BEIRUT: HIV diagnoses are predicted to rise if drug use in Lebanon continues to grow in popularity, an addiction center spokeswomen said Thursday. The dangerous practice of sharing heroin needles is said to be responsible for the increase in the number of HIV cases in Lebanon, said Dala Fakhredine, a psychotherapist at the Lebanese addiction center Skoun.
Although the infection rate of HIV is currently relatively low in the country compared to the average worldwide figures, Skoun predicts a spike in the number of cases due to an increase in heroin use and the practices associated with it. They compared the situation to that of Western countries in the 1960s and 70s before cases dramatically increased.
Heroin is the most common addiction among patients that come to Skoun. Patients at Skoun both sniff and inject the drug, said Fakhredine.
Lebanon has no reliable statistics on drug addiction, but the team at Skoun sees many more male addicts than female. Most of their patients are in their 20s and come from a wide range of social backgrounds.
“Last year I had 50 male [patients], maybe five female,” said Fakhredine.
“The younger people are at more of a poly-drug using stage; when they get older they tend to stick to one substance.” Many young users often start off on “softer” drugs, then move on to harder drugs such as heroin, she added.
“A lot of them start smoking hashish at school, and then they escalate and start using heroin,” she said.
Skoun, founded in 2003, is the first walk-in outpatient facility in Lebanon, advocating prevention, awareness and psychological treatment for drug users.
Some of their patients come to them voluntarily, while others are sent by the courts. “When a patient first arrives we evaluate what’s happened, what’s happening and what’s needed. After psychological assessment there is therapy … they need help to stop. They need help to cope,” said Hayat Fakhouri, an addiction counselor at the center.
“When [voluntary] patients come in here, they are heavily addicted and are aware of the harm they have done to themselves, emotionally and psychologically,” said Fakhouri.
Fakhouri believes treating the patients requires “a combination of medication and relapse prevention strategies,” but also a key aspect of this strategy is family support. “Families sometimes are a big incentive. They also help the patient cope with cravings. Lots of patients ask their parents to stop them from going out and to keep an eye on them for protection from themselves.”
The strain put on families by addicts has been experienced by both Fakhouri and Fakhredine, who have had patients kicked out by their families, “but they get brought back home within a few days,” added Fakhouri.
Another function Skoun performs is to lobby for the government to shift the current emphasis in legislation from prosecution to treatment, like the long-term strategies for treating patients that some European systems have.
But Fakhouri expressed concern that “it will take a long time for [the government] to start thinking like that.”
This shift is sought as prosecutions seem to be making matters worse for addicts as there is a greater temptation to use in prisons with the high number of readily available pills in prison, according to Fakhouri, who adds that addicts are also frequently affected by the violence that they see inside.
But the Lebanese are not strangers to violence. “We see a few people who are 40-45 years old who used to fight in the wars and use heroin, but this is a small part. We don’t see a direct result from the violence, but maybe there is some psychological transmittance from the culture of being at war. Any effects could play anywhere, on all of us, not just on drug users,” said Fakhredine.
