Ask Sikandar why he switched from opium to heroin and his answer is concise: It was easier to get.
Sikandar, who is 35 but looks 50, started using opium back in 1993, when he was 16 and the country had descended into civil war. By the late 1990s, the sticky paste was harder to find on the streets of Dushanbe, but refined heroin was “everywhere,” including in the city’s prisons, where Sikandar has spent 14 of the past 19 years on drug-possession charges and picked up HIV along the way.
Today, drug users, and a number of Western analysts, say that police and prison guards are deeply involved in Tajikistan’s local heroin trade, contributing to what researchers say is an HIV epidemic. Police deny the charge. Some Tajik health officials, meanwhile, disagree with experts who say that injecting drug use in the country is on the rise, fueled by vast amounts of cheap heroin coming over the porous 1,300-kilometer border  with Afghanistan.
According to estimates by the United Nations Office on Drugs and Crime (UNODC), over 90 percent of the world’s opiates are produced in Afghanistan and up to 30 percent transit Central Asia annually, mostly via Tajikistan, to lucrative markets in Russia and Europe. In 2009, that would have included roughly 90 metric tons of heroin. Paradoxically, UNODC figures also show that the heroin seized in Tajikistan fell by 58 percent between 2005 and 2010, as production in Afghanistan rose, with the area under cultivation increasing by 18 percent.
A recent European study says that corrupt officials in Tajikistan “directly facilitate the distribution of drugs” both inside and outside prisons and have little incentive to offer users medical support. “Law enforcement officials provide (confiscated) heroin to favored dealers, arrest or harass competing dealers and exploit drug users in various ways for the sake of information, money or sexual favors,” says the 2011 report by Vilnius-based Eurasian Harm Reduction Network (EHRN). Drug users who spoke with EurasiaNet.org in Dushanbe in recent weeks confirmed the allegations, insisting the country’s penitentiaries are awash with heroin controlled by prison officials and saying police control the street trade as well.
An Interior Ministry spokesman denied police involvement in narcotics dealing. “There hasn’t been any of that. And it doesn’t happen in prisons either,” he said April 5, noting one exception near the border earlier this year. Repeated calls to the prison service went unanswered.
If law-enforcement officials are involved in the drug trade, a number of institutional factors may play a part. Police and prison personnel receive tiny salaries and venality among public officials is widespread, with Tajikistan ranked 152nd of 183 countries in Transparency International’s 2011 Corruption Perceptions Index. Police must also meet arbitrary quotas for arrests, giving them an incentive to lock up users while ensuring “that the activities of larger criminal and drug trafficking organizations will go on unimpeded,” says the EHRN report. Furthermore, under Tajik law, possession of more than half a gram of heroin -- about one or two doses, costing $4-$6 in Dushanbe -- is considered intent to sell. And the burden of proof lies with the suspect. As a result, drug users report having to buy protection from police, or face jail.
Meanwhile, Tajik officials and experts disagree about local drug-use trends. With growing supply, prices are falling, encouraging a “definite increase” in the number of addicts, says Pulat Jamolov, director of Spin Plus, an NGO that offers clean needles and support to users in two safe houses in Dushanbe’s sprawling, Soviet-built suburbs. Most researchers agree with Jamolov. But Khushbakht Hasanov, director of the National Center for Drug Monitoring and Prevention at the Ministry of Health, says overall drug use in Tajikistan has fallen since 2007. The official number of registered drug addicts in 2010 was about 7,400, though the Red Cross estimates the actual number is between 60,000 and 100,000.
Both Jamolov and Hasanov agree, however, that drugs and dirty needles are creating a surge of HIV infections in Tajikistan’s prisons. According to a report by Hasanov’s office, after a round of HIV testing in 2010, the number of newly registered cases in prisons more than doubled. Hasanov believes injecting drug use accounts for almost 60 percent of all new HIV infections. The EHRN study implies that many cases go unregistered, saying Tajikistan has an “HIV epidemic in prisons … driven by the shared use of unsterile drug equipment.” Indeed, Sikandar, who asked his last name not be printed for fear of reprisals, says he may have contracted the virus in prison where, sometimes “a hundred of us would use one needle.”
A related public health concern is that vast numbers of incarcerated users are not getting the rehabilitation treatment to which they are legally entitled.
Ali, 35, spent a year in jail in 2009-2010 for possessing half a gram of heroin, he says. “As part of my sentence, I was supposed to get six months of treatment, but they just locked me up,” he told EurasiaNet.org.
“A lot of work is done to punish users as criminals, but not much is done to support them,” said Jamolov of Spin Plus. “The authorities simply don’t believe in helping people who use drugs; they think users are all the same as sellers.”
From Tajik press reports of regular drug raids, one would think counter-narcotics officials are making great progress in their war on drugs. Four kilos here, 10 kilos there—busts happen on a weekly basis. There may be lots of drug arrests, but authorities are not arresting the right people because, according to Western diplomats and aid officials, the major traffickers have high-level protection.
International donors have spent hundreds of millions of dollars on border security and counter-narcotics programs in Tajikistan and adjacent areas of Afghanistan. But the effort, said one senior Western official involved in the drug war, “is a joke. The West has accepted that narcotics are the price for relative security on Afghanistan’s northern border.” No one, he said, will risk destabilizing Tajikistan by trying to take the drugs and the money – equivalent to 30 percent of GDP, some estimate – out of the economy.
What does that mean for Sikandar? These days, the trick is being sure to “have enough cash to pay off the police” when they harass him. His habit long ago consumed concerns about more mundane details, like what has happened to his wife and baby daughter. In the backstreets of Dushanbe’s crumbling 46th Microdistrict, as he wonders where he’ll get cash for his next dose, he can take solace knowing that the price of heroin continues to fall.