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Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D.

Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

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Page 1: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority

Mohamed Afifi, M.D. Richard Isralowitz, Ph. D.

Nasser Loza, MDRichard Rawson, Ph.D.

Page 2: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Picture Jerusalem

Page 3: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Picture Safe Passage to Gaza

Page 4: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 5: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Project Background 1 1997 Educational program organized by

ECF (Oslo Accord Group) with Israeli Foreign Ministry, Palestinian Council of Health and USAID and Dutch Government

Group of 40 Palestinians and Israelis met in Beersheva and a Palestinian group of 75 health and religious leaders in Gaza Strip to discuss nature/extent of drug problems in Middle East.

Page 6: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Project Background 2 Participants included health, police and

political leaders. Israeli side presented some data on

heroin and marijuana use. Palestinian presented anecdotal information and concerns.

Considerable acrimony/mutual accusations about source of illegal drugs.

Page 7: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Project Background 3 Palestinian and Israeli leaders

organize a series of bi-lateral meetings in Palestinian/Israeli communities.

Week-long training at Al Quds University for 200 Palestinian professionals, attended by senior Palestinian/Israeli/ WHO officials plus 2 day bi-lateral Beersheva workshop

Page 8: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Project Background 4 Group of 8 Palestinian and Israeli

professionals travel to Los Angeles (funded by Friends Research Institute) for planning session.

Decision made to apply for Middle East Regional Cooperation grant to establish a Israeli-Palestinian drug abuse monitoring system, produce an article and edited book.

Page 9: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Project Background 5 MERC Application submitted Dec

1999 Book contract (Praeger-

Greenwood), Jan 2000; Article to Addiction outlined.

Page 10: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC Application Drug abuse is important for public health,

criminal justice and political reasons. Nature and extent of drug abuse problems

poorly documented in Israel (Russian immigrants poorly studied: MDMA use believed extensive, but no data.

Drug use in Palestinian Territory unknown but believed to be heroin, marijuana, inhalants.

Page 11: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC Application 2 Collection of data needs multiple

approaches sampling key populations including high school students, arrestees, individuals in health system.

Stakeholders need to involve public health, criminal justice and political leaders.

Venue for presenting/interpreting data should involve tri-lateral group, with US researchers to provide technical support.

Page 12: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC PLAN Establish 3 data collection methods

(school survey, reporting from hospitals, urine collection/survey from arrestees.

Data will be collected from 2 Israeli cities (Haifa and Beersheva), 2 Gaza cities (Gaza City and Khan Younis) and 2 West Bank cities (Ramallah and Hebron)

Page 13: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 14: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 15: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 16: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Rick and Pilou at dead sea

Page 17: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC PROJECT Intifada Began Sept 200 MERC Grant Approved May, 2001 Initial meet in Tel Aviv in June 2001,

Afiffi unable to leave Gaza. Afifi travels to Los Angeles, August

2001 All 3 parties meet in Washington DC

October 2001 and visit US Agencies.

Page 18: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC PLAN Budget: $500,000 for 2 years

US: (Friends Research Institute) $75K

Israel: (Ben Gurion U) $150K Palestinians: (Substance Abuse

Research Center, an NGO) $250K

Page 19: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC I Work Accomplished Book Published 2002 Article in Addiction 2001 Survey of drug use among 1000

Palestinian students in Gaza Survey of 1000 high risk youth in

Israel 15 Presentations at national and

international Meeting

Page 20: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC I Work Accomplished 14 Training events with Israelis

and Palestinians Identification of an Egyptian team Submission of MERC II: Israel and

Egypt MERC II Approved in Dec 2003

Page 21: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 22: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Great Sphinx

Page 23: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

101_0126

Page 24: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

MERC II Israel and Egypt

Data collection on drug abuse treatmentin Israel and Egypt

Extensive training conducted in both countries

Another 18 professional trainings and presentations in Israel and Egypt

To date, 4 international presentations

Page 25: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Israel Group

Page 26: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

100_0069

Page 27: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D
Page 28: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Recent Developments Conference planned for Cairo Oct

2004 Will include UNODC and its group of 27

regional experts (North Africa and Gulf) Will include WHO and 42 country

region (Morroco to Pakistan) National Institute on Drug Abuse Sponsored by UCLA

Page 29: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Recent Developments Institute of Peace Grant for conference

in Spring of 2005 in region with Arab and Israeli participation

Potential involvement of the Rockefeller Institute and Facility in Bellagio, Italy

MERC III: Israel and Lebanon under review

Page 30: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

LESSONS LEARNED Oaks do grow from acorns, if

provided the necessary follow up and hard work.

Communicate respect Focus on good science Stay flexible and patient Engage necessary scientific advisors

Page 31: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

LESSONS LEARNED Minimize political discussions Maintain low profile and

understand political needs of all parties

Relationships matter Don’t do it for the money

Page 32: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Jafa Evening

Page 33: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

Bazaar in cairo

Page 34: Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D

101_0198