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Cannabis and Palestine: Before the War Polydrug Use Was a Serious Issue, Now What?

Cannabis and Palestine: Before the War Polydrug Use Was a Serious Issue, Now What?

A BMC Psychiatry study conducted before the Israeli/Hamas war found that polydrug use was a serious issue in Palestine, especially in the West Bank, and that synthetic marijuana use is prevalent among teenagers and young adults.

Salwa Massad and Others

20 October 2023 at 08:00:00

Below are excerpts from the BMC Psychiatry Research study into drug use in Gaza and the West Bank. This was from a study carried out in 2017 so the current reality is obviously very different given the war. However, the trends are there to see, that youth substance abuse is becoming an increasingly problematic issue in densely populated areas, never mind those that are mired in conflict.


Background


The unique socioeconomic context in Palestine, characterized by political and economic tensions, creates conditions that facilitate the spread of illicit drug use among Palestinians. This paper presents findings from a 2017 survey of high-risk drug use (HRDU) among males in four regions in Palestine: the West Bank (north, middle, and south) and the Gaza Strip. These findings are essential for developing effective policies to respond to the increasing use of drugs among Palestinians.


Methods


Eligible participants were males aged 15 years and above who used at least one drug other than non-synthetic hashish or marijuana during the previous week. Participants underwent a face-to-face interview and had their drug use verified by urinalysis. Data were collected using respondent-driven sampling and data were analyzed using the successive sampling estimator. Multivariate regression analysis was conducted to examine factors associated with ever seeking rehabilitation services for illicit drug use in the West Bank and the Gaza Strip.


Results


A total of 400 males who use drugs were sampled in Gaza, plus 299 in the south, 300 in the north, and 299 in the middle region of the West Bank. It is estimated that there are 26,500 male HRDUs in Palestine comprising 1.8% of the male population aged 15 and above. Findings indicate that polydrug use is a serious issue in Palestine, especially in the West Bank, and that synthetic marijuana is prevalent among teenagers and young adults.


Conclusions


Palestine must strengthen its national efforts to scale up harm reduction and treatment and care options for people suffering from drug use disorders, especially those involved in polydrug use. Additional measures are needed to prevent substance use among children and youth, support the families of people who use drugs, and ensure the continuity of HRDU services during emergencies.


Peer Review reports


Background


Drug use is criminalized, hidden, and stigmatized in most societies. Worldwide, an estimated 36.3 million people, or about 5.5% of the population aged between 15 and 64 years, used drugs at least once in 2020, and around 13% of all drug users suffered from drug use disorders, including dependence. 


The Mediterranean region has been affected by the widespread use of illicit drugs. Although the extent of illicit drug use in Arab countries is difficult to estimate due to the limited availability of research and the stigma associated with it. 


Available data indicate abuse of Tramadol (the common brand name is Tramal, a drug that affects the central nervous system and used primarily to treat severe pain) in Egypt, heroin in Libya, cannabis and heroin in Morocco and Algeria, and different illicit drugs in Jordan. In Saudi Arabia, the most commonly used illicit drugs are amphetamines, heroin, and cannabis, with trends increasing in the use of cannabis and amphetamines, 


Furthermore, the use of synthetic cannabinoids, also known as “Spice” and are typically sold as “herbal blends” or “incense”, are of growing concern. Spice products can have different potency based on number and types of additives which are known to increase the risk of unintentional overdose.


In Palestine, the unique socioeconomic context characterized by political and economic tensions has created conditions that facilitate the spread of illicit drug use. Some research indicates that Palestinian youth use illicit drugs to cope with the existing harsh conditions, which include political violence, house demolitions, arrests, restrictions on movement, and land encroachments. 


The use of more than one drug simultaneously, or polydrug use, is a serious concern in Palestine. 


Factors associated with polydrug use include being younger, being younger at first drug use, and poor mental health. Furthermore, despite the rising global incidence of drug addiction, there is still a treatment gap whereby only 10.6% of those in need of assistance received rehabilitation services. 


Factors associated with seeking reahbilitation services for illicit drug use include support from family and friends, plus awareness of the availability of and accessibility to rehabilitative programs. 


Currently, the West Bank has only three government drug treatment centers, including the Methadone Treatment Center, and five private centers, in addition to rehabilitation centers in Israel. In the Gaza Strip, there are four public rehabilitation centers and one newly established private rehabilitation center for women.


Drug use is exacerbated by the the absence of a unified Palestinian authority and police system, internal Palestinian conflict, weak enforcement of laws, and limited control of borders to combat the trafficking of illicit drugs. 


UN estimates from official sources indicate that there are about 10,000 registered drug users in the West Bank and the Gaza Strip, and about 15,000 in East Jerusalem. Among heroin users, 40% are injecting. The Anti Narcotic Department Annual Report 2016 found that drug seizures increased more than 2.5-fold between 2012 and 2016 (582 vs. 1437 respectively), along with the number of arrests for drug abuse violations (681 vs. 1754 respectively) in the West Bank.


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