Introduction
Substance misuse is becoming a more significant global public health issue, even in the Arab world. Data on substance misuse in Arab nations are relatively scarce, nevertheless. As some Arab nations attempt to normalize relations with Syria, the topic of captagon has been heavily discussed in regional diplomatic meetings (Laher, 2021). As countries sought to control the illicit drug trade, the highly addictive stimulant, akin to amphetamine, was being produced in large quantities in Syria (Laher, 2021). It was trafficked to the Gulf countries as an instrument of exchange in negotiations to reinstate Syria’s participation in the Arab League.
Therefore, the former brand name of a once-lawful amphetamine stimulant was captagon. Chemiewerk Homburg first sold the stimulant fenethylline under the brand name Captagon in 1961 (Laher, 2021). Since then, the medication has been marketed as a therapy for narcolepsy, attention-deficient hyperactivity disorder, and, to some extent, anxiety (Laher, 2021). Regardless of a few reported incidents of abuse, it was classified as a psychotropic drug by the World Health Organization almost 40 years ago, which rendered it a prohibited substance in the United States (Laher, 2021). The use of captagon by many people in the UAE endangers public health due to the underestimation of risks by its consumers.
Short-Term and Long-Term Health Consequences of Drug Use
The popularity of the drug makes people disregard its adverse health consequences. Due to its adaptability, the medication has gained popularity among various individuals, including high-level professionals who must maintain focus for extended periods, students who spend nights preparing for exams, and those who typically overwork (Al Omari et al., 2022). Women in Saudi Arabia take it to help them lose weight, and males use it to boost vitality (Rose & Söderholm, 2022). In Gulf countries, including the UAE, captagon is less illegal than heroin and alcohol (Rose & Söderholm, 2022). The short-term consequences of captagon include increased energy levels and a feeling of excitement. However, the tolerance to the drug appears comparatively quickly, and the dose the person needs becomes more dangerous to their health.
Long-term usage of fenethylline may result in severe depression, agitation, eyesight impairment, and heart issues. Amphetamine abuse can cause severe muscle, heart, and nerve problems (Shalaby et al., 2022). The other bulking chemicals included in the tablets also pose significant health hazards.
Drugs and HIV
It states that no studies have investigated the prevalence of HIV risk behaviors, relapse factor of nontreatment compliance, and treatment perception among people who use stimulants in the UAE (Shalaby et al., 2022). Fenethylline’s amphetaminic form and chemical similarity to brain chemicals like dopamine and adrenaline. They activate the central nervous system, resulting in increased alertness, concentration, endurance, and a sense of happiness, as well as suppression of hunger (Shalaby et al., 2022). In general, the effect on the nervous system is significant, ultimately leading to its destruction in the long term.
Another point of concern is that people with drug stimulants are more likely to engage in risky HIV behaviors. Amphetamine use has been associated with an elevated risk of HIV transmission in numerous groups worldwide (Jawa et al., 2022). A highly addictive stimulant, amphetamine can lower inhibitions while boosting sexual desire, self-confidence, and prolonged energy (Jawa et al., 2022). These physiological consequences may make amphetamine users more prone to participate in risky behaviors for HIV transmission, like having several partners, not wearing condoms, and exchanging sex for cash or drugs (Jawa et al., 2022). A study conducted in the UAE’s communities reveals these dangers, even compared to other drug users (Al Omari et al., 2022). In all cases, drug use impacts the brain, which changes judgment and lowers inhibitions. Drug use may increase a person’s likelihood of making choices that raise their risk of contracting or spreading HIV. These include engaging in sexual activity without using condoms or HIV preventive and treatment drugs, having sex with more than one partner, or trading sex for drugs.
Drugs and Sex Work
It is critical to mention the connection between using drugs and sex work. Women who sold sex had a greater prevalence of HIV. HIV prevalence was 21% in non-sex workers and 32% in female sex workers at baseline (Jawa et al., 2022). 10% of employed female sex workers and 7% of the remaining female participants had HIV recurrence during the examination (Jawa et al., 2022). The reported incidence of sexually transmitted diseases was not very high, but it was slightly higher for female sex workers (Jawa et al., 2022). As already mentioned, drug use in general and captagon consumption in particular are closely connected with increased sexual activity and a decrease in critical thinking skills. Therefore, the likelihood of having unprotected sexual relations with prostitutes is significant among captagon users.
Individuals who use stimulants are vulnerable to engaging in risky needle-sharing behaviors. The first reason for developing this addiction is the need to increase the drug’s dose, and heroin, through injections, has a more significant effect on the human state compared to captagon (Jawa et al., 2022). The second point is connected with the environment in which people use captagon. As mentioned, many individuals use it for socializing in the company, and their critical thinking abilities are lowered after utilizing the stimulant. Therefore, these situations increase the chances of trying other drugs and needle sharing.
