In Bishkek, the capital of the Central Asian nation of Kyrgyzstan, which lies along heroin-smuggling routes from Afghanistan into Russia and deeper into Europe, talking to rocks has become an integral element in treatment for heroin addiction.

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BISHKEK, Kyrgyzstan —

Inside a yurt that was lavishly appointed with local prayer rugs and felt tapestries, a young man prepared for a ritual that is catching on here as a solution to a global problem but is, well, grounded in local tradition.

“Rock,” the young man said, “I admit that I am a drug addict.” On a carpet in front of the man sat the object he was speaking to: a river stone, rounded and mottled green, about the size of a loaf of bread.

A psychologist sat nearby, coaxing the addict — a lawyer who wanted only his first name, Arman, made public — to go further. The mood was somber.

“Stone, I give you my anger and my aggression,” Arman said. “I give you all my negative qualities that appeared from smoking opium.”

A surprising number of people speak to rocks here in Bishkek, the capital of the Central Asian nation of Kyrgyzstan, which lies along heroin-smuggling routes from Afghanistan into Russia and deeper into Europe. Rocks have become an integral element in a treatment method for heroin addiction called lithotherapy.

At the Nazaraliev Medical Center, a clinic that has pioneered the approach, twitching, tattooed addicts pad about in pajamas, toting their rocks to and from therapy sessions.

Though at first blush all this appears cartoonish — perhaps reminiscent of the Pet Rock fad in the 1970s — treating heroin addiction here and throughout the former Soviet countries has taken on a life-or-death urgency as addiction rates rise.

Doctors at the center found that men from Central Asia’s conservative, Muslim culture were reticent to admit their addiction in group therapy, a common way to help drug addicts begin to overcome their dependence. But it was discovered that they opened up nicely to rocks.

The Nazaraliev Medical Center, which treats patients, mostly men, from Central Asia, Russia and Arab countries, began using the rock method a decade ago, just as a flood of heroin poured out of Afghanistan.

Fearing that eradicating opium fields would alienate Afghan farmers and turn them toward the Taliban, the U.S. military adopted a policy of tolerating cultivation. The business of growing poppies boomed, by all accounts.

By last year, according to the United Nations’ annual drug report, opium cultivation reached the highest level globally since the 1930s, and about 85 percent of that total was grown in Afghanistan, a few hundred miles south of here.

In Bishkek, heroin has become so accessible that “it’s like buying sesame seeds,” said Georgy Kavtaradze, a former user who now runs an outreach program for addicts.

As the heroin flow rose, the Nazaraliev Medical Center refined its rock therapy.

“Not every person is able to admit their addiction publicly,” said Azamat Usupov, a psychologist. “They admit it to a rock instead. The patient has an intimate conversation with a rock.”

The clinic claims some success: More than 80 percent of its patients remain drug free a year after treatment, a good result for heroin users. In interviews, addicts said they were skeptical at first but came to appreciate this approach to treating their addiction.

Yerzhan Amalbayev, 47, a self-described heroin smuggler who operated along a stretch of road in Kazakhstan, said he had been through the program twice. After the U.S. occupation of Afghanistan in 2001, he said, the purity of the heroin improved as opium prices dropped, and he started using more heavily. The better heroin became known in Central Asia as Allah’s Tears.

Aleksandr, a ship’s cook from Vladivostok in the Far East of Russia, said he started using heroin in 2005, when it “appeared on every street corner” and a dose sold for the equivalent of about $8. Heroin became more abundant, he said, but he did not blame U.S. policies in Afghanistan. “I say: ‘Rock, nobody is to blame. I have only myself to blame.’”

After their initial conversations with rocks, addicts are encouraged to talk out their problems in three or four sessions and then take a pilgrimage with their rock, or meditate in a yurt.

As the program developed, the doctors wove in local legends that doctors say serve as Jungian archetypes, to help patients form a narrative of struggle and victory over addiction.

At the end of the monthlong treatment, the addicts hike up a grassy hill on the outskirts of Bishkek and heave their rock onto a growing pile of stones there, at a folk Islamic pilgrimage site called Tashtar-Ata, or the Father of the Rocks.

About 5,000 addicts have thrown their stones at this place over the past decade, according to the clinic, forming a heap representing those thousands of stories of pain and struggle with addiction. Not all the rocks were thrown there by addicts, though; local residents with problems unrelated to narcotics also heave rocks at the site.

Usupov said addicts are told a legend about the site, of a warrior who fought evil spirits there and won. However, the warrior was said to be so tired afterward that he lay down to sleep and died, and his heart turned into a pile of stones.

Several addicts interviewed at the clinic said they associated this rising rock pile outside Bishkek with another Central Asian legend, this one identifying the rock heap as one of the legacies, however unexpected and unwanted, of the United States’ war in Afghanistan and the accompanying rise in opium exports to former Soviet countries.

In a pasture high in the mountains in Kyrgyzstan sits a pile of river stones at a site associated with Tamerlane, the medieval, nomadic conqueror.

On his way to a battle, according to the legend of this pile, “Tamerlane asked every soldier to carry a stone into the mountains and throw it in the meadow,” said Arman, cradling his rock in the yurt after his first therapeutic session with a stone.

“Coming back, Tamerlane asked everyone who survived to pick up a rock,” he said. “A pile remained. Each rock in that pile represented a lost soldier.”