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Rsa Report Lebanon 2003.Pdf Preface UNITED NATIONS OFFICE ON DRUGS AND CRIME The Regional Office for the Middle East and North Africa of the United Nations Office on Drugs and Crime (UNODC) was established in Cairo in 1997. The Regional Office serves as a resource and coordination center advising Governments and other partners in the region on issues of drug control and crime prevention. It also develops and implements technical assistance programmes to address problems in the area of drug control and crime prevention. One of the problems for drug control and crime prevention in North Africa and the Middle East is the lack of detailed information and data, which are essential for the development of strategies and assistance programmes. To address this problem the Regional Office undertakes a number of assessments by technical experts, which are published in this series of Technical Reports on Drugs and Crime in North Africa and the Middle East. The main objective of this series is to provide a platform to share with the wider audience such as researchers, operational experts and decision-makers, the results of technical assessments in drug control and crime prevention. The series also aims at providing useful information for international and national organizations, as well as non-governmental organizations active in drug control and crime prevention. The views expressed in these technical reports are of the authors and do not necessarily represent the official policy of the United Nations Office on Drugs and Crime. The designations and maps in the publication do not imply the expression of any opinion whatsoever on the part of the United Nations concerning the legal status of any country, territory or area or of its authorities, frontiers or boundaries. In response to the growing threat of drug abuse and based on a strong proactive approach, the Government of Lebanon has cooperated with the United Nations Office on Drugs and Crime to carry out a study on Rapid Situation Assessment of Trends of Drug Abuse in Lebanon. The study was launched in 2001 to provide a better understanding of the nature, extent and trends of the drug abuse situation in Lebanon. The study was conducted by the Institute for Development, Research and Applied Care (IDRAC), a Lebanese NGO specialised in Mental Health, and was implemented in cooperation with the concerned public authorities, namely the Ministries of Justice, Interior and Health, as well as private associations working in the field of drug demand reduction. I take this occasion to thank all those who contributed to this study. I hope that the findings of the study would be helpful to counter drug abuse in the region. Mehdi Ali Regional Representative for The Middle East and North Africa 1 INSTITUTE FOR DEVELOPMENT, RESEARCH AND APPLIED CARE IDRAC (Institute for Development, Research and Applied Care) is a Lebanese non-governmental non-profit organization whose members have been working in the area of mental health since 1982. IDRAC has conducted over the years several mental health research studies (epidemiological, clinical, and psychopharmacological), and have been involved in intensive academic training in the aforementioned fields. In 1993, IDRAC participated in a Rapid Situation Assessment study to evaluate the use and pattern of drug use in Lebanon, during which IDRAC was asked to play a role in coordination, training, and analysis. Additionally, IDRAC prepared in August 1993, an expert report to the World Health Organization-Geneva entitled “Substance Abuse in Lebanon, Special Reference: Women and AIDS”, which gave a brief outlook about the substance abuse treatment and rehabilitation facilities in Lebanon, their geographical setting and distribution, as well as the predisposing, enabling and protective factors related to women’s substance abuse behavior in Lebanon. On a parallel level, IDRAC has conducted with the financial assistance of the Lebanese National Council for Scientific Research (LNCSR) a substance use monitoring survey, so far in two phases (Phase I: 1991 and Phase II: 1999) for the purpose of assessing the prevalence of and factors related to substance use (illicit and licit, including alcohol and nicotine) among an at risk population-university students. Having been a key participant in the last RSA in 1993, having worked over the years with several international, academic, and governing bodies involved in epidemiological research, and having been itself involved in major epidemiological studies on substance use, IDRAC was commissioned by the United Nations Office on Drugs and Crime to conduct another Rapid Situation Assessment Study (RSA) in Lebanon for the year 2001. We hope that research-based decisions become the standard in policy-making; thus regular and targeted