The Middle East and Addiction: A complex picture for those seeking treatment.

A useful definition of culture was offered by Dwight Heath in his paper: Cultures and Substance Abuse. He said that culture is ‘a system of patterns of belief and behaviour that shape the worldview of the member of a society. As such, it serves as a guide for action, a cognitive map, and a grammar for behaviour.[1]

Substance abuse is in no way limited to one particular cultural group. Throughout the ages almost all culturally distinct groups have fallen prey to the temptation of alcohol and drugs and had to deal with the ensuing addictions. As such, within their unique cultures, they have developed certain codes of behaviour when dealing with issues surrounding drugs and alcohol.

This article will look at how addiction is viewed by those living in Middle Eastern countries and the difficulties that arise when seeking treatment.

Substance abuse is the excessive and habitual use of alcohol and other illicit or prescription drugs. However different countries and cultures have varying definitions of what substances are and are not considered to be “illicit”. Historically most cultures have used and abused alcohol and other drugs. However, ‘sociocultural beliefs can shape the approach to and behavior regarding substance use and abuse. Culture plays a central role in forming the expectations of individuals about potential problems they may face with drug use.[2]

Drugs and addiction in Middle Eastern Countries
According to experts, problems relating to addiction in Middle Eastern countries are still being ignored in some communities due to continuing stigmas that surround drug and alcohol dependance and abuse. “For so many reasons this subject is taboo in the community,” said Dr Ali Al Marzooqi, director of public health and research development at the National Rehabilitation Centre in Abu Dhabi. ‘“Because of our culture and religious values, many think this problem of addiction does not exist…It exists in every single country and the burden here in our region is probably the same as in the US.”[3]’ According to Dr Philip Robins, university reader in the politics of the Middle East, faculty fellow at St Antony’s College, University of Oxford and the author of a new study Narcotic Drugs in Dubai: Lurking in the Shadows, the issues are the same in Dubai. He states that “drug addiction remains a taboo in many circles. Within society at large there is a strong social stigma attached to drug dependence.”[4]

For years now independent organisations and social workers have been attempting to highlight the issues around substance abuse in Arab states. There has been a demand for governments to gather statistics and take action, but even now as the problem continues to increase, statistics are hard to come by. Dr Robins says that ‘efforts to collect reliable research data are hampered by the “closed nature” of Emirati society, the essential illegality of drugs and the extensive surveillance techniques put in place by the state.[5]

Although the statistics are not readily produced or even researched, there are an estimated 500,000 drug users – obviously many are in North Africa, Egypt, the Lebanon and Syria due to the large population in these areas. But now it is also becoming clear that around the Persian Gulf where the availability of oil means that the economy has a surplus of cash and Asian and Western cultures are mixing with the Arab community, the number of substance abusers has grown alongside the population. ‘ “What is unusual in the U.A.E. is the demographic diversity of the population,” said Mohamed Abdul-Aziz, the United Nations drug agency’s regional representative in the Middle East and North Africa.”That is a positive on the economic side,” he said, “but on the cultural side it becomes a real challenge.”[6]

Some statistics that are available report that ‘amphetamine and abuse of other drugs is very prevalent[7]’, this is despite the fact that countries in the Middle East implement the extremely strict Sharia law where punishment for drug addiction can result in between 4-10 years in jail in most countries. If you are caught in the Middle East transporting drugs, the crime may be punished with a life sentence or even death. Looking at the policies for drug trafficking specifically in Dubai, Dr Robins suggests that they focus too much on stopping the supply rather than helping the addicted and therefore reducing demand. ‘“Dubai is institutionally and experientially poorly placed to develop an effective strategy on demand-side activism.”[8]’ He also believes that the zero tolerance approach makes people less inclined to speak out and inform on drug activity so will actually hinder authorities.

Due to the high punishment for drug use and the cultural and religious stigma associated with it, many people living in middle eastern countries fear talking to friends or family about any issues relating to drugs. Because drug addiction is culturally very stigmatised, families where drug addiction is present tend to feel very ashamed if it becomes known that there is a problem. The stigma also makes it extremely hard for known recovering addicts to reintegrate themselves back into society. Because of this, it also makes treatment hard to implement or be understood in these countries. Consequently, despite the thousands of individuals needing help, there is a lack of many high quality treatment centres in the Gulf states.

[1] Heath DW. Cultures and substance abuse. Psychiatr Clin North Am. 2001;24:479-496 as discussed in Abbott P & Chase D. Culture and Substance Abuse: Impact of Culture Affects Approach to Treatment.
[2] ibid.
[3] Underwood, Mitya. UAE facing up to the stigma and the challenge of drug abuse.
[4] ibid.
[5] Underwood, Mitya. UAE facing up to the stigma and the challenge of drug abuse.
[6] Fattah, H. Dubai finds it has imported a drug problem.
[7] Ibrahim Y, Hussain SM, Alnasser S, Almohandes H, Sarhandi I. Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center. Ann Saudi Med. 2018;38(5):319–325. doi:10.5144/0256-4947.2018.319
[8] Underwood, Mitya. UAE facing up to the stigma and the challenge of drug abuse.

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