Current Perspectives on Substance Use Disorders in Afghanistan

Substance use disorders (SUDs) are a significant public health issue in Afghanistan, affecting people, families, and communities. The nation's expanding illicit drug economy, driven by poverty, joblessness, and limited education, compounds the problem. Opioids are the most harmful illegal drugs, responsible for over 70% of disability-adjusted life years attributed to SUDs. Addressing SUDs in the country is hindered by infrastructure gaps, limited public and commercial sector support, and an unallocated government budget. Cultural factors, like drug use normalization and free borders, exacerbate the problem. The significant psychological toll of SUDs results from factors like trauma, instability, stigma, and resource constraints. In Afghanistan, women report higher rates of depression, anxiety, and PTSD than men, with abuse playing a role in the development of mental illnesses. Youth in Afghanistan are heavily impacted by poverty, economic hardship, and conflict, resulting in lost educational, health, and job prospects due to radicalization and recruitment. Substance use heightens the risk of domestic violence, joblessness, poverty, and negatively impacts children's academic performance and behavior. In Afghanistan, prevention and treatment of SUD are complicated due to cultural, social, economic, and political factors. A national comprehensive SUD prevention program is needed that should be adapted to culture and low source setting.