Contact Rick Rawson at:
rrawson@mednet.ucla.edu
Middle East Regional Cooperation (MERC) Projects
(Middle East Initiatives)
UCLA ISAP has been conducting work in the areas of drug abuse research, training, and service development in the Middle East for over a decade. The initial impetus for the work was a request from Professor Richard Isralowitz of the Spitzer Department of Social Work of Ben Gurion University in Beer Sheva, Israel. Dr. Isralowitz was interested in teaming up with researchers from ISAP (then known as the UCLA Drug Abuse Research Center) to begin an evaluation of what he believed to be an increasing drug abuse problem in Israel and the Palestinian Authority. It was Dr. Isralowitz’s vision to use the common problem of drug abuse in Israeli and Palestinian communities as a focus of cooperation between health, social service, and criminal justice system leaders in Israel and Palestine.
Initial Middle East Efforts
The initial effort was a series of meetings in Israel, Gaza, and the West Bank in which the nature and extent of the drug problem in Israeli and Palestinian communities was discussed and debated. It became clear from these discussions that there was a need for some systematic data collection on the problem, since without data, rumor and guesswork served as the basis of policy and service development.
Dr. Rawson and Jeanne Obert, executive director of the Matrix Institute on Addictions (see www.matrixinstitute.org), a nonprofit affiliate of ISAP that provides substance abuse treatment, were invited to Jerusalem to provide a week-long program of training on substance abuse research and treatment. This training was attended by physicians, psychologists, and social workers from Israel and representatives of the Palestinian Authority from the Gaza Strip and the West Bank. Representatives from local universities, the Israel Ministry of Health, and anti-drug authorities also were present at the training.
Following this initial visit, a contingent of Israeli and Palestinian clinicians, administrators, and researchers, the Israelis led by Dr. Isralowitz and the Palestinians led by Mohammed Afifi, MD, a physician from the Substance Abuse Research Center in Gaza, visited UCLA through the financial support of the Matrix Institute on Addictions and the Friends Research Institute, Inc. (www.friendsresearch.org). The group visited local treatment programs and law enforcement agencies, and met with UCLA ISAP researchers to plan a course of action to obtain funding to evaluate substance abuse in their regions.
Middle East Regional Cooperation Program Grants
A trilateral executive committee was established that included Dr. Afifi, Dr. Isralowitz, Dr. Rawson, and Albert Hasson (of ISAP). This committee submitted and received a grant from the United States Agency for International Development (USAID), Middle East Regional Cooperation (MERC) program to establish a network of researchers that would meet semiannually to discuss the current epidemiology of substance use in Israel and the Palestinian Territories. The data collection plan initially focused on drug use among school-aged youth. This grant was funded to UCLA ISAP in 2001. Since then, more than 3,000 youth have been surveyed in Israel, the Gaza Strip, and the West Bank. Data from this project have been the source of numerous conference presentations and publications.
Using the experience obtained through the effort of the first USAID-MERC grant, Dr. Isralowitz, Dr. Rawson, Al Hasson, and Fawzy Fawzy, M.D. (Professor and Executive Vice Chair, UCLA Department of Psychiatry and Biobehavioral Sciences) teamed up with Nasser Loza, M.B.CH.B, M.Sc., D.P.M., F.R.C.Psych, Director of the Behman Hospital, Cairo, Egypt, to submit a second USAID-MERC grant to collect data on the nature of the drug abuse problem in Egypt and to expand work in Israel. To that end, a system of data collection has been established using the Addiction Severity Index at three treatment sites in Cairo and four sites in Israel This project, was funded from 2002 to 2006.
These projects were developed and implemented during a very difficult time in the Middle East and the United States. The most recent Intifada in the Palestinian Territories had just began as the Israeli-Palestinian grant started, and continues today. Shortly thereafter, the Sept. 11, 2001, attacks on the World Trade Center and Pentagon occurred in the United States, with the subsequent military action in Afghanistan and Iraq. Cooperation between the investigators was highly scrutinized within their respective countries, yet this remarkable group of individuals persisted to see their projects through to completion.
The research work that has been conducted as a result of the MERC grants is only a small part of the impact of this project. As the UCLA researchers have traveled to the Middle East region to work on the MERC projects, they have used these opportunities to offer training, promote service development, and build cooperation in the region. Additional outputs of the MERC program have included an extensive series of training and professional education sessions conducted in more than 10 sites in Israel from 1999-2005, and presentations at major Egyptian Universities and professional associations.
2004 Cairo Conference
One highlight was a 10-day long conference in Cairo during October 2004 that was promoted by UCLA ISAP. This conference brought together an unprecedented group of professionals from major Egyptian universities and medical schools, private hospitals, the United Nations, the World Health Organization, the U.S. National Institute on Drug Abuse, and the Royal College of Psychiatry. In addition to ISAP faculty, including Drs. Rawson, David Farabee, and Tom Freese, as well as epidemiologist Beth Finnerty, the U.S. participants included Thomas McLellan, Ph.D., and Deni Carise, Ph.D., from the University of Pennsylvania, and Frank Vocci, Ph.D., and Ahmed Elkashef, M.D., from the National Institute on Drug Abuse. A forthcoming publication from the United Nations Office of Drugs and Crime summarizes many of the presentations from this conference.
2005 Istanbul Conference
Another highlight was the Sept. 5-7, 2005, conference held in Istanbul, Turkey, “Delivery Systems for Substance Abuse Treatment: An International Conference.” Substance abuse experts from 23 countries, including Iraq, Iran, Israel, Palestine, Afghanistan, Russia, and the United States, gathered to discuss substance abuse challenges in their countries and to promote regional cooperation on substance abuse issues. Many participants stated intentions to pursue professional cooperation based on discussions and contacts established at the conference.
Other related training efforts in the Middle East have resulted from the foundation created by the MERC research grants. Trainings and service development consultations in Lebanon, Oman, and Saudi Arabia have occurred since 2002 as a result of the MERC program.
Potential Future Collaboration
Recently, a grant proposal for a collaborative researcher training program was submitted to the National Institutes of Heath Fogarty Center to establish a cooperative research training project between UCLA and the Cairo University School of Medicine. If successful, this project will create a long-term collaborative relationship between faculty at UCLA and the faculty of one of the most influential medical schools in the Middle East.
