Tuesday, October 18, 2005
A conference was just concluded in Beirut which appears to be a first ever to focus on the problem of addiction in Lebanon. The title of the meeting says it all: New perspectives for the prevention and treatment of addiction. It reflects the openness – indeed, the eagerness – of Lebanese government officials, academicians and clinicians to cast an analytical eye on the policies and practices that have reigned to date, and consider candidly and without prejudice other alternatives. Sadly, such openness and candor are totally lacking in some of the countries of the world with the biggest addiction problems and with the least success to date in addressing them.
The United States and Russia are the most egregious examples of this “flat-earthism” ideology, which clings slavishly to premises and practices that they themselves have demonstrated to be unequivocal failures, while refusing to introduce and/or expand approaches proven internationally to lessen criminality, disease, suffering and death. Between Russia and the US there is a distinction worth noting, however, with regard to “substitution” treatment. Russia rejects out of hand a treatment with which it has no experience, while the US has for decades provided methadone treatment to hundreds of thousands and confirmed its effectiveness for individuals and the general community - but refuses to expand its availability to the roughly 80% of opiate dependent individuals who remain without access.
The tone of the Beirut conference was set with the introductory comments of a highly distinguished group of speakers: MOHIT Ahmad, M.D., Director of the Division of Health Protection and Promotion for the Regional Office for Eastern Mediterranean, WHO, Cairo, Egypt; Dr. Mohamad Khalifeh, Minister of Health for Lebanon; Ms. Nayla Moawad, Minister of Social Affairs; and Ms. Sarah Trad, Executive Director of SKOUN, the Lebanese Addiction Center and the organizer of the meeting. Each of these speakers emphasized the following fundamental principles:
- Drug users must be viewed as people – individuals needing treatment and not criminals to be punished.
- Harm reduction measures are common sense and all must be considered.
- All forms of treatment must be encouraged, including – very specifically – “substitution” treatment with medications such as Methadone and Buprenorphine.
The Lebanese and international speakers (including experts from Iran, Switzerland, France and the USA) elaborated on these themes before an audience comprised largely of clinicians, who responded with obvious interest and enthusiasm.
Conclusion: it would appear that Lebanon will follow the lead of certain other countries that, very recently, have determined a law-enforcement, punitive, zero-tolerance approach has proven to be a dismal failure, and consequently have made a public commitment to develop rapidly and on a massive scale “substitution” treatment and various forms of harm reduction to reduce the deaths, misery and costs associated with illicit drug use.