To find a path

17 August 2015
Alisher Ismailov, Dushanbe, Tajikistan. Harm Reduction organization SPIN Plus, Deputy Director. Married, two children.

In Tajikistan, we have always had free access to drugs. When I was young, drugs were available virtually on every block. So I began as a recreational user, with soft drugs, that was normal. Years passed, the Soviet Union collapsed, I did my army service and returned. At that moment, hard drugs were the trend. We watched American movies that promoted heroin use, and thought that was very attractive. In 1996, heroin appeared on our market as well. I tried it – I was curious and interested, and I’d also seen a lot of it on TV. My first experience was life-changing; it felt as if I was in heaven. At that time, I didn’t realize what dependency was, I wasn’t aware of the side effects… It was about reducing stress and having fun.

I realized later what it was. Once we had to leave the city and I didn’t have the drugs. Then I experienced withdrawal for the first time and realized I was hooked. And still I went on convincing myself that I was in control, that I could quit and had the willpower to stop using at any point. That went on for twenty years.

In 2004, I had an overdose after which I ended up at a drug treatment clinic. By then, they had started a rehab project. Then I tried quitting for the first time. The project helped me realize that had been happening to me all those years, and I had a reassessment. I realized that the withdrawal wasn’t the most important thing, that it was all in my head. After rehab they suggested I worked as a volunteer consultant, and I stayed in the project. I had intent to begin a new life. I began dating a girl and I wanted to marry her... Once I had a test and suddenly I got diagnosed with HIV. This news was shattering, and I relapsed after two years of sobriety…

Three years later, me and my friends organized SPIN Plus. It became our baby, our home. The organization introduced harm reduction projects; we gave out injecting kits for drug users, and even naloxone. I went to a self-help group and was able to quit. What helped was that I could see my friends who had successfully quit doing drugs. They tried and they quit. They had families and led normal lives. Their example inspired me and I also stopped using drugs.

As for harm reduction, it had a huge influence on me. The information, the sterile needles, the discussions of OST – opioid substitution therapy (at that time it still wasn’t available in Tajikistan), the naloxone – this meant a lot to me. After I quit, I attended a workshop on substitution therapy in Kyiv. I had a lot of questions then. I thought, does it really work, maybe one should just quit drugs? But I remembered how difficult it had been and I realized that if I had an opportunity to do that through OST, I would be fully in favour of it. Substitution therapy would have helped me quit safely without any stress. Indeed, people on OST have a strong motivation. They create families, give birth to children, live full lives and people that surround them often don’t even realize that the person is dependent on drugs.

About 90% of people in our organization have an experience with drug use. When we voice our concerns, when we turn to government services on our own behalf, that sends a clear message. And it breaks stereotypes because most government people think drug users are worthless. And here they see healthy motivated guys that calmly express themselves and share their problems. And the government people’s perception changes. Wherever we go – to power structures, healthcare facilities or drug treatment services, we are listened to and sometimes even applauded.

We talk a lot about harm reduction, and the key idea that we try to convey is that harm reduction increases security. In general, decision makers often have no time and they can’t be easily reached. But when you tell them right away that you’re an ex-drug user, something happens: they begin to listen to you, they get interested – what is it that a former drug user can say?

We, who have been through that, have a stronger power of persuasion compared to everyone else. Usually we just tell them about ourselves and gradually switch towards discussing harm reduction. People ask us what it is, and then we tell them about it. During each visit, we try to convey the idea that harm reduction is a necessary thing that absolutely must be funded. Of course, many are prejudiced: they think we are promoting drug use, spreading drugs and so on. Then I usually say: if I’d had access to sterile needles when that was necessary, I wouldn’t have gotten HIV.

I am proud of my journey through the hard times, through fire and water, and of what I have become. I am proud of my family, I love my wife and son. This is the higher force that supports me and keeps me in check. I love my friends and my relatives – it’s my circle and my family. Of course, I can’t change the world but I can change my environment. And if I had a chance to replay my life and start from scratch, I wouldn’t change anything. To reach the point where I am now and realize how valuable that is. 

Also I want to motivate others, those who haven’t addressed this issue yet. Imagine yourselves in the woods, in a swamp. The swamp is everywhere and you feel like you can’t escape. Harm reduction is a cane that can help you feel for a path to get out. I wish that you all find that path and leave your dependency behind.