Heroin Use Is Soaring in One of the World’s Unlikeliest Places

There are more junkies than ever in Tanzania—but there is also more help for them.

A syringe sucks up a mixture of heroin and water prepared on a foil wrap as addicts shoot up in Zanzibar's Stone Town. (Photo: Katrina Manson/Reuters)

Mar 26, 2015· 1 MIN READ
Vince Beiser has reported from more than two dozen countries for Wired, Harper’s, The Atlantic, Rolling Stone, and others. In 2014 he won the Media for Liberty Award.

The growing appetite in Europe and North America for the world’s most notorious drug is inflicting serious collateral damage in an unexpected place: East Africa.

In recent years, stricter border security in the Balkans and warfare in the Middle East have disrupted the long-established routes smugglers use to bring heroin from Asia to the lucrative markets of the West. In response, they’re increasingly moving their wares by sea through Kenya and Tanzania. That’s becoming a problem for the locals.

“Soon after heroin entered [the Tanzanian port city of] Dar es Salaam in the 1990s, its cruder form—brown instead of white—snaked its way into bustling urban neighborhoods,” reports Al Jazeera’s Sarika Bansal. “A dose of brown heroin, known on the street as brownie, costs as little as a dollar.”

As a result, there are more than 500,000 heroin users in East Africa, the United Nations now estimates, most of them in Tanzania. Faced with this growing crisis, Tanzania’s government has launched a major effort to prevent and treat heroin addiction. As part of the initiative, it’s embraced a tactic that has proved effective but still engenders controversy: providing junkies with methadone, a narcotic pain reliever.

Tanzania’s methadone clinics are the first in mainland sub-Saharan Africa. “Few governments, donors, or nonprofits in Africa work with heroin users. Médecins du Monde, an international nonprofit that serves heroin users in Tanzania, estimates that fewer than 1 percent of drug users on the continent have access to support services, let alone treatment plans like methadone,” writes Bansal.

Tanzania’s program is backed by PEPFAR, the U.S. government’s international initiative to combat HIV/AIDS, because heroin users tend to spread the disease by sharing needles. About 5 percent of Tanzanians are HIV-positive; the number soars to 40 percent among Tanzanians who inject drugs.

That’s partly because of a practice known as “flashblood”: One user shoots up, then draws his own blood and gives it to a cash-strapped buddy for a secondhand high. “A walk through a dusty heroin shooting gallery in Temeke…gives an indication of how common this practice is,” writes Bansal. “Several addicts drifted by with blood-filled needles attached to their limp arms, eyes glazed and mouths agape.”

The good news is that the methadone clinics seem to be helping. Since 2011, more than 2,000 heroin users have begun the program, and most have stuck with it. A local NGO called Youth Volunteers Against Risky Behaviors, which hands out clean syringes in places where drug users hang out, is helping steer addicts to the clinic.

Methadone isn’t the only tactic the country is introducing. Former addict Suleiman Mauly introduced the 12-step program to the island of Zanzibar a few years ago; now there are 11 recovery houses where 3,000 addicts have received treatment.

They can use all the help they can get. Drug agencies are warning that Afghanistan, the world’s top exporter of heroin, is pulling in a record opium harvest this year—which will likely send even more of the drug flowing through Tanzania.