He tells me that one gram of crack cocaine costs between
$12-$18, making it as good value as heroin, but with a high that packs an
altogether different punch. Shahram tells me that in his neighbourhood, the age
for using drugs is falling: 'I now see kids starting at 14, 15. I have seen them
using around schools, in breaks, scoring in the playground.'
Alcohol, which is illegal
in this dry Islamic state, can also be easily bought on the black market, but as
Hamid rightly indicates, alcohol is not cheap a bottle of red wine of the sort
you might pick up at your local off licence for $10, will set you back $40 in
Tehran a professional such as a teacher earns around $350-$400 per month. And
while different punishments for drinking, making or possessing alcohol are
minutely set out in religious rulings that govern Iran, there are no specific fatwas given about narcotics, and so the
laws on drugs have struggled to find a religious foundation the most common
one used is issued by Ayatollah Khomeini and states that 'one is not allowed to
harm oneself'. The harshest punishment of execution can be meted out to
individuals
holding more than 30 grams of heroin or 5 kilograms of opium, and the much of
the Iranian prison population comprises those arrested for drug offenses; of
46,930 imprisoned in December-January 2006, 31 per cent were addicts, with a
further 40 per cent arrested on drug-related offences, according to Justice
Minister Jamal Karimirad. But the high rate of HIV infection in prisons, through
shared needles, is one of the factors that has persuaded the government to adopt
a less punitive approach to tackling drug addiction. Although there are no firm
statistics, according to Hamidreza Setayesh, UNAIDS country officer for
Iran, around 48 per cent of prisoners
are addicts and they tend to inject as it attracts less attention than smoking
the drug. And in a study published last year, it was found that those at risk
were 12 times more likely to contract HIV in prison. 'Prisons though have
upscaled their approach now,' Hamidreza Setayesh points out. 'There are
rehabilitation and education programmes inside jails and 6,000 people are being
given methadone. Clean needles are given out and there is much less needle
sharing.'
Up in the centre of town, I
drop in on another drug rehabilitation centre, another NGO with another
approach. Aftab is located on a quiet street and looks much like a regular
house. With its bright blue painted banisters and doorframes, Aftab has a
detoxification ward upstairs where addicts pay to be weaned off drugs, and
offices downstairs used for outpatient meetings. Dr Masood Sedghy says that of
the addicts he sees here, 80 per cent of them are addicted to crack. 'Most of
the people we treat are poor, but we do have some middle class patients and even
some from the rich section of society.' But he points out that many of the rich
users prefer shisheh meaning glass,
methamphetamine or crystal meth, so called after the glass pipe that it is
smoked out of. And with house prices, drug prices are geographically sensitive,
as you head further uptown, the drugs of choice become more expensive with one
gram of crystal meth costing around $120, a huge expense in the Islamic
Republic.
In
2005 the director of the Iranian National Centre for Addiction Studies estimated
that 20 per cent of Iran's adult population was 'somehow involved in drug abuse'
and an official survey, whose findings were released in 2005, showed that drug
smuggling and sales in Iran was a 10 billion dollar market in 2004, nearly three
quarters of the total revenue from Iran's oil market during the same period.
Southern Tehran, where
Persepolis and the Iranian National Centre for
Addiction Studies are located is the traditional, conservative heart of
Iran. The city's poorest people live
here, forming the backbone of the support enjoyed by President Mahmoud
Ahmadinejad who was voted in by them and others like them, people who thrilled
at his promises to fight the corruption crippling the country, to improve the
economy, create jobs (official unemployment figures stand at 11 per cent but in
reality are estimated to be around 25 per cent) and redistribute the country's
oil wealth. But 18 months after he took power the economy is sorrier than ever.
With inflation soaring official figures put it at 20 per cent but the reality
is thought to be at least double and the price of basic foodstuffs fluctuating
weekly, they have yet to see any of these promises fulfilled.
More
than 50 per cent of the Iranian population lives under the poverty line,
according to official estimates provided by the Iranian Central Bank (although
again it has been suggested by members of Iran's parliament that the reality is
90 per cent), which sets the poverty line at an income of around $300 per month
for a family of five.
A government poll showed
that 80 per cent of Iranians believe that there is a direct link between
unemployment and drug abuse, something I heard reiterated constantly. The
government of Iran regularly fails to produce the
one million jobs needed annually to accommodate new workers entering the job
market, the result of Khomeini's baby boom.
Leaving south
Tehran, I get on
an efficient metro which whizzes me up to Mirdamad, up in the prosperous north
of the city. Walking along the wide boulevards of uptown Tehran canopied by
plane trees etched with snow, with the Alborz mountains rising up behind, I am
struck by the stark difference between the two parts of the city, a divide that
is not just aesthetic and financial, but also ideological. Now, a tragic
epidemic unites the city of two halves the devastation being wrought by drugs
in all sections of society, with the authorities seemingly unable to stop
it.
Shahram had said
to me in Rey. 'The police are more likely to fine people than arrest them,' he
said. 'Partly because the attitudes to addiction have changed, it has become so
common that everyone realises it is a problem so they don't treat it so harshly.
But also, well, people are very poor
' Shahram does not say so and nor does
anyone I speak to, but I have heard of dealers bribing local police to allow
them to work their patch. Unlike in the south up here in the north of the city,
no-one goes to the local park to score. I have heard that in Tehran, you are never ten
minutes away from a dealer a reputation for efficiency the dealers up here
cultivate. The preferred method of scoring is to have your drugs delivered,
dealers just need a mobile phone and a motorbike to get through the traffic and
most well-to-do kids make sure they arrange to meet in a quiet back street where
they wait in their cars. But whether scoring in a shiny BMW in the foothills of
the north or shooting up in a park in Rey, the young drug users of Tehran have a litany of
dissatisfaction, disillusionment and disappointment spurring on their
destructive habits.
With so much
attention inside and outside the country fixed on Iran's nuclear
programme, the issue most likely to change the face of Iranian society for ever
seems destined to never make the headlines.
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