Drug Use Rehabilitation
There is no approved medication to treat ATS disorder, unlike opioid use disorder. Relapse has become a significant issue among individuals who have been stimulated, as investigations have shown. People are more inclined to relapse after being released from the mandatory treatment center, especially when they return to the environment where the use of captagon is widespread.
Another risk factor for relapse is the individual’s lack of motivation (Wu et al., 2019). Complete refusal from drug use supposes the ultimate change of lifestyle habits, which is complicated. The individual needs to avoid companies where stimulants are acceptable; they should develop health habits, and a depressive state of mind can ruin the person’s motivation (Wu et al., 2019). These factors are critical in avoiding drug use, and all of them are difficult for some people to achieve when their mental state is vulnerable and their life situations are connected with drug use.
The process of relapsing frequently starts long before the person takes the drug. They are reverting to previous patterns, and accepting the loss of some of the person’s adjustments during rehabilitation can be the first step towards it. Among the early warning indicators of the relapse phase are the following.
First, the person starts considering or daydreaming about previous drug use. Then, they refuse to ask for help when they need it emotionally or do not ask for help at all. In the next stage, they reestablish relationships with individuals and locations associated with previous drug usage (Wu et al., 2019). The process is completed with a rise in the usual behaviors the person exhibits when using. Patients may also have distinct markers that indicate they are slipping out of recovery, in addition to these typical ones.
Patients’ self-awareness will grow, and their recovery will be strengthened if they are taught to recognize the early indications of a potential relapse. Additionally, numerous possibilities allow the person to step in, resume treatment-oriented activities, and continue their journey toward recovery during the relapse phase. Studies show that about 60% of people with drug abuse disorders recover long-term (Wu et al., 2019).
Nevertheless, before they experience permanent recovery, most require multiple cycles of lapse-relapse therapy readmission. Regardless of the number of times a patient has attempted to recover, professionals should encourage their efforts to do so. A prolonged recovery may result from multiple treatment sessions having a favorable cumulative effect.
Since almost half of patients with substance dependence relapse within three months of detoxification, early intervention is crucial for preventing relapses (Wu et al., 2019). This is because the early stages of recovery are frequently the most susceptible to potential failure. Relapse can happen at any point during recovery since dependence is a chronic, recurrent condition. Specific individuals even experience relapses after years of treatment (Wu et al., 2019). These details explain the mechanisms that lead people to continue using captagon after treatment and their hesitations to seek professional help in some instances.
Barriers to Recovery
People who use stimulants for a comparatively long period experience a lot of barriers to treatment. They like to come for treatment, neither voluntary nor involuntary, because they are afraid of further stigmatization for drug use and due to their faith in the complete safety of captagon. A survey conducted among directors and clinical staff of drug addiction treatment agencies revealed that inadequate possibilities for ongoing education and training. Coupling low incomes with long work hours significantly impedes the attraction and retention of qualified personnel, as well as the provision of adequate care to clients (Shalaby et al., 2022).
The survey participants highlighted the lack of respect for the counseling profession due to the stigma attached to substance misuse as a major obstacle to entry and retention in the area (Shalaby et al., 2022). Additional studies looking at how counselors view the field of substance abuse treatment suggest that bureaucratic demands, high caseloads, inadequate funding, little time for one-on-one counseling, and a lot of paperwork lead to burnout in the workplace and subpar client care (Shalaby et al., 2022). All these aspects make the work of the counselor specializing in treating captagon users challenging.
Conclusion
The paper responds to two objectives regarding using captagon as a popular stimulant in the United Arab Emirates. The first goal is to identify the motives of stimulant use among PWUS in the United Arab Emirates (UAE). The second objective is to investigate the HIV risk behaviors associated with stimulant use among PWUS in the United Arab Emirates (UAE). The issue is relevant for the country and corresponds to the global tendencies regarding the use of stimulants such as captagon. It suggests that applying drug control methods from other countries might be effective in the UAE context.
The investigation reveals that the problem of captagon use is significant in the UAE and poses a threat to the country’s public health. The national well-being depends on the health of its citizens and people working in the state, and the normalization of stimulant use is consistent with the risks to individuals’ mental and physical health. In addition, the spread of captagon use is connected with the increased chances of HIV and other sexually transmitted diseases, car accidents due to the loss of attention and control of people, and other cases. It allows hypothesizing that the findings from this study have the potential to help policymakers in the UAE develop effective harm reduction interventions and improve treatment accessibility for captagon users.
References
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