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Drug Abuse in the Middle East

A Focus on Syria

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Handbook of Substance Misuse and Addictions

Abstract

Drug abuse is one of the major health problems that impose huge economic and social burdens all over the world leading to disability, mortality, and the need for health care services. The problem of drug abuse is on the rise in different countries of the Middle East including Syria whereby the start of the Syrian war in 2011 was one of the devastating factors for the community. The war caused a spread of fear, anxiety, depression, and accordingly drug abuse. Unfortunately, selling drugs was used to buy weapons to fuel the war. Also, the combatants were new customers for drugs during this conflict. These factors shifted the site of drug production to Syria which also became a producer for new drugs (e.g., Farawla) or counterfeit Captagon tablets. In fact, the published documents do not reflect the exact figures of drug addiction in the Middle East in general and Syria in particular. This chapter highlights the situation of substance abuse in the Middle East with emphasis on Syria according to the available information and provides calls for conducting more researches to cover the gaps in different researches and take preventive measures for drug addiction.

“The right dose differentiates a poison from a remedy”

Paracelsus in the 16th century

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Abbreviations

CNS:

Central nervous system

COVID-19:

Coronavirus disease 2019

DALYs:

Disability-adjusted life years

DSM:

Diagnostic and statistical manual of mental disorders

GABA:

Gamma-aminobutyric acid

HIV:

Human immunodeficiency virus

INCB:

International Narcotics Control Board

ISIL:

Islamic State in Iraq and the Levant

KSA:

Kingdom of Saudi Arabia

STJ:

Syrians for Truth and Justice

UAE:

United Arab Emirates

UNHCR:

United Nations High Commissioner for Refugees

UNOCHA:

United Nations Office for the Coordination of Humanitarian Affairs

UNODC:

United Nations Office on Drugs and Crimes

WHO:

World Health Organization

References

  • Abazid H, Abou-Isbab S, Abu Farha R et al (2020) Drug abuse in Syria: pattern of use, causes and perception as perceived by Syrian addicts. J Pharm Health Serv Res 11(2):183–188

    Article  Google Scholar 

  • AbdelWahab MA, Abou el Magd SF et al (2018) An examination of motives for tramadol and heroin use in an Egyptian sample. J Addict Dis 37(3–4):123–134

    Article  PubMed  Google Scholar 

  • Ahmadi J, Tabatabaee F, Gozin Z (2006) Physical trauma and substance abuse. J Addict Dis 25(1):51–63

    Article  PubMed  Google Scholar 

  • Akl EA, Jawad M, Lam WY et al (2013) Motives, beliefs and attitudes towards waterpipe tobacco smoking: a systematic review. Harm Reduct J 10:12

    Article  PubMed  PubMed Central  Google Scholar 

  • Alabdalla MA (2005) Chemical characterization of counterfeit Captagon tablets seized in Jordan. Forensic Sci Int 152(2):185–188

    Article  CAS  PubMed  Google Scholar 

  • Alaryan T, Hasan TA, Eshelli M et al (2019) The misuse of prescribed drugs during the Syrian crisis: a cross-sectional study. Int J Ment Heal Addict 19:1–10

    Google Scholar 

  • Albsoul-Younes A, Wazaify M, Yousef AM et al (2010) Abuse and misuse of prescription and nonprescription drugs sold in community pharmacies in Jordan. Subst Use Misuse 45:1319–1329

    Article  PubMed  Google Scholar 

  • Al-Hasnawi SM, Aqrawi R, Sadik S et al (2009) Datapoints: Iraqi psychiatrists’ perceptions of substance use disorders among patients. Psychiatr Serv 60:728

    Article  PubMed  Google Scholar 

  • Al-Hemiary NJ, Al-Diwan JK, Hasson AL et al (2014) Drug and alcohol use in Iraq: findings of the inaugural Iraqi community epidemiological workgroup. Subst Use Misuse 49(13):1759–1763

