[ rapid situation assessment [RSA] study of alcohol and drug use in Lebanon]

Research on substance use and misuse in Lebanon is scarce and, when available, focuses on a specific substance or a limited segment of the population. The objective of this Rapid Situation Assessment [RAS] study was to survey the use of multiple substances in diverse segments of the Lebanese population. A multi-method and multi-sample survey was conducted to collect quantitative and qualitative data from the academic sector [high school and university students], substance users in treatment or under arrest [prison, detention], and non-institutionalized "street" users. Age of first use of substances started as early as 9 years in the youth sample. Moreover, 12% of the high school students reported smoking one or more packs of cigarettes per day and 9% of the university students met criteria for DSM-IV alcohol abuse. Cannabis represented the most commonly used illicit drug in both high school and university students, and tranquilizers were the most frequently misused medicinal substance. Heroin was responsible for 50% of the treatment admissions, followed by cocaine [20%], and alcohol [20%]; heroin was also the most common substance of arrest. Recidivism was almost the rule for heroin users across all treatment settings. Unperceived need for treatment was the most common reason for not seeking treatment in non-institutionalized drug users [47.6%]. Injecting drug use was a common behavior noted within substance using populations, in treatment and non-institutionalized [about 50% of them], with a high rate of needle sharing practices. About half of all patients in treatment had a history of police arrests, and about one-third of those in prison ever received prior treatment for substance use. The study points towards a growing trend for substance use problems in early adolescence that warrants close monitoring. Further investigation of these patterns is needed since the Lebanese population might have specific pathways of abuse. There is a need to bring together various health, legislative, and academic stakeholders for a continuous appraisal of data from substance abuse studies as evidenced by the recent, although slow, progress in the fields of legislation and treatment that follow such concerted efforts

Suicidality in the Arab World part II: Community studies

This paper reviews hospital and government based articles on suicidality in the Arab world. A systematic search was conducted up to 2006 [Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Palestine, Saudi Arabia, Sudan and United Arab Emirates]. Results varied across countries and methods. The Arab hospital studies, estimated annual rates of attempted suicide ranging from 1.9/100, 000 to 127/100, 000. The Arab police and government records reported annual completed suicide rates of 1.1/100, 000 to 6.2/100, 000. Several risk factors were identified. While in hospital based studies, attempt was related to being single, aged 15-25 years, primary to secondary level education, students, housewives, unemployed, belonging to over-crowded large families, and having a low socio-economic status. In addition, many psychiatric disorders were identified as risk factors, most commonly depressive disorders, adjustment, personality, and drug dependence/abuse disorders. Completed suicide victims were more frequently males, 20 to 40 years old, single, manual workers and unemployed. In conclusion, accurate recording methodology in hospitals and governmental institutions are needed to assess the prevalence and risk factors of suicidal behaviours in the Arab World

Epidemiologic assessment of substance use in the Arab world

Epidemiological studies on substance use are rare in the Arab world. The purpose of this paper is to present a systematic review of all published epidemiologic research in the Arab world up to 2007 using several search engines such as PubMed, PsycInfo, and IDRAAC web database. Research in the Arab world was conducted on specific subpopulations ranging from students to autopsies, at times on large numbers and only one published article on a national basis. Despite the rigid laws against substance use in this region, alcohol is the most used substance, especially among high school and university students ranging from 4.3% to 70.1%. Males use substances more than females except for tranquilizers and barbiturates, the trends changing in a recent report from the L.E.B.A.N.O.N study. As reported by Western counterparts, substances carry a burden on several levels including social impairment, problems of violence, and HIV. Risk factors for substance use include mainly family problems and peer pressure. However, there remains a clear need for national data on substance use in the Arab world in an attempt to identify the magnitude of the problem, and track it for proper monitoring and intervention

Suicidality in the Arab World part I: community studies

This paper reviews published community based studies that assessed suicidality in the Arab world. A search was conducted on several search engines [PubMed, Psychinfo, IDRAAC WEB/CD] up to 2006 [Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Palestine, Saudi Arabia, Sudan and United Arab Emirates]. Results varied across countries and methods. In Arab community studies, the prevalence of lifetime suicide ideation varied from a low of 2.09% to a high of 13.9% and the lifetime prevalence of attempts from 0.72% to 6.3%. In about all community studies which assessed lifetime and 12 months suicide, ideation was significantly related to being a female. Twelve month suicide ideation was significantly related to depressive symptoms and experiencing more life events, illnesses and using more tranquilizers/sleeping pills. One month's suicide ideation was related to non-married status, not having children and a history of psychiatric disorders, specifically MDD, dysthymia, agoraphobia, OCD and GAD. When compared to female university students, females who were displaced or refugees were significantly more likely to report suicide ideation [within the "past few weeks"]. In conclusion, national epidemiological studies are needed to assess the prevalence and risk factors of suicidal behaviors in the Arab World