Crisis in Lebanon: Escape to Drugs as Self-Therapy

Lebanon is going through one of the world’s worst economic crises. Many people struggle with mental health problems. The consequences: drug use and suicidal ideation increase.

In the midst of the car exhaust from Tripoli, the poorest city in Lebanon, Karim Saad stands and sells dusty biscuits from a black plastic bag. His fingernails have been chewed off and the sun has faded the colors of his tattoos on his arms and neck. Saad, who doesn’t want his real name published, is hoping to earn some money with the biscuits. He has been unemployed for four years, says the father of three. He is now addicted to hashish and salvia, a hallucinogenic drug. “Because of the economic situation,” says Saad. “It’s the only way to clear your head in this situation.”

Like Saad, many people in Lebanon are doing. A previously unpublished study by the American University of Beirut now shows for the past year what aid organizations have only suspected until now: drug use in Lebanon has increased noticeably during the crisis compared to previous years.

The more intensely the respondents felt depression, stress or anxiety states, the more likely they were a greater – or first-time – abuse of cannabis, tablets or alcohol, for example, explains study author Lilian Ghandour.

Poverty, unemployment, trauma

According to their findings, mental health problems are widespread in Lebanon: Among the younger respondents under 30 years of age, more than 90 percent said they experienced moderate or high levels of stress. Around two thirds suffer from anxiety and more than one in three suffer from moderate to severe depression.

According to the United Nations, around three in four people in Lebanon live in poverty. Their number has risen sharply in the past two years. The reason for this is a series of crises that shook the country: a dramatic decline in the value of the Lebanese lira, a rapid rise in the price of food, gasoline and medicines, the devastating explosion in the port of Beirut, in which more than 200 people and hundreds of thousands were killed had traumatic experiences. Added to this are the corona pandemic, power outages, political instability, armed groups and increasing numbers of refugees.

Functioning in a crisis

Since the beginning of the crisis in autumn 2019, Tatyana Sleiman from the Lebanese NGO “Skoun” has been observing that more and more drug addicts and mentally ill people are seeking help. “Skoun” tries to provide information and support with therapy offers and a social worker network. Social workers also talked to Karim Saad, the biscuit seller, about the dangers of his addiction – and about possible treatments. In the past few months, however, so many people have contacted us that Sleiman now regularly has to turn down those seeking help.

She believes that many people’s drug use is a coping strategy in order to be able to continue functioning in the crisis. Unlike in the past, hashish, heroin and alcohol, for example, are no longer consumed to celebrate, but mainly to cope with stress, says Sleiman. Many would resort to drugs to treat their depression, sleep, or anxiety disorders themselves. Also because private therapies and imported drugs are now almost unaffordable for most – if they still exist. In contrast, the prices of many drugs in Lebanon have barely increased. “They are readily available everywhere,” says Sleiman – although in almost all cases their use is illegal.

Stigma makes life difficult for many

But the psychological consequences of the crisis not only lead to increased drug consumption, but also apparently to more people who want to talk about their suicidal thoughts. The number of calls to the only nationwide hotline for suicide prevention and mental problems has doubled since May: The “Embrace” clinic in the Beirut district of Hamra, whose volunteers operate the hotline, now registers more than 1000 calls per month. A large proportion of the callers have either acute, concrete or subconscious thoughts of suicide.

“There are many wounds that cannot be seen and that are not treated,” says the head of “Embrace”, Lea Zeinoun. It assumes a high number of unreported suicides. Because many traumatized and addicts still kept their psychological problems and suicidal thoughts to themselves out of shame. These issues continue to carry a religious and social stigma in Lebanon.

“But things are changing,” observes Zeinoun: The way society deals with mental problems, drug addiction and thoughts of suicide have improved significantly in recent years. “Even religious institutions are involved in the discussion,” says Zeioun. “That’s great.”

Imams and Mukhtars go with them

Even conservative representatives of civil society praise the fact that people are talking more and more openly about mental problems and addiction. “The awareness is there, but not enough,” says Jalal Ahmad. He is a Mukhtar – a neighborhood chief – from Tabbaneh, a strictly Sunni neighborhood in Tripoli. “Those who are particularly poor are particularly vulnerable,” reports Ahmad – the image of the criminal drug addict is changing.

Just like the imams, the Muslim clergy, he has only limited influence. In direct contact in the neighborhood, he could take away addicts’ substances or organize help. He also values ​​working with NGOs. But the problem lies deeper, believes Ahmad: Only an improvement in the economic situation can really solve the problem – “Jobs for young people, for example.”

In the Lebanese government, however, Ahmad has no hope: “The state is not interested in people, they don’t care.”