Addiction is on the rise, writes Magda El-Ghitany. Thankfully a new national strategy to counter it is in the making "In Egypt," one former heroin addict testified, "access to any kind of drug is a piece of cake." Months into his course of treatment, this source prefers to be identified as "I". "They're everywhere," he said. "Taking them is as easy as smoking a cigarette." And hence, perhaps, the phenomenal spread of drug abuse, especially among the young. Indeed Mohamed Ghanem, Ain Shams University psychiatry professor and director of the Ministry of Health addiction department at the Abbasiya Mental Hospital, indicates that the average age of heroin users has dropped to 17, and that the incidence of female users, negligible at the start of the 1990s, is now almost as high as that of their male counterparts. Accurate statistics are hard to come by, but Ghanem estimates that there must be 20,000-25,000 heroin addicts in Egypt; the figure for bango (locally produced marijuana) being much higher. The Arab Conference of Drug Prevention, organised by the National Council for Childhood and Motherhood (NCCM) in collaboration with the United Nations Regional Office on Drugs and Crime for the Middle East and North Africa (UNODC) -- and inaugurated last week under the auspices of Mrs Suzanne Mubarak -- therefore could not have been better timed. The largest such gathering in the Arab world to date, it featured over 140 speakers with specialties ranging from medicine to media and representing legal and official institutions. A three-day event, it also provided for workshops on combating drugs and possibilities for enhancing collaboration in the field of preventing trafficking. The highlight did not come until the closing session of the conference, however, when Mrs Mubarak announced the launch of the Egyptian Strategy for Protecting the Young from Drug Abuse -- a programme that focusses on prevention, aiming to effect a dramatic decrease in demand for illegal narcotics by 2008, in accordance with the 1998 UN Political Declaration on the Guiding Principles of Drug Demand Reduction. The strategy is different in that it is holistic, pooling the efforts of various sectors. "Addiction is a multi-faceted phenomenon. It is critically spreading and all Egyptians must cooperate to combat it," NCCM Secretary Mushira Khattab told Al-Ahram Weekly. Efforts intensified with the NCCM national conference in 2001, which launched a successful youth recruitment programme through which the young conveyed the message to their peers. The strategy, Khattab noted, will try to capitalise on such success, using the same recruits, "the young listen only to their peers." The media, families, schools and religious institutions are to adopt the programme, too. UNODC regional representative Mohamed Abdel-Aziz feels that the principal obstacle in the way of drug prevention is lack of coordination: "If children find out early enough from parents and teachers, they are unlikely to be misled later on." The UN International Day Against Durgs and Illicit Trafficking next Sunday (26 June) will, in the same vein, promote the slogan, "Value yourself, make healthy choices". According to an UNODC press release, the campaign rests on encouraging the young to "consider health-related reasons why they should stay away from drugs" and instead adopt hobbies like sport, music or theatre. At the centre of the strategy's goals is prevention, but treatment, psychiatrists say, must provide for comprehensive follow-up. With the introduction of the Fighting and Treating Addiction Fund (FTAF), one psychiatrist testified on condition of anonymity, treatment in Egypt has improved since the 1990s, a time when few medical personnels were appropriately trained and the inadequate conditions of state-run hospitals made the process "chaotic" and ineffective. Indeed conditions at the addiction ward of the infamous Abbasiya Hospital surpassed expectations by far. Males and females occupy two segregated buildings across a broad expanse of green, and the living quarters boast a library and painting room as well as a sports arena. One of the patients' paintings, entitled The End of Addiction, depicts a former patient who, after running away from the hospital, died of a heroin overdose. Due to hospital regulations, however, the Weekly was not permitted to interview patients. Treatment generally divides into a two-week detoxification phase (during which withdrawal symptoms are dealt with), followed by a rather more trying two- to four- month assessment with a view to eventual reintegration. "During the assessment phase," Ghanem explained, "we try to determine the patient's weak and strong points -- if the cause of the addiction is peer pressure, psychiatrists encourage the patient to develop an alternative social life; if the patient is driven by love for his family, they emphasise the role of family members in his life." During rehabilitation, the third and last phase of treatment and perhaps its greatest challenge, the patient forges a connection with his follow-up psychiatrist -- a necessary part of the support he requires in the next two years, during which Narcotics Anonymous (NA) -- an "international community-based association of recovering drug addicts" -- can also play a part. The full course requires at least two years; and its success, Ghanem insists, depends entirely on the addict's own persistence in making a change. "I" agrees: "For two years I resisted treatment, then I felt I was turning into the remains of a human being, so I sought a cure myself." Nine-hundred hospital beds are available for drug addicts, 600 of which in seven state-run hospitals (Khanka, Abbasiya, Shubra, Fayoum, Maamoura, Ain Shams and Mattar). According to Tareq Abdel-Gawwad, Cairo University psychiatry professor and president of the International Society of Addiction Medicine (ISAM), treatment improved in state-run hospitals when they started employing professionally trained specialists. FTAF support has been vital, he added, since it is an expensive process. But though public hospitals now offer the same quality of treatment as private ones, he added, research and statistics remain inadequate. A 140-bed annex to Qasr Al-Aini scheduled to open in September will provide much needed space. According to Abdel-Gawwad, the annex's acting director, it will also introduce a comprehensive treatment programme in line with Mrs Mubarak's strategy, providing for the latest facilities and an exchange forum to enhance treatment techniques among practitioners. Treatment costs will be covered under three different systems depending on the patient's means: a patient pays either the whole cost, half of it or nothing at all. Red tape notwithstanding, Abdel-Gawwad (who was concerned that the annex might not open on time) expects funding to be the principal obstacle: "LE2.5 million are still to be made available." Wealthy individuals are called upon to make contributions to this end -- an important goal, since much hope hangs on that particular establishment carrying out and thus demonstrating and testing the principles of Mrs Mubarak's strategy. Indeed, since it will be part of Cairo's largest university hospital, the medical knowledge and expertise the annex will generate and spread may well prove invaluable in itself. But one can only hold one's breath.
