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For peace and pain: the medical legitimisation of Afghanistan's poppy crop
  1. Amir Attaran1,2,3,
  2. Andrew Boozary3
  1. 1Faculty of Law, University of Ottawa, Ottawa, Canada
  2. 2Faculty of Medicine, University of Ottawa, Ottawa, Canada
  3. 3Ottawa Aesculapian Society, University of Ottawa, Ottawa, Canada
  1. Correspondence to Professor Amir Attaran, Institute of Population Health, One Stewart Street, Ottawa, ON K1N 6N5, Canada; aattaran{at}


Since the overthrow of the Taliban in 2001, there has been an overall increase in illicit opium production in Afghanistan and mounting human losses. The United Nations has attributed 1 million human deaths to Afghan opiates over the past decade. As the war in Afghanistan nears a crucial mark, the NATO coalition forces and Afghan people can no longer afford the same ineffective counternarcotics strategy. This commentary proposes a strategic revision that reframes Afghanistan's poppy problem as an opportunity for global public health. Specifically, The Afghan poppy crop could be repurposed away from illicit drug production, and towards manufacturing licit opioid analgesics to address unmet needs for pain palliation, particularly for diseases such as HIV/AIDS and cancer in the developing world—that is, illegal opium could be converted into legal pain medicine, solving two problems at once. We present a supply-and-demand that illustrates how this useful exchange could be made, and discuss the political opposition that now stands in the way and perpetuates the unsatisfactory status quo in Afghanistan.

  • Medical ethics

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  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

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