    Article  PubMed  PubMed Central  Google Scholar 

  • Al-Imam A, Santacroce R, Roman-Urrestarazu A et al (2016) Captagon: use and trade in the Middle East. Hum Psychopharm Clin 32(3):e2548

    Article  Google Scholar 

  • Al-Juhaishi T, Al-Kindi S, Gehani A (2012) Khat: a widely used drug of abuse in the horn of Africa and the Arabian peninsula: review of literature. Qatar Med J 2:5

    Article  Google Scholar 

  • Al-Kandari FH, Yacoub K, Omu F (2007) Effect of drug addiction on the biopsychosocial aspects of persons with addiction in Kuwait: nursing implications. J Addict Nurs 18:31–40

    Article  Google Scholar 

  • AlMarri TS, Oei TP (2009) Alcohol and substance use in the Arabian gulf region a review. Int J Psychol 44(3):222–233

    Article  PubMed  Google Scholar 

  • Alshomrani A, Khoja A, Alseraihah S et al (2017) Drug use patterns and demographic correlations of residents of Saudi therapeutic communities for addiction. J Taibah Univ Med Sci 12(4):304–312

    PubMed  PubMed Central  Google Scholar 

  • Alzahrani H, Barton P, Brijnath B (2014) Self-reported depression and its associated factors among male inpatients admitted for substance use disorders in Saudi Arabia. J Subst Use 20(5):347–353

    Article  Google Scholar 

  • Alzyoud S, Kheirallah KA, Weglicki LS et al (2014) Tobacco smoking status and perception of health among a sample of Jordanian students. Int J Environ Res Public Health 11:7022–7035

    Article  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders. DSM-5, 5th edn. American Psychiatric Association, Arlington

    Book  Google Scholar 

  • Aqrawi R, Humphreys K (2009) Responding to rising substance misuse in Iraq. Subst Use Misuse 44(12):1744–1748

    Article  PubMed  Google Scholar 

  • Arslan MM, Zeren C, Çelikel A et al (2015) Increased drug seizures in Hatay, Turkey related to civil war in Syria. Int J Drug Policy 26(1):116–118

    Article  PubMed  Google Scholar 

  • Awudu GA, Besag FM (2014) Cardiovascular effects of methylphenidate, amphetamines and atomoxetine in the treatment of attention-deficit hyperactivity disorder: an update. Drug Saf 37(9):661–676

    Article  CAS  PubMed  Google Scholar 

  • Bassiony MM, Abdelghani M, Salah El-Deen GM et al (2018) Opioid use disorders attributed to tramadol among Egyptian university students. J Addict Med 12:150–155

    Article  PubMed  Google Scholar 

  • Beckley JT, Woodward JJ (2013) Volatile solvents as drugs of abuse: focus on the cortico-mesolimbic circuitry. Neuropsychopharmacology 38(13):2555–2567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Benjamin A, Chidi N (2014) Drug abuse, addiction and dependence, pharmacology and therapeutics. Sivakumar Joghi Thatha Gowder, IntechOpen. Available via https://www.intechopen.com/books/pharmacology-and-therapeutics/drug-abuse addiction-and-dependence. Accessed 15 Feb 2021

  • Boutayeb A, Boutayeb S (2005) The burden of non communicable diseases in developing countries. Int J Equity Health 4:2

    Article  PubMed  PubMed Central  Google Scholar 

  • Chaman R, Kalan ME, Dastoorpoor M et al (2020) A tendency to drug addiction and associated risk factors: a case-control study. J Drug Abuse 6:48

    Google Scholar 

  • Damiri B, Sandouka HN, Janini EH et al (2020) Prevalence and associated factors of psychoactive substance use among university students in the West Bank, Palestine. Drugs: Educ Prev Poli 27(2):173–182

    Google Scholar 

  • Devi S (2021) Health in Syria: a decade of conflict. Lancet 397(10278):955–956

    Article  PubMed  Google Scholar 

  • Drug Enforcement Admin, US Department of Justice, and United States of America (2003) Fenetheylline and the Middle East: a brief summary. Available at https://www.dea.gov/

