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By Ahmed Elkashef, Anas Fekri, Hamad Al Ghaferi, Ali Al Marzooqi, The National Rehabilitation Center, department of Public Health and Research
SUBSTANCE USE DISORDERS IS on the rise globally with an estimated 250 million people worldwide have used tried drugs at least once in their life time (World drug report 2014) and about 50 million used drugs in the 30 days.

Despite the lack of national statistics on SUD trends in the United Arab Emirates (UAE), the country is witnessing rise in the number of patients seeking treatment for SUD and/or referred from the court system for treatment as reflected by admission data to the treatment and rehabilitation facilities in the National Rehabilitation Center in Abu Dhabi (El Kashef et al. 2013).

There are many possible reasons for this, one is increasing awareness of the general public of the dangers of drug use as a result of the many awareness campaigns that the National Rehabilitation Centre (NRC) and others e.g. Ministry of interior, Local police authorities. Another reason is expanding treatment services, as seen after the NRC opened outpatient services in 2009/2010, a sharp increase in admissions almost ten folds followed. The geographical location and affluence of the citizens of the UAE make them target for drug cartels. According to the UNODC world drug report the UAE is a primary transit country for air-trafficking of illicit substances, location bordering southwest Asia, position it on the route between the countries that cultivate and produce illicit substances and the worldwide consumer market.

The NRC in Abu Dhabi is the largest comprehensive prevention, treatment andrehabilitation center for substance use disordersin the UAE. The NRC was established in 2002 on the directives of the late Sheikh Zayed bin Sultan Al Nahyan, the former president of the UAE. In 2010, the Emirate of Abu Dhabi issued a law under which the center expanded its functions to include conducting research and studies in the field of substance use disorders and propose policies and legislations in coordination with other competent authorities which will contribute to the prevention and treatment of such disorders, these efforts have contributed to new changes and amendments to the National anti-narcotic Law in the UAE which was approved by H. H. Sheikh Khalifa bin Zayed Al Nahyan the President of the United Arab Emirates in 2016.

Methods:
Literature review of published reports on recent trends (last 10 years) on SUD were completed using PubMed and Google Scholar search engines. Search criteria were to include studies on the Trends of Substance Use Disorders in the UAE with the following key words: UAE, Abu Dhabi, Dubai, Sharjah, Ras Al Khaima, Umm Al Quwain, Ajman, Fujairah, substance use disorders, epidemiology, trends of use/misuse/abuse, drug addiction, drug dependence, treatment, rehabilitation, prevention and outcomes.

Results:
Three studies met search criteria were found. One study was conducted by the NRC (Elkashef et al, 2013), a 10 – year retrospective study from NRC on the profile of patients with substance use disorders and treatment outcomes. The second study (Alblooshi et al, 2016), a cohort study on the pattern of substance use disorder in the UAE in 2015. The third and fourth studies (Alhyas et al, 2015), a qualitative study on Adolescents’ perception of substance use and factors influencing its use in UAE, and Parents’ Perceptions and Beliefs on Adolescence and Substance Use: A Preliminary Qualitative Study in Abu Dhabi, United Arab Emirates.

Discussion:
El Kashef et al. 2013, showed that there has been a steady increase in SUD over 10-years period from 2002 – 2011 with increasing trends of prescription drugs and polysubstance addiction among youth. It also showed a drop in relapse rate from 60% in the first two years the center opened which gradually improved down to about 20% in recent years. More than half of the patients treated in NRC were single, unemployed and had education below secondary school level. Alblooshi et al. 2016 study, reported rise in the use of prescription medications in the UAE, particularly among younger patients (less than 30 years of age), and continuing use of elicit opioids among males above 30 years of age. The majority of the cohort in that study (Alblooshi et al. 2016) were polysubstance users. Alhyas et al. 2015, showed that the Knowledge of substances and related consequences of use varied between adolescents’ groups but was compatible with participants’ age and school years. Many factors were believed to increasethe risk of substance use among adolescents such as peer pressure, inadequate knowledge of  the harmful consequences of drug use, family-related factors, affordability and availability of substances, boredom and affluence. On the other hand, religiosity was as a shield against substance use, especially alcohol. The study was successful in exploring adolescents’ awareness of substances and associated harm to health from their use. Also, it identifies a number of risk and protective factors based on the perceptions of a group of Adolescents.

Conclusions:
The studies available on the Recent Trends of Substance Use Disorders in the UAE are few. However, they show good evidence and necessity for establishing a nation policy to handle the increasing trend of polysubstance use and non-medical use of prescription medications specially among youth. The policy should encourage performing more epidemiological and outcome measure studies as well as setting and delivering evidence based prevention programs and preventive measures for the problem of SUD in UAE.

This article originally appeared in the Arab Health Newsletter 1 February 2018

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