There's a story in the medical journal Emergency Physicians International, in which a Saudi doctor finds a male patient convulsing on the floor of his ward, unable to talk. Suspecting the young man may be showing early signs of a heart attack, he bundles him into a treatment room. A nurse whips the cubicle curtain closed, leaving his family crying outside. The young man pulls the doctor close – "Don't tell my parents, but I've taken amphetamines."
Last year, 30 per cent of global amphetamine seizures came from Saudi Arabia. The United Nations ranks the country as the biggest consumer of illegal stimulants in the region. While khat and hashish are common-place, the drug of choice is Captagon – a substance similar to speed. Police seize around fifty million tablets each year.
Invented by an American drug company, doctors used Captagon throughout the Sixties and Seventies to treat narcolepsy and depression. Initially, researchers believed it would be a safer alternative to standard amphetamines, but the US government placed Captagon on a controlled substance list in 1981, and five years later the World Health Organization followed suit – banning the tablets globally. Captagon was deemed too addictive.
Nowadays the Captagon available in Saudi Arabia is likely to be a mix of the genuine substance and a host of fake alternatives. Captagon, like crystal meth, can be produced extremely cheaply almost anywhere, even using materials which can be bought over the counter. Despite this, pills can sell for over ten or even twenty pounds each.
Saudi Arabia appears to have the highest usage per capita in the region – although because of strict cultural norms and an institutional aversion to solving the problem, the exact extent of usage is not known. Saudi officials at the Ministry of Interior estimate that the sixty million tablets seized each year represent just 10 per cent of the total in the market.
"Why Captagon has become so unpopular in the region is unclear," says Justin Thomas, author of Psychological Well-Being in the Gulf States. "Young people are using it to stay awake or as a weight-loss aid." Obesity has risen in Saudi Arabia in recent years, and body image has become more important. Socialising also often goes on late into the night, but young Saudis are still expected to present themselves at school or university very early in the morning.
Thomas explains that in-depth research about Captagon usage in the Kingdom is unhelpfully scant. In 2008, a rare study suggested that users were more likely to be under-educated males in their twenties or early thirties.
This demographic profile is in line with international norms for drug usage, however Saudi Arabia is unusual in that such a low proportion of women take drugs. The study spoke to nearly five hundred users and just thirteen were female. A study conducted in Kuwait saw even more polarised results – out of over eight hundred Captagon users surveyed, only two were women.
In fact, while Saudi Arabia has an extraordinary usage per capita (accounting for thirty percent of the world's amphetamines but just 0.1 per cent of the population) it is not the only Middle Eastern country were amphetamine usage is rocketing. Each year, UAE police and coastguard units seize around four million capsules of Captagon. The actual amount being imported may be far higher. In 2009, an unusually successful raid on a single warehouse revealed a stash of four million. The massive haul of drugs had been smuggled in by sea, according to local newspaper The National, hidden in large roles of textiles. Captagon even has a folk nickname "Abu Hilalain," which means "Father of the Two Crescent Moons." The name mimics the designs imprinted on the tablets.
Lebanon was once an industrial production hub for amphetamines, but its regional importance has ebbed away as the conflict in Syria has escalated. In 2012, the Lebanese government announced that around twelve million tablets had been confiscated. The following year, that number dropped by 90 per cent as illegal labs relocated en masse to war-torn Syria. Producers wanted to be closer to the market: illicit amphetamines are now widely used by rebel forces fighting Assad, to keep awake and treat stress.
There is media speculation both from western outlets, such as Reuters, and local media organisations, that proceeds from the Captagon sales in Syria are now being used to fund weapons sales. This is difficult to prove, but last week a large shipment of small arms was stopped by a Jordanian border patrol, heading into the warzone. Alongside over two hundred weapons, ten thousand capsules of Captagon were confiscated, suggesting the two trades may be inter-linked in some way.
Captagon is not the only drug being used widely in Saudi Arabia. James M. Dorsey, blogger and author of The Turbulent World of Middle Eastern Soccer, suspects the football clubs of Saudi Arabia are riddled with narcotics.
"Fouad Anwar, a former Saudi player and captain of the national team, recently denounced the rampant use of hashish by players, and called for drug tests," Dorsey told Middle East Monitor. "Fouad made the claim on Saudi sports channel al-Riyadiyah at the beginning of March."
Anwar says he wanted to "ring the alarm," that he was acting in the public interest, and refused to be drawn further on the topic – saying that he didn't want to be accused of personal bias against certain players.
Hashish usage is also thought to be common in the Kingdom. Much of it originates in Afghanistan, before being smuggled in overland through Yemen or by sea. The product is considered low-grade by international standards.
Last November, Saudi coastguards caught four Yemenis carrying nearly four hundred kilos of hashish, sailing towards the coastal village of Shaqiq. Keen to block off overland routes, Saudi border enforcement agencies have also started work on a 1000 mile fence along the Saudi-Yemeni border – specifically aimed at stopping smuggling. The wall will also include cameras for remote surveillance.
Middle East Monitor spoke to an anonymous Western expat, who had lived in Saudi Arabia for sixteen years and worked as a hashish dealer. He told us about the dangers of dealing in a country where capital punishment is a typical punishment for drug offences.
"I knew dealers that were publicly executed. The death penalty was generally enforced, so it's one of those things you don't wanna mess with."
"We didn't really get paid in cash – our profits were in hashish itself. If I bought 5,000 Riyal worth of drugs, I would keep perhaps 150g for myself," he said, "before distributing the rest to my customers."
This profit-in-kind is colloquially known as "the death snitch," a dark humourous nod to the risks involved.
According to the ex-dealer, executions of locals were "widely enforced." However the ex-dealer believed Western expats may be treated a little differently. "I had two American friends caught with a small amount on them. They spent twenty four hours in a cell, and then were deported with a permanent visa ban for life."
He added "I don't think they would have executed me, as an expat."
Heralding the New Year, the Saudi Interior Ministry proudly announced that the first two government-sanctioned executions would be drug smugglers. One man had been caught in Jeddah, trying to smuggle heroin into the country in his stomach, the other in Qatif, Eastern Province. Both men were victims of Saudi Arabia's infamously punitive judiciary, who regularly dole out death sentences for drug offences.
Although enforcement agencies are rigorous, local organisations seeking to understand more about the drug problem, or help with treatment, are suspiciously unreachable. We tried to contact local charities and drug information centres but none were able to comment.
Expert sources suggest that the problem is not an issue the Saudi government would like to be widely publicised, or even acknowledge, although the Ministry of Interior does run their own drug rehabilitation centre, and some efforts are being made to refine treatments. While hashish remains a problem, addiction to Captagon reportedly makes up fifty percent of attendees.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.