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Kazakhstan is a Central Asian country bordered by Russia, China, Kyrgyzstan, Uzbekistan, and Turkmenistan. The ninth-largest country in the world, its territory is larger than all of Western Europe, though it is extremely sparsely populated. It was the last formerly Soviet republic to become independent, in December 1991, and since then has been steadily improving its economy through work on its hydrocarbon industry.

Kazakhstan is a significant stop along the trafficking route for Afghan heroin, traditionally trafficked to Russia but increasingly following new routes westward to Europe as well. Some of the drug cartels working in Kazakhstan now are run by or associated with cartels in Germany and the Baltic States. Poor border management and the extremely large area of a sparsely settled country make it a relatively easy country to smuggle goods through. A number of international agencies have lent assistance in attempting to tighten up borders, as have the European Union and the United States. Corruption is extremely high, making it easy for wealthy cartels to do business.

Marijuana grows wild in much of the south, and there is some small-scale cultivation of opium poppy, some of which is processed into heroin; the precursor chemicals necessary for such processing are available in Kazakhstan for industrial purposes. Most of the marijuana and opium produced in Kazakhstan is sold in Russia, where there is a larger and more prosperous market, despite the risk of crossing the border.

Most Kazakh drug users are men under 35, but since the 1990s, the number of female users has been increasing steadily. Heroin and opium overdoses have become a significant problem, with more than 4,000 cases a year (out of a population of about 16 million). Heroin and opium are the drugs of choice for at least two-thirds of total users, and the predominance of intravenous usage among such users has contributed to the spread of HIV over the last 20 years. Most intravenous drug using women are either prostitutes or exchange sex for drugs, further complicating the spread of HIV. “Trust points” have been set up in Kazakhstan's major cities: these are services providers for intravenous drug users, focusing on needle/syringe exchange. The Mother to Child nongovernmental organization further focuses on services for the mothers of intravenous drug users, some of whom can be shockingly young by Western standards.

Under Kazakh law, suspected drug users may be held by police and subjected to compulsory drug testing at a narcology dispensary operated by the Ministry of Health, and to subsequent prosecution if applicable. Critics of Kazakhstan's anti-drug efforts claim that a Ministry of Health drug test provides an opportunity for the staff and police to demand a $50–$100 bribe in exchange for a negative test, and refusal can result in a positive test regardless of the individual's actual guilt.

Police are likewise known to plant drugs on people in order to meet their strictly enforced monthly arrest quota. Furthermore, the police can effectively hold suspects indefinitely: though the Kazakh Constitution guarantees rights of due process and free legal counsel, the Criminal Code allows suspects to be detained without being charged for up to 12 months with the approval of the General Prosecutor, and the detention extensions approved by lower-ranked prosecutors are rarely challenged.

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