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Methamphetamine and

the Middle East

SANDRA B. McPHERSON

FARSHID AFSARIFARD

Introduction

Although the focus of this book is forensic applications associated with

methamphetamine abuse in the U.S., the substance is produced and marketed

globally. Accordingly, it is appropriate to consider issues relating to interna-

tional levels of abuse, as well as to appreciate the interweaving of local,

national, international, political, and ethnic factors that play a role in the

spread of methamphetamine.

Both authors of this chapter have had experience in the Middle Eastern

and Northern African region. Farshid Afsarifard, born and raised in Iran,

has lived in the U.S. since 1976, and recently returned to Iran to provide

mental health and substance abuse education to government and mental

health institutions in that country. Sandra McPherson has spent time in Gaza,

the West Bank, Israel, and Egypt, evaluating health-related issues from a

human rights perspective, with an emphasis on mental health and substance

abuse and on the treatment programs established to serve the Palestinians

in 1990.

Although there are strong prohibitions against alcohol and drug use in

the Islamic world and those areas inﬂuenced by the traditional force of that

religion, problems related to substance abuse have never been unknown and,

in fact, have shown signiﬁcant increases in recent years, especially from the

1960s forward. Furthermore, although the long-standing link between the

production of heroin and narcotics in Central Asia and their export to the

West has been known as a prime factor in some of the earliest identiﬁed

serious drug abuse problems in the U.S., the ongoing global aspect of drug

production, drug trade, and drug use in the case of methamphetamine has

not been adequately appreciated. The constituent parts of methamphetamine

have been tracked in transit to and from the U.S. and abroad. Ecstasy abuse,

in particular, is a phenomenon that has spread throughout the world (United

Nations, 2000; see also Seper, 2002; Trickey and Kennedy, 2002).

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Whenever there is a global trade in any substance, licit or illicit, political

as well as social implications intertwine. The situation with methamphet-

amine is no exception. Problems involving methamphetamine use of the type

detailed throughout this book have been noted in Thailand, Spain, Germany,

Canada, the U.K., Australia, the Czech Republic, Iran, Palestine, Israel, India,

and Egypt, among others. A search of major news releases for 2000 to 2002

produced 196 articles detailing methamphetamine-related events in coun-

tries throughout the world (see “Battle against ecstasy,” 2001; Sot, 2001;

Tr emlett, 2001; “Woman nabbed,” 2001; Chu, 2002; Russo, 2002). Ecstasy is

viewed as a global trade commodity. Politically, the emergent issue of terror-

ism and its link to drugs, which was initially spotlighted in the U.S. press as

a way terrorist organizations in the Middle East are funded, is becoming

recognized as having much more complex sociopolitical aspects (see espe-

cially articles by Bruce, 2002; Klein, 2002; Krikorian, 2002; Solomon, 2002).

Drug rings that have been identiﬁed as Israeli organized crime based operate

out of a country generally viewed as an ally of the U.S. (“Israelis said at head,”

May 3, 2001). The universality of the drug trade then allows competing

national and political interests to selectively perceive their opponents as

supporting the use of drugs as a way to engage in hostile interventions in the

ongoing struggle.

Interestingly, a peace initiative in Gaza and the Territories involved a

meeting of Israeli and Palestinian addictions and mental health specialists.

Supported by the U.S. government, the conference sought more adequate

programs of intervention. Although it was marred by difﬁculties with Israeli

regulations, which initially hampered attendance, the conference resulted in

reduction of misperceptions and the establishment of a more adequate basis

for treatment, as well as mutual recognition of the problems that the con-

temporary drug trade was creating for both peoples (Isralowitz et al., 2001).

has documented, for example, the problems of ecstasy in Israeli

society with its association to violent criminal acts, including gang rape

(“A long night of horror,” May 11, 2001; “Four charged with gang rape,” May

17, 2001).

Geopolitical Interconnections

Current information available through government and other sources

clearly illustrates that methamphetamine, in common with other drugs, is

embedded in a complex multilevel international set of factors and connec-

tions. In effect, there are multiplex networks that disseminate information

about illicit drugs and facilitate the distribution and trade in the substances

(see, for example, “War on Drugs,” January 23, 2001). This network has

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Ha’aretz

been facilitated by existing connections and routes established during the

colonial period of the 1700s and 1800s and also reﬂects current competing

or converging interests of governments and criminal organizations (United

Nations, 2000).

One of the precursors of today’s methamphetamine distribution network

was the poppy trade out of Iran, Afghanistan, and Pakistan. The primary

conduit to Europe and the U.S. was through Turkey, which remains to this

day a preferred route to move heroin and hashish/cannabis (United Nations,

2000). It is hypothesized that these connections are no longer one-way, but

rather represent a complex of international highways. Thus, although meth-

amphetamine in its various forms is created in laboratories throughout the

world, most ecstasy has been produced in the Netherlands and secondarily

in Belgium and then shipped elsewhere. The spread of ecstasy into Southeast

Asia has followed some of the original European colonialization routes and

has been facilitated primarily by Israeli criminal organizations. In Western

and Eastern Europe, the criminal organizations primarily responsible for

distribution and trade have been Russian (United Nations, 2000).

Ecstasy as a form of methamphetamine has an interesting history in and

of itself. It was ﬁrst created in Germany in 1912 for use as an appetite

suppressant. It was subsequently discovered by psychotherapy practitioners

in the U.S. and seen as a facilitator of that process, at least for a short while.

