February 21, 2011
Addiction: A First in Sub-Saharan Africa: Methadone Maintenance Program
By DONALD G. McNEIL Jr.

With the help of the American government, the first methadone maintenance program in sub-Saharan Africa opened this month in a hospital in Dar es Salaam, Tanzania.

While heroin use is not common in Africa, it has been growing recently in Tanzania’s port cities, which are used to ship the drug, usually from Afghanistan to Europe. Drug couriers may be paid in heroin, creating a new group of addicts.

Tanzania now has an estimated 25,000 drug injectors, 40 percent of them infected with H.I.V., according to the Pangaea Global AIDS Foundation, a San Francisco-based group that is advising the Tanzanian government on the program. The United States President’s Emergency Plan for AIDS Relief, created by President George W. Bush, is paying for it.

Needle-sharing spreads both H.I.V. and hepatitis. Last year, an American researcher reported finding Tanzanians practicing “flashblood,” in which one addict injects herself with another’s blood in the hopes of sharing the high.

In Africa, fear of the unfamiliar often leads to accusations of witchcraft, and if heroin use is unfamiliar, methadone is even more so. Methadone is even more addictive than heroin, though it is given in oral doses meant to be small enough to produce no high. In announcing the opening of the program at Muhimbili Hospital, the American Embassy in Tanzania said it was “fully aware that challenges will likely be encountered whilst services are being established.”

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