But with so many addicts in Kabul, the hidden places are spilling into public view. One of those places is a bridge over the Kabul river in the neighborhood of Pol-e-Sukhta, near Kabul University. There, hundreds of addicts gather daily for their fix.
Recently, I went to the bridge to learn more. On the first visit, drug dealers chased me away with stones. On the second, accompanied by police, I was able to mingle with the addicts undisturbed and learn their stories.
The world I enter in the darkened recesses beneath the bridge stinks of urine and feces and is filled with trash. But the men there do not notice. Their attention is fixed only on the bright fire of their matches heating the heroin paste until it smokes and, then, for several blissful moments they enter the state they crave most of all, where nothing touches them.
Inadequate Medical Help
I speak with one user who had already been hours under the bridge and is between fixes. He says his story was typical of those around him, just as those around him were typical of the some 8 percent of Afghans the UN says is addicted to drugs, often opium or heroin. That is 8 percent of the population between the ages of 15 and 64, twice the world average.
I said, 'I'm sick, I can't walk.' But the doctor said, 'we have no bed for you'
The man, who does not give his name, says he is 38 and used to be a professional football player. He says he picked up his habit while he was a refugee in Iran. There, he says, drug dealers offered people their first tastes of opium and heroin for free, knowing they would become addicted.
I ask if he ever tried to kick his habit since returning to Afghanistan. Yes, he says.
"I decided to leave [this habit behind]. I went there [to the hospital] for one month, coming and going, coming and going, and they told me 'don't smoke.' I said, 'OK.' The doctor told me, the day you decide, then don't smoke. So, I stopped. But then I began to vomit and have diarrhea. I said, 'I'm sick, I can't walk.' But the doctor said, 'we have no bed for you,'" he said.
The doctor had only one treatment for him: "The doctor told me to take cold showers. But I didn't feel better, I felt worse. Later, the doctor asked, 'are you feeling better now?' I said, 'yes.' And then he said, 'take this broom and sweep the hospital'. I said, 'am I a patient or a cleaner?' And the doctor said, 'if you don't do it, I will kick you in the stomach.'"
The man, who soon relapsed, tells his story so matter-of-factly that he seems to have lost hope he will ever end his addiction. And, unfortunately, the statistics for drug use in Afghanistan support that view.
Only one in 10 addicts receives any drug treatment, because programs are rare and underfunded. According to a study last year by the UN Office of Drug Control (UNODC) there are roughly 700,000 people in Afghanistan who want treatment for their addictions but cannot gain access to a facility. And even when they gain access, long-term treatments like methadone substitution are rarely available, making the likelihood of relapse high.
Unhappy Locals
The presence of so many addicts under the bridge is deeply disturbing for residents of the area. One man, Hamidullah, who lives nearby recently left this recorded message for Radio Free Afghanistan's popular talk show "Liberty Listeners."
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