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Women and Drugs in Tajikistan
Open Society Institute Assistance Foundation - Tajikistan
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This document is a short report based on the results of a
sociological study on the subject of women and drugs. The
study was conducted in Tajikistan between February 1st
and May 1st, 2000, by a research group headed by
Tatiana Bozrikova, holder of a candidate’s degree in philosophy.
Financial support was provided by the Open Society Institute
Assistance Fund in Tajikistan (OSIAF-Tajikistan).
The empirical material in the study was gathered from the
following sources:
- a broad-based public opinion poll;
- methods involving expert assessments (an expert commission
poll);
- a poll of woman inmates convicted of crimes involving
illegal drug-dealing;
- analysis of medical charts of patients receiving either
in-patient or out-patient care at the Republic Drug Treatment
Hospital and analysis of the conclusions of forensic drug
experts.
- WOMEN AND THE PROBLEM OF DRUG ABUSE/ADDICTION IN TAJIKISTAN
The Problem of Drug Abuse/Addiction
Due to a variety of special circumstances Tajikistan
has become one of the primary transfer points for the flow
of drugs. These circumstances include civil war, a dramatic
deterioration in the socio-economic situation of most population
groups, proximity to Afghanistan and Pakistan, transparent
borders, a lack of clearly-defined customs regulations, law
enforcement agencies’ inexperience in combating the drug mafia
and drug abuse/addiction as well as underfunding and lack
of resources on the part of law enforcement agencies, among
other issues. As drugs are transported through Tajikistan,
some portion of them remains there and is dispersed throughout
the country.
It is difficult for any country to determine the extent
and nature of drug use. In the case of Tajikistan, the lack
of an established, effective mechanism for discovering drug
addicts and establishing records on them, as well as the lack
of legislation regulating drug treatment, make it impossible
to determine the precise number of drug users and people suffering
from drug addiction. There is a high degree of hidden drug
use and addiction due to fear of prosecution or repressive
measures by law enforcement bodies.
The number of recorded drug addicts in the country is increasing
each year, as indicated by statistical patterns. It is particularly
worth noting that in recent years the incidence of drug addiction
morbidity has increased sharply vis-à-vis the previous
year. In 1996 the growth rate increased over that of 1995
by 14.9%, while in 1999, this figure was 49.6%.
Tajikistan Health Ministry statistical data indicate that
the number of people suffering from drug addiction increased
from 823 in 1995 to 2703 in 1999. Drug use experts are of
the opinion that these numbers should be multiplied by a factor
of twenty to get a more or less realistic picture of the degree
to which drug abuse and drug addiction have taken hold in
the republic. According to norms promulgated by the World
Health Organization, on average one in fifty drug addicts
are noted in official records. If we take this as a guide,
that means that in 1999 there were 135,000 drug addicts in
Tajikistan.
Analysis of the indicators based on type of drugs presents
an alarming picture of increased growth in the number of heroin
addicts; in 1998, 687 heroin addicts received treatment, while
in 1999 that figure jumped to 1162. The city of Dushanbe is
the area hardest hit in this regard.
In the two years from 1997 to 1999, drug addiction morbidity
indicators per ten thousand people in Dushanbe increased by
a factor of 6.6, and for heroin addiction, this indicator
increased during the same period by a factor of 27. On January
1st, 2000, heroin addicts accounted for 67% of
all recorded drug addicts. We see these proportions continuing
to change, with an increasing number of heroin users.
Drug addiction among women is a comparatively new phenomenon
in Tajikistan, but one which is now on the rise. According
to official data, from 1997 to 1999 the number of women registered
at the Republic Drug Treatment Hospital increased from 19
to 55. Thus, in 1999, women made up 3.2% of the total number
of drug addicts in Dushanbe. It is worth noting that among
drug addicts, the proportion of women receiving a first-time
diagnosis of drug addiction has increased each year during
this period (from 4 women to 25). Between 1997 and 1999 the
number of women receiving a diagnosis of drug addiction for
the first time in their lives increased by a factor of 6.3
and in 1999 equaled 3.5%.
Results of a public opinion poll reveal that the vast majority
of those polled (75.5%) acknowledge that there is a drug addiction
problem in the country, and that it is severe. Another 13%
of respondents feel that this problem does indeed exist, although
it is not severe. At the same time, more than two per cent
of those polled completely deny that there is such a problem,
and 9% are undecided. If we break down responses according
to views on the severity and the extent of the problem, 11%
deny that there is a problem or are undecided, a figure which
gives cause for concern about the degree of public awareness.
