Culture of heroin use threatens futures of many of Lebanon’s youth


There is a rising problem among Lebanon’s youth which many are trying to ignore.

Lebanon, which is known internationally for its long history of drug cultivation, now has a rising number of addicts overwhelming the country’s drug rehabilitation centers.

“There are an estimated 10,000 to 15,000 drug addicts in Lebanon, and around 75 percent of them are heroin addicts,” says Nadya Mikdashi, director of Skoun, a Beirut-based addiction rehabilitation center. “However, there hasn’t been a comprehensive study, so the real number is unknown.”

“A lot of the studies have largely focused on Beirut and not other areas, so the real number of addicts could be far higher in reality,” she continues. “Worryingly we have seen the number of submissions grow in recent years.”

Skoun treats on average about 120 patients a year at a non-residential facility. Mikdashi claims they have a high success rate by allowing people to continue their lives and by offering psychological support alongside medical help.

She admits outpatient rehabilitation is not right for everyone though, saying that “in some cases, residential treatment facilities are a better option as some addicts cannot break that cycle alone.”

“Non-residential treatment is beneficial as it allows us to work with relapse in real time, as often addicts leave rehab and start using again,” Mikdashi says.

“Rehabilitation is a process and we do not penalize our patients for relapsing,” she adds.

Skoun has recently organized workshops, working in close partnership with the judiciary and the police, municipal leaders and religious leaders to promote a greater awareness of the problem and try and address some of the stigma involved with drug addiction. Skoun hopes that by reaching out to communities they can help many addicts reclaim their lives.

According to Mikdashi, drug-related deaths are very under-reported. She stresses that addicts often have no access to health care and as a result are at great risk. “We definitely need more drug education in Lebanon.”

In a study conducted in Lebanon of intravenous users, out of 120 active heroin users, 70 percent tested positive for Hepatitis-C. This is a very troubling statistic as it shows needle-sharing is very common within this community.

“If only one person in this group contracts HIV or AIDS there will be an explosion of the virus within the country,” said Elie Araj, director of the SIDC association, a Lebanese-based health-care NGO.

SIDC is a health-care association that deals with nursing care and community development. Established in 1987, SIDC works with HIV/AIDS patients and provides peer-to-peer education and advocacy campaigning.

“At SIDC we reach out to 600-700 intravenous heroin users each year and they are those most at risk to HIV,” he said. “Our reports found that there is a high rate of needle sharing between drug users and a high rate of Hepatitis B and C.”

“We are encouraging the government and pushing advocacy and lobbying groups to promote substitution therapy.”

Substitution therapy involves providing a substitute to opiate-based drugs to try and wean addicts off the drug. “This helps drug users not take heroin and keeps them from intravenous use.”

“SIDC also provide clean syringes to users to help prevent needle-sharing.”

Araj says that heroin use is an old problem in Lebanon. “The problem increased with the start of the Lebanese Civil War, when Lebanon became a producing country,” said Araj. “Now, the new generation is increasing its use of heroin in Lebanon.”

“People are doing it from a younger age,” said Araj. “We don’t know why yet, there have been no studies conducted about the problem.”

“All we can say is that this could be due to heroin being less expensive than before and it being readily available.”

According to Araj, heroin is invading all class categories.

But he points out that because it is cheap it is being used widely by the working classes.

In 1998 Lebanon passed law 673, which was a huge step in trying to deal with the problem. Law 673 stated that drug addiction was not a crime in itself within Lebanon.

But there has been no real implementation of the policy since its establishment.

“Frankly there is no comprehensive policy in Lebanon on drugs,” said Araj. “Lebanon is only offering drug users two choices: prison or abstinence.”

“Science has proved that drug use is a chronic disease and at the moment we only offer prison and this is not healthy,” said Araj.

“We offer detox and social re-integration based on a system of sociological and psychological support.”

Araj said Lebanon has the responsibility to get a comprehensive policy and strategy to tackle the epidemic and allow for implementation of Law 673.

“We also need to give drug users a wide option of services related to their choices and specific and individual needs as well as the creation of a drugs taskforce within Lebanon.”

A graduate student at a prominent Lebanese university who wanted to be identified as Ali has struggled to quit heroin. Like most addicts, he had been consumed by his addiction and dropped out of college, despite being academically gifted.

“I am going into rehab tomorrow” he said. “I wanted to get fucked up one more time as a goodbye to my love affair with ‘H.’”

“I gave up college for heroin. I have severely damaged my relationship with my family too, they have had the final straw, they are sending me to rehab,” Ali explained.

In confidence, his friends also told The Daily Star they had grown tired of his attitude and that addiction was consuming his personality.

Proportionally, for such a small country, it seems more of the youth are willing to experiment with heroin in Lebanon. As Mikdashi said: “Heroin addiction is across the board in Lebanon, with many social groups afflicted.”

“Heroin use in British universities isn’t so common” said Mikdashi, “but over here, Heroin use is rife in colleges, it is readily available and it is very cheap.”

“The youth are told all drugs are evil and destroy you morally and physically,” she continued. “When they reach their teens, they experiment with cannabis and alcohol and learn to distrust what they have been taught,” she added.

Mikdashi says “There is not enough education here, and not enough frank discussion about drugs; trying heroin is not seen as a big thing and many are unaware of the dangers.”

“What we have to realize in Lebanon is that people are going to try drugs regardless of what religious or political authorities tell them. Our only option is to deal with the problem openly and realistically,” she said. “In addition to treatment and prevention we need lobbying and awareness to actively help control the problem.”

Another addict, who wanted to be called Tarek, recovered from his addiction a few months ago. “I was shooting up every day for about eight months” he said, refering to intravenous drug use. “I used to pick up about $1,000 worth a week for me and my friends; by picking up in bulk it was practically free.”

“I dropped out of college just before my finals, I lost friends and I even fought with my brother over my addiction,” he said. “I moved away and cut contact with a lot of the people that were in that cycle of addiction with me, my life is so much better now that I am clean.”

Tarek introduced me to another addict Youssef, who also didn’t want to reveal his real name. He had already been out of rehab and had relapsed. His seemed distant and unaware of his surroundings. In a much deeper state of denial, he didn’t want to talk about anything negative about heroin.

Rather, he stressed how good the stuff he was getting was, how easily he could get it, and any talk of coming off the drug was far from his mind. He too had lost many of his family and friends to his addiction. Tarek confided there were many others with Youssef’s mindset in Lebanon and that the problem was only growing among the youth.

As Araj states addiction is a chronic disease.

“No-one can ignore this fact any longer,” he said. “We need to work as a society to treat the problem as we would any other disease, and offer treatment in the best possible ways.”

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