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

Abstract

BackgroundFor 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 abuse 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 FindingsTrained 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 (which includes both hashish and marijuana), 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 among 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.ConclusionsOur 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 ...

Prevalence of <i>Catha edulis</i> (Khat) Chewing and Its Associated Factors among Ataye Secondary School Students in Northern Shoa, Ethiopia

“…A survey conducted in a rural community in southern Ethiopia establishes a prevalence of 50% (Alem et al, 1999). In addition, study conducted in Somalia reported that approximately 36.4% of the respondents had chewed Khat in the week preceding the interview (Odenwald et al, 2007). The difference may be stimulated by studies were conducted many years back, rules and regulation enforcement differences.…”

Exposure to violence and PTSD symptoms among Somali women

“…The strong relationship between posttraumatic symptoms and health have been described elsewhere (Green & Schnurr, 2000;Schnurr & Green, 2003), including among Somali refugees (Bhui et al, 2003) and Somaliland excombatants (Odenwald et al, 2007b). We did not find any significant relationships between PTSD symptomatology and physical health variables (health complaints and frequency of health service utilization).…”

“…Participants reported their history of health problems using a fixed list of common health complaints defined by a previous survey conducted in Somalia (Odenwald et al, 2007a(Odenwald et al, , 2007b. Information regarding access to health services included number of health-related clinical visits and obstacles to accessing health service.…”

On the efficacy of Narrative Exposure Therapy

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