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Increasing drug use strains Yemen’s services

SANA'A, 30 June 2014 (IRIN) - An influx of cheap counterfeit pharmaceuticals and illicit drugs, coupled with rising unemployment and an increasingly disillusioned society, is driving substance abuse in Yemen, according to civil society organizations, aid agencies, anti-drug campaigners and health and security officials, placing a growing strain on already stretched services.

"Drug abuse is a huge problem in Yemen and has become a bigger problem since 2011, especially synthetic drugs as they are more available and cheaper prices," said Golala Ruhani, a development consultant who recently worked on community outreach projects on drugs in Yemen.

The rise in substance abuse is affecting the long-term health of drug users and is contributing to already low morale in a country where half of all young people are currently unemployed, according to the UN Development Programme. It is also placing an additional strain on under-resourced police and healthcare departments where the problem has been particularly pronounced, such as in the southern port city of Aden and Taiz, an industrial hub in central Yemen, both part of established smuggling routes.

“It makes it even harder to do our job”

"It is a phenomenon, there is no denying it," said medical doctor Rajeh al-Mulaiky, general manager at Taiz's al-Thawra Hospital who has seen a rise in substance abuse in the city since the popular uprising in 2011 that eventually ousted long-time Yemeni leader Ali Abdullah Saleh. The problem is increasingly widespread, he said.

"It is well-known, the effects of drug use in general, but it's not just a health problem, it's a social problem," he said. "The addicts affect their surroundings. Under the influence, addicts attack people, they steal. It is also causing us a lot of problems, especially at the [accident and emergency department]."

A doctor at the emergency department at al-Gamhouria Hospital in central Aden echoes al-Mulaiky's account of the additional strain placed on the already hugely under-resourced healthcare system. "Every night we have people coming in who have got into fights, who have overdosed, or who are trying to trick us into giving them pills," the doctor says. "We already don't have enough doctors or rooms so it makes it even harder to do our job."

Abdulhakeem al-Ashwal, deputy head of security for Taiz, said substance abusers had been involved in rising numbers of violent incidents and petty crimes in the city, adding that they are often encouraged by their suppliers to sell drugs on to their friends, widening the network. Al-Ashwal describes an incident in Taiz in February where a young man at a wedding had taken a strong sleeping pill - sold on the street as “Crocodile” - and tried to fire a rifle in the air but instead shot several other guests at the wedding. "It is horrible. This young man's life is destroyed but also that of his family."

Underlying causes

With names like Crocodile, Gaddafi, Red Flow, Yellow Flower and King’s Coma, users see drugs as something fun without necessarily knowing the risks they pose.

Mohammed*, a former addict, said drug dealers were increasingly lacing their products with more dangerous substances. For example, marijuana, which has long been available in Yemen, is now mixed with sleeping pills and hallucinogens. Among the most common substances sold are strong sleeping pills, painkillers - including varieties that contain opiates, anti-depressants and anxiety relief drugs. It has recently become popular for substance abusers to inject Tramadol, a strong prescription painkiller.

Demand is driven by high levels of unemployment and a growing sense of nihilism among young Yemenis, many of whom feel that the 2011 uprising was a failure and fear there is little hope for Yemen in the future.

"People want to escape from reality. They have no hope, no jobs, no dreams, no education," says Abubakr Ali Baabbad, 23, who works at the Youth Centre, a community outreach project that deals with drug abuse in Aden. There is nothing for young people to do other than find escape through substance abuse, "so you chew khat or you take drugs,” he said, referring to the green-leafed stimulant chewed daily by many Yemenis. “The culture supports it.”

"The problem began in 2011, with the revolution. Drugs started appearing in the streets, for free. The dealers used the squares where protests were held. The people got addicted there; the problem started there."
Mohammed al-Shubaibi, president of Taiz University, said he had had to crack down on drug dealing at the university campus. He agreed that a lack of extracurricular activities on offer to younger Yemenis was a fundamental problem. “Even when they are at university, young people have too much time on their hands,” he said. “There are no parks, no sports, no clubs. So there is no alternative.”

To date, no reliable data has been gathered on the number of people abusing drugs in Yemen, or on the purported link between substance abuse, petty crime, and hospital admissions, making it hard to measure the exact extent of the problem.

"We really need to look at the problem in depth," says an Aden-based anti-drugs campaigner, who requested anonymity because of the sensitivity of the topic. "I suspect that the findings would be surprising to many people. The level of drug use would be very high."

Supply and demand

Yemen’s drug problem is part of a wider nexus of issues. Security deteriorated visibly in 2011, when rival factions from within of the Saleh regime clashed violently under the cover of a popular uprising. Yemen's transitional government, in place since December 2011, and its interim president Abd Rabbu Mansoor Hadi, have since struggled to restore order, with factional forces loyal to the ousted leader continuing to wield influence.

The deterioration in security inside Yemen made it easier to sell drugs on the streets.

Meanwhile, increased insecurity along Yemen’s borders with Saudi Arabia and Oman - key destinations for both illicit drugs and smuggled pharmaceuticals in past - led to a glut in supply and falling prices.

"[The problem] began in 2011, with the revolution," says Baabbad. "Drugs started out with the pharmacies but they started appearing in the streets, for free. As much as you want. Some areas of the revolution were out of government control. The dealers used the squares [where protests were held]. The people got addicted there; the problem started there."

According to al-Mulaiky, supply is largely driven by smuggling, but also through illicit sales at pharmacies, and theft from medical facilities. The smugglers sell the drugs either to pharmacies or directly to addicts.

Many smuggling operations combine different cargoes, including drugs, arms, and East African migrants either looking for asylum, employment opportunities, or both, in Yemen or in the neighbouring Gulf states, said al-Ashwal. Recently, traffickers have been opening up new channels of distribution by offering migrants the chance to pay off debts or make money by transporting drugs into Taiz and distributing them on the streets.

"It is a growing problem, especially over the last two years or so, but we are trying to control it," said al-Ashwal. "We don't know the exact source but smugglers bring the drugs from Africa. We did our best to control the source which is the sea. We are trying to arrest the traffickers.”

Others see a political dimension to the problem. A number of people interviewed by IRIN believe that cheap pharmaceuticals were first distributed to protesters in 2011 either by pro-regime groups - in the hope that they would induce apathy among the protesters - or by anti-government forces - who thought they would embolden protesters.

Reversing the trend

Reversing the trend of increasing drug use will be long and difficult. "Tackling drug abuse in any country is complex and difficult - and there needs to be an involvement of families, communities, and national health organizations, education authorities, legal and social services," Ruhani says.

Unfortunately, she adds, the Yemeni government has done little so far to put together a comprehensive strategy to tackle the problem.

In Taiz, the local government has taken some steps to tackle the issue: Al-Ashwal, for example, has led efforts to monitor the sale of drugs at pharmacies in Taiz more closely.

An official working in local government in Taiz lauds both his and al-Mulaiky’s efforts, but complains the central government has done little to support such initiatives. "Every department is stretched in terms of resources, time and money," he says. "Without support from [the capital] Sana'a, there is only so much they can do."

Most national police work is focused on preventing smuggling rather than uncovering distribution networks, anti-drug campaigners say. Meanwhile, Yemen has no specialized drug treatment centres, meaning that only the wealthiest Yemenis have access to proper care, in either Egypt or the US.

*not a real name

ps/ha/cb

Theme (s): Health & Nutrition, Security,

[This report does not necessarily reflect the views of the United Nations]

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