Drug and Alcohol Use in Iraq: Findings of the Inaugural Iraqi Community Epidemiological Workgroup

Abstract

Background: Reports suggest increased use of alcohol, prescription drugs, and illicit drugs in Iraq in the past decade, which may portend an increase in substance use disorders (SUDs) and, thus, an increased need for treatments. Objectives/Methods: To develop better information on the nature and extent of drug and alcohol use in Iraq, the Iraqi Ministry of Health, with support from the US government and technical assistance from US researchers, held an initial Iraqi Community Epidemiology Work Group meeting in May 2012 in Baghdad. Drug seizure data were the primary data source, provided by Iraqi law enforcement and customs officials. Ministry of Health officials presented data from hospitals (medical and psychiatric), outpatient clinics, and health centers, as well as from surveys of medical patients, pharmacy patients, and prisoners. Results: The data suggest that the most commonly used substances are alcohol, hashish, and prescription drugs. New drugs in Iraq's drug use scene include the amphetamine-type substances “Captagon” and crystal methamphetamine, and the painkiller tramadol. Seizures of Captagon, methamphetamine, Afghan opium, teriac (a crude form of opium), and heroin at border crossings may indicate that these substances are becoming more popular. A plan for an ongoing program of CEWG meetings was developed. Conclusions: Drug and alcohol use in Iraq is increasing and new drugs are appearing in the country. An ongoing program for monitoring drug use trends and informing Iraqi policy makers is important for public health planning, including the development of strategies to identify citizens with SUDs and provide them treatment.

Keywords :

• drug and alcohol use in Iraq
• epidemiology
• drug seizure reports

THE AUTHORS

Nesif J. Al-Hemiary, MD (BMC), currently serves as an assistant professor of General Adult Psychiatry at the College of Medicine, University of Baghdad. He received his MBChB at the University of Baghdad in 1986 and was granted his psychiatry specialty degree by the Iraqi Commission of Medical Specializations (ICMS) in psychiatry in 1994. He was the first graduate of the ICMS psychiatry specialty degree, after which he held posts as officer and specialist/consultant psychiatrist at various military hospitals throughout Iraq. He is also the chair of the Scientific and Ethical Committee within the Iraq National Mental Health Council, vice president of the Iraqi Psychiatric Association, and an active member of the Council of Arab Board of Psychiatry.

Jawad K. Al-Diwan is an assistant professor in Epidemiology, Department of Community Medicine, College of Medicine, Baghdad University. He has a MSc and fellowship in epidemiology. His interests are psychiatric epidemiology, mental health, and biostatistics.

Albert L. Hasson, MSW, has worked in the field of substance use disorder research and treatment since 1977. He began his career as a research associate at the Sepulveda Veterans Administration Medical Center, Drug Dependence Treatment Center, implementing research protocols in the use of naltrexone and levo-alpha-acetylmethadol (LAAM) for the treatment of narcotic addiction. For the past 10 years, he has served as the coordinator for the Pacific Region Node of the NIDA Clinical Trials Network at the UCLA Integrated Substance Abuse Programs.

Richard A. Rawson, PhD, is the co-director of the UCLA Integrated Substance Abuse Programs in the UCLA School of Medicine. He has been a member of the UCLA Department of Psychiatry for over 20 years and is currently a professor-in residence. He has published 6 books, 30 book chapters, and over 200 professional papers and annually conducts over 50 workshops, paper presentations, and training sessions.

GLOSSARY

• Captagon: Also called “01 pills,” an amphetamine-type drug that likely contains methamphetamine.

• Community Epidemiology Work Group (CEWG): A network of researchers from a region or country that meets semiannually to discuss the current epidemiology of drug abuse. The main mission of the workgroup is to provide ongoing community-level surveillance of drug abuse through the gathering of quantitative and qualitative data. CEWGs provide recent descriptive and analytical information about the nature and patterns of drug abuse, rising trends, vulnerable populations, and social and health consequences.

• Teriac: A crude form of opium sold in digit-sized chunks that is either eaten or smoked in a variety of ways, including using a “shisha” (waterpipe).

• Tramadol: An opioid-type analgesic that is a relatively weak mu-opiate agonist.