The World Health Organisation recognises methadone as heroin users’ best hope of a cure, but the government in Uzbekistan continues to ban it, and has ordered doctors to promote healthy living instead.
Since the government axed a four-year methadone programme in early 2009, doctors have written several times to the health ministry asking them to reintroduce the heroin substitute.
Medics claim that many recovering addicts have relapsed and started taking heroin again after their methadone was withdrawn.
In a directive issued in early January, the health ministry rebuffed the doctors, telling them methadone was “counter to the national interests and mentality of the Uzbek people”. Medical staff should not even mention the substitute drug as an option when seeing patients, and should instead advocate healthy lifestyles and well-established treatments that are not “from the West”.
While there is no miracle cure for heroin addiction, substitution therapies such as methadone are still “the most promising method of reducing drug dependence”, according to the World Health Organisation.
The Central Asian states are transit routes for heroin produced from Afghan opium and heading for European markets. Countries that find themselves near the start of a trafficking route commonly face a growing domestic addiction problem as narcotics are both cheap and plentiful. According to 2010 figures from the United Nations Office on Drugs and Crime, there are an estimated 119,000 heroin users in Uzbekistan.
The methadone pilot project, under which another heroin substitute buprenorphine was also offered, began with 600 drug users and eventually encompassed more than 3,000.
One of these was Hanifa in Tashkent, who weaned herself off heroin in 2006 by taking methadone mixed with yogurt, which she said protected her from painful withdrawal symptoms.
When the project was scrapped, Hanifa returned to heroin.
Karim from Samarkand in western Uzbekistan also participated in the project and said that when it ended the consequences were “terrible”.
“Many died of overdoses because they started taking hard drugs again,” he said.
A doctor working with addicts in the capital Tashkent said that after he wrote to the health ministry questioning the project’s closure, he was warned to stay silent.
“I was threatened with consequences if I didn’t stop citing methadone as an alternative method of treatment,” he said.
Dilorom Nabieva of the government’s committee for religious affairs said the ban was completely appropriate.
“This form of medical treatment is contrary to Islamic values and also to universal ideas about what is acceptable,” she said. “Giving drugs to sick people so that they can experience pleasure cannot be considered treatment,” she added.
This article was produced as part of IWPR's News Briefing Central Asia output, funded by the National Endowment for Democracy
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