The purpose of this study was to describe prior use of detoxification and addiction treatment programs among injection drug users (IDUs) in Kabul, Afghanistan. From 2005-2006, IDUs (n= 464) recruited into this cross-sectional study completed an interviewer-administered questionnaire and whole blood rapid testing with fingerstick samples for HIV, syphilis, and hepatitis C antibody and B surface antigen testing. Participants were predominantly male (99.8%), Afghan (98.9%), and had little formal education. Correlates of detoxification and addiction treatment were identified with logistic regression. The majority (94.0%, n= 435) felt great/urgent need for treatment, of whom, 56.3%(n= 245) reported inability to access treatment. Prior detoxification was associated with new needle use with each injection (AOR= 1.91, 95% CI: 1.12–3.26) and prior incarceration (AOR= 1.81, 95% CI: 1.04–3.13). The study’s limitations are noted. Rapid scale-up and subsidy of needle and syringe programs and opioid agonist treatment is urgently needed in Kabul.