We have been driving for over an hour. After battling our way through Beirut’s morning traffic, we slowly wind our way into the surrounding mountains. Hidden deep within (but yet managing to overlook the Mediterranean) is the Oum El Nour center. “No pictures of the building” I am quickly told when I pull out my digital camera. This, of course, is to protect patient privacy.
Although there are few recent studies in Lebanon, the WHO estimates a prevalence of approximately 0.2% for opiate abuse, 0.1% for cocaine abuse and 2.5% for alcohol abuse [1]. Oum El Nour (which means Mother of Light in Arabic) is one of a few inpatient rehabilitation facilities in the country.
We arrive with our AUB contact and are promptly introduced to one of the directors. As usual, we are stunned by how friendly and open everyone is towards a group of random American strangers. Average stays range from 15 to 18 months here and both men and women are offered care free of charge. The center is partly funded by the Lebanese Ministry of Health but also relies heavily on private benefactors.
The men’s center is home to 60 men, most of them polysubstance abusers including IV heroin. Patients are initially evaluated by a GP on admission and tested for HIV and hepatitis. If necessary, they are referred to outpatient psychiatrists in addition to seeing the therapists and counselors at the center. The use of methadone or buprenorphine is not legal in Lebanon and instead a strict abstinence policy is implemented.
“The difference in Lebanon,” the director explains, “is the presence of family as an integral part of the rehabilitation process.” The addict here is rarely homeless and usually lives within a busy household. “But what about the few who are homeless?” I ask, recalling the patients with substance abuse that I’ve treated over the last few years. To this I am met with largely blank stares and, after a somewhat prolonged pause, our friend from AUB answers, “it is very very rare. We may live within a tent, but we do so with our family”.
After detox and an initial isolation phase, relatives are brought in quickly and considerable time is spent with therapists working on family relations. The director believes this emphasis accounts for the extremely high rate of program completion (45%). Although long-term success rates are unknown, the AUB school of public health is busy collecting this data. In the meantime, patients are happy to receive another chance within the peaceful confines of Oum El Nour.
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