BASRA, Iraq: The rows of self-harm scars that course upward on the teenager’s forearms from her wrists nearly to her elbows are reminders of dark times.

At age seven, the now 19-year-old was diagnosed with sickle-cell anemia, a hereditary disease that comes with painful symptoms, including inflammation of the hands and feet and frequent infections. She became a regular visitor to a hospital where she was given Tramadol, an opioid medication that brought some relief.

Eventually, though, she was obtaining the medication even when there was no pain.

“When I reached 15, I became addicted to it and wanted to take it no matter how,” she said, her face pale and lips bluish. She described how she would cut her arms with a razor when she was high or depressed. She agreed to discuss her addiction with The Associated Press (AP) only on condition of anonymity because of the stigma attached to addiction in Iraq.

She is part of a phenomenon in Iraq’s southern Basra province, where illegal drug use and sales have reached previously unseen levels, mainly among youths, over the past three years. Basra is at the forefront of a nationwide spike in drug sales and consumption that has transformed Iraq from merely a corridor for drug trafficking to neighboring countries.

Since late 2014, arrests for drug dealing and use have nearly doubled in Basra compared to 2011-2014, a senior police officer with the province’s anti-narcotics department said. From October 2015 to December 2017, police arrested 4,035 dealers and users, he said. In 2017 alone the number of arrested late in the year stood at 3,479, the officer said.

A Health Ministry official said nationwide the numbers have also nearly doubled in the same three-year period, though specific numbers were not immediately available. He, too, spoke on condition of anonymity because he was not authorized to speak to the media.

Government officials and activists blame Iraq’s porous borders, a widespread ban on alcohol, and corruption and unemployment as reasons for the increase. Though the problem nationwide is low compared with neighboring countries, it is expanding, said Dr. Emad Abdul-Razzaq, the federal Health Ministry’s adviser on psychological wellness.

“The reports we have indicate that there is an increase,” he said.

Drug use is most prevalent in Basra, followed by Baghdad and Maysan provinces, authorities said.

The most popular narcotic in Iraq, Abdul-Razzaq said, is crystal methamphetamine, the white crystalline drug produced in neighboring countries and ingested by inhaling, smoking or injecting. Locals simply call it “crystal.” Others turn to drugs prescribed for relieving pain and treating psychological disorders, such as Parkizol, Valium and Somadril, as well as morphine-based derivatives like codeine.

During Saddam Hussein’s rule, sales and possession of narcotics could be punished by a death sentence, which curbed smuggling. However, with the removal of the death sentence after the 2003 US-led invasion that toppled Saddam, Basra saw an increase in the smuggling and sales of narcotics, including new ones such as hashish and methamphetamine.

The Basra anti-narcotics officer said that since late 2014, the drug trade has thrived because of a security vacuum left when many forces were moved from the borders to join the fight against Daesh group, which swept through nearly a third of Iraq that year. Along with methamphetamine, authorities in the province began to seize hashish and small amounts of opium and pills, he said.

Psychiatrist Aqeel Al-Sabbagh said he believes the official statistics on drug abuse do not reflect the reality in the province.

“When we try to talk to the addicts about others they know, we get the feeling there are whole areas that are completely plagued,” he said.

Al-Sabbagh’s colleague, Nazhat Najim, said crystal meth is the most popular substance in Basra, with 62.1 percent of the country’s consumption located in the province. It is followed by Tramadol and hashish. The most affected are between the ages of 18 and 30, with 10 to 12 percent of them women, he said.

Al-Sabbagh, who heads the psychiatry department at Basra General Hospital, said the country lacks specialized rehabilitation centers and medicines and suffers from a severe shortage of psychiatrists, psychologists and social workers. He advises his patients to seek treatment abroad — mostly in Iran, Jordan and Egypt.

Iraq is set to open its first specialized mental health and rehabilitation center in Basra with about 40 beds after Al-Sabbagh pleaded for years for such a facility. He is still awaiting authorities’ approval to hire doctors and psychiatrists from Egypt to treat patients and train Iraqis.

Facing a growing problem, Basra’s Anti-Narcotics Department was transformed from a small office with 15 troops and an officer in 2014 to a department boasting 195 troops and 17 officers. Another 85 security members will join soon. Last year, it added two new detention halls to the existing one to cope with increasing numbers of addicts and dealers.