However, by 1988, it had become a Schedule I controlled substance. Even

earlier, in 1977, it had been so classiﬁed in the U.K. Ecstasy has consistently

been misrepresented as a drug that has no serious physical impacts, essentially

an innocuous recreational substance. Its availability serendipitously co-

occurred with the rise of so-called acid house and techno music and a young

people’s fad of staying up all night and dancing. That fad, incidentally, began

on the Spanish island of Ibiza, also known as XTC Island, and thus the name

of the drug. In 1988, the “summer of love” unfolded in the U.K. with young

people thronging to music and laser light parties in ﬁelds and warehouses.

Ecstasy was the primary enhancer and maintainer of the frenetic activity

(United Nations, 2000).

A study of Turkey’s place in the general international drug trade is nicely

illustrative of the way various interests are addressed and is certainly similar

to the situation in South America. Thus, criminally based organizations,

which have facilitated the movement of drugs through Turkey since the days

of the Afghanistan/Pakistani/Iran Triangle, are well established and covertly

supportive of and supported by the Turkish government. Assassination of

human rights activists and other persons critical of the government is part

of the

quid pro

quo

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that takes place, and it is not uncommon for people with

drug connections to be publicly overt about their occupations or identity.

The government has granted private armies connected to these organizations

control of whole regions (United Nations, 2000). If, as is likely, the same

conduits that send drugs from Central Asia to the West now also facilitate

the movement of ecstasy from Western Europe into Iran, a certain irony but

a practical reality is illustrated.

The continuation of interwoven history, geography, and politics is also

illustrated in the immediate Turkish situation. Turkey, which historically had

some economic dependence on the drug trade, is now even more committed

to that source of revenue as a consequence of the Gulf War of 1991. That war

closed Turkey’s access to Iraqi oil, with the result that there was an immediate

and ongoing increment in the degree to which the government was support-

ive of the drug trade. Interestingly, just as the U.S. and Western Europe have

not signiﬁcantly pressured Turkey to end its persecution of the Kurds and

the destruction of their villages, they have taken relatively little notice of the

enhanced Turkish activity facilitating the drug trade (United Nations, 2000).

Finally, there is a clear link established between the operation of terrorist

organizations and the ongoing drug trade operations. Given the current

world situation and the multinational efforts to identify and control terrorist

groups, hidden money sources have become extremely desirable. Drug

money is one such hidden source. Accordingly, drug ring ﬁnancing of ter-

rorist groups has been extensively documented (see, among others, Klein,

2002; Roberts and Marin, 2002; Solomon, 2002).

Government Complicity as a Factor

It is reasonable to understand that while drugs have always exercised a certain

controlling inﬂuence outstripping the desires of societies to end their abuse

by virtue of addictive potentials of human beings, it also needs to be under-

stood that the proﬁt motive has never been far from the drug dealer’s oper-

ations. That statement can be validated in terms of legitimate as well as

nonlegitimate drug operations. Furthermore, in the case of nonlegitimate

operations, some degree of covert or overt government complicity becomes

an issue. Thus, the behavior of the Turkish regime is an obvious example of

signiﬁcant government support for drug-related operations that have inter-

national implications. Similarly, the operations in Colombia have been

closely tied to more legitimate political levels. Even Israel has only recently

made money-laundering illegal in drug-related cases (United Nations, 2000).

Given that for some years a major source of the trafﬁcking and delivery

systems has been Israeli-based criminal organizations, the lack of concern

for reducing the proﬁt level through forfeiture is at least an omission of

signiﬁcance. In other words, even if not intended, Israel became in fact a

hidden support for the trade.

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In general, countries in the Middle East have deemed any substance

involvement, including alcohol, illegal and immoral. Nonetheless, in these

same nations, upper-status persons engage in such behavior and rarely suffer

legal consequences. In addition to selective enforcement, it can be hypothe-

sized that highly authority-driven government systems may derive a beneﬁt

from drug use in their populations. With the development of computer

technology, there is easy access to major sources of nongovernment-approved

information. Having large segments of the younger and more-likely-to-rebel

population self-absorbed and using drugs may be viewed as a desirable way

to eliminate challenges to the power base. Such a strategy might underlie

differential enforcement and also may be reﬂected in the lack of extensive

support for substance abuse treatment programs.

Business Aspects: Ecstasy as a Case in Point

Production costs for ecstasy (or MDMA) vs. revenues obtained represents

an extremely favorable ratio. The history, production, and use patterns of

ecstasy as they have occurred across the world scene illustrate effective busi-

ness operations. The substance moved from an intended therapeutic drug to

become a recreational drug. Controls were attempted in U.S. and Western

Europe by labeling it a controlled substance and making possession and use

illegal. Consistent with the experience of Prohibition, Ecstasy’s popularity

rose dramatically starting in the late 1980s and increasing throughout the

1990s as a favorable climate of youthful extremism, popular music, and

erroneous belief systems combined to make a ready market for a drug whose

proﬁt margin was excellent. Throughout Europe ecstasy has been effectively

“advertised” as a harmless drug. It is often combined with other drugs to

create a variety of effects (notably cocaine and alcohol). Based on seizure

patterns, by 1999, there was a serious increase in its use and it had become

the second most commonly abused drug (after forms of cannabis) in the

European market. Large-scale producers created pills imprinted with pop

logos such as smiley faces and car brand signs, all of which were consistent

with the notion that the pill was relatively harmless. These makers would

also customize logos for large orders (United Nations, 2000). The described

business patterns are those well known to any legitimate marketing and

production organization.

Cultural Factors and Treatment Implications

Historically, the Arab and Islamic cultures have had a more advanced view

of mental health issues in general than was found in Western practice and

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