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Captagon Fuels War and Amphetamine Abuse in Syria, Saudi Arabia, and Lebanon

2015-12-02

Captagon is a combination of amphetamine and theophylline, called a codrug, and is circulated in the body as both drugs.  It was first synthesized in 1961, and was briefly used for such purposes as treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy.  It was thought to be a milder alternative to amphetamines, but was found to have the same abuse potential.  It was banned in the US in 1981 and by international organizations in 1986.  There was, at that time. little abuse of this drug anywhere, but it was clear that Captagon held no advantages over amphetamine and theophylline given separately.  The drug’s popularity began to take off around the turn of the century, at the same time as opioid use and abuse increased in the US.  (Global Initiative)

Captagon is popular in the Mideast and is the most-used illicit stimulant in Saudi Arabia, where the majority of patients treated for substance use disorder are dependent on amphetamines.  In October 2015, a Saudi prince and four others were detained in Beirut in connection with the seizure of two tons of Captagon found on a private jet bound for Riyadh, Saudi Arabia.  In November, two more tonnes(sic), amounting to “almost 11 million tablets” were seized by Turkish agents in the Hatay area on the Syrian border.  (Wikipedia)

It is said that illicit Captagon manufacturers in Syria, displaced by the civil war, moved their operations to Lebanon.  The Beirut seizure mentioned above suggests that the source was indeed in Lebanon.  Captagon has also been manufactured in Bulgaria, Slovenia, and Serbia.  By 2006, manufacture in Turkey began.  The “Captagon” now being circulated is usually  a mixture of amphetamines with various active ingredients, such as ephedrine.  The size of these seizures suggests the size of the market for this drug: it is thought that less than ten percent of any drug produced is captured by authorities.  Estimates of drug demand in Saudi Arabia amount to 500 million tablets a year.  (Global Initiative)

The drug is popular for its stimulating and aphrodisiac effects; it is so widely used in these countries that there is no doubt that the Syrian Army as well as insurgents, including ISIS, are using it and probably manufacturing it.  The advantages for the user, at least on first or “naive” use, are that it stimulates the mind and dulls pain, making the user feel invulnerable.  This effect is a dramatic increase over the effect normally produced by such stresses as acute perceived lethal threats; the mind races, the body feels no pain, and time seems to slow down.   These effects are accompanied by a rise in blood pressure, frequently to abnormal levels, and an increase in heart rate.  More important from a military standpoint is the drug’s ability to maintain alertness and “on task” performance, even in boring or tedious activities.

The effects of amphetamine have been known since 1929 and it was widely used by soldiers on all sides in WW II.  It is still administered to pilots in the US Air Force.  Amphetamines were widely used and abused all over the world, peaking in the US in 1969 and returning today to similar levels.  Benzedrine (amphetamine base for inhalation)  was available “over the counter” (prescription-only categories did not exist at that time) from 1933.  Treatment with amphetamine for minor or “neurotic” depression was in favor from the late 1930’s.  Current estimates place the number of Americans dependent on amphetamines at roughly 300,000 (0.1% of population) (American Journal of Public Health)

The advantages of these effects on the battlefield are obvious: soldiers are braver,  can go further and overcome more obstacles and minor wounds.  A continued supply is critical to the maintenance of alertness in a prolonged engagement; the effects may begin to wear off in as little as six hours.  Twelve to twenty four hours after a single dose, the user’s condition is worse than useless militarily.  When administered to pilots for long missions, long-acting forms of amphetamine or repeated doses are necessary.

Continued, daily use of amphetamines results in a development of tolerance and loss of the acute effects, which may be partially overcome by larger doses but eventually leads to complete loss of the perceived effect.  It is necessary to spend some time in the “off” state, with concomitant sensations of fatigue, sleepiness, and increased sensitivity to pain.  This is, again, a dramatic version of the effects seen normally after acute stress is relieved and chronic stress sets in.

There is a significant risk, if the drug is abused or even after a single dose, of the development of hypersensitivity to stimuli and paranoia.  “Amphetamine psychosis” is a condition that mimics the acute paranoia and delusions experienced by schizophrenics and in the manic phase of bipolar disorder.   When in this state, an individual will believe that others have a malign intent or are “out to get me”; this suspicion extends even to otherwise staunch comrades.  Delusions of persecution in which the most benign acts can appear to have ulterior motives and hallucinations can supervene.  (social and medical experience)

The behavior of Islamic State soldiers and administrators suggests that they may be chronic users of Captagon.  The Islamic State’s very nature makes it essential that they manufacture anything that they need within their boundaries, so manufacturing and smuggling the drug are also distinct probabilities.

The behavior of Stalin, especially during the latter stages of his rule, is typical of the paranoid state.   Stalin is not known to have used amphetamines but drank and smoked heavily and was known to have atherosclerosis.  When he died, supposedly of a stroke, in 1954, his cohorts were so afraid to disturb him that he lay stricken for twelve hours in his bed without anyone coming to his aid.  (Wikipedia)

An article about Captagon smuggling in “Global Inititiative Against Transnational Organized Crime”: http://www.globalinitiative.net/amphetamines-anarchy-and-assad/

Here is an article about Captagon in Vox: http://www.vox.com/world/2015/11/20/9769264/captagon-isis-drug

An article in The New Republic about our military’s administration of Dexedrine to pilots, and soldiers’ use of anabolic steroids, energy drinks, opioids, laxatives, diuretics, and  other drugs:  https://newrepublic.com/article/112269/112269

Front page of a report on substance abuse in the military by the Institute of Medicine: http://iom.nationalacademies.org/Reports/2012/Substance-Use-Disorders-in-the-US-Armed-Forces.aspx

An article in Time magazine about Syrian combatants profit from sales of amphetamines: http://world.time.com/2013/10/28/syrias-breaking-bad-are-amphetamines-funding-the-war/

 

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2 Comments leave one →
  1. Richard L Steagall permalink
    2015-12-02 19:02

    Conrad,

    You are the doctor. This is much more dangerous than amphetamines?

    Isn’t amphetamines usage a necessity for combat soldiers involved in lengthy operations?

    If you platoon is so sleepy they cannot keep watch or run patrols then you will be shot and killed by the enemy.

    >

    Like

    • 2015-12-02 22:24

      No, they are all dangerous, more or less to the same degree that they are effective, when misused, but very useful under controlled conditions. Combat units cannot survive in the field for prolonged periods taking any stimulant at all because of the side effects and degradation of long term performance that sets in after two weeks on the average but pilots, who can fly for twenty four or thirty six hours then sleep for a week, can do it if they’re debriefed and allowed to sleep. Distributing it to front line soldiers just before a big offensive would be creepy but potentially effective and the Nazis may have tried it. I’ve heard stories about the use of Benzedrine in Vietnam, especially at the medic tents of front line units before being on duty at night… funny how we still lost the war… ps thanks for reading and especially for commenting but that doesn’t mean you ever have to comment again!

      Like

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