The United Nations Office on Drugs and Crime (UNODC) has released a report indicating that by 2023, approximately 27,000 individuals in Afghanistan, including 2,670 women and 2,150 children under 15, were engaged in high-risk drug use. The study’s findings reveal that nearly half of these high-risk drug users had no formal education. According to the report, one in five was homeless, and many relied on irregular work or criminal activities to fund their drug use.
The report, titled “High-Risk Drug Use in Afghanistan,” was jointly prepared by the UNODC, its Country Office for Afghanistan (COAFG), and the Research, Analysis, and Trends Section in Vienna, with financial support from the United Nations Development Programme (UNDP).
UNODC emphasized that the report presents findings from three interconnected studies: a 2022 mapping of drug use hotspots, interviews with key experts in the same year, and a 2023 survey on high-risk drug use.
The study indicates a decline in cannabis and opium use but a significant increase in the use of synthetic drugs such as heroin and methamphetamine. According to the report, these substances carry higher risks, including severe addiction, overdose, poisoning, infectious diseases among injecting users, anxiety, depression, isolation, and various forms of psychological and physical harm.
The report highlights that the trend of injecting drug use is particularly concerning. Approximately 8 percent of respondents reported having injected drugs at some point, with over 75 percent of those who inject sharing needles.
UNODC noted that access to quality treatment services, especially in rural areas, remains limited. Although more than half of the respondents had experienced some form of treatment, social stigma and inadequate access to support services significantly hinder recovery and treatment efforts.
The report defines high-risk drug use as non-medical use, primarily of opioids or amphetamine-type stimulants, by individuals facing related issues such as health problems, legal challenges, or family difficulties. The three studies were conducted across Afghanistan’s 34 provinces to enable comprehensive estimates.
Hotspots and Prevalence of High-Risk Drug Use
The report states that in 2022, a total of 651 hotspots where individuals publicly consumed drugs were identified across 32 provinces. The total number of individuals engaged in high-risk drug use in these hotspots was estimated at around 27,000, including 2,670 women. Kabul had the highest number of high-risk drug users at 4,700, followed by Faryab with 3,200. Kunduz and Balkh followed with 1,640 and 1,588 users, respectively. The findings indicate that approximately 9 percent of users in these hotspots injected drugs.
Kandahar City had the highest number of gathering points at 64, followed by Kabul City with 55. Additionally, 43 points were recorded in Faryab, 39 in Badakhshan, 39 in Nangarhar, and 38 in Balkh. Nimruz (7.9), Zabul (5.5), and Nuristan (5.3) had the highest rates of gathering points per 100,000 population. However, the Taliban claimed that only 28 gathering points exist in Kabul, with similar discrepancies observed in other provinces.
Social Characteristics of High-Risk Drug Users
The report’s findings show that the average age of the 6,893 interviewed individuals engaged in high-risk drug use was 35 years. Compared to the general population, these individuals generally had lower socio-economic status, with half having no formal education.
Over one-fifth of respondents in the hotspots had experienced homelessness, and about 70 percent were employed, though three-quarters of them worked in irregular jobs. The report notes that family and friends provided financial support in 43 percent of cases, while one-third of individuals resorted to criminal activities to fund their drug use.
Patterns of Drug Use
The report states that over half of the individuals began with cannabis as their first substance, followed by opium and then heroin. Men typically started drug use earlier and with cannabis, while women reported starting with opium. The most common substances used among all participants were methamphetamine or amphetamines, heroin, cannabis, and opium. Among men, opioids (mainly opium and heroin), stimulants (mainly methamphetamine), and cannabis were more prevalent.
Among women, the most common substances were opium, methamphetamine, heroin, and other sedatives. Cannabis use was rare among women, and simultaneous use of multiple substances was common, with half using two substances and 10 percent using three simultaneously. The findings indicate that heroin, with an average monthly cost of $35, and methamphetamine, at $28, accounted for the highest monthly drug expenses.
Harms Associated with Drug Use
The report notes that nearly 96 percent of respondents scored 5 or higher on a severe dependency scale, indicating serious drug dependence. Heroin was reported as the substance causing the most health, legal, or family-related harm, followed by methamphetamine and amphetamines. Among women, opium caused the most harm.
The negative effects of drug use included health problems (87.7 percent), poverty (65.1 percent), family issues (63.8 percent), as well as work or educational difficulties, behavioral issues, and legal challenges. Additionally, even among those who never injected drugs, 11.8 percent were affected by at least one of five infectious diseases, including HIV, HCV, HBV, TB, and sexually transmitted infections (STIs).
Injectable Drug Use (IDU)
The report states that approximately 8 percent of hotspot respondents had a history of injecting drugs, with 5.3 percent having done so in the past six months. Those who were injected were generally older, had lower education levels, higher unemployment rates, and often relied on financial support from others. Among these individuals, heroin was the most common injected substance (70 percent), followed by methamphetamine (31 percent).
Most injections (86.6 percent) occurred in public places such as abandoned houses, cemeteries, and streets, with over three-quarters (76.6 percent) sharing needles and syringes in the past six months. The main reasons for sharing were a lack of access to sufficient needles (68.2 percent) and an urgent need to use drugs (41.9 percent).
Drug-Related Crimes and Treatment History
The report indicates that about one-fifth (18.4 percent) of hotspot respondents had been arrested for drug-related crimes, with a significantly higher rate among men (19.9 percent) than women (1.1 percent). Additionally, half of the respondents (51.6 percent) had received treatment for substance use disorders at some point, though the rate was notably lower among women (29.1 percent) compared to men (53.5 percent).
Over half of those who received treatment (52 percent) reported undergoing treatment only once. The report emphasizes that over two-thirds of individuals found accessing substance use disorder treatment services in their area difficult. Key barriers included financial constraints (57.4 percent) and fear of social stigma (42.7 percent).
Trends Over Time (2009 vs. 2023)
The report compares the current findings with a similar study from 2009, revealing significant changes. Literacy rates among participants have increased, but a higher proportion of individuals reported being homeless or living alone.
A decline in cannabis and opium use was observed, while heroin and stimulant use, particularly methamphetamine, has significantly increased. These changes indicate a shift in drug use patterns and the social conditions of users compared to previous years.
Apparent Increase in Injecting Drug Use
The report suggests that drug use prevention programs should be designed and implemented with Afghanistan’s cultural and socio-economic contexts in mind. These programs should target reducing children’s vulnerabilities and strengthening families through education, support, and empowerment. The report emphasizes the need to enhance and expand treatment services for substance use disorders, particularly comprehensive interventions that include medication-assisted treatment, psychosocial support, and housing assistance.
The UNODC report also reflects the Taliban’s perspectives. The Taliban stated that the survey was conducted before their April 2022 directive on collecting addicts and banning drug use, suggesting that the results may not reflect the current situation. They believe that publishing these findings now could cause public confusion about their recent efforts and achievements in combating addiction. The Taliban also expressed doubts about some of the report’s statistics, disputing their accuracy.
The report notes that the Taliban reacted to certain sections, rejecting the generalization of Afghanistan’s economic dependence on illicit products. They also expressed “serious concern” about sections addressing sexual relationships among drug users and condom distribution, stating that these claims lack evidence and contradict Islamic principles. The Taliban warned that such content could harm the religious and cultural identity of Afghanistan’s Muslim population.