    Google Scholar 

  • El Khoury J (2018) The use of stimulants in the ranks of Islamic state: myth or reality of the Syrian conflict. Stud Confl Terror 43(8):679–687

    Article  Google Scholar 

  • Hamarneh S (1972) Pharmacy in medieval Islam and the history of drug addiction. Med Hist 16(3):226–237

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hamdan-Mansour A, Halabi JO, Dawani HA (2009) Depression, hostility and substance use among university students in Jordan. Eur Psychiatry 24(S1):52–63

    Article  Google Scholar 

  • Hasan NM, Loza N, El-Dosoky A et al (2009) Characteristics of clients with substance abuse disorders in a private hospital in Cairo. Egypt J Muslim Ment Health 4(1):9–15

    Article  Google Scholar 

  • Hassan GP, Ventevogel H, Jefee-Bahloul A et al (2016) Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci 25(2):129–141

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Herbert M (2014) Partisans, profiteers, and criminals: Syria’s illicit economy. Fletcher Forum World Aff 38:69–86

    Google Scholar 

  • Holman RB (1994) Biological effects of central nervous system stimulants. Addiction 89(11):1435–1441

    Article  CAS  PubMed  Google Scholar 

  • Ibrahim Y, Hussain SM, Alnasser S et al (2018) Patterns and sociodemographic characteristics of substance abuse in al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center. Ann Saudi Med 38(5):319–325

    Article  PubMed  PubMed Central  Google Scholar 

  • International Narcotics Control Board (INCB) (2013) New York. Available via https://www.incb.org/documents/Publications/AnnualReports/AR2013/English/AR_2013_E.pdf. Accessed 29 Apr 2021

  • Kalix P, Brenneisen R, Koelbing U et al (1991) Khat, a herbal drug with amphetamine properties. Schweiz Med Wochenschr 121:1561–1566

    CAS  PubMed  Google Scholar 

  • Katselou M, Papoutsis I, Nikolaou P et al (2016) Fenethylline (Captagon) abuse – local problems from an old drug become universal. Basic Clin Pharmacol Toxicol 119(2):133–140

    Article  CAS  PubMed  Google Scholar 

  • Kogan NM, Mechoulam R (2007) Cannabinoids in health and disease. Dialogues Clin Neurosci 9(4):413–430

    Article  PubMed  PubMed Central  Google Scholar 

  • Kravitz M, Nichols W (2016) A bitter pill to swallow: connections between Captagon, Syria, and the Gulf. J Int Aff 69(2):31

    Google Scholar 

  • Kristen G, Schaefer A, von Schlichtegroll A (1986) Fenetylline: therapeutic use, misuse and/or abuse. Drug Alcohol Depend 17(2–3):259–271

    Article  CAS  PubMed  Google Scholar 

  • Mahesh P (2020) Cocaine abuse and treatment. J Drug Abuse 6:619

    Google Scholar 

  • Makeen AM, Alanazi AM, AlAhmari MD et al (2020) Delphi consensus on research priorities in tobacco use and substance abuse in Saudi Arabia. J Ethn Subst Abus 16:1–12

    Google Scholar 

  • Mohamed NR, El Hamrawy LG, Shalaby AS et al (2015) An epidemiological study of tramadol HCl dependence in an outpatient addiction clinic at Heliopolis Psychiatric Hospital. Menoufia Med J 28(2):591

    Article  Google Scholar 

  • Mohammed HR, Zhang Y, Newman IM et al (2010) Waterpipe smoking in Kuwait East. Mediterr Health J 16:1115–1120

    Article  CAS  Google Scholar 

  • Momtazi S, Rawson R (2010) Substance abuse among Iranian high school students. Curr Opin Psychiatry 23(3):221–226

    Article  PubMed  PubMed Central  Google Scholar 

  • Murray CJ, Lopez AD (2013) Measuring the global burden of disease. N Engl J Med 369(5):448–457

    Article  CAS  PubMed  Google Scholar 

  • Nayak K (2020) Effect of smoking-related illness and alcohol addiction on human health. J Drug Abuse 6:47

