Corruption in hospitals and police aside, there is a more daunting problem preventing drug addicts from receiving proper treatment
Drug addiction doesn’t get much light in the Azerbaijani press. It’s not discussed – it’s whispered about.
Families sweep the problem under the rug instead of addressing it head on – fatal cases of drug use are labeled by anything other than their name, more often than not: gas poisoning.
Because the topic doesn’t get much press in Azerbaijan, the topic is shrouded in a number of questions and myths.
In 2010, the number of registered drug users stood at 28 per 10,000 population. Now, the number has grown to 30.
But the official 30,000 registered individuals doubtfully represent the reality on the ground, and the fact that the country is a serious transit country for drugs from Afghanistan, Central Asia and Iran to Russia and further on into Europe gives grounds to believe that the problem is far more serious.
We spoke to drug users and experts in the field to shine a much needed light on the issue.
arid seemed giddy when he came to the meeting. “Sorry, I’m a bit high,” he said, drawing two fingers to his lips and pretending to puff away at a joint.
Farid first tried drugs in university while studying abroad. He was given a joint at a party.
“I was already very drunk. The effect it had on me? I’d describe it as a waking-dream.
I tried pot again a week latern – I was sober then. I liked it. I smoke marijuana pretty often – I think it’s better for you than alcohol, and it’s not as harmful as other drugs.”
What’s your poison?
It goes without saying that some drugs can harm you instantly.
But other drugs, if you look around the internet, have a less clear effect on the body and mind. Some drugs are even touted as medicinal, natural – but they can still be unpredictable: everybody reacts differently. And the effect of narcotics on the body can change from experience to experience.
Narcology expert Vafa Aliyeva says that all drugs are dangerous in their own way, especially the drugs of the ‘new generation’.
“Over the past two years in Azerbaijan, so-called ‘designer drugs’ are becoming more and more popular. They can kill you the first time you try them.”
But even less dangerous drugs pose their own threats.
Farid spoke about a number of his friends who ended up using harder drugs after getting into marijuana.
“It all happens the same way. You go to the dealer one day, who tells you: ‘You know, I don’t have any pot today… how about something else?’ A person decides to give the ‘something else’ a try. The dose gradually increases, and you develop a dependence on the drug.
Then your money runs out. And all of a sudden you’re looking at drugs that are cheap, but that science has barely had the time to look at, and that are much more dangerous.”
Farid had some experience with this chain of events himself. He continued experimenting after first trying marijuana. Most often, his friends would offer him ‘something else’, and they’d trip together.
He’s tried a lot of drugs: MDMA, ecstasy, amphetamines and others.
“The feeling [with many drugs] is like that of being wrapped in a warm, fuzzy blanket of ‘good’.
“Then there are the optical allusions, or drugs that help you be ‘more effective’.
“If you haven’t opened your textbook all semester, and you have to read it in just 11 hours before the exam, then there’s nothing else other than cocaine to help you. That’s what I did every exam season. Once I even snorted coke right at the exam.
“When I came back to Baku, I continued experimenting with drugs, but it was more difficult to find them – MDMA, ecstasy, marijuana, mostly. I’ve tried everything that I can get my hands on.”
Many drugs in Baku are easy to get, and they’re not too expensive – sometimes it costs just a few dollars for a dose of what you’re up for. The contact information for dealers is passed by word of mouth.
Farid says there are always side effects.
“The worst is after methamphetamines. First off, your tongue is all banged up, because you’ve been chewing it up all night, you’ve been drinking water, smoking cigarettes, chewing gum… and after all that, it’s painful to eat. And you can’t sleep, either.
“Once, I had to go to a job interview, when I was still coming down from a new drug. They hired me, but told me I had to start immediately. I had so hoped to just go home and lay in bed.”
Many think that once you try heavy drugs, you’re done for. That does happen, for sure, but it didn’t with Farid. He has tried many drugs, but for the most part only uses marijuana.
Now, he says, his real addiction is cigarettes.
Who is considered an addict?
Psychologist Azal Isazade says the line between a person that simply uses drugs from time to time and a drug addict is very fine. You can compare it with alcoholism, and smoking marijuana and just loving beer.
But you have to take into account that you get addicted to drugs much quicker than to alcohol. For example, 3-4 heroin trips are enough to get addicted.
“Signs of addiction include lethargy, pain, and depression, and when a person takes their next dose, they became more active and cheerful,” says Isazade.
“Many people, due to stereotypes, don’t differentiate between someone who uses pot occasionally and someone who is addicted to really heavy drugs, like heroin,” says Farid.
“Such people really worry about you, because once a week you allow yourself to smoke weed, but at the same time they are calm if you drink vodka at three o’clock in the afternoon.”
But many of Farid’s acquaintances have been less fortunate.
“I had a friend, a classmate, who got addicted to cocaine. He ignored his studies, didn’t sleep for three days, and then slept for two straight.
