Hence, the Lebanese Addictions Center- Skoun - came to being at the initiative of the above healthcare professionals as a nonpareil therapeutic outpatient facility that not only aims to help drug users overcome their addiction in a caring environment but also promotes drug prevention as an integrated component of education and works towards effacing the stigma associated with drug addiction in mainstream society in Lebanon.

Skoun was first conceptualized in 2001 but it wasn’t until 2003 that it became officially registered as an NGO concerned with providing specialized treatment services for substance users. Currently, Mrs. Nadia Mikdashi holds the post of Executive Director at the Center. Ms. Sara Trad is President of the Board while Dr. Ramzi Haddad serves as Team Coordinator.

Treatment

Since it started, Skoun has had high success rates and has helped people reclaim their lives and resume productive paths, thus earning widespread credibility as one of Lebanon’s pioneering rehabilitation centers with around 250 patients treated every year at a cost no more than USD 1000 per patient annually. Substance users usually approach Skoun through one of three following ways: some visit the center of their own volition, others are encouraged by their friends or family to contact the center while numerous cases are referred by schools, hospitals, psychologists or the judiciary.

The treatment at Skoun is administered by a multidisciplinary team consisting of psychiatrists, psychotherapists, clinical supervisors, addiction counselors, family medicine specialists and registered nurses who work together to cater to the needs of patients struggling with substance use and to facilitate their recovery process. The first step includes a comprehensive case assessment, based on which the team develops a holistic treatment plan tailored to the needs of each individual patient.

The treatment plan may include counseling sessions, case management and regular follow-ups and reviews, group therapy, and family sessions. Based on the outcome of the assessment, this treatment plan can also include medical treatment, as well as other psychiatric medication, with regular monitoring and reassessment. Regular medical check-ups, after-care support and family support are all part of the treatment services. Even when discharged, patients remain part of the Skoun family and are welcome to drop in again if the need arises.

Prevention

Adolescence is usually fraught with intense emotional and interpersonal problems where teenagers face extreme hormonal and psychological fluctuations accompanied with an inability to fit in what it seems to them an ever complex world. Hence, the compulsion to find an outlet by experimenting with drugs occurs mostly during this phase and is often influenced by peer pressure.

With health practitioners and substance users reporting the age of onset of substance use to be between 15 and 17 (Skoun’s study) and knowing that adolescents are the most susceptible to falling into addiction, Skoun sets up awareness and prevention sessions in particular for this age range.

The campaigns target over 30 schools annually and the programs are addressed to over 3000 students between 13 and 16 years of age, around 500 teachers, school staff and parents. Skoun organizes training sessions, interactive workshops and discussion groups to educate youth about drugs and enhance the essential skills they need to foster their critical thinking, self-esteem and emotional maturity. The Skoun prevention team also provides training for teachers and staff to help integrate the Life Skills education program into the curriculum.

A Mobile Education Unit is also available to disseminate drug-related information and promote prevention practices among all community members during music events or schools fairs to name but a few.

Addiction in Numbers

Lebanon is home to 11 NGOs and 15 hospitals specialized in the treatment of substance dependence. Skoun was the first to conduct an overarching nationwide study on such dependence in Lebanon. The study revealed that the majority substance users in 2009 were between 18 and 34 years of age with males forming an overwhelming majority. Although substance users came from all socio-economic backgrounds, 37 to 62% were found with a low socio-economic status.

Cannabis, heroin and cocaine were classified as the substances most consumed across all samples. However, the list extended to include alcohol, sedatives and tranquilizers, inhalants, etc. With respect to the factors that impact the initiation, maintenance and completion of treatment, the samples interviewed cited the lack of vacancies and presence of waiting lists as significant reasons for the lack of treatment initiation. In 2009, only 321 out of the 774 substance users who presented themselves for treatment at NGOs received it. The cost and duration of treatment, and types of services provided by existing treatment centers were among the other factors that prevented the completion of the treatment.

Although psychiatry departments at hospitals are equipped to accommodate a larger number of patients than NGOs, the cost of treatment amounting to 234 USD per day, is too expensive for drug addicts to afford.