The drug known as Captagon is the most in-demand narcotic in the Middle East.
Millions of pills are being intercepted by customs officials in the Gulf every month as the region continues to crack down on trafficking.
But what is Captagon, who is consuming it and what effects does it have on users?
What is Captagon?
Captagon was first created in 1961 as an alternative to amphetamine and methamphetamine and was used to treat attention deficit hyperactivity disorder and, less commonly, depression.
The drug, however, was never given regulatory approval by the US Food and Drug Administration (FDA) and in 1981 it was declared a controlled substance after the medical community determined that the drug’s addictive properties outweighed its clinical benefits.
By 1986 manufacturing Captagon had been outlawed in almost every country, but illegal production of the drug continued.
Criminal gangs from Bulgaria and Turkey are believed to have helped to introduce Captagon to the Middle East, where production has flourished in territory beyond the control of fragile states such as Syria and Lebanon.
Today, most of the pills being sold as Captagon across the region have little in common with the tablets produced in the 1960s.
Although stamped with the Captagon logo, these counterfeit pills – often white or yellowish brown in colour – are much less likely to contain fenethylline, the chemical first used in the original tablets.
They are instead more often made up of a mix of other amphetamine derivatives that are easier to produce, as well as additives such as caffeine, quinine and paracetamol.
Who is taking it?
Captagon quickly became associated with the civil war in Syria, after reports emerged of fighters on both sides using the drug on the battlefield.
Talk of ISIS fighters being imbued with supernatural powers after dosing up on handfuls of pills were fanned by producers and the fighters themselves, but have largely been discredited by experts.
Analysts often questioned the drug’s influence on the conflict, pointing instead to the Captagon trade being a lucrative revenue stream for the different warring sides in Syria. The main markets for Captagon are in the Gulf, where it is popular as a recreational drug with young people, particularly in Saudi Arabia.
Data on how widespread the use of Captagon is in Saudi Arabia is scarce, but it is known to be popular as a party drug and among students under pressure to perform academically.
In 2015, the secretary general of Saudi Arabia’s National Committee for Narcotics Control said that the majority of the kingdom’s drug addicts were between 12 and 22 years old, with as many as 40 per cent of those addicted to Captagon being in that age group.
What effects does it have on users?
Captagon is a highly addictive amphetamine. It works by stimulating the central nervous system, increasing alertness and concentration and allowing users to stay awake.
It has been compared with drugs such as Adderall, another amphetamine used to treat ADHD in children.
Despite the descriptions of extremist fighters in Syria feeling invincible while on the drug, the effects of Captagon are generally mild, with users reporting feeling mild euphoria, as well as being talkative and more energetic.
But Captagon abuse can have devastating consequences for those who become addicted.
Long-term amphetamine users can suffer from a range of side effects including confusion, hallucinations, nausea, vomiting, seizures, high blood pressure and heart palpitations, according to The Cabin, an addiction services group that operates in Saudi Arabia.
Other side effects reported by regular users include blurred vision, vertigo, breathing difficulties, heart palpitations, gastrointestinal symptoms, muscle and joint pain, mood swings, confusion, feelings of anger and irritability.
When users try to quit taking Captagon pills, they often encounter strong withdrawal symptoms, including fatigue, that cause them to seek out the drug again.
Treatment for Captagon addiction usually includes psychotherapy, as well as exercise and diet programmes.