Interestingly, the responses of the experts and the woman
inmates reveal a different picture. All 100% of the experts
and 90% of the woman inmates are convinced that the problem
of drug addiction in Tajikistan is currently quite severe.
The study shows that not only does the problem of drug addiction
occupy a position of enormous importance in the public consciousness,
but also that the vast majority of people see the spread of
drugs through the country as a matter with disastrous repercussions
for the entire people and the nation.
A clearer picture, reflecting the level of Tajikistanis’
public awareness of the social menace associated with this
problem, is provided by an analysis of the answers to the
question: "How dangerous are drug addiction and drug
trafficking for Tajikistan now and in the future?" The
study showed that an absolute majority of women (79.4%) and
men (81.7%) see the greatest danger posed by drugs as having
to do with a possible increase in crime. According to those
polled, drugs also pose a great danger, i.e., an increase
in mortality (71.4% of women and 69.8% of men). The public
is aware that drug addiction has a pernicious effect, destroying
the moral foundations of society and causing the country’s
reputation in the international community to drop. At the
same time, however, the public is not sufficiently aware of
the danger drug addiction poses in respect to a general nationwide
decline or degradation in mental and physical health and public
standards (almost half of those polled, both women
and men).
The poll revealed that public awareness of the dangers posed
by drug addiction and drug trafficking depends on the educational
and socio-professional status of the respondents (including
women). The higher the respondents’ educational level and
socio-professional status, the greater their awareness of
the dangers the proliferation of drugs poses to the country
now and in the future. However, those polled were more in
accord, regardless of educational and socio-professional differences,
in their assessments of how drug addiction and drug trafficking
affect the spread of crime.
Responses regarding how easy it is to get hold of drugs in
Tajikistan testify to the availability of drugs. As expected,
34% of the women in the general sample (and 38.6% of the men)
and 46% of woman inmates feel that it is not very difficult
to obtain drugs in the country, and according to 25.5% of
the women (and 35.3% of the men), they are very easy to obtain.
Among woman inmates, an even larger number holds this opinion,
52.7%. Thus, around 60% of the women in the general sample
and 98.7% of the woman inmates state that it is indeed quite
an easy matter to obtain drugs in Tajikistan.
According to expert opinion, the primary reason for the increase
in drug addiction is that heroin is easily obtainable and
inexpensive on the domestic market. According to these sources,
heroin is less expensive than vodka.
Involvement in Drugs by Various Population Groups
In the course of the study, an attempt was made to determine
the extent to which members of various demographic groups
are involved in drug use. Specifically, the question was asked,
"Have you ever had occasion to try drugs?" 93.6%
of those polled responded that they had never had occasion
to try drugs. 4.3% had tried drugs once (0.4% of women and
10.1% of men). Another 1.6% had tried drugs several times,
while 0.6% do so when they have the opportunity, or on a regular
basis. Thus, 6.5% of those polled were involved in drug use
in one way or another.
As factors motivating them to use drugs 54. 6% of the respondents
mentioned curiosity (50% of women and 54.9% of men), 12.4%
a desire to be like everyone else (16.7% of women and 12.1%
of men) and 8.2% mentioned the desire to forget and the desire
to escape their troubles and life problems (16.7% of women
and 7.7% of men). For women, such factors as the desire to
forget their troubles and life problems and the desire to
be like everyone else are among the most important motivations,
while for men curiosity and idleness are the leading reasons.
In analyzing these data, it must be kept in mind that in
spite of the anonymous nature of the poll, some of the respondents
nonetheless could not bring themselves to make an open admission
and were not always honest as to their involvement in drug
use. It is therefore necessary to take into consideration
a corrective coefficient.
In order to get a fuller picture of the extent to which
people are involved in drugs, respondents were asked, "Are
there people close to you or people whom you know who use
drugs?" 2.7% of the women in the main sample and 20%
of the woman inmates acknowledged that there were many drug
users among their close friends, relatives and acquaintances.
16.3% of women from the main sample stated that there were
drug users among the people close to them and their acquaintances,
but not many.
Analysis shows that the largest number of those who personally
know drug users are to be found among the unemployed (31.1%)
and students (31.9%). If we take into account the fact that
young people constitute the largest subgroup among the unemployed,
these data fill out an alarming picture of the proliferation
of drug addiction throughout Tajikistan as a whole, and of
the acute situation among young people in particular. The
picture is no more comforting as regards other groups. One
third (33.4%) of people working in the "power structures"
[Translator’s note: The term "power structures"
refers to government bodies engaging in law enforcement, surveillance
and military activities] number drug addicts among their
personal acquaintances, as do about 30% of professionals in
various fields, industrial workers, people employed in the
transport and communications sectors and office workers. People
from all social and professional groups, from retirees and
housewives to engineers and technical workers, number drug
users among their close friends, relatives or acquaintances.
