Drug Abuse in the Middle East

Drug Abuse in the Middle East

R. Srinivasa MurthyR. Srinivasa MurthyEastern Mediterranean Regional Eastern Mediterranean Regional

Office of World Health Organisation, Office of World Health Organisation, Cairo, Egypt. Cairo, Egypt.

R. Srinivasa MurthyR. Srinivasa MurthyEastern Mediterranean Regional Eastern Mediterranean Regional

Office of World Health Organisation, Office of World Health Organisation, Cairo, Egypt. Cairo, Egypt.

Illicit Drug Index-2005Illicit Drug Index-2005

DRUG ABUSE IS PUBLIC HEALTH PRIORITY

• Scope of the Presentation:Scope of the Presentation:– Introduction to countries of Middle Introduction to countries of Middle

EastEast– Drug abuse- production and supplyDrug abuse- production and supply– Drug abuse- Magnitude of the problemDrug abuse- Magnitude of the problem– Drug abuse- Health impactDrug abuse- Health impact– Drug abuse- interventionsDrug abuse- interventions– Drug abuse- ChallengesDrug abuse- Challenges

Countries of the Middle EastCountries of the Middle East

• Region ofRegion of–Contrasts, Contrasts,

–Conflicts and Conflicts and

–Challenges.Challenges.

GNP in USD$GNP in USD$

1700 USD – 4000 USD

4000 USD – 9000 USD

1000 USD – 1700USD

< 1000 USD(lowest $169)

> 9000 USD( highest $28270)

Life Expectancy Life Expectancy

< 50 Years

50 – 65 Years

> 65 Years

Adult Literacy RateAdult Literacy Rate

> 81%

65% - 80%

< 64%

Less than 15 yearsLess than 15 years

< 40%

> 40%

EMRO-Countries in Complex Emergencies and Post-Conflict situations

Doctors /10 000 populationDoctors /10 000 population

10 - 20

2 - 10

> 20

< 2

Psychiatrists/100,000Psychiatrists/100,000

0.41.6

0.151.0

0.1 0.2

1.3

1.3

3.4

2.0

0.1

0.041.00.50.5

1.0

2.0

0.8

0.1

• Drug Abuse- Drug Abuse-

•Production Production and Supplyand Supply

Evolution of Afghan opium poppy cultivation since 2000

2000200082,000 ha82,000 ha

200120018,000 ha8,000 ha

2002200274,000 ha74,000 ha

2003200380,000 ha 80,000 ha (+ 8%)(+ 8%)

Tentative estimate of cannabis resin production and main source countries

7,400 metric tons

•Magnitude of Magnitude of the Problemthe Problem

Source: World Health Organization, Eastern Mediterranean Regional Office, 2002

OMABAH

SUDIRAUAE

MORKUW

PAKSAAIRQOPT

EGYJOR

LEBSYR

YEMTUN

DJI

0 10 20 30 40 50 60 70 80

%

Risk Factors: Smoking prevalence among men in EMRO

Drug Abuse Pattern in the RegionDrug Abuse Pattern in the Region

• Opioids- Afghanistan, Bahrain, Opioids- Afghanistan, Bahrain, Iran, Pakistan, OmanIran, Pakistan, Oman

• Khat- Djibouti, Somalia, YemenKhat- Djibouti, Somalia, Yemen

• Stimulants-Stimulants-

Regional SituationRegional Situation

• Age of starting drugs is decreasingAge of starting drugs is decreasing

• Injectable drugs is increasingInjectable drugs is increasing

• Women are using drugs more oftenWomen are using drugs more often

• Contribution to spread of HIV/AIDSContribution to spread of HIV/AIDS

• Majority of the drug abusers are not Majority of the drug abusers are not seeking treatmentseeking treatment

DRUG ABUSE IS PUBLIC HEALTH PRIORITY

•Health Health ImpactImpact

The Facts… in the EMR… cont’dThe Facts… in the EMR… cont’d

0.16%

0.77%

0.99%

2.15%

3.26%

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

Rat

e H

IV P

osi

tive

1999 2000 2001 2002 2003

Year

Rate of HIV Positive tests among IDU by year

The Facts… in the EMRThe Facts… in the EMR

2.15%2.01%

3.63%

7.80%

13.50%

0%

2%

4%

6%

8%

10%

12%

14%

% t

ran

sm

itte

d t

hro

ug

h I

DU

1998 1999 2000 2001 2002

Year reported

AIDS cases transmitted through IDU

0

10

20

30

40

50

60

70

80

1996 1997 1998 1999 2000 2001 2002 2003

Year

%Al Razi addiction treatment unit - % of admissions HIV positiveAl Razi addiction treatment unit - % of admissions HIV positive

•Regional Regional InitiativesInitiatives

Regional InitiativesRegional Initiatives

• High Recognition of the problem:High Recognition of the problem:– June 2005,Cairo,EgyptJune 2005,Cairo,Egypt– High Level Arab Conference for High Level Arab Conference for

Protecting the Youth from Substance Protecting the Youth from Substance AbuseAbuse

– 22ndnd Inter agency Working Group on Inter agency Working Group on Young People and HIV/AIDS in MENA. Young People and HIV/AIDS in MENA.

– Youth in the Middle EastYouth in the Middle East

Innovative Regional InitiativesInnovative Regional Initiatives

• Specialised treatment facilities-Specialised treatment facilities- Libya, Libya, Kuwait, Saudi Arabia Kuwait, Saudi Arabia

• Prevention through Life skills educationPrevention through Life skills education Eg. Egypt, Iran, OmanEg. Egypt, Iran, Oman

• Harm reduction strategies-Harm reduction strategies- needle needle exchange, methadone treatment Eg. Iranexchange, methadone treatment Eg. Iran

• Triangular clinicsTriangular clinics• Public Mental Health EducationPublic Mental Health Education• Involvement of Religious leadersInvolvement of Religious leaders

Regional Strategy for Substance Use and DependenceRegional Strategy for Substance Use and Dependence

• 1. 1. Development of National policy- Development of National policy- multi-sectoral with networking;multi-sectoral with networking;

• 2.Increasing understanding of causes, 2.Increasing understanding of causes, consequences and care;consequences and care;

• 3. Human Resource Development;3. Human Resource Development;• 4.Wide range of services in Community;4.Wide range of services in Community;• 5.Promotion of psychosocial wellbeing 5.Promotion of psychosocial wellbeing

and prevention and prevention

WHO ROLE WHO ROLE

• RAPID- Reg. Adv Panel on Impact of Drugs-RAPID- Reg. Adv Panel on Impact of Drugs-since 2002since 2002

• AdvocacyAdvocacy• LegislationLegislation• ResearchResearch• Setting standards for care and HRDSetting standards for care and HRD• Coordination with UNODC, UNAIDS, Coordination with UNODC, UNAIDS,

UNFPA,UNESCO,Arab LeagueUNFPA,UNESCO,Arab League• Models of PreventionModels of Prevention