By
Alex Taylor
BEIRUT:
Rabih’s struggle with heroin addiction began three years ago. Today he is in
treatment at Skoun Lebanese Addiction Center, grateful that he took the radical
steps to change his life.
“I
would have never thought I would become an addict. I went into addiction to
save someone and then I plunged with them. It can happen to anyone,” says the 30-year-old
Rabih (not his real name), who has experienced firsthand the stigma and lack of
support that comes with seeking treatment for substance abuse in Lebanon.
“It
is very hard in Lebanon. You can’t just go and ask help from anyone,” Rabih
continues.
“Even
my parents didn’t have a clue for the three years I was using. They didn’t know
until I actually stopped and I told them. For them it’s a disgrace and for
their entourage to know, it’s also a disgrace.”
Skoun’s
outpatient clinic in Monnot has treated many people like Rabih since it was
established in 2003 – 214 substance users in 2011 alone – and is now working to
broaden its reach with a new clinic in the Beirut southern suburb of Shiyah,
the first clinic to offer treatment to drug users in an area largely devoid of
clinical addiction services.
The
new location – tucked away in Shiyah near the edge of Ain al-Rummaneh – was
chosen in response to reports of growing prevalence of drug use in Dahiyeh.
Skoun is seeking to open up the same services it offers in Beirut to a
population that is harder to access, explains Nadine Moussa, the treatment
coordinator for the new clinic and an occupational therapist.
“We’re
trying to cater to Dahiyeh, Ain al-Rummaneh, Shiyah ... a lot of [Skoun]
service users have reported that a lot of the drugs come through here.
Reportedly there is an increase in the prevalence [of substance abuse] in those
areas, and that’s what we’re trying to assist with, decreasing those numbers,”
says Moussa, leading a tour of the compact, newly constructed clinic on the
ground floor of an unmarked apartment building.
“I
can say that there’s a lot of dealing in that area. Certain sectors are known
for the dealing of certain substances,” says Rabih, from personal experience.
The problem, he continues, “has really exploded in the last three years.
[Skoun’s services] are really needed.”
The
outpatient services provided at Skoun Shiyah – at no cost to patients – include
psychological and general practitioner consultations, testing for Hepatitis B,
Hepatitis C and HIV, medical follow-ups, opiate substitution therapy (a newly
legalized treatment in Lebanon that uses buprenorphine to help users stop
dependence on opiates like heroin or opium), educational services and, in the
future, legal and vocational services. Above all, Skoun seeks to provide a
nonjudgmental, confidential environment that meets drug users at whatever point
they are at in their lives, however ready they may be to accept change.
“We
are all about harm reduction,” explains Moussa, explaining that this entails
helping substance users to maintain health without requiring complete
abstinence to access Skoun’s services. “There are lots of things people don’t
know when they start to use drugs. Hopefully, with information, they want to
cut down and get to a point where they are abstinent. It’s about working on
their personal goals with them.”
“The
thing about Skoun is that they help you reach the decision [to stop], they
don’t pressure you to reach the decision because in the end if you don’t make
the decision, even if you go to other centers or clinics and spend years there,
you’re going to go out and contact the dealer,” Rabih says.
Full
statistics on the prevalence of drug use in Lebanon are difficult to produce,
yet Skoun has undertaken a continuous data collection project among its own
patients and spearheaded a nationwide needs assessment in 2009 of drug users in
Lebanon “to assess demographic, clinical and legal characteristics of substance
users and the needs of treatment centers in the country.”
According
to Karen Estefane, head of research at Skoun and leader of the national study,
70 percent of drug addicts seeking treatment at Skoun are abusing or dependent
on heroin, followed by users seeking treatment for cannabis (hashish) and cocaine
addiction – statistics that were confirmed by the national assessment.
These
drugs comprise the top three for users that come to clinics or seek treatment.
But Estefane says reports from addiction professionals also point to “an
increase in the use of sedatives and tranquilizers,” though there is no data on
the national prevalence of use in this category.
The
case for opening the center in Shiyah was based on Skoun’s observations and the
fact that “NGOs, municipalities and drug enforcement bureaus had designated
this area as vulnerable,” Estefane notes. With time, data collection will begin
at the Shiyah clinic to better assess and provide for the needs of the
community.
For
now, Moussa and the team at Skoun Shiyah are keeping a low profile as they ease
into their new community.
“There
are still a lot of stigmas associated with drug use in Lebanon and to open a
center in an area where there aren’t many centers and there aren’t many
services [oriented to drug users] – people are not used it – to come in guns
blazing isn’t appropriate in terms of the community,” Moussa explains, adding
that the team was beginning to meet with local stakeholders, religious figures
and municipality leaders to introduce their work.
Nonetheless,
two weeks in, the clinic has received 30 patients. “A lot more people are
coming in and we don’t even have a sign out yet,” Moussa remarks with surprise.
“We have some walk-ins, people coming in and asking what exactly we’re doing,
and the feedback has been quite positive so far.”
Rabih
hopes that others will be able to access the help he was lucky to receive from
Skoun: “Of course there are exceptions, but mostly addicts want to get rid of
their addiction, they just don’t know how. They have no support network, no
help, no means. That’s what Skoun offers.”
http://www.dailystar.com.lb/News/Local-News/2012/May-15/173415-addiction-center-expands-services-to-shiyah.ashx#axzz1upf1xgxm
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