Behind the staggering statistics of the Captagon crisis sweeping the Middle East lie countless tales of human misery caused by addiction.
The problem is now washing up on the shores of the UK, where addicts unable to buy the drug have been seeking help as they go through the painful process of withdrawal.
Many have been treated by Dr Sophia Khalique and Rameez Ali, an addiction therapist, who have seen first-hand the damage caused by Captagon to the minds and bodies of patients from the Middle East.
Mr Ali has more than 25 years working in the UK’s National Health Service, while Dr Khalique was an NHS general practitioner before going into private practice on Harley Street, central London.
Using expertise gleaned over three years of working together, they are now offering a new dedicated service for patients from the region to travel to London to obtain highly personalised and discrete treatment for their addiction.
As part of our series on global health, The National spoke to the pair about how their knowledge could help practitioners in the Middle East deal with the Captagon crisis.
The patients they hope to attract will join the many from region who have already sought out Harley Street treatment over the years.
Dr Khalique and Mr Ali are offering “concierge medicine” with staff “available 24/7 to meet patient needs”.
Mr Ali explained "from the work we've been doing, we've identified an unmet need" for treatment among Captagon addicts from the Middle East.
The US and the UK estimate the global trade in Captagon is worth about $57 billion, with 80 per cent of the world’s supply produced in Syria as a source of revenue for regime of President Bashar Al Assad, which has now been hit with Western sanctions as a result.
The amphetamine-based drug is consumed in pill form and induces periods of heightened concentration as well as feelings of confidence and euphoria.
The Harley Street doctor fighting Captagon addiction in London
It is consumed by a cross-section of society in the Middle East, from migrant workers to the young and relatively well-off, who use the drug to get through life as well as for partying.
It is people from this latter group Dr Khalique and Mr Ali been encountering in London over the past three years, they told The National in the doctor’s Harley Street surgery.
Who are the patients they’ve been seeing?
Mr Ali has been working in the Edgware Road area of London, where there is a sizeable population of Middle Eastern heritage, for about the past 20 years.
About three years ago, pharmacists began telling him more and more customers were seeking treatment for anxiety, insomnia and depression and were seeking stimulants, such as Ritalin, which is used to treat Attention deficit hyperactivity disorder (ADHD).
“They got in touch and mentioned the symptoms and Captagon,” he said.
“I wasn’t too sure what Captagon was so I did some research. Dr Khalique was one of the few doctors who was willing to provide for a programme to meet the health needs of these patients.
"She also noticed this trend in Captagon-related issues so that's how the collaboration started."
Now about 30 per cent of his referrals are Captagon users, though many consume other drugs such as cocaine and cannabis.
Over the past year he estimates the number of Captagon users he has treated has doubled.
Many of them are high-flying, postgraduate students who use the drug to cope with the academic pressure and workload.
And with the ability to keep people awake for up to 20 hours, Dr Khalique says “of course it’s used as a party drug”.
Both Mr Ali and Dr Khalique said many patients use the drug after feeling they are under parental pressure to succeed, so they take the drug because it gives them a sense of confidence.
“Peer pressure is huge. Even competitiveness among their cousins, we hear that a lot,” said Mr Ali.
“The families might be quite wealthy but they want to get one over their cousins, over their relatives, in education, financially. Their parents have high expectations of them.”
But their use of Captagon is “absolutely” kept secret from their parents.
Road to recovery
Once a patient seeks help, the pair work in tandem, with Dr Khalique dealing with medical issues caused by the drug, while Mr Ali oversees the recovery process.
Dr Khalique said patients exhibit symptoms as agitation, insomnia, inability to focus, hypertension and blood pressure changes. There is also a danger of a “major heart attack”.
To help addicts recover, on offer is a “discrete bespoke service” in a "secure environment", with those coming for treatment given the option of in or outpatient care.
Each patient is different, with treatment tailored to individual needs but a common time frame for treatment is two weeks of psychological intervention and withdrawal from Captagon.
“It’s about confidentiality, meeting their needs and being available for them 24/7,” said Mr Ali.
A key part of the tailored service is a team of Arabic-speaking male “sober buddies”, who will be with the patient around the clock, seven days a week.
This is to support them during the “isolation of withdrawal when paranoia kicks in” and they will stay in the patient's home or even go to a hotel for the duration of treatment.
During the difficult process of withdrawal, patients can experience agitation, depression, anger and frustration, says Mr Ali, with many of them tearful "because they can't understand what's happening to them psychologically".
Dr Khalique said a team of psychologists led by Mr Ali is on hand to help patients in their journey, while a bright, spacious surgery provides a "calming atmosphere" for patients.
Two male doctors from the Middle East have been hired to cater for patients who have up until now without exception been men, she added.
"You can't do this type of care in private practice without being available around the clock for patients' physical and mental health needs. The term is concierge medicine and that's what we provide."
Once they’ve gone through treatment, the symptoms begin to subside and Mr Ali says he notices a transformation.
“That edginess has gone and then we get to know the person and the reason why they’re taking it.”
But with relapse rates for addiction up to 80 per cent, he is concerned about what happens to his patients when they return home.
Help for the Middle East
Dr Khalique says she already disseminates knowledge among her peers about the work she does on treating addiction and that’s something that could be shared with those providing treatment in the Middle East.
Mr Ali says he runs a charity in Birmingham dealing with drug addiction in the Asian community.
(A)OPTA offers workshops and seminars to non-medical organisations in the Middle East, promoting harm reduction and therapeutic intervention.
In the meantime, the pair are hoping to see patients they feel are unable or unwilling to access care in their own countries, including women.
"There's a cohort of patients in the Middle East who are not accessing services for whatever reason so there's an unmet need," said Mr Ali.
"There's maybe embarrassment of being labelled an addict, which they feel might hurt their future prospects.
"Also we don't know how many women are using the drug, so there is huge potential there as well."
