In Iran, heroin is easier to get than beer and cheaper than a carton of milk. Smugglers use the country as distribution point for the estimated 4,950 metric tons of opium produced in neighboring Afghanistan every year. “In Central Asia there’s not as much alcohol or marijuana as there is in the West, so heroin is the first drug many people try,” says Christopher Beyrer, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. (Beyrer is researching HIV outbreak along Afghanistan’s smuggling routes). “These may be societies that appear to be devoutly Muslim, but like young men everywhere there’s a tremendous desire among them to get high and get laid. They don’t usually talk about AIDS in these regions so people aren’t always aware that they shouldn’t be sharing needles. Many countries also have paraphernalia laws that forbid the possession of syringes and pipes, so sharing is often a necessity. This is the case across the regions of Russia and Central Asia: Intravenous drug use is the principal driver of the spread of HIV. Among addicts, about 20 to 40 percent are HIV-positive, and hepatitis B is even more common.”

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