    Google Scholar 

  • Nichols W, Kravitz M (2015) Soldiers of Abu Hilalain: an investigation into Captagon trafficking by Syrian war militias and what it means for U S Foreign Policy. Available via http://www.economistes-arabes.org/fr/soldiers-of-abu-hilalain-an-investigation-into-captagon-trafficking-by-syrian-war-militias-and-what-it-means-for-u-s/. Accessed 20 Mar 2021

  • Nichols T, Khondkar P, Gibbons S (2015) The psychostimulant drug khat (Catha edulis): a mini-review. Phytochem Lett 13:127–133

    Article  CAS  Google Scholar 

  • Nordegren T (2002) The A-Z encyclopedia of alcohol and drug abuse. Brown Walker Press, Parkland, p 327. ISBN 1-58112-404-X

    Google Scholar 

  • Obeid S, Lahoud N, Haddad C et al (2020) Factors associated with anxiety among the Lebanese population: the role of alexithymia, self-esteem, alcohol use disorders, emotional intelligence and stress and burnout. Int J Psychiatry Clin Pract 24(2):151–162

    Article  PubMed  Google Scholar 

  • Otoom SA, Sequeira R (2006) Health care providers’ perceptions of the problems and causes of irrational use of drugs in two Middle East countries. Int J Clin Pract 60(5):565–570

    Article  CAS  PubMed  Google Scholar 

  • Oxford English Dictionary (2017) Available via https://public.oed.com/blog/june-2017-update-new-words-notes/

  • Prochaska J, Das S, Young-Wolff K (2017) Smoking, mental illness, and public health. Annu Rev Public Health 38(1):165–185

    Article  PubMed  Google Scholar 

  • Rosenblum A, Marsch LA, Joseph H et al (2008) Opioids and the treatment of chronic pain: controversies, current status, and future directions. Exp Clin Psychopharmacol 16(5):405–416

    Article  PubMed  PubMed Central  Google Scholar 

  • Said AM, Okasha A, Okasha T et al (2012) Quality of life and personality dimensions in Egyptian substance dependence patients. Addict Disord Treat 11(1):36–42

    Article  Google Scholar 

  • Shafagoj YA, Mohammed FI, Hadidi KA (2002) Hubble-bubble (water pipe) smoking: levels of nicotine and cotinine in plasma, saliva, and urine. Int J Clin Pharmacol Ther 40(6):249–255

    Article  CAS  PubMed  Google Scholar 

  • Shahabi S, Skempes D, Pardhan S et al (2021) Nine years of war and internal conflicts in Syria: a call for physical rehabilitation services. Disabil Soc 36:1–5

    Article  Google Scholar 

  • Shehnaz SI, Khan N, Sreedharan J et al (2013) Self-medication and related health complaints among expatriate high school students in the United Arab Emirates. Pharm Pract (Granada) 11:211–218

    Article  Google Scholar 

  • Steenkamp C (2017) The crime-conflict nexus and the civil war in Syria. Stability 6(1):11

    Article  Google Scholar 

  • Sussman, S. & Ames, S.L. (2001). The social psychology of drug abuse. Buckingham, U.K. Open University Press.Available at https://www.academia.edu/23945162/The_social_psychology_of_drug_abuse.

  • Sussman S, Ames S (2008) Concepts of drugs, drug use, misuse. In: And abuse in drug abuse: concepts, prevention, and cessation. Cambridge studies on child and adolescent health. Cambridge University Press, Cambridge, pp 3–17

    Chapter  Google Scholar 

  • Sweileh WM, Zyoud SH, Al-Jabi SW et al (2014) Substance use disorders in Arab countries: research activity and bibliometric analysis. Subst Abuse Treat Prev Policy 9(1):1-9

    Google Scholar 

  • Syrians for Truth and Justice (2018) Endemic substance abuse in Hama and Idlib countryside, some 200,000 addicts in Idlib with only one treatment center. Available via http://www.stj-sy.com. Accessed 24 Mar 2021

