HEROIN ADDICTS 'ARE ON THE RISE'

Record Numbers Of Drug Users Are Crippling Bahrain's Rehabilitation Service.

Robert Smith Reports In The First Of a Three-Part Series

Heroin addicts have soared to record numbers in Bahrain, says a top doctor.

This, combined with a chronic bed shortage, is threatening to cripple the
drug treatment service.

The number of new heroin addicts registering at the Almoayyed Drug and
Alcohol Treatment and Rehabilitation Centre quadrupled last year, according
to consultant psychiatrist and centre head Dr Abdulnabi Derbas.

In 2002, 44 new patients (including one female) were admitted to the centre
for heroin addiction treatment.

However, last year the number of new patients rocketed to 165 (again
including one female), which is the highest ever.

Meanwhile, the number of follow-up cases at the centre rose from 2,934 in
2002 to 4,439 last year - also the highest ever.

That is an unprecedented increase of over 50 per cent in the number of
people receiving continuing treatment for heroin addiction - again in the
space of just one year, said Dr Derbas.

Also worrying is the fact that the number of cases has continued to
increase at a similar rate this year.

"We are facing a crisis," he told the GDN.

"Sometimes you get a drug addiction epidemic - we had one in the 1980s.

"We are getting another one. The first was in 1983 and it was a problem."

There may be several reasons for the disproportionate increase in the
number of new cases and the number receiving follow-up treatment.

One is that the number of referrals from the Interior Ministry has
increased - suggesting that more heroin users are being arrested.

Another is that former patients may have relapsed and gone back to the
centre for help.

However, Dr Derbas said current Health Ministry facilities were unable to
cope with the huge demand.

"We are dealing with thousands. We have 140 heroin addicts on the waiting
list (to be admitted as inpatients).

"The number of cases is up, admissions, people waiting, follow-up patients
and the number of deaths have increased.

"We are facing a lot of difficulties, a lot of problems."

Although there are 140 heroin addicts on the waiting list, the unit is
equipped to treat just 13 inpatients at a time.

It may take a month for one patient to be discharged, at which point they
continue to receive treatment as outpatients.

That means addicts have to wait several months before they can be admitted
- - continuing to use heroin despite expressing a desire to quit.

Dr Derbas says there have been instances where addicts have overdosed on
heroin and died while waiting for a bed.

In addition to the 13 beds in the unit, another three are being used on
hospital wards which were not meant for drug addiction therapy.

Meanwhile, a first-floor ward opened at the centre six years ago has never
been used because of a staffing shortage.

"The first floor was opened in 1998," said Dr Derbas. "It has not been used.

"There are beds, but we have no staff. It can accommodate more than 15 beds
- - but that is still not enough."

One explanation put forward by Dr Derbas for the current crisis is
developments at a regional level, such as the Iraq war and the war on
terror, which have diverted attention away from the war on drugs.

However, British author, futurist and public speaker Dr Patrick Dixon says
the problem may lie closer to home.

In his book The Truth About Drugs - Facing the Big Issue of the New
Millennium he says social problems at a local level - such as unemployment
and poverty - may be to blame.

"When people lose hope, drug addiction becomes a great risk," he says.

"When people cannot find rewarding work and feel their existence is
meaningless, a chemical or liquid cosh to anaesthetise against reality
becomes very attractive.

"That is why it is no surprise to find the highest levels of drug addiction
of various kinds among some of the poorest and most marginalised in our
society.

"Time and again surveys show convincingly that good education and career
prospects together with happy personal circumstances are protective against
drug addiction."

Dr Derbas, who is also chairman of the National Committee for Demand
Reduction, is now spearheading Bahrain's participation in a GCC study into
reducing demand for drugs.

It is being carried out in every GCC country to assess the extent of the
problem across the region.

The results are expected to be published by the end of the year and each
country is supposed to submit a proposal for tackling the problem of drug
demand.

Dr Derbas says the aim is to draw up a regional strategy to prevent drug
addiction occurring in the first place.

"It is better to prevent the first occurrence of substance abuse from the
start," he said.

"It is a big approach and will form GCC policy on how to approach drug
addiction.

"At least there will be a structure for treatment - there should be on
approach for the whole Gulf.

"Some countries are very developed, while others are not."

He is also calling for a national committee on drug addiction and says
there are plans to increase staff at the drug treatment centre.

"Our plan is to open the first floor, which will take the number of beds to
30," said Dr Derbas, who acknowledges that is still not sufficient.

"I think the ministry will give us an extra 40 nurses, as well as another
doctor. We also plan to recruit a psychiatric counsellor and an
occupational therapist.

"The thing is to accept everyone - motivated or not."