Everyday Drugs, Everyday High
Volatile substance abuse is a growing problem in Qatar, and health professionals are struggling to cut through the culture of silence, write Chantelle D’Mello and Noora Al Thani.
- Sheikh Sultan Abdulla Alataibi: "If the addict goes voluntarily or is brought by his relatives of the first degree, he will not be prosecuted or judged."
- Dr. Taher Shaltout: “The most vulnerable group is students and youth. Those between the ages of 15 and 40.”
- Volatile substances available in local supermarkets are often abused.
- The Arshedny Addiction Treatment Centre, Dafna. 60 of the centre’s approximately 100 predominantly Qatari patients are addicted to pills.
- Pharmaceutical product abuse is another issue of grave concern.
- Hospitals like Hamad Medical Corporation and Rumaillah have a three-step rehabilitation process.
- Craft and artwork done by recovering addicts at the Arshedny Addiction Centre.
At 20, George was already hooked. Everyday, for months, he relished the feeling of getting high. Vivid hallucinations and psychedelic dreams were part of his daily routine. These were not the results of recreational hallucinogens like LSD and psilocybin (magic mushrooms), however.
Here in Doha, with no contacts to dealers in marijuana or other recreational drugs, George resorted to available substances. Inhalants like butane (lighter fluid), carburettor fluid, and ethyl chloride (muscle sprays), and prescription medication like Lyrica, Sedofan, and Tramadol, all available locally, became his “drugs” of choice.
George’s story is not unique.
In fact, between 3 to 5 percent of adults are addicted to drugs and alcohol in Qatar, estimates Dr. Mounir Soussi, an addiction specialist at the Alaween Social Rehabilitation Centre, according to a report in The Peninsula last year.
“The most vulnerable group is students and youth,” says Dr. Taher Shaltout, a psychiatrist at Hamad Medical Corporation. “Those between the ages of 15 and 40.”
The issue, however, is grossly under-reported, Dr. Shaltout adds. “Most of the addicts are still in what we call the silent group. They are [in] society, but nobody knows. Many of them are still afraid to come to our services. Because [they fear] they may be known in society.”
For Rahul, 22, it was the availability of inhalants and prescription medications that led him to test these substances. “I heard about inhalants from a friend of mine when I was about 16,” he says. “There was nothing available in Doha at the moment, so I decided to give it a try.”
Volatile substance abuse
Butane, available at most convenience stores in pressurised cans, is used as an inhalant. Its effects are graphic.
“There are a lot of visuals,” said George, “At one point, the light in my car started sucking up objects. I looked back to see where they were going, and I saw a head floating on a cloud.”
Another inhalant is ethyl chloride, a topical anaesthetic skin refrigerant,d. “You feel a buzzing sound for about 15 seconds, then euphoria, then calm,” says Rahul, adding sale of the gas, previously available at Behzad Pharmacy, has since been discontinued. Carburettor fluid, available at Sidra and various car accessory stores has similar effects.
“It’s called volatile substance abuse. Unfortunately, it has a very deleterious effect on the sinuses. It affects the neurons; they dilute or dissolve the fats of [cells in] the sinus. We’ve seen many cases where they develop prolonged psychosis,” Dr. Shaltout says.
Threat of social retribution and criminal consequences has led many users – new and old – to substitute mainstream drugs with available substances like inhalants and pills.
Most of Qatar’s addicts are addicted to the latter.
Law lenient for those who seek help
Sheikh Sultan Abdulla Alataibi, the manager of the Arshedny Addiction Treatment Centre estimates that more than 60 of the centre’s approximately 100 predominantly Qatari patients are addicted to pills.
Lyrica (pregablin), CNS stimulants, and muscle relaxants are the most commonly abused today.
Penalty for the production, sale, or trafficking of drugs, especially for recidivists, is harsh. Law No. 9, established in 1987, even allows the death penalty.
Despite the severity of the law, the government is lenient towards addicts who seek help.
“Treatment centres at hospitals promise full protection and anonymity for patients, [and] are independent of the government. If [patients] are arrested during treatment, they will be set free, according to the law,” says Shaltout.
“If the addict goes voluntarily or is brought by his relatives of the first degree, he will not be prosecuted or judged,” adds Sheikh Sultan.
Spurred by these reassurances, some have started seeking help.
“I’ve been taking [pills] for around 25 years When [my medications] weren’t available, I used Lyrica, JKF, and other medications,” says Ali Ahmed, one of the Arshedny Center’s many Qatari patients. “In the beginning it was very nice, I felt that I was superman but then I [realised] that I [was] the lowest one in the world, my life was a disaster, I ruined myself, my house, my family. When I heard about this center, I came immediately”
Access to treatment
Currently there are two main treatment routes – medical and religious. Hospitals like Hamad Medical Corporation and Rumaillah have a three-step rehabilitation process. The first of this is a detoxification process.
“We admit patients to our wards for at least 1-3 weeks. There, we medicate them with other drugs, called sedative hypnotics to decrease withdrawal symptoms. We taper their use gradually until they stop altogether,” explains Dr. Shaltout.
On the other hand, private centres like Arshedny, which is fully funded by the Diwan and Sheikh Jassim Bin Hamad, the Emir’s personal advisor, focus on healing through faith.
“Here there is no treatment, no injections, nothing. Here they have a programme that works. They have a religious guide that helps you through, reminds you to pray if you didn’t and tells you to read Quran. When you wake up they tell you to do your bed, its like you’re a child all over again until you get there eventually,” says Ahmed.
Sheikh Sultan too is a recovering addict.
A problem on the rise
Despite efforts, the number of addicts is on the rise.
“We have over 60 Qataris in treatment for addiction to pills,” says Sheikh Sultan.
Dr. Shaltout echoes the statement. “When I came here in 1994, the in-patient unit was half empty. Now, we have waiting lists.”
Dr. Shaltout attributes this to local society’s denial of the problem.
“Until a few years ago, society was resisting this idea. They tried to say that we are free from a [drug] problem. Most of the [efforts] are directed towards treatment and rehabilitation. From my point of view, we have to direct our attention to the prevention. We have to increase awareness and [tell] society that we do have a problem. [And,] we have to be open to discussion. That’s the only way we can fix this,” Dr. Shaltout says.
While The Peninsula reported in August 2013 that “Qatari authorities have a 90 percent success rate in identifying drug traffickers,” Dr. Shaltout estimates that a mere 10 percent of drugs smuggled into the country are seized, giving users numerous outlets to satiate their addictions.
Nevertheless, discussion seems to be the first of many steps in managing the problem, culminating, hopefully, in a culture of abuse awareness. Currently, the lack of a structured drug education program gives rise to a population largely unaware of the adverse psychological and physical effects of these otherwise innocuous everyday substances.
In the next part we will explore the brewing of, and trade in, moonshine.
With reporting by Hamza Alony
Editor’s Note: Due to the sensitive nature of some parts of the article, it has been edited since it was first published.