Addiction pathways: a cross-sectional study of patients in drug treatment centers in Kabul, Afghanistan

Background Drug addiction poses a critical and growing public health concern in Afghanistan. Despite the magnitude of the issue, little is known about the backgrounds and experiences of individuals seeking treatment. This study explores socio-demographic, familial, and environmental factors associated with addiction among patients admitted to Drug Addiction Treatment Centers (DATCs) in Kabul.Methods A descriptive cross-sectional study was conducted among 300 patients (150 males, 150 females) in DATCs of Kabul. Data were collected using a structured questionnaire on socio-demographic characteristics, family structure, trauma exposure, and addiction history. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, and regression models were used for analysis.Results The mean participant age, mean age at first drug use, and mean age of addiction were 28.4 ± 12.6, 20.32 ± 9.36, and 21.56 ± 9.86 years, respectively. Sample characteristics were similar to national/provincial figures. Significant associations were found between younger age at onset and factors including witnessing domestic substance use, living in extended families, and those never married (P < 0.001 for all). No significant gender differences were observed.Conclusions Addiction in Afghanistan is widespread across demographic groups, often beginning early in life. Prevention strategies must focus on early exposure, family environments, and youth vulnerability. Culturally sensitive, trauma-informed care and expanded treatment access are urgently needed.