“Once he told me how he fell at home and lost consciousness. He doesn’t know how long he laid like that on the floor. Sometimes, he has this awful look in his eyes, as if he’s sick and looking for hope. Though now it seems that he’s drug-free.
“I’ve had friends that have been addicted to meth, or heroin. They weren’t ‘undesirable elements’. They weren’t running away from a harsh reality. They just wanted the pleasure.”
No such thing as a ‘former’ addict?
Psychologist Azad Isazade:
“There is a kind of half-myth that drug addiction is not treatable. Yes, it is very difficult. But the fact is that those who have been ‘cured’ are ‘invisible’ – they don’t shout about their past on the street. Therefore, people notice mostly those who break down again and again.
I have had many successfully cured patients. I now meet with one of them once a month, and we began with daily visits.”
Narcotics expert Vafa Aliyeva explains that the phrase ‘former addict’ is misleading:
“We don’t say ‘former addict’ because recovery is a lifelong process. However, people change drastically after being rehabilitated. They are even happy, later, to have confronted such misfortune because they feel that they have become spiritually richer, overcoming their dependence.”
y father, who no longer lives with us, was addicted to heroin. When I was still in junior high, I often smelled something strange coming in from the patio. My brother and I found these foul-smelling “pebbles” there. Once I licked this “pebble” – my mouth grew numb, and something strange was happening to my head. It was heroin. Sometimes I would steal a lick when my father wasn’t looking.”
As an adult, Kamil tried a drug called ‘spice’ – a smokable synthetic drug prohibited in many countries. Its active ingredient is cannabinoids, and gives an effect similar to that of marijuana.
“When I smoked, the whole world felt like it consisted of only one room and the feeling was so real that I wanted to jump out of the window to find out what was outside the house. I went up to the window once, ready to jump, but a friend pushed me away.”
“It all started innocently, for fun. I wanted to feel the music – I’m a musician. But the fact is that I have latent schizophrenia and therefore the drugs affected me more strongly. I also have synesthesia.
“I can see the colours of sounds, the temperature of sounds. I feel the music in colour. And here, thanks to chemistry, it all intensified hundreds of times over.”
An example of drugs’ unpredictability is a “bad trip” – when a drug user receives a horror movie instead of the usual “movie about a better life”.
“I remember once I smoked spice with some friends. This was my first bad trip. Every movement was accompanied by sounds from the cartoon Tom and Jerry. Some strange images came into my mind that I couldn’t get rid of. I laid on the floor, afraid they’d catch me. I saw newspaper clippings, a photo of me laying on the floor, surrounded by cops. Everything was portrayed as if in cartoon style.”
Over time, Kamil developed a dependence on spice.
“I am a musician, and it inspired me. Other things in my life weren’t developing, weren’t moving forward. Sometimes, I took doses that would have been enough for five people. I increased it all the time.
“And only when the spice was gone — I could not find it anywhere — I realized that I was addicted.
“After a while, I began to feel severe back pain, my whole body ached. Like during the flu. But there was something new in this pain.
“You’re lying under a blanket in a cold sweat – you’re cold, your eyes hurt. I was disgusted by everything, I didn’t even want the spice. And it was terrible for me to realize that if I just smoked, I would feel better, but only for forty minutes. And then I’d be back where I started.
“I became aggressive, I yelled at people around me, and once I almost beat a friend. I stopped being a person.
“Once I was under the influence of spice, and when the police saw me in this state, I could not even run away. I remember, I sat in the car with them and thought: the worst thing has already happened, you can relax and enjoy. As a result, I ‘agreed’ with them on the spot, gave them money, and they let me go.”
The police and the law
In Azerbaijan, the purchase or possession of drugs “in quantities exceeding those required for personal consumption” faces a prison term of up to three years.
Some drug users say that the police often catch people buying soft drugs they intend to use themselves, and then allow them to pay a bribe – that is, they ask their parents for 1,500-3,000 manat [$900-1,800].
Then there were other chemicals of unknown origin, and overdoses.
“I remember how we tried some weird stuff right in the courtyard. Sh*t went south. Nobody could stand up. I thought I was going to die, and I wanted this to happen at home. With my last strength, I got to the apartment, fell to the floor in the hallway and waited until it passed, prayed, swore that I would not use it anymore.
“I realized that such a lifestyle would kill me. I began to reduce my use of drugs. In the end, I stopped smoking and got rid of my addictions.”
“My addiction cost me dearly. I had a lot of debts to different people and had to sell things. I broke up with my girlfriend because drugs took away the money and time that I used to spend on her.”
“I had a close friend. He began to shoot up. Honestly it would have been easier for me if he had just died rather than start injecting. This is a completely different creature, whose thoughts are only busy searching for the next high.
