The ‘forgotten crisis’ of Afghanistan has exposed more and more young Afghans to mental health problems and drug abuse amid dwindling donor support and crumbling healthcare under the Taliban regime, said experts at a high-level side event at the recent meeting of the Commission on Narcotic Drugs in Vienna Austria.

Since the Taliban imposed a drug ban in April 2022, opium poppy cultivation in the war-ravaged country has dropped by around 95%, according to the United Nations Office on Drugs and Crime (UNODC). 

But experts claim that drug abuse, particularly among the youth, is getting worse – and is being compounded by a lack of treatment.

The WHO estimates that around 2.9 million people abuse drugs in the country, while nine million have mental health issues in a population of around 38,3 million.

Holistic approach

At the side-event on “Mental health and substance use disorders in Afghanistan”, hosted by the World Health Organization (WHO), UNODC, the European Union (EU) and the Japanese government, stakeholders said the rapidly deteriorating socio-political environment in the country posed new challenges that require a more holistic approach and engagement with the Taliban authorities to save millions of lives. 

Jean-Luc Lemahieu, UNODC’s director of policy analysis and public affairs, said that many youngsters trying to escape the Taliban’s oppressive system of governance are vulnerable to drug abuse and exploitation, including radicalization.

Programmes linking reducing drug use and “active livelihood support and vocational skill training” should be offered in the country, he suggested.

UN officials noted that the “near-total contraction of the opiate economy is expected to have far-reaching consequences” for rural communities who relied on income from cultivating opium.

“Farmers’ income from selling the 2023 opium harvest to traders fell by more than 92 per cent from an estimated $1,360 million for the 2022 harvest to $110 million in 2023,” according to UNODC.

The WHO estimates that 23.7 million Afghan people will need humanitarian assistance this year as economic conditions in the country deteriorate. In addition, 9.5 million people have no or very limited access to healthcare.

Experts at the event warned that mental health and drug addiction can have far reaching public health consequences, including higher mortality rates, infectious diseases like HIV, hepatitis as well as diminished productivity.

Social tensions

Raffaella Iodice, Chargée d’Affaires and deputy head of the EU Delegation to Afghanistan, told the conference that mental health issues and drug addiction can trigger social tensions and negatively influence stability in communities. 

“Investing in drug demand reduction and mental health, quality, evidence-based and comprehensive treatment and prevention can pave the way for more sustainable and resilient communities that are critical for advancing the overall economic situation,” she said.

The EU is supporting a 100-bed Female and Children Drug Addiction Treatment Centre (DATC) in Kabul, which was established in December 2023.

It assists mothers and children up to the age of 17, offering “child counselling sessions that surpass conventional education, acting as a crucial pillar of support for young minds navigating the complexities of addiction”, according to a report from the WHO EMRO region. 

Easy access to drugs

Abdul Hakim, who was enrolled in a drug addiction treatment centre in Kabul eight months ago after 20 years of drug addiction,  told Health Policy Watch that the easy availability of drugs was one of main reasons why many return to addiction after treatment and recovery.  

“If the authorities collect the drugs and dealers from the market, we will recover and stop using drugs,” he said.

Kabul city resident Gholam Ali, whose son became addicted to drugs eight years ago, told Health Policy Watch that his son has been treated several times, but easy access to drugs has made him addicted to it again. 

“There was no clinic left that I did not take my son to. He is treated for one or two months in each clinic, but when he leaves the clinic, there are drug addicts and drugs available outside, and he turns to drugs again,” said Ali.

Anja Busse, a UNODC programme officer working on prevention, treatment and rehabilitation,  said that the treatment model in Afghanistan is unable to meet the needs in the country. 

“The outpatient services in the community would need to be widely expanded and to be integrated in the community based health care approaches to have a continuum of care,” said Busse.

“ The reduced availability of previously widely used opioids at local markets has potentially increased risks for people with drug dependence due to increased levels of police interactions.”

Afghanistan’s health system system has been struggling to meet mounting demands amid dwindling aid and restrictions. Stigma is also a problem.

“Whether we are facing a mental health patient or substance use disorder client, we are facing a major stigma issue and most of the communities,” said Dr Vail Al-Raas, the mental health and psychosocial support coordinator at the International Medical Corps in Afghanistan.

She suggested the mental health treatment programs should be integrated into existing public health programmes to use existing infrastructure and resources. 

“This can give [these programmes] a good chance to expand and be implemented on the ground, and interest has recently been shown by some donors.”

Image Credits: Resolute Support Media, UNODC.