Ahmed was 12 years old and living in Saudi Arabia when he tried his first Captagon pill.
"It makes you feel like you have a superpower, but if you take the pill a few times, your face starts to change. I have seen it destroy the people around me," he told The National.
Captagon – a synthetic amphetamine first developed in the 1960s as a treatment for attention deficit hyperactivity disorder – has become one of the most widely used drugs among young substance abusers in Saudi Arabia.
"The good ones, the purest ones, are called Lexus," said Ahmed, 26.
Reliable data on the scale of drug use in Saudi Arabia is scarce, but researchers in 2016 estimated that as many as three quarters of the Saudis being treated for drug addiction had become addicted to amphetamines – mostly Captagon.
"When I was 20, I became an addict. I would take one every three to four days," he said. It took a year and a half for Ahmed to decide to seek help.
Captagon in the Middle East
"I felt I didn't deserve to treat my body like this. I had consistent black eye circles, and my face looked hollow. I looked sick. And I started to see how it is ruining the lives of people around me, especially those who take more pills than me, and I feared I would end up like them."
Consumption of the pills in the kingdom has helped Captagon – usually in the form of a small, off-white pill – become the most in-demand drug in the region, prompting a major crackdown from customs authorities to counter rising trafficking.
Saudi Arabia's war against Captagon smugglers
The kingdom's drug market is the end of the road for most of the pills produced in Syria and Lebanon, according to the UNODC World Drug Report 2021.
The lucrative trade has created a kind of arms race between the smugglers and the customs officials, with the authorities always on the lookout for inventive smuggling methods.
Saudi Arabia's authorities are cracking down, and say they are intercepting more Captagon than any other drug.
"We stop attempts to smuggle quantities of all sorts of drugs, but the majority are Captagon," said Abdulmalik Al Obaid, security adviser at the General Authority of Zakat and Tax.
"The weirdest smuggling method ever caught was an attempt to smuggle 15 million Captagon pills using grapes," he told The National.
In another foiled scheme, he said, 14 million pills were found hidden inside wooden boxes along with eight million pills hidden in grain bags.
The authority is using every tool at its disposal to catch the shipments at more than 35 entry and exit points on the kingdom's borders, including X-ray scanners and drug detecting dogs, Mr Al Obaid said.
Security officials are also trained to examine and assess travellers' behaviour.
In 2019 alone, Saudi Arabia seized almost 146 million of the amphetamine tablets, according to the UNODC report.
Lebanon and Syria are the most common source of Captagon tablets in Saudi Arabia, but some of the pills that make it are manufactured in Jordan, where the authorities in 2018 dismantled a laboratory producing Captagon.
The explosion in smuggling led the authorities to take drastic action to prevent more pills from reaching the kingdom.
In April 2021, Saudi Arabia banned the import and transit of agricultural produce from Lebanon after five million pills were found hidden in a shipment of pomegranates from Lebanon.
The crackdown has forced smugglers to find ever more creative ways of bringing illicit substances into the country.
In March 2021, 15 members of an international criminal group were arrested in Austria for the trafficking of about 10 million Captagon pills.
The drugs were allegedly manufactured in Lebanon and had been smuggled by sea container to Belgium and then by land to Austria, with the intended final destination being Saudi Arabia.
The criminal group, which had drug depots in Germany as well as in various provinces in Austria, is estimated to have shipped 25 to 30 tonnes of Captagon tablets from Austria to Saudi Arabia as air freight between 2016 and 2021.
The crackdown is also hitting users, who say the price of the drug has doubled since the ban on Lebanese imports.
Before the ban, the average price for one Captagon pill was 60 riyals ($16), while the purer form, known by its street name Lexus, went for 120 riyals ($32).
"If you were buying a large quantity, let's say a bag of 150 pills of Lexus, it used to cost 16,000 riyals," said Ahmed. Now the price for a similar quantity of pills is about 32,000 riyals, he said.
One doctor who works mainly with Captagon users in an addiction hospital in Saudi Arabia's western region, reported the same rise in prices.
"My patients tell me they used to get the tablets for 15 riyals ($4). Now they get them for about 30 riyals," said the doctor, who did not want to be named.
What impact is Captagon having in Saudi Arabia?
The influx of drugs is a serious threat to the health of Saudi Arabia’s young people.
In 2020, about 26,000 people tested positive for amphetamine use in the kingdom, said Dr Faisal Albishi, the head of the treatment and rehabilitation committee at the National Committee for Anti-Narcotics.
Dr Albishi said that people who abuse amphetamines usually start around the age of 18 and continue to use the drugs until their late 20s or early 30s, with only a few continuing past this point.
"I once had a patient who was 60 years old and still abused Captagon," he told The National.
Amphetamine abuse takes a physical and psychological toll on users, he said, with common symptoms that include rapid weight loss, headaches, hypertension and an increased heart rate.
Ahmed said he has watched on, helpless, as his friend’s faces changed, becoming gaunt, with dark circles appearing under their eyes.
Captagon abuse can also cause psychological side effects such as depression, psychosis, hallucinations and increased aggression, Dr Albishi said.
The addiction hospital doctor said hallucinations in particular were widespread among his patients.
"You find some patients who will hallucinate then hurt their wives. Some become paranoid, feeling someone is watching them," he said.
"I had a patient who started breaking all the furniture in his house. He believed there were cameras in the furniture," he said.
Breaking the addiction cycle
The kingdom's health authorities advise people struggling with Captagon addiction to get clean with a detox, which lasts for two to three weeks.
"The detoxification should ideally be in the hospitals, then it is followed by a rehabilitation programme," Dr Albishi said.
Rehabilitation programmes are offered in a hospital setting, rehabilitation centre or in outpatient clinics and can take up to a year.
Programmes vary according to the needs of patients, but generally include psychological treatment, social intervention and religious intervention.
"The main goal of this stage is to rebuild the person from the beginning, to give him a supportive system in the centre or in the hospital," Dr Albishi said.
But even with treatment, some of the effects of amphetamine abuse can linger long after users quit.
"Amphetamines, like other substances if one abuses it and then quits, some of its effects can continue," Dr Albishi said.
"In the long run, there is a clear effect on brain cells, and it will continue for years," he said.
While the anti-narcotics department and the customs authorities work on stopping the pills from entering the kingdom, the National Committee for Anti-Narcotics – of which Dr Albishi is a member – is working on how to reduce Captagon use in the country.
"In general, addiction is a disorder. For any disorder, we need to provide a good prevention system and good treatment system," he said.
The prevention strategy works by stopping people from getting into the addiction cycle in the first place.
"One of the main strategies is to concentrate on the role of the family," he said.
Families have an important role to play in stopping drug use at an early stage, he said. The National Committee for Anti-Narcotics is running outreach programmes to make families aware of the problem.
"It is good for the family to know the signs and symptoms of amphetamine abuse and to look out for them," he said.