An anti-anxiety drug linked to drug abuse deaths across the globe has emerged as the primary substance of choice for addicts in the UAE, a senior doctor has said.
Gabapentin was listed as the most prevalent drug taken by addicts at the National Rehabilitation Centre (NRC).
The scale of abuse of the drug, which is available with a prescription in many countries, has only recently emerged.
In certain doses it induces a sedative effect and is said to be popular with opiate addicts.
The International Society of Addiction Medicine conference in Abu Dhabi heard on Thursday that medics are now seeing more patients addicted to gabapentin than tramadol, the tightly controlled painkiller often linked to many drug cases in the emirates' criminal courts.
Dr Nael Moustafa told addiction experts gathered at Emirates Palace that in 2013, a majority of NRC patients listed tramadol as their primary substance of abuse and that continued in 2014 and 2015. In fact, a 2015 study of 250 users found 40 per cent only used tramadol.
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But last year tramadol was put into second place after gabapentin. Tramadol has since dropped to fourth place.
The anti-anxiety drug pregabalin, often marketed as Lyrica, is now the second most abused drug.
“This is what we know now,” said Dr Moustafa.
Last month, the British government said it intends to criminalise gabapentin, making it a 'class C' drug. It was previously available on prescription. Official figures linked it to 59 deaths in England and Wales. Pregabalin - which is also set to be criminalised - was linked to 111 deaths.
Earlier this month, reports in Scotland said that gabapentin had been listed as the cause of death in the death certificates of more than 150 people in 2016.
Drugs like tramadol, gabapentin, pregabalin are a challenge for police and addiction counsellors in the UAE, he said.
“What we see is patients start to experiment with drugs that were mainly prescribed [to them], and usually they experiment through their peers,” said Dr Moustafa.
He suggested that "a lot of private clinics" are not vigilant enough when it comes to prescribing tightly controlled medicines, often pain or anti-anxiety pills, to patients.
"There is a lot of doctor shopping. Patients will go to several primary clinics and get several packs of tramadol and then start using it," he said.
Away from official channels, the main source of drugs is on the black market, which he said are typically smuggled in from Iran, Egypt and India.
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
The biog
Favourite hobby: taking his rescue dog, Sally, for long walks.
Favourite book: anything by Stephen King, although he said the films rarely match the quality of the books
Favourite film: The Shawshank Redemption stands out as his favourite movie, a classic King novella
Favourite music: “I have a wide and varied music taste, so it would be unfair to pick a single song from blues to rock as a favourite"
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The smuggler
Eldarir had arrived at JFK in January 2020 with three suitcases, containing goods he valued at $300, when he was directed to a search area.
Officers found 41 gold artefacts among the bags, including amulets from a funerary set which prepared the deceased for the afterlife.
Also found was a cartouche of a Ptolemaic king on a relief that was originally part of a royal building or temple.
The largest single group of items found in Eldarir’s cases were 400 shabtis, or figurines.
Khouli conviction
Khouli smuggled items into the US by making false declarations to customs about the country of origin and value of the items.
According to Immigration and Customs Enforcement, he provided “false provenances which stated that [two] Egyptian antiquities were part of a collection assembled by Khouli's father in Israel in the 1960s” when in fact “Khouli acquired the Egyptian antiquities from other dealers”.
He was sentenced to one year of probation, six months of home confinement and 200 hours of community service in 2012 after admitting buying and smuggling Egyptian antiquities, including coffins, funerary boats and limestone figures.
For sale
A number of other items said to come from the collection of Ezeldeen Taha Eldarir are currently or recently for sale.
Their provenance is described in near identical terms as the British Museum shabti: bought from Salahaddin Sirmali, "authenticated and appraised" by Hossen Rashed, then imported to the US in 1948.
- An Egyptian Mummy mask dating from 700BC-30BC, is on offer for £11,807 ($15,275) online by a seller in Mexico
- A coffin lid dating back to 664BC-332BC was offered for sale by a Colorado-based art dealer, with a starting price of $65,000
- A shabti that was on sale through a Chicago-based coin dealer, dating from 1567BC-1085BC, is up for $1,950
