A report just released by the United Nations Mission in Afghanistan states that there were 2,754 civilian deaths and 4,805 civilian injuries in that country during 2012. Unmentioned is a serious side effect of the conflict: the high number of opium-addicted children in Afghanistan.

The number has increased systematically the past few years.

The situation is not limited to Afghanistan. Children are affected in Pakistan as well. In Karachi alone, there are tens of thousands of child addicts most of who receive no care or support. New and more effective policies are needed to address this situation.

A study conducted in Afghanistan showed that in 25 percent of homes where adult addicts lived there were signs of significant drug exposure in the children tested, some as young as 14 months. The children exhibited typical behavior for opium-heroin addicts: experiencing withdrawal when the drug was removed.

Not only were opium products found in indoor air samples, but the concentrations were extremely high.

This suggests that, as happens with secondhand cigarette smoke, contaminated indoor air and surfaces pose a serious risk to children’s health.

The extent of health problems in children as a result of such exposure is not known. What is known is that the number of adult drug users has increased from 920,000 in 2005 to over 1.5 million in 2010, according to Zalmai Afzali, spokesman for the Ministry of Counter-Narcotics in Afghanistan. A quarter of those users are thought to be women and children.

If current trends continue, Afghanistan could become the world’s top drug-using nation on a per capita basis.

According to the U.N. Office on Drugs and Crime (UNODC), no other country in the world produces as much heroin, opium and hashish as Afghanistan, a sad distinction for a country already ravaged by war. Control efforts so far have concentrated on poppy eradication and interdiction to stem exports. Less attention has been paid to the rising domestic addiction problem among children.

Among the factors leading to increased levels of drug use in adults are the high unemployment rate throughout the country, social upheavals caused by the war and those that preceded it, and the return of refugees from Iran and Pakistan who became addicts while abroad. In both of those countries, the high number of opium-addicted children is also a serious problem, particularly among street children.

Although Iran’s government has opened several shelters for street children in Tehran, many more centers are needed to care for them.

According to some estimates, there are 35,000 to 50,000 children in that city who are forced by their parents or other adults to live and beg in the streets or to work in sweat shops for very low wages.

These children are subject to all kinds of abuse. Many of them end up in organized prostitution rings as part of the sex trade. Children are often transported to other countries where they are obliged to work as prostitutes, while others simply disappear.

In Karachi alone, where tens of thousands of children are addicted to hashish, children addicted to stronger drugs present other problems. The increasing number of street children has led to more street crime as children become involved in drug trafficking in the city.

Those who inject drugs face the additional risk of HIV-infection by sharing contaminated syringes. “Drug addiction and HIV/AIDS are, together, Afghanistan’s silent tsunami,” declared Tariq Suliman, director of Nejat’s rehabilitation center for the U.N. Office for Humanitarian Affairs.

The distinction between producing and consuming countries has now changed.

“Traditionally consuming countries become producers of synthetic drugs. In turn, producing countries become consumers. What remains is a shared international responsibility. No country should be left on its own this way,” said Jean-Luc Lemahieu, the UNODC country representative.

There are about 90 drug treatment centers dispersed throughout Afghanistan, but most are small, poorly staffed and underfunded. The United States and its allies have the resources to rapidly expand and adequately fund such treatment and rehab centers throughout the country.

The great number of opium-addicted children in Afghanistan is one of the darkest legacies of this ill-fated war.

Cesar Chelala, M.D. and Ph.D., is an international public health consultant and a winner of the Overseas Press Club of America award.