Saturday, May 09, 2009
Nidal al-Mughrabi and Ivan Karakashian
Reuters
GAZA/OCCUPIED
JERUSALEM: Palestinians struggling to cope with the Israeli blockade of
Gaza and the trauma of war are turning to painkillers and
tranquillizers at a rate that risks triggering a wave of addiction.
There is also evidence of mounting recreational drug use as Gaza drifts
in limbo, with no clear political future.
Gaza
residents reported health problems after a 22-day Israeli war on the
territory last January, with most citing psychological problems and
stress, according to a survey published by the United Nations Gender
Task Force on April 21.
"With
increased trauma and stress and limited access to professional
psychosocial services, there is a rising problem of self-medication
with unsupervised pharmaceutical therapies among the Gaza population,"
said a summary presented in Occupied Jerusalem.
One
eighth-grade teacher, speaking to Reuters on condition of anonymity,
said she recently found several 13-year-olds using tramadol
hydrochloride, a strong painkiller sold under the brand name Tramal
which is now the drug of choice in the Gaza Strip.
A boy had stolen the drug from his parents' room and passed it to friends, unaware of its potency or the risk of addiction.
A
synthetic opioid developed by German company Gruenenthal in 1977 to
treat moderate to severe pain, Tramal has caught on among Gaza
high-school students, male and female, said Islam Shahwan, a Hamas
police spokesman.
There are
rich profits to be made on drugs, which pharmacists and other traders
say can be smuggled in through tunnels from Egypt and sold for several
times the purchase price.
"Every kind, anything you want, comes through the tunnels that are still functioning," said Salim, a doctor and pharmacist who declined to give his full name, referring to a crackdown on the supply tunnels.
Palestinians
say some 1,400 people including 926 civilians died in Israel's war from
December 27 to January 18 on the Gaza Strip.
Israel,
which says it launched the offensive to halt daily salvoes of
short-range rockets from Gaza, claims that most of the dead in its own
tally of 1,166 Palestinians killed were fighters.
Besides extensive destruction, the bombing has added to the Gaza Strip's problems of poverty, unemployment and overcrowding.
"To deal
with depression here in Gaza, many take these drugs, especially youths
who've lost their jobs, who sit at home and don't have a salary," said
Taysir Diab, a psychiatrist at the Gaza Community Mental Health Program
(GCMHP).
Tramal
pills at 100 mg doses sell for 25 Israeli shekels ($6) for a box of 10.
Besides Tramal, pharmacists named Elatrol (amitriptyline hydrochloride)
and older antidepressants such as Valium (diazepam) and Anafranil
(clomipramine) as commonly used.
Also popular - and much more expensive - is a mystery pill stamped "$". Mental health professionals say addiction is rife.
Turning to
tranquillizers and other self-medication is not an uncommon practice in
response to the chaos of war, such as in besieged Sarajevo and other
cities in the Balkan conflicts of the 1990s, when normal regulations
broke down.
Gaza lacks
professionally trained psychiatrists and psychologists, said GCMHP
president Eyad al-Sarraj. Doctors with limited knowledge often
prescribe medication for the physical symptoms of psychosomatic
problems.
But controls over the drugs are also loose.
"The law makes it clear that drugs of this kind should not be given to people without a prescription," said Sarraj. "But there is no control of this so people can go and buy over the counter any drug they want."
Salim said Gazans' consumption of anti-anxiety drugs and anti-depressants had risen dramatically.
"During the war people were tense, afraid, and they lacked the ability to concentrate,"
he said. "The situation continued after the war because of the
continued state of internal division and the possibility of a renewal
of war."
Prospects
of lifting the Israeli embargo depend on healing the Palestinian split
between Hamas and Fatah, but so far talks to this end have made no
substantial progress.
Once in
control, Hamas banned sales of natural opioids, but failed to regulate
synthetics like Tramal, which its police began to encounter during
raids on drug dealers.
"We have
discovered from investigations and interrogations that some drug
addicts take Tramal in large doses and big quantities when they do not
find [opiate] drugs," said Hamas police spokesman Shahwan.
"I know a
case where one went into a coma," said Nabil Abu Dalal, a pharmacist at
the GCMHP. "He'd taken 1,000 mg of Tramadol in a single dose."
The
Hamas-run Health Ministry recently renewed instructions not to sell
medication without prescriptions, and to enforce the rule, Shahwan said
policemen disguised as youths tested city pharmacies.
"We
detained some pharmacists for illegally selling Tramal," he said. "We
released them soon after they made pledges not to sell it.
Unfortunately, it is still being sold privately."
Psychiatrist
Diab said improved and prolonged sexual performance, a side effect of
Tramal and similar drugs, adds to their popularity among young men
between the ages of 18 and 30.
"Police
have warned merchants and tunnellers against smuggling Tramal and other
drugs and we have confiscated thousands of boxes," Shahwan said.
The pill
with a dollar sign stamped into it is called Saada (pleasure). It is
smuggled through the tunnels and sold on the black market in Gaza, but
neither its composition nor its manufacturer is known, said Abu Dalal.
Though it is not widespread like Tramal, a dose of Saada can cost from 50 to 100 Israeli shekels, he said.
Sameh the
merchant said he spends 500 shekels ($120) a month on Tramal and other
similar drugs. "It makes me feel good," he said. "I forget my problems
for some time."
"I hope
this will have some end, but I doubt it," said GCMHP president Sarraj.
"I think that we have to brace ourselves for even more serious
problems."