Public Opinion Regarding Drug Users
What are the public’s attitudes toward drug users? On the
whole, women are more favorably disposed toward drug addicts
than men. 40% of women (and among woman inmates, 83.3%) feel
that they should receive medical treatment. Over 14% of the
women in the main sample and 6.7% of the woman inmates noted
that they felt sorry for people who use drugs (while for men
this figure was only 9.3%). 3.8% of women and 7.1% of men
in the main sample expressed indifference. 19% of women and
16.7% of men (and 4% of woman inmates) condemn such people,
and 8.9% of women and 9.9% of men suggest isolating them from
society. 11.6% of the women and 13.1% of the men (as well
as 2% of the woman inmates) stated that they should be held
responsible for their actions within the framework of the
criminal justice system. No significant differences in the
respondents’ answers based on age, education and socio-professional
level were noted.
A Socio-Demographic Portrait of Drug Addiction Patients
Analysis of medical histories from the Republic Drug Treatment
Hospital confirmed that men are represented in greater numbers
among drug addiction patients. The age categories represented
in greatest numbers were the 25 to 29 group (31.8%), the 30
to 34 group (27.3%) and those between 20 and 24 (21%). Then
came people between 35 and 44 (13.6%), 45-54 (1.3%) 15-17
(1.0%) below 14 (0.3%) and above 55 (0.1%). Thus, people between
20 and 34 accounted for 80.1%.
At the same time, the survey data reveals that woman drug
addicts are generally younger. Among men, those under 24 years
old constitute 23% of the group, according to the following
breakdown: 18-19 years, 2.6%, 20-24 years, 19.1%, while women
in the same below-24 age group represent 36.6%, according
to the following breakdown: 18-19 years old – 7.2%, 20-24
years old – 28.1%.
Most patients (57.7%) were unemployed at the time when they
checked into the hospital. 16.1% worked in industrial enterprises,
transportation, etc. 5.9% were professionals who had had higher
education, 4.9% were street/market vendors or salesclerks.
In 4.4% of the cases, the patients were office workers, and
in 2.4% of cases, housewives. Identical numbers, 2.1% in both
cases, were students and agricultural workers. Scientists,
scholars and people from the literary and arts communities
constituted 0.3%, and others, 4%.
A substantial number of the unemployed, 27.4%, had not
had a job in over two years. (In 56.1% of cases the source
information contained no indication as to the length of time
the subjects had been jobless.) Statistical analysis of the
data indicates that gender is correlated with a number of
variables. For example, there were no rural residents among
woman drug addicts, while 5.1% of the men were from rural
areas.
Another trend noted was an emerging shift of drug addiction
from the capital city to other regions of the country: while
up until 1996 virtually all patients were residents of Dushanbe,
in 1999 this number dropped to 82.5% of the total number of
drug addicts.
How Drugs are Consumed; Distinguishing Features
As this study shows, heroin is the most widely used drug
(60.3%), followed by opium, (10.7%) and hashish (3.9%). In
10.7% of cases, two or more types of drugs were used at the
same time, for example heroin and hashish. The type of drug
used depends on the year when the patient was registered.
Thus, up until 1997 there were no cases of heroin addiction
among the medical cases analyzed in this study, but in a period
of three years the relative numbers of addicts using various
types of drugs changed significantly, showing an increase
in heroin users, such that in 1997 heroin addiction constituted
26.9% of all cases studied, and in 2000, 93.9%.
Another factor affecting drug choice is the patient’s age.
The lower the age category, the greater the frequency of heroin
use. In the below-eighteen age category, heroin was used by
100% of the patients studied, in the 18-19 category, it was
used by 80% of the patients, by 67.8% in the 25-29 category,
and so on, diminishing to 33.3% in the 45-54 age group.
The type of drug has a certain impact on the method of use:
hashish was smoked in 100% of cases, heroin was smoked in
45.5% of the cases and taken intravenously in 16.3% of the
cases, and in 25.3% of cases a shift was observed from smoking
or inhalation to intravenous use. Opium was taken intravenously
in 90.9% of the cases. The high frequency with which heroin
smokers shifted to intravenous use is particularly worth noting.
