The Consumption of Khat and Other Drugs in Somali Combatants : A Cross-Sectional Study

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PLoS Medicine. 2007, 4(10), e341. Available under: doi: 10.1371/journal.pmed.0040341
Zusammenfassung

Background
For more than a decade, most parts of Somalia have not been under the control of any type of government. This failure of state is complete in the central and southern regions and most apparent in Mogadishu, which had been for a long period in the hands of warlords deploying their private militias in a battle for resources. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized. The present study provides information about drug use among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control to our knowledge the first account on this topic.
Methods and Findings
Trained local interviewers conducted a total of 8,723 interviews of armed personnel in seven convenience samples in different regions of Somalia; 587 (6.3%) respondents discontinued the interview and 12 (0.001%) were excluded for other reasons. We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis, psychoactive tablets (e.g., benzodiazepines), alcohol, solvents, and hemp seeds in their units. The cautious interpretation of our data suggest that sociodemographic characteristics and drug use of military personnel differ substantially between northern and southern/central Somalia. In total, 36.4% (99% confidence interval [CI] 19.3% 57.7%) of respondents reported khat use in the week before the interview, whereas in some regions of southern/central Somalia khat use, especially excessive use, was reported more frequently. Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing (on average, 70.1% in previous week, 99% CI 63.6% 76.5%), followed by smoking cannabis (10.7%, 99% CI 0% 30.4%), ingesting psychoactive tablets (8.5%, 99% CI 0% 24.4%), drinking alcohol (5.3%, 99% CI 0% 13.8%), inhaling solvents (1.8%, 99% CI 0% 5.1%), and eating hemp seeds (0.6%, 99% CI 0% 2.0%). Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets.
Conclusions
Our data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our results, we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use. We recommend that future disarmament, demobilization, and reintegration (DDR) programs need to be prepared to deal with significant drug-related problems in Somalia.

Zusammenfassung in einer weiteren Sprache

Hintergrund: Seit über einem Jahrzehnt steht der größte Teil Somalias unter keinerlei Regierungskontrolle. Dieser Failure of State ist am deutlichsten im Zentrum und Süden des Landes und wird am deutlichsten in der Hauptstadt Mogadishu, die während der langer Jahre von sich gegenseitig bekämpfenden Warlords und ihren Milizen kontrolliert wurde. Im Gegensatz dazu wurde der Norden des Landes durch Regionalregierungen stabilisiert, die jedoch keine internationale Anerkennung haben. Die vorliegende Studie über Drogenkonsum konzentriert sich auf aktive Angehörige regulärer bewaffneter Einheiten und Milizen und hebt regionale Unterschiede im Bezug auf den Einfluss staatlicher Ordnung hervor nach unserer Erkenntnis ist dies die bislang erste derartige Studie.
Methoden/Hauptergebnisse: Trainierte einheimische Interviewer führten insgesamt 8,723 Interviews mit Angehörigen regulärer bewaffneter Einheiten und Milizen in sieben unsystematisch gewonnenen Stichproben in verschiedenen Regionen Somalias durch; 587 (6.3%) Personen brachen das Interview ab und 12 wurden aus anderen Gründen von der Auswertung ausgeschlossen. Neben grundlegenden soziodemographischen Informationen wurden der selbstberichtete Khatkonsum und der in den jeweiligen Einheiten wahrgenommene Konsum von Khat, Cannabis, Psychopharmaka (z.B. Benzodiazepine), Alkohol, Lösungsmittel und Hanfsamen erhoben. Auch bei vorsichtiger Interpretation sprechen die Daten dafür, dass sich bewaffnetes Personal hinsichtlich soziodemographischer Charakteristika und Drogenkonsum erheblich zwischen dem Norden Somalias und den südlichen bzw. zentralen Landesteilen unterscheidet. Insgesamt geben 36.4% der Befragten an, in der Woche vor dem Interview Khat konsumiert zu haben (KI 99% 19.3 57.7%), wobei in einigen südlichen und zentralen Landesteilen Khatkonsum an sich und vor allem exzessiver Konsum häufiger berichtet wird. Angaben zum eigenen Khatkonsum und die Wahrnehmung des Konsums in den eigenen militärischen Einheiten unterschieden sich deutlich. In der Wahrnehmung der Befragten ist Khat die am häufigsten konsumierte Droge (im Durchschnitt von 70,1% in der vorangegangenen Woche, KI99% 63.6 76.5%), gefolgt von Cannabis (10.7%, KI99% 0 30.4%), Psychopharmaka (8.5%, KI99% 0 24.4%), Alkohol (5.3%, KI99% 0 13.8%), Lösungsmittel (1.8%, KI99% 0 5.1%) und Hanfsamen (0.6%, KI99% 0 2.0%). Der wahrgenommene Khatkonsum in den eigenen Einheiten unterscheidet sich kaum zwischen Nord- und Südsomalia, während der wahrgenommene Konsum aller anderen Drogen alarmierend hohe Werte in einigen Regionen Südsomalias erreicht, besonders im Bezug auf Cannabis und Psychopharmaka.
Schlussfolgerungen/Relevanz: Die Daten legen nahe, dass sich der Konsum von Drogen während der lang dauernden Konflikte in Südsomalia quantitativ und qualitativ verändert hat, vor allem weil die hier dokumentierten Konsummustern erheblich von den traditionellen abweichen. Unsere Ergebnisse müssen zwar in Studien mit Zufallsstichproben repliziert werden, aber wir ziehen dennoch schon jetzt den Schluss, dass in Südsomalia die Drogenprobleme in bewaffneten Einheiten und anderen Risikogruppen bislang unbekannte Dimensionen erreicht haben, besonders weil wir vermuten, dass mit unserer Erhebungsmethode der wahre Drogenkonsum unterschätzt wird. Wir empfehlen, dass zukünftige Demobilisierungs-, Entwaffnungs- und Reintegrationsprogramme in Somalia auf ein erhebliches Drogenproblem vorbereitet sind.

Fachgebiet (DDC)
150 Psychologie
Schlagwörter
Khat, Chat, Miraa, Exkombattanten, Veteranen, Khat, Somalia, Amphetamin, Reintegration, Demobilization
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Zitieren
ISO 690ODENWALD, Michael, Harald HINKEL, Elisabeth SCHAUER, Frank NEUNER, Maggie SCHAUER, Thomas ELBERT, Brigitte ROCKSTROH, 2007. The Consumption of Khat and Other Drugs in Somali Combatants : A Cross-Sectional Study. In: PLoS Medicine. 2007, 4(10), e341. Available under: doi: 10.1371/journal.pmed.0040341
BibTex
@article{Odenwald2007Consu-10868,
  year={2007},
  doi={10.1371/journal.pmed.0040341},
  title={The Consumption of Khat and Other Drugs in Somali Combatants : A Cross-Sectional Study},
  number={10},
  volume={4},
  journal={PLoS Medicine},
  author={Odenwald, Michael and Hinkel, Harald and Schauer, Elisabeth and Neuner, Frank and Schauer, Maggie and Elbert, Thomas and Rockstroh, Brigitte},
  note={Article Number: e341}
}
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