Most of the HIV cases I treated in the US were gay.

However, this article in today’s NY Times reminded me that HIV via IV drug abuse is a major problem in parts of China that lie near to the “Golden Triangle”.

But Malaysia? Again, presumably the heroin is coming from the Golden triangle also.

But on googling about Heroin, I found this article: LINK on Iranian addiction, which is increasing due to the resurgence of the opium crop in Afghanistan.

At present, there are three million drug abusers in Iran, most addicted to heroin. (in comparison, the US has an estimated 900 000 heroin addicts). The addiction rate is fueled by high unemployment, poverty, hopelessness, and boredom, the same reasons that fuel addiction in other countries. However, unlike the US or many parts of Europe, where heroin addiction is a small part of the overall addiction problem, it is the main drug of abuse in Iran.

And the Washington Post estimates one quarter of addicts who inject heroin are infected with HIV, and that two thirds of those with HIV have caught it from dirty needles. For this reason, last year Iran authorized doctors to prescribe Methadone to addicts, trying to stop the spread of HIV.

Over 90% of the world’s heroin is produced in Afghanistan, and 60% of it goes through Iran on the way to Russia and Europe.

Since the liberation of Afghanistan, local farmers have reverted to growing opium poppies to survive. The US and European policy is to eradicate the crop, but givein the increase in Taliban fighting from Pakistan, THIS REPORT urges anti terror/anti Taliban forces should not be involved in drug eradication, and that by stopping the warfare and establishing peace and building the infrastructure is the first priority, since farmers will not be willing to stop planting poppies unless they have an alternative way to feed their families.

The irony of all of this is that those spreading terror are ultimately fueling death and destruction in their own lands. (The Taliban is Sunni but some have taken refuge in Shiite Iran. There is little information about addiction in Saudi Arabia or in other countries of the Middle East, however, there has been a surge in heroin usage in Central Asia.

Given the large number of overseas workers in the Persian Gulf, one would expect to find a huge problem of HIV associated with commerical sex and illicit drugs, and the sexual exploitation of female domestic workers. Again, I was unable to find reliable statistics on this.

But the irony might be that increasing freedom in Afghanistan, along with the failure of the international community to provide promised developmental aid, might end up as a “blowback” of heroin addicts in those countries and in countries that look the other way at the Taliban and other radical groups in their midst.

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Nancy Reyes is a retired physician living with her husband in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket and she posts medical essays to Hey Doc Xanga Blog

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