Tramadol, captagon and khat use in the Eastern Mediterranean Region: opening Pandora's box

Hossein Mohaddes Ardabili; Abolfazl Akbari; Parnian Rafei; J L Butner; Riaz Khan; Yasser Khazaal; Abdulmalik Zuhair Arab; Mohammed Rafiq Qazizada; Basma Al-Ansari; Alexander Mario Baldacchino

doi:10.1192/bji.2021.53

Tramadol, captagon and khat use in the Eastern Mediterranean Region: opening Pandora's box

BJPsych Int. 2022 Aug;19(3):58-62. doi: 10.1192/bji.2021.53.

Affiliations

¹ Psychiatry Resident, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; and International Society of Addiction Medicine New Professionals Exploration, Training & Education Committee (ISAM NExT), Calgary, Canada.
² Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
³ MSc. Clinical Psychology, Department of Psychology, Faculty of Psychology and Education, University of Tehran, Iran; and International Society of Addiction Medicine New Professionals Exploration, Training & Education Committee (ISAM NExT), Calgary, Canada.
⁴ Addiction Medicine Specialist, International Society of Addiction Medicine New Professionals Exploration, Training & Education Committee (ISAM NExT), Calgary, Canada.
⁵ Professor, Psychiatry Specialist, Department of Psychiatry, Frontier Medical College, Affiliated to Bahria University, Abbottabad, Pakistan.
⁶ Full Professor of Addiction Psychiatry, Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Switzerland.
⁷ PG Researcher, Division of Systems Medicine, School of Medicine, University of Dundee, UK.
⁸ Dr., Communicable Diseases Control Directorate, National AIDs Control Program, Communicable Diseases Control Directorate, Ministry of Public Health, Kabul, Afghanistan.
⁹ PhD Addiction Medicine, Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia.
¹⁰ Medicine, Psychiatry and Addictions Professor, Division of Population and Behavioural Science, School of Medicine, University of St Andrews, UK. Email amb30@st-andrews.ac.uk.

Abstract

As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat.

Keywords: Eastern Mediterranean region; Epidemiology; captagon; khat; tramadol.

Publication types

Review