IRAN'S WAR WITH SOARING DRUG ADDICTION

AMIR Tehrani is 23, hepatitis positive and three months clean of heroin.

He is a volunteer at a radical syringe hand-out programme in the heart of
working class south Tehran - a new front in Iran's long-fought war against
drugs.

With more than a million addicts, the authorities fear epidemics of
hepatitis and HIV.

"I was introduced to heroin by my mother and her friends when I was 15,"
Tehrani says. "I used to just smoke it but started injecting about three
times a day last year.

"I've been on methadone for three months now but my family don't care. My
mother has been in a string of temporary marriages with younger men and
when I'm on drugs, it gets me off her back."

Tehrani now spends most of his time at the drop-in centre where addicts are
given clean syringes, offered medical treatment for abscesses and other
injuries, and encouraged to move to a methadone treatment programme.

Sitting near the entrance to a small alley, the centre is reached through a
nondescript door covered by a cloth curtain. In a courtyard, about two
dozen men sit and chat, smoking cigarettes and waiting to see a doctor.
They will each be given a pack containing free needles, disinfectant swabs,
a spoon for preparing the heroin mixture and a filter to remove impurities
in the drug.

A woman sits to one side, moving her arms slowly and without co-ordination.
Blood is caked on her forehead, and her black manteau - the long outer
garment demanded by the religious authorities - is covered in dirt.

For Iranian women, the stigma of addiction is greater than for men and many
turn to prostitution to pay for their habit.

Persepolis, the non-governmental organisation that runs this centre, wants
to open a new one for women only but has not yet secured the funding.

The centre, which also hands out condoms, is a rare example of socially
progressive policies in a deeply conservative country.

"If I was not a doctor, I should have been an advocate, because it's the
only way I could do something so crazy here," said Dr Bijan Nasseri, who
founded Persepolis five years ago and moved the organisation to Tehran from
Shiraz in 2002.

"We needed more than 100 advocacy meetings before the government agreed,
but we now have their backing and the deputy health minister has visited us."

The change in policy is indicative of a failure to control heroin supply
and of growing public health concerns. The government has realised that
treating addicts like criminals does not combat the problem, but it takes
time for the message to filter down.

Police sometimes lie in wait for addicts coming out of the drop-in centre
and beat them up or take them to prison. But Dr Nasseri said such incidents
have become less common as the police become better acquainted with the
benefits of the programme.

The fear of HIV and hepatitis growth was crucial in winning the hearts and
minds of the religious regime. Dr Nasseri said the number of injecting
users who are HIV positive has long passed the 5 per cent watershed, beyond
which the disease can quickly spread to the rest of the population.

The government says there are 1.2 million drug addicts in Iran and a
further 800,000 regular users, but local drug-treatment NGOs say the true
figures are much higher.

After the revolution, drug use became a criminal offence and addicts were
given the lash or even executed. But as the younger generation boomed,
unemployment rose and availability increased, drug use soared. It now
stretches across the classes.

"We live next to one of the world's biggest drug producers and are on the
transit route to Europe, so there is a great increase in drug use," said
Parviz Maliki, head of the Aftab Society, which runs a treatment clinic in
central Tehran.

"After the fall of the Taleban, the [Afghan] government wasn't able to stop
the trade so production is getting higher and higher and more drugs are
flowing into Iran, which has caused a big rise in addiction."

What happens in Afghanistan has a direct and immediate impact in Iran. When
the Taleban banned poppy farming in 2000, the price of opium shot up and
many people turned instead to the cheaper and more addictive heroin.

Now, with a bumper Afghan poppy harvest, both drugs are flooding the market
at reduced prices.

While vast amounts of Western money has been spent stemming Afghanistan's
massive heroin export trade, Afghanistan itself is facing a catastrophic
scenario of booming domestic addiction largely unaided.

Few countries could be deemed more vulnerable. A processed hit from the
poppy plants that grow wild by the roadsides costs less than $1 - easily
within the reach of the poorest peasant, and perfect for blotting out the
miseries of 25 years of war and poverty.

With near total public ignorance of its addictive effects and little health
or education infrastructure, it is no surprise that the number of addicts
is rocketing.

"The problem gets worse every day," said Dr Tariq Suliman, the deputy
director of the Nejat clinic in Kabul, which has just ten beds for
full-time treatment.

"We used to have hardly anybody addicted - but in the last three years that
has risen to about 62,000 in Kabul alone. We desperately need more clinics
for treating people and educating them about the dangers. In most provinces
right now there is nothing at all."

While Afghan addicts traditionally smoked raw opium, around one in ten now
uses heroin instead, partly as a result of the growing number of locally
based factories refining the product for export.

With some estimates putting addiction levels at anything up to one million
- - one in twenty-five of the population - Afghanistan's fledgling government
is finally waking up to its massive home-grown smack habit.