Initial Middle East Efforts

Initially, the kind and size of the drug problem in the Israeli and Palestinian communities was discussed in several meetings in Israel, Gaza, and the West Bank. In order to reduce the amount of guesswork used to develop policy and services, these discussions showed the need for organized data collection on the problem.

Dr. Rawson and Jeanne Obert, then executive director of the Matrix Institute on Addictions  (a nonprofit  partner of ISAP that treats people with substance abuse problems, see www.matrixinstitute.org), were invited to Jerusalem to provide a one-week training program for substance abuse research and treatment. Doctors, psychologists, and social workers from Israel and representatives of the Palestinian Authority came to these trainings. Representatives from local universities, the Israel Ministry of Health, and anti-drug authorities were also present.

After the first visit, Dr. Isralowitz and Mohammed Afifi, MD (a doctor from the Substance Abuse Research Center in Gaza), led a team of Israeli and Palestinian healthcare providers, administrators, and researchers to visit UCLA. They were funded by the Matrix Institute on Addictions and the Friends Research Institute, Inc. (www.friendsresearch.org). The group met with local treatment programs, law enforcement agencies, and UCLA ISAP researchers to plan how to get funding to evaluate substance abuse in the Middle East.

Middle East Regional Cooperation Program Grants

A three-part administrative committee was formed to create a group of researchers that would meet a few times a year to talk about the current state of treatment methods for substance abuse in Israel and the Palestinian Territories. The committee, which included Dr. Afifi, Dr. Isralowitz, Dr. Rawson, and Albert Hasson (of ISAP), received a grant in 2001 from the United States Agency for International Development (USAID), Middle East Regional Cooperation (MERC).  The plan for collecting data first focused on drug use among school-aged youth.  Since then, more than 3,000 youth have been studied in Israel, the Gaza Strip, and the West Bank. Data from this project have been used in many meetings and presentations.

After getting experience from 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 grant from USAID-MERC. The goal of this grant was to collect data on the kinds of drug abuse problems in Egypt and to increase work in Israel. Using the Addiction Severity Index, a system that rates the level of addiction of its patients, they created a method of collecting data at three treatment sites in Cairo and four in Israel. This project was funded from 2002 to 2006. 

These projects were created and applied at a very hard time in the Middle East and the United States. The most recent uprising in the Palestinian Territories had just begun as the Israeli-Palestinian grant started. Shortly after, the Sept. 11, 2001, attacks on the World Trade Center and Pentagon happened in the United States, followed by military action in Afghanistan and Iraq. Although cooperation between the investigators was viewed with suspicion in their own countries, this amazing group of people completed their projects.

The research work of the Middle East Regional Cooperation program (MERC) grants is only a small part of the impact of this project. When the UCLA researchers traveled to the Middle East to work on the MERC projects, they also offered training, promoted service development, and built cooperation in the region. In addition, they created a broad series of training and professional education sessions in more than 10 sites in Israel from 1999–2005 and gave presentations at major Egyptian Universities and professional associations.

2004 Cairo Conference

UCLA ISAP promoted a 10-day conference in Cairo in October 2004 that brought together the largest ever 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, Frank Vocci, Ph.D., and Ahmed Elkashef, M.D., from the National Institute on Drug Abuse. An article from the United Nations Office on Drugs and Crime briefly reviews many of the presentations from this conference.

2005 Istanbul Conference

Another highlight was the Sept. 5–7, 2005, conference 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, came together to talk about substance abuse problems in their countries and encourage regional teamwork to solve them. Many participants said that they would like to pursue professional cooperation based on discussions and contacts made at the conference.

The organization created by the MERC research grants has led to other training efforts in the Middle East. Training and service development sessions in Lebanon, Oman, and Saudi Arabia have also taken place since 2002 as a result of the MERC program.

Potential Future Collaboration

Recently, a grant proposal for a joint researcher training program was sent to the National Institutes of Health (NIH) Fogarty Center to create a project between UCLA and the Cairo University School of Medicine. This project aims to create a long-term collaborative relationship between faculty at UCLA and the faculty of one of the most important medical schools in the Middle East.