    Google Scholar 

  • The Global Initiative against Transnational Organized Crime (2016) The nexus of conflict and illicit drug trafficking: Syria and the wider region. Available via https://globalinitiative.net/. Accessed 20 Apr 2021

  • The World Drug Report (2017) released by The United Nation Office on Drug and Crime (UNODC)

    Google Scholar 

  • United Nations High Commissioner for Refugees (UNHCR) (2014) 2014 Syria regional response plan strategic overview. UNHCR, Geneva. Available via http://www.unhcr.org/syriarrp6/docs/Syria-rrp6-full-report.pdf. Accessed on 16 Apr 2021

  • United Nations Office on Drugs and Crime (UNODC) (2011) Amphetamines and ecstasy Assessment, 2011 Global ATS Global smart program. Available via http://www.unodc.org. Accessed 7 Apr 2021

  • United Nations Office on Drugs and Crime (UNODC) (2016) 2011 Global assessment of amphetamine-type stimulants (PDF). Accessed 5 Apr 2021

    Google Scholar 

  • United Nations Office on Drugs and Crime (UNODC) (2018) World drug report 2018 global overview of drug demand and supply. SPC Syrian Penal Code 2000

    Google Scholar 

  • UNOCHA (United Nations Office for the Coordination of Humanitarian Affairs) (2020) Humanitarian needs overview: Syrian Arab Republic. Available via https://www.humanitarianresponse.info/en/operations/whole-of-syria. Accessed 2 Mar 2021

  • UNODC (2010) UNODC and league of Arab states launch US $ 100 million five-year regional programme

    Google Scholar 

  • Van Hout MC, Wells J (2016) Is Captagon (fenethylline) helping to fuel the Syrian conflict? Addiction 111(4):748–749

    Article  PubMed  Google Scholar 

  • Walsh JK, Fillingim JM (1990) Role of hypnotic drugs in general practice. Am J Med 88(3A):34S–38S

    Article  CAS  PubMed  Google Scholar 

  • White JM, Irvine RJ (1999) Mechanisms of fatal opioid overdose. Addiction 94(7):961–972

    Article  CAS  PubMed  Google Scholar 

  • Whiteford HA, Degenhardt L, Rehm J et al (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study. Lancet 382(9904):1575–1586

    Article  PubMed  Google Scholar 

  • World Drug Report (2017) Available via https://www.unodc.org/wdr2017/. Accessed 21 Apr 2021

  • World Health Organization (2004) The economics of tobacco in the Eastern Mediterranean Region. Available via https://www.applicationsemrowhoint/dsaf/EMRPUB_2004_EN_776.pdf. Accessed 21 Apr 2021

  • World Health Organization (2013) World Drug Report. Available via https://www.unodc.org/unodc/secured/wdr/wdr2013/World_Drug_Report_2013.pdf. Accessed 29 Apr 2021

  • World Health Organization (2014) Global status report on alcohol and health, Individual country profiles. Available at https://apps.who.int/iris/bitstream/handle/10665/112736/9789240692763_eng.pdf;jsessionid=9C6A01A5F3AAAAE391D7C67C27B33EDB?sequence=1

  • World Health Organization, WHO (2010) Atlas of substance use disorders Country profile: Iraq. Available via http://www.who.int/substanceabuse/publications/atlas_report/profiles/iraq.pdf. Accessed 7 Apr 2021

  • World Health Organization (2017). Available at https://www.who.int/emergencies/crises/syr/syria-who-annualreport2017.pdf.

  • Zaidan ZAJ, Dorvlo ASS, Viernes N et al (2007) Hazardous and harmful alcohol consumption among nonpsychotic psychiatric clinic attendees in Oman. Int J Ment Heal Addict 5:3–15

    Article  Google Scholar 

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Abazid, H. (2022). Drug Abuse in the Middle East. In: Patel, V.B., Preedy, V.R. (eds) Handbook of Substance Misuse and Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-92392-1_140

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