“One guy from our school was a genius gambler, like at billiards, cards, or backgammon. There were legends that he could leave the house with small change in his pocket, and return with three thousand dollars. He was not allowed into many illegal “establishments” because he played so well. Apparently, from a care-free life and an excess of easy money, he began to shoot up heroin.
“We have a place in the area where local guys gather. And he sits there. Schoolchildren passing by greet him. And he gets up and starts yelling at them: ‘You don’t understand anything! You are nothing! I hate you! See what you did to me!’
“And then he takes off his shoes and with all his strength kicks his foot on the concrete curb.
“He rarely appears in crowded places, and when he does, he is looked at as a ghost.
“I knew another guy, married, with a young son. He was also on heroin. He looks quite normal, though. You can often see him getting in a taxi with his wife and taking her to where she provides sexual services for a fee. Most likely, she is also shooting up.”
y ex-husband and I met just a month before moving in together. Everything was fine – he wanted a family, children, he was always very patient. We never quarreled. I knew that he had once been addicted to drugs, but then quit. I thought back then: what willpower he has, well done!
“You don’t notice many things until you experience life with a drug addict. You write it off to fatigue, a hangover, or something else.
“And then you start noticing the lies, inventing pretexts to leave home, then stealing, then overdosing.
“I remember a neighbor brought my husband home when he had collapsed from an overdose on the street. He ordered me not to let him sleep, afraid that he wouldn’t wake up. It was the epitome of absurdity. His mother and I sat up with him, playing games to keep him from going to bed. He was thinking normally, answering, but it was also clear that in fact he was not there, but in some other world.
“I think he was living in that world for as long as I knew him. But I lived in a continuous nightmare. I began to notice syringes on the streets, which ordinary people calmly pass without seeing them. I began to pay attention to men in long-sleeved shirts in the summer.
“In addition to the need to watch my husband’s every step and to check whether there were any traces of injections and other charming moments, we had to deal with state agencies. With drug clinics. There they took 400 manat from us in order to, firstly, accept him into a programme (without a bribe there is never any room), and secondly, to register him under a different name.
“There is no talk of any treatment at the dispensary. I have friends with the same problem in the family, but I do not know anyone who would be cured in a Baku dispensary, because there, it is simply impossible. There they give you substitute drugs and tie people to beds.”
Treatment for drug addiction in Azerbaijan
A new drug treatment centre was recently opened in Azerbaijan, but so far it only offers a rehabilitation department, says Doctor Vafa Aliyeva.
“The rehabilitation network is only now being built, but in countries such as Russia, Ukraine and Belarus, it has been established for a long time, so if a patient speaks Russian, it is much more efficient and faster to send him there.”
If all drug addicts in Azerbaijan decided to be treated in a hospital, they would not have enough places in clinics.
Baku has a City Drug Dispensary and the Republican Drug Treatment Centre (400 beds). In other cities there are small specialized departments in hospitals.
In state clinics, methadone therapy is still used, the replacement effect of which does not go further than the technical purification of the body from drugs.
There are also independent communities operating under the 12-step programme since 2014, which patients find via the recommendations of the Baku City Dispensary.
“And we’ve ended up at the police too,” says Maryam.
“There is no specific crime of ‘drug use’, but if you’re high and the police see you, they can figure it out. And you’ll be imprisoned for ‘dealing’ – that is, if you can’t figure out how to pay a bribe. Sometimes, if the family has no money, the addict may simply be let go.
“To anyone who has such trouble with loved ones, I can tell them: there is an opportunity – leave. First take them in your arms, and take them to where the drug addicts are treated. Take them away from their “friends”, from familiar dealers, from the police.
“If you see that the person himself does not want to be treated, leave. Do not believe any promises, because those who are addicted to drugs are no longer people.”
How can drug addiction be treated?
We can draw several conclusions from the above:
- If you need to have someone hospitalized and treated in a clinic, it is better to take the patient abroad;
- This has two aims: one, to tear him away from his users circle, and two, to provide a patient with truly qualified assistance and help;
- The desire of the addict to receive treatment is key;
- If you have to remain in Azerbaijan, look not for a good clinic, but for good doctors.
The classic treatment regimen of detoxification and getting rid of the acute dependence of the person to drugs is key. A psychologist must be involved in the process, especially afterwards.
Psychologist Azad Isazade:
“It is often accepted in society that drug addicts are considered dangerous and useless, which is completely wrong.
“I personally believe that drug addicts deserve pity and sympathy. This is my personal approach, because I can’t help a person if I don’t have pity, sympathy and empathy towards him.”
Not in my family!
Due to stereotypes, it often seems to people that drugs are something that cannot happen to their children “because our family is not like that”.
Practice shows that complacency, tabooing the topic, and including drug addicts as some kind of “lower” caste are just as dangerous as “bad company”.
But most dangerous of all might be the silence concerning the problem. Though the corruption in hospitals and the police doesn’t help, general ignorance and dismissiveness of the issue can be even more damaging.