Pubdate: Mon, 11 Feb 2002 Source: New York Times (NY) Copyright: 2002 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Elaine Sciolino REHABILITATION JOINS RETRIBUTION IN SAUDI DRUG WAR JIDDA, Saudi Arabia, Feb. 4 - The sword falls swiftly on a drug dealer's neck in the kingdom of the Sauds. There is nothing secret or ambiguous about the policy. Even before visitors land on Saudi soil, entry forms state in red letters in English and Arabic that trafficking in drugs is punished by death. Beheadings are routinely conducted in public squares, the details chronicled in the press. Thirty-five convicted drug traffickers were executed in 2000, in most cases after swift, secret trials without lawyers or juries. The government says the harsh punishment and the kingdom's relative isolation from drug sources make drug addiction less widespread than in countries like Iran or Pakistan, where heroin moves with refugees and merchants over long, porous borders with Afghanistan. But it is a serious enough problem that the rulers have begun - albeit on a very small scale - to deal with it in a very un-Saudi way: openly. And while the government treats drug trafficking as criminal activity, it has begun to regard drug, alcohol and nicotine dependence as treatable illnesses. One reason is that although an estimated 65 percent of Saudi Arabia's population is under the age of 25, this is a place that bans movie theaters, concert halls, discotheques and dating. Sports activities, particularly for women, are limited. Without a choice of healthy diversions for young people, drugs have increasingly become a source of entertainment and escape. "We don't think that the drug problem in our country can be described as a phenomenon," said Dr. Suhail al-Banna, director of Al Amal Hospital in Jidda. "But whatever you call it, we are very concerned about it and are dealing with it." The government provides no statistics on drug consumption, interdiction, and trafficking, but according to the State Department's annual global drug report, anecdotal evidence "suggests that Saudi Arabia's relatively affluent population, large numbers of unemployed youth, and the high profit margins on narcotics smuggled to Saudi Arabia make the country an attractive target for drug traffickers and dealers." Al Amal, whose name means hope, is one of four drug treatment centers in a country of 21 million people, about 15 million of them Saudis. Patients are offered group therapy, dental treatment, X-rays, sonograms, massages, physical therapy and biofeedback. They can swim, play pool and Ping-Pong, read in the library, work out in the fitness center and walk in the garden, whose caged roof prevents escape. During detoxification, each patient is given a private room and bath, a prayer rug and a copy of the Koran. Like all observant Muslim men, patients pray five times a day. Three paintings by an ex-addict that hang in a craft room illustrate the particular Saudi approach to the problem: Drugs lead to crime leads to death. In the first painting, a young man is seen experimenting with cigarettes, a water pipe, alcohol, sleeping pills, hashish and heroin. "Don't kill yourself, because God is merciful," the artist wrote. "But whoever does these things is sinning and bears the consequences." In the second painting, drugs and alcohol have driven the addict to adultery, rape and murder. In the final painting, the addict is blindfolded, his hands tied behind his back, his body covered in blood. Above him hangs a large curved sword. "We have not killed you," the artist wrote. "You have killed yourself." Transparency goes only so far, and the hospital's head of security tried to block the painting so that it could not be photographed. In terms of treatment, however, the hospital confronts the problem head on. A psychodrama program, for example, simulates the drug environment. The floor of the treatment room is covered with the paraphernalia and accouterments of dependence: an empty bottle of Scotch, hypodermic needles, cigarette butts, plastic takeout containers, a hashish pipe, a magazine with photographs of women and a deck of cards. "We show how low an addict can get," said a Sudanese psychologist- in-training. "We try to stimulate the craving, which gets greater and greater, and then we deal with the anxiety that results. We reduce the craving gradually with relaxation techniques similar to biofeedback. We use all international standards." Male nurses and security officers staff an out-patient facility and pharmacy. There, a father has brought his psychotic son who is dependent on pills. Ambulances bring in emergency patients, often identified through a 24-hour hot line. The hospital serves more than 200 male Saudi patients. Expatriates are jailed and then deported. There is no drug facility for women. "Females don't usually have such problems," said Dr. Ossama T. Osman, the hospital's medical director, who studied medicine in Illinois and spent three years at the National Institutes of Health in Maryland. Not true, said a female psychiatrist who works at a mental hospital in the kingdom. "There are many women with alcohol and drug dependencies," she said. "And women, especially women who are confined to the home, suffer from depression, and often self-medicate. They come to us but there's not much we can do for them. We can keep them for a day or two and then they leave. It's not something this society wants to face." One recovering addict at the hospital was introduced to be interviewed, a 31-year-old former flight attendant with Saudia Airlines who had yellow-tinted glasses and close-cropped hair, and spoke good English. "I used heroin, and when you use heroin, you lose everything - money, your family, your friends," he said. "Maybe it was the problems with my family that led me to drugs. Maybe it was that I was grounded by the airline." Patients are not allowed to be photographed. The kingdom is a place where family secrets are usually not shared, and to acknowledge drug addiction publicly could bring shame on the family. "We operate in complete secrecy because we know there is still a stigma for people using drugs," said Dr. Banna, the hospital's director. Drugs are smuggled into the country either by air or sea by pilgrims going to Mecca or by other travelers, who sometimes use children as carriers. Pakistan, Afghanistan, Nigeria and Turkey are the main sources. Heroin and hashish are the most commonly used drugs, but cocaine is available and some young people sniff acetone, glue and paint. Alcohol is banned, but available, and most prescription drugs, including sleeping pills, amphetamines and anti-depressants, can be bought over the counter without prescriptions. One place to buy alcohol (fermented palm juice makes a potent home brew) and imported hashish and heroin is the Qarantina slum of southern Jidda. The neighborhood was named decades ago because it was the area where pilgrims with contagious diseases were quarantined before they were allowed to travel on the annual hajj to Mecca. It is a neighborhood of rusty cars, crumbling buildings and an unreliable sewage and water system where both foreigners who have overstayed their visas and Saudis struggle to survive. The availability makes it difficult for ex-addicts to stay clean. "It's not that drugs are that prevalent in Saudi Arabia," said the recovering addict in the hospital. "But if you know where look for them, you can find anything you want. So I have to figure out how to survive on the outside." - --- MAP posted-by: Josh