careful scientific study of substance use should be the norm. It remains that private governmental and international bodies should set up regular coordination to pool resources, already very scarce in this part of the world. Elie Karam Director IDRAC 3 RSA RESEARCH TEAM UNODC Consultants: Reychad Abdool a IDRAC Principal Investigator: Elie G. Karam b, c, d Co-Investigators: Lilian Ghandour b Wadih Maalouf b, e Kareem Yamout b Consultants: John Fayyadb,c, d Caroline Cordahi b, c, d Aimee Nasser-Karam b, c, d a: UNODC, Regional Office for the Middle East and North Africa, Cairo, Egypt b: IDRAC, Institute for Development, Research, and Applied Care, Beirut, Lebanon c: Department of Psychiatry and Psychology, St. George University Hospital, Beirut, Lebanon d: Department of Psychiatry and Psychology, School of Medicine, Balamand University, Beirut, Lebanon e: Department of Mental Health, Johns Hopkins University, Baltimore, United States of America 5 Acknowledgement Special thanks are due to the following experts: Aaraj Elie, Street Survey Component Aya Hadi, Prison Survey Component Boustany Antoine, Treatment Centers Component Chakkour Michel, Internal Security Forces Component Oueidat Raymond, Ministry of Justice Riachi Ralph, Ministry of Justice Yazigi Mona, Rehabilitation Centers Component UNODC and IDRAC wish to extend their appreciation and gratitude to all RSA participants (See Annex I), who were actively involved in various aspects of the study, and whose combined efforts helped contribute to its accomplishment. They also like to thank the Lebanese Council for Scientific Research, members of IDRAC, and private donors for their financial contribution Dr. Mehdi Ali, Regional Representative, UNODC, Dr. Elie Karam, Director, IDRAC, during the opening of the conference on “Substance Abuse in Lebanon: where are we?” held in Beirut in May 2002 6 Abbreviated table of Contents Page Chapter One: Introduction to the Lebanon RSA Study....................................................... 15 Chapter Two: Contextual Assessment.................................................................................... 17 Chapter Three: Resource Assessment....................................................................................... 21 Chapter Four: Review and Critique of the Lebanese Law on Drugs.................................... 31 Chapter Five: Methodology of the Lebanon RSA Study..................................................... 39 Chapter Six: Results of the Lebanon RSA Study................................................................ 53 Chapter Seven: Discussion......................................................................................................... 97 Chapter Eight: Recommendations............................................................................................ 107 References: ........................................................................................................................... 119 Annexes: ........................................................................................................................... 125 Appendices The following appendices can be made available upon request by contacting UNODC or IDRAC: A. Data Tables I. High school survey II. University survey III. Substance using populations: Substances users under arrest, in prison, in hospitals, Accueil, or rehabilitation centers, or in streets IV. Treatment Specific data (Hospitals, Accueil, Rehab) V. Significance tables ( For university and high school samples only) B. Official Statistical Data I. Arrests and Seizures (Year 1999, 2000, 2001) II. Admissions to treatment (Year 1999, 2000, 2001) C. Description of the refusals in Accuel D. Questionnaires I. High school survey (In English and French) II. University survey (In English and French) III. Treatment survey (In Arabic) IV. Street survey (In Arabic) V. ISF survey (In Arabic) VI Prison survey (In Arabic) E. Feedback from Field Workers in the Street Survey F. Feedback from Field Workers in the Prison Survey Abbreviated Table of Contents 7 Detailed Table of Contents Chapter One: Introduction to the Lebanon RSA Stud 15 Chapter Two: Contextual Assessment 17 I. Background II. Migration A. Internal B. External III. Economic Overview IV. Education V. Employment VI Regional Development Chapter Three: Resource Assessment 21 I. Substance Use Services: Health Care, Prevention and Awareness 22 A. Role of the private sector 1) Treatment Centers 2) Non-Governmental Organizations (NGOs) B. Coordination Among the different NGOs C. Role of the Ministry of Public Health II. Internal Security Forces: Central Bureau for Drug Enforcement 30 A. Structure B. Role Chapter Four: Review and Critique of the Lebanese Law on Drugs 31 I. Organization of the law 33 II. Synopsis of
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