In a suburb off the coast of Alexandria in Egypt, a rehab centre is helping dozens of Kuwaiti citizens and expatriates overcome a problem that official figures show is increasingly plaguing the small Gulf country: drug addiction.
Established in 2017 by a Kuwaiti couple, who witnessed how lack of support for addiction could devastate a family, the rehab centre provides comprehensive care away from any potential judgment addicts may experience in their home country.
“Almost every Kuwait household has had to fight this epidemic that has seeped into their personal lives,” Ahmed Al Eisa, one half of the duo that founded Al Mustaqbal rehab centres, told The National.
“This is where we step in.”
Over the first six months of 2021, more than 1,200 citizens and residents reported their children to Kuwaiti authorities for addiction. And between 2015 to 2020, the Ministry of Interior arrested more than 11,000 people for drug possession.
The statistics are staggering among a population of a little over 4.3 million according to World Bank estimates for this year, with expatriates making up a little over 60 per cent of the population.
Kuwait has long worked to keep drugs off its streets, having signed the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances in 1988 and enrolled its specialised office in drug control training sessions and seminars.
Mr Al Eisa and his wife Suhare Al Mahmoud co-founded Al Mustaqbal — the Arabic word for future — after they were unable to get their family member the inpatient support they needed to overcome their substance abuse.
“Even sending my relative to London to get the help he needed and get treatment didn't work,” said Ms Al Mahmoud.
“The centres outside of the region couldn't possibly begin to comprehend the societal and cultural variables — ingrained in a more Muslim and a more traditional culture — that may play into this unhealthy relationship between an addict and their addiction.”
Their centre in Egypt aims to help Kuwaiti citizens, expatriates living in Kuwait, and GCC nationals overcome their addiction and set them up for a stable and productive future.
The couple initially tried to establish the inpatient centre in Kuwait but Ms Al Mahmoud said they were turned down after “the government insisted there was no need for a private clinic or centre when there was a government-funded one”.
Law 14 of 2019 on all mental health cases, including substance addiction and abuse stipulates that the period of time required for psychological evaluation does not exceed 72 hours from the date of the evaluation request or entry in a government mental health facility.
Following the assessment, the patient may then stay in only government paid facilities for up to three months and in some cases six months, but no longer.
For many drug users, that may not be enough time to kick the habit resulting in the likelihood of a return to addictive behaviour, say the couple.
Until 2015, addicts in Kuwait would be treated at the only government inpatient psychiatric hospital that contained 130 beds.
As addiction became more prevalent, the government opened the Addiction Treatment Centre, which has 350 beds for “first timers” and 200 beds for “more advanced rehabilitation stages”. Of these, 25 beds are reserved for women addicts in each section.
But Mr Al Eisa and Ms Al Mahmoud says despite efforts to increase capacity, these centres do not contain enough beds and facilities to tackle the country’s growing addiction issue.
Since its establishment, Al Mustaqbal has opened two centres for detoxification and two more for rehabilitation and recovery in Alexandria, with plans for opening an all-women's centre in the next year.
Though most centres focus on recovery of male addicts, statistics show that women are equally susceptible to substance abuse in Kuwait.
“Women have been struggling in silence with addiction stemming from numerous problems within the confines of their home, whether it be family strife or pain management for chronic pain,” Mr Al Eisa said.
“Out of every five addicts in Kuwait, three of them are female.”
Official figures show that between 2010 and 2021, more than 800 people died of narcotic and psychotropic abuse in Kuwait. The death rate from overdose rose by about 67 more people with each passing year, compared to the year prior.
Alexandria and Al Mustaqbal: An unlikely but perfect fit
The couple chose to open their centres in Egypt, a country with experienced doctors and a long history of successfully treating cases of addiction.
Doctors in Egypt would also be familiar with Middle Eastern cultural norms and understand the pressures Kuwaiti addicts may be feeling.
“Alexandria seemed like a good fit. the nature of the people are calmer here, the place is calmer, a perfect place for people undergoing symptoms of withdrawal, which is usually the state we receive outpatients [in],” said Ms Al Mahmoud.
A former patient of Al Mustaqbal praised the centre as being a hub where “many nationalities and walks of life came together to overcome this dark cloud in their life”.
The former addict, who asked not to be named, said he had previously tried to overcome his substance abuse at other international rehab centres but was not successful. Another advantage of opening the centre in Egypt was to remove patients from the path of potential scrutiny from some members of Kuwait’s conservative society.
The centre accepts both Kuwaitis and residents of Kuwait, as well as GCC nationals, by offering a refuge for people who may worry about being stigmatised if they seek treatment at one of the country’s government centres.
“I heard about [Al Mustaqbal] from a friend, who had been through a similar experience,” said the former patient.” It was a plus to go through treatment outside of Kuwait. To avoid seeing people I know.”
Al Mustaqbal has a small centre in Kuwait, where patients who received treatment in a centre in Alexandria can go for follow-up consultations with Dr Shaimaa Abdellatif.
A certified psychiatrist for 19 years, Dr Abdellatif joined Al Mustaqbal in 2019.
“Al Mustaqbal is a success story, and it's not a one-man show,” she said. “I found my own way to apply the many strategies at hand to provide the right treatment plan for each of our patients with the help of the team — especially when they relapse.”
Relapse is common among recovering addicts, even with hands-on treatments and careful medical attention. This makes every success story all the more special for Dr Abdellatif.
“The best moment where I felt a sense of accomplishment, is when I attended the graduation ceremony of one of my patients who had had multiple relapses,” she said. On graduation, or successful completion of treatment, the centre sends a medical team to recovering addicts' homes in Kuwait to follow up the treatment.
One of the greatest challenges is to prevent relapse on return to Kuwait.
Official statistics showed a significant increase in the activity of drug and psychotropic promoters during the first half of 2022, with more than 822 drug seizures reported during the same period. Authorities frequently caution against drug use, saying the rise in addiction has changed the pattern of crimes. According to local statistics, 72 per cent of murders, aggressive behaviour and thefts are caused by drug addiction.
“Boredom is the number one reason many of Kuwait's youth resort to drugs,” said Mr Al Eisa.
“That and societal pressure to have the best and the most out of your peers, whether it be possessions or fame.”
Another graduate of Al Mustaqbal said his addiction grew from what he thought was innocent, casual use.
“I started my relationship with addiction as a recreational user, in social gatherings and when I travel,” he said. In the end, it was his family that realised he had become addicted and referred him to Al Mustaqbal.
Success stories such as these are what keep Ms Al Mahmoud and Mr Al Eisa dedicated to their work and in expanding their treatment centres, despite many challenges.
“We are currently losing money, Many of the medications are out of stock so we have to look for pricier alternatives, and some of our patients can no longer pay for our services, either due to their family rescinding payments or other reasons,” said Ms Al Mahmoud.
“But we determined to stick by them and see their journey through.”