Discussing 'soft' approaches to primary prevention of problematic drug use for children and young people today, I was reminded of one of my most interesting training jobs. In 2008 I was invited by the government of Saudi Arabia to travel to Riyadh and deliver a three week training programme to social workers and school counsellors in strategies to prevent drug use amongst school-aged (male) children.
This visit had come about as 2008 was the first time that the Kingdom of Saudi Arabia (KSA) had submitted statistics for drug seizures to the United Nations Office on Drugs and Crime. They reported that in 2006 that over 12 tons of amphetamine-type substances (ATS), particularly 'Captagon' (see below), had been seized in KSA. This is equivalent to the sum of all UK seizures – the biggest amphetamine market in Europe – from 2000 to 2006, in a country having less than half the population of the UK, though with a far higher proportion of people under 21. This also represented 26% of global amphetamine seizures in 2006. As KSA is on a peninsula with no other country except Yemen, and given that most of the amphetamines seized were believed to have been manufactured in Turkey and Bulgaria, this wouldn't suggest that KSA was a transit country and that most seizures were destined for consumption in KSA. According to the UN’s latest World Drugs Report, in 2015 the Saudi authorities seized more than 11 tonnes of ATS, excluding Ecstasy.
Fenethylline (or Phenethylinne), commonly known by the trademark name Captagon, is one of the most popular drugs used among the young affluent populations of the Middle East. Since the cessation of legal production of Captagon (in 1986), originally produced as a treatment for Attention Deficit Hyperactivity Disorder (ADHD) this synthetic amphetamine-type stimulant has been clandestinely produced in southern Europe and trafficked through Turkey to the consumer markets on the Arabian Peninsula, the primary market for Captagon. According to the United Nations, it is the primary amphetamine-type stimulant consumed in the region. Authorities in Saudi Arabia, Kuwait, and Qatar, report that use is prevalent among their younger, more affluent citizens.
What was known about patterns of Captagon use at the time suggested social use by affluent young males; use as a dieting aid by females; its use to stay awake whilst driving (KSA often has distances in excess of 200 miles between major urban areas) and as an aid to study (use as a cognitive enhancer). Educational achievement is highly valued, especially amongst the young and afluent. According to The Economist, Justin Thomas, a Briton who lectures on psychology at Zayed University in Abu Dhabi, says many users believe (or pretend to themselves) that it is a medication, a myth reinforced by some producers, who market the drug in blister packs. “This pseudo-medical veneer protects the user from feeling they are involved in an activity that is haram (forbidden by the Koran),” he says.
The Saudi Attitude to Drug Use
Saudi Arabia is the birth place of Islam and under Islam, all intoxicants are ‘haraam’ or ‘not permitted’. This includes alcohol, cannabis, opiates, cocaine and apmphetamines. The smoking of tobacco is debateable as is the use of Khat, particularly near the border with Yemen. The Qur'an is the constitution of the country, which is governed on the basis of the Sharia (Islamic Law). Within such devoutly Muslim society such as in KSA, to use drugs, particularly problematically, risks bringing shame on families (which are large in KSA) often necessitating a greater requirement to keep drug use secret from families.
The Training Brief
The first part of the training brief was to train Social Workers and School Counsellors from across KSA in basic drugs awareness. The second part was to design a pilot programme to be delivered to males in schools across the Kingdom with the main objective being to prevent or at least delay drug use as it was recognised that early or heavy use of drugs was a risk factor for problematic use later on.
If providing drug awareness can be a contentious topic in schools in the UK, in KSA this is especially pronounced. Discussing drugs is often seen as taboo and the dominant educational response is to use ‘shock tactics'. Because drug use is seen as contra to the teachings of Islam, there is little understanding as to why this is not a sufficient response and a Harm Reduction approach was out of question. The brief was really to develop a 'drug use prevention programme' that could be delivered without mentioning drugs too often!
Taking a lead from the 'Project Blueprint' I designed the programme around a Normative Educational and Social Influence Model.
Normative Educational Models
Normative Education Models seek to address any misconceptions that students might have about the prevalence of drug use and misuse. It makes three assumptions:
- Young people overestimate the extent of drug use amongst their peers
- They wrongly believe this behaviour is normal
- Because of their beliefs they are vulnerable to social pressures to use drugs
The Social Influence Model
The Social Influence Model recognises that social influences play a role in people starting to use drugs. These influences may be from the media, friends or family. It is an alternative model to purely information based strategies (if people know about drugs they won’t use them) or affective education (drug use is a result of low self-esteem and incorrect ‘values’). This is not to say that these are not important, they still play a part, but are not the primary approach.
The Programme Design
It was possible to design a programme that did not focus on specific drugs or substances. Rather it focused on the concept of a range of substances with the potential to cause harm or to be dependence-causing if used without care or appropriate medical supervision. This was made to include alcohol, tobacco, volatile substances, and prescription medicines as well as what we in the UK would consider illegal or illicit substances. The programme design also utilised the positive influences of tenets of the Islamic faith.
It focussed on developing an understanding
- That drug use amongst their peers is not normal
- That media messages are not always accurate
- About the concept of risk and risk management
and also provided the children with skills in
- How to evaluate media messages
- How to seek out relevant information for themselves
- Developing and practicing communication, negotiation and decision-making skills
- How to resist social pressures and influence
(A contemporary approach would probably focus in resilience-building activities too)
Two months prior to the delivery of the programme, teaching materials, resources and hand outs were sent to the National Centre for Youth Studies for evaluation and translation.
These materials were subsequently translated and proved invaluable in preparing the co-facilitators / translators for assisting in the delivery of the programme. This also allowed participants to receive comprehensive notes to support the programme delivery.
There really is something strangely satisfying, though, about seeing your work translated into Arabic!
A number of years later a book that I co-wrote was also translated into Arabic, unrelated to my orginal visit, but still very pleasing.
About Hugh Asher
Hugh is an author, practitioner, trainer, researcher and consultant.
He keeps rare breed sheep and cows.
He also shares his house with the world’s largest puppy, called Charlie.
Although he was told from a young age that “Life isn’t fair” he has refused
His vision for a better world involves giving people the skills and