On the whole, intravenous use was the most widespread method
of drug use, figuring in 35.3% of the cases, followed by smoking,
33.9%, with another 19.1% of patients shifting to intravenous
use after they had smoked or inhaled drugs for a certain period
of time. The latter type of response relates most often to
heroin use.
According to the study results, one distinguishing factor
of drug consumption among women is the more frequent choice
of the intravenous method--53.9%, as compared with 30.1% among
men. Moreover, while 22.3% of the men initially smoked drugs,
shifting to injection only later, this figure for women is
7.8%. This fact may indicate that women have a greater tendency
to resort to intravenous drug use from their very earliest
contact with drugs.
Another issue covered by this study had to do with the primary
reasons for a return to drugs post-treatment. Of course, this
is a matter that depends to a great extent on subjective factors.
Nonetheless, in 71.5% of the cases, the main reason for the
relapse, regardless of gender, was described as a strong hankering
for drugs. It is interesting that while among men in 10.5%
of the cases the relapse was attributed to inflammatory or
provocative behavior by the respondent’s associates, only
5.7% of the women gave this as a reason. Family conflicts
were given as a reason by women in 8.6% of cases and by men
in 15% of cases.
Thus, the most significant reason for post-treatment return
to drug use, according to the study, is a hankering or desire
for drugs. Once again this refutes the erroneous notion common
among drug addicts that the primary way in which drug addiction
manifests itself is via physical addiction or dependency,
which is associated with withdrawal symptoms such as "the
shakes." In fact, the low success rate in treating drug
addicts worldwide has to do with psychological addiction,
or, in other words, with the desire for drugs, as indicated
by the results obtained in this study.
These results also point to the low effectiveness rate
of treatment: among 62.8% of repeat drug users, the average
length of remission period (the period of abstention from
drug use) is one month or less and only 2.3% remain off of
drugs for over two years.
It should be noted that the average remission time depends
to some degree on the age of the patient: remission periods
of greater than a year were found only among patients older
than twenty-five, while among patients younger than nineteen
the average remission period was six months or less.
Furthermore, we noted that among woman drug addicts who returned
to drugs after treatment, the average remission period was
six months or less and the proportion of remissions lasting
one month or less was quite large (75.8%). For men this figure
is 60%, while in 2.2% of cases the remission lasted an average
of more than three years. In our view, this comparison points
to a less favorable prognosis for woman drug addicts than
for men.
- WOMEN AND THE PROBLEM OF DRUG TRAFFICKING IN TAJIKISTAN
The Problem of Drug Trafficking
In 1999 in Tajikistan a decisive war was declared on the
illicit sale of narcotic substances. Various departments of
the Internal Affairs Ministry, bodies overseen by the Customs
Committee and the Committee for the Defense of the National
Borders as well as a group of border troops of the Federal
Border Service of the Russian Federation confiscated 2565
kilos of narcotic substances, including 709 kilos of heroin.
In addition, the "power" ministries discovered 940
cases involving the cultivation of narcotic plant crops, which
they then destroyed, and 155 criminal cases were initiated.
Nonetheless, even if all the sources of the drug threat within
the country were to be rooted out, the problem would still
be great cause for concern. According to official statistics,
21,000 tons of raw opium were produced in Afghanistan in 1998,
and in 1999, that figure was 46,000. This is about 460 tons
of heroin. A sizeable portion of this lethal cargo will pass
through Tajikistan. Only an insignificant part of this flow
is confiscated within the country.
Drug trafficking and the broad proliferation of narcotic
substances lead to steady growth in drug abuse/addiction.
What connections does public opinion make between these two
problems, and which one of them, drug trafficking or drug
abuse/addiction, is the more acute problem in Tajikistan?
In the social consciousness, these two problems are linked
and each occasions the other. And truly, the more widespread
drugs become, the more people become addicts, and the more
addicts there are, the greater the market for narcotics. More
than 60% of the respondents from the main poll feel that both
problems are severe in Tajikistan (62.2% of men and 60.7%
of women). Only 22.6% of those polled (25.4% of the men and
21.1% of the women) feel that drug trafficking is the more
severe problem, and a mere 7.6% of the main poll (6.0% of
the men and 8.0% of the women) feel that drug abuse/addiction
is more severe. A significant detail: men weight the seriousness
of drug trafficking somewhat more heavily, while women, to
the contrary, deem drug abuse/ addiction to be the more serious
problem. The experts’ assessment was rather unexpected: an
absolute majority of them feel that the problem of drug trafficking
is more serious (80.0%) while 20.0% of them feel that drug
abuse/addiction is the more serious problem. PAGE
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Posted February 20,
2001 © Eurasianet
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