Drug use among Syrians has almost tripled since the civil war began in 2011, with refugees in neighbouring countries also at higher risk of substance abuse, an imminent report will reveal. The draft document seen by <i>The National </i>highlights the devastating effect of conflict on Syrian society, as the loss of community has made the young more susceptible to addictive drugs, with few medical resources available to support them. It also sheds light on the little-known health implications of Captagon, a highly addictive amphetamine, which has raised security concerns in the Gulf and Europe. “Substance abuse in Syria is not just a security issue, it’s affecting society, leading to more crime and people using the money to buy drugs instead of food,” said Dr Zaher Sahloul, president of the US-based medical aid charity MedGlobal, which compiled the report with the World Health Organisation. “We are seeing the disintegration of society,” he added. The report surveyed Syrians who were either living in regime and opposition-held areas, or were refugees in neighbouring countries such as Turkey and Lebanon. The north-east of Syria controlled by the SDF did not respond to requests to participate in the survey. In Syria’s regime-controlled areas, more than one in 10 (11 per cent) of people reported taking drugs. This more than doubled among Syrian refugees who sought asylum in Lebanon, Turkey and Jordan, where one in five people (20 per cent) reported using drugs. The opposition-held regions of north-western Syria recorded the lowest cases of drug use, at 5 per cent, with those living in displacement camps at higher risk. This is an exponential rise since the start of the conflict in 2011, the report found, where 3 per cent of Syrians from all three groups reported using drugs before that year, compared to 8 per cent today. The vast majority of the respondents were under 40, with almost one in 10 drug users (9 per cent) under 30. Three quarters of the surveyed group had university-level education, prompting concerns that the rate of substance abuse may be higher elsewhere. Recent reports have highlighted the Syrian regime’s involvement in Captagon trafficking to the Middle East and Europe, which it allegedly uses to fund the cash-strapped government. UK and US sanctions were imposed on relatives of President Bashar Al Assad, due to their suspected involvement in the production and trafficking of Captagon. The European Union drugs agency this month<a href="https://www.thenationalnews.com/world/europe/2023/09/13/captagon-produced-on-demand-in-netherlands-for-middle-east-export/" target="_blank"> warned some of the bloc's ports</a> were being used to smuggle the tablets and that Captagon was being produced in the Netherlands. More than 40 per cent of addicts reported using Captagon – making it the second most commonly used drug after cannabis, the MedGlobal report found. The drug causes depression and irritability, the report found. The families and children of users were also at risk of becoming users themselves, its authors said. Lebanon-based psychiatrist Maya Bizri, a co-author of the report, said the issues around Captagon went beyond addiction. “Stimulants and Captagon are correlated with crime and corruption. People are selling these substances for their financial needs, because there’s no other opportunities. It is a societal cancer,” she said. Though 65 per cent of drug users were unemployed, or had a monthly income of less than $100, they could obtain drugs as cheaply as $10 a month. People surveyed in the report in opposition held areas said that Captagon was supplied from regime-held areas and Hezbollah, a Lebanese militia that supports the Assad regime. But Dr Sahloul believes an unrecognised threat is addiction to opiates, which rose as a result of injuries from the conflict, and a lack of medical resources. “The opiates crisis is more important to my mind than Captagon, because it is more dangerous and more difficult to treat,” he said. The risks of opioid addiction were particularly acute in north-western Syria, an opposition-controlled area with limited access to international aid, which has been subject to regular campaigns of Russian bombing. “Many of the standardised detox and maintenance treatment regimens that are used in the US are not available in north-western Syria. You have to get creative around making the best out of what you have access to. There are also logistical barriers in accessing hospitals," said Dr Bizri. The Azzaz Specialty Psychiatric Hospital, which is supported by MedGlobal through a partnership with Physicians Across Continent, is the only specialist psychiatric hospital serving a population of 4 million in north-west Syria, and includes a drug rehabilitation centre. The area has only four psychiatrists, according to the World Health Organisation. This is compounded by a shortage in nurses trained to administer opiates or to look for signs of addiction. The stigma associated with drug abuse has deterred patients from seeking help, and MedGlobal will host workshops in the coming weeks to establish the most effective ways of encouraging addicts to get treatment in north-western Syria.