Below is an article recently published by the NYTimes.com, which can originally be found HERE. Percy Menzies has provided feedback to this article stating the benefits of Naltrexone and why it should be a viable medication option for treatment of heroin addiction in Third World countries.
This is one of the most distressing and depressing pictures I have ever seen. Can you imagine the misery of heroin addicts becoming a spectacle – akin to watching animals in a zoo. What is being done to help these people?
This is going to get worse as the US troops pull out of Afghanistan. We owe it to people of Afghanistan to offer them treatment that is meaningful. Needle exchange programs is not going to do it. Every treatment including naltrexone should be offered as a treatment option. Naltrexone would be particularly suited if it is combined by incentives like food rations, clothing, housing for coming to the clinics to ingest the medication 2-3 times a week.
Indeed, naltrexone is better suited as a medication to prevent relapse after detoxification. Unlike methadone and buprenorphine, naltrexone has no street value and cannot be abused. It is most unfortunate that we have given in to the politics of heroin treatment and completely ignored the potential of using an non-addicting medication like naltrexone to help patients in Third World countries.
– Percy Menzies, President of ARCA / MIRA
KABUL, Afghanistan — Each afternoon, spectators line a bridge in west Kabul and gaze down. They have not come to stare at the Kabul River — a dismal trickle of muddy runoff this time of year — but at the figures huddled on its garbage-strewn banks.
Some of the men below rock back and forth, or crawl on all fours. Others sit perfectly still, with blankets over their heads, shielding lit matches from the wind and their gaunt faces from the men on the bridge above.
This is where Kabul’s surging numbers of heroin addicts gather to smoke, inject and occasionally die — usually with an intently staring audience. Some look on in judgment, others with pity.
As opium cultivation has soared in Afghanistan over the course of the war, addiction levels have followed. Kabul residents have increasingly watched the problem play out in public, a spectacle in a city with few others.
“We just watch them,” Ali Juma, 30, a construction worker, said. “We want to see the fate of these people.”
On a recent afternoon, some of the observers covered their noses, partly because of the stench below and partly because they worried that the smoke wafting up might trigger addiction in them, they said.
Most of them had been watching for at least 10 minutes, some for twice that long. For a time, their focus converged on an addict, likely dead, whose twisted body had not moved for as long as anyone had been watching. Then they went back to looking at the living, including those just hanging on.
“Look at that person and the condition he is in,” Abdul Qadir, 32, said, pointing to a man struggling up the riverbank to where another man lovingly smoothed out a piece of aluminum foil used to smoke heroin. “Why do people live like this?”
Mr. Qadir had been on his way home — in his hand he carried a bag of cabbage — when he decided to stop and watch the addicts, a part of his normal routine. “Not every single day, but I come here most days,” said Mr. Qadir, who works as a driver.
Hamidullah, 27, an off-duty soldier, took a sterner view. “They are destroying themselves right in front of us,” said Hamidullah, who goes by just one name. “I believe people are accountable for their own actions and if you start smoking hashish, it can become heroin. The last thing will be death for them.”
A little ways down the bridge, an apple seller named Ahmed Javid said he felt only pity and believed the addicts were the victims of larger societal problems. “They are suffering a lot.”
Some, he noted, had picked up the habit in Iran, working as migrant workers. “Others got it from bad friends.”
Mr. Javid offered that he had a cousin “in the last stages; now he injects heroin.” But the country was to blame, more than his cousin, he said. “It was due to all the war and fighting,” he said. “That’s how it is in this country.”
Many on the bridge blamed the government for not doing more to care for its citizens.
“It’s embarrassing to see that the government is doing nothing to help all these hopeless people,” said Faz ul-Din, another off-duty soldier. “I wonder how the government officials sleep at night, not even thinking of the pain that their fellow countrymen are going through.”
Government officials do have a plan. It involves moving addicts from encampments around Kabul to a large facility where they will be weaned off opiates. The treatment center will be on the grounds at Camp Phoenix, a former United States Army base handed over to the Afghan government. Camp Phoenix was once one of the largest Army bases in Afghanistan, suggesting that some foresight went into its selection as a future home for the addicts.
Accurate figures regarding the number of heroin and opium users across Afghanistan are hard to come by. In recent years, United Nations officials have estimated that about 2.7 percent of adults in Afghanistan are opiate users, one of the highest rates in the world, similar to that of Russia and Iran. Over all, officials with the United Nations estimate, there are 1.3 million to 1.6 million drug users in the country, about 5 percent of Afghans.
But a former counternarcotics official with the Afghan government, Hadi Khalid, said most official reports played down the extent of the problem. He said there was deep embarrassment over how addiction rates had risen despite billions of dollars in development assistance.
“We have about two million addicts,” Mr. Khalid, a retired lieutenant general, said, claiming that Afghanistan had a higher rate of addiction than any other country he knew of.
Experts say the addiction rates are largely driven by surging poppy cultivation across Afghanistan, along with the proliferation of laboratories within the country that refine the opium paste into heroin.
For the time being, encampments of addicts out in the open are still a novel sight for many Kabul residents. And they seem to attract more attention than other forms of suffering.
Not far-off, a woman in a burqa begged amid traffic as her toddler sat in a pothole, perilously close to passing cars. Nobody paid them much mind.
But on a recent afternoon, a teenager got off his bike and bent down to where an elderly addict was asleep on the street. Then he snapped a close-up photo with his cellphone.