Overview of drug markets in the European Neighbourhood Policy-South countries : regional report 2022.
Date: 2023-01-19
Institutions: European Monitoring Centre for Drugs and Drug Addiction
Subjects: Algeria, Egypt, Israel, Jordan, Lebanon, Libya, Morocco, Palestine, Southern neighbourhood, Syria, Tunisia, drug addiction, drug traffic, illicit trade, narcotic, organised crime, report

EN

Overview of drug 
markets in the European 
Neighbourhood  
Policy-South countries

Regional report

2022

I  Legal notice

This publication of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is protected by 
copyright. The preparation of this report has been funded through the EU4Monitoring Drugs project, which is 
financed by the European Union. The views expressed herein can in no way be taken to reflect the official opinion of 
the European Union.

Luxembourg: Publications Office of the European Union, 2022

© European Monitoring Centre for Drugs and Drug Addiction, 2022

Reproduction is authorised provided the source is acknowledged.

Recommended citation: European Monitoring Centre for Drugs and Drug Addiction (2022), Overview of drug 

markets in the European Neighbourhood Policy-South countries: regional report, Publications Office of the European 

Union, Luxembourg.

Print

ISBN 978-92-9497-837-0

doi:10.2810/27784

TD-08-22-302-EN-C

PDF

ISBN 978-92-9497-833-2

doi:10.2810/765393

TD-08-22-302-EN-N

EU4MD 

Funded by the
European Union

Praça Europa 1, Cais do Sodré, 1249-289 Lisbon, Portugal 
Tel. +351 211210200 
info@emcdda.europa.eu I  www.emcdda.europa.eu
twitter.com/emcdda I  facebook.com/emcdda

I  Contents

  4  I  Acknowledgements
  5  I  Introduction
  7  I  Key findings
 10  I  Main drivers and facilitators of drug markets
 14  I  Cannabis
 21  I  Captagon and other amphetamines
 25  I  Cocaine
 28  I  Heroin and other opioids
 31  I  MDMA
 32  I  New psychoactive substances
 33  I  Diverted pharmaceuticals
 36  I  Outlook
 38  I  Abbreviations
 39  I  References

 
 Acknowledgements 

This report is based on a study conducted by the Global Initiative against Transnational 
Organized Crime (GI-TOC) under the EU4Monitoring Drugs (EU4MD) project funded by the 
European Union (EMCDDA Contract code: CT.21.EU4MD.0048.2.0).

GI-TOC drafting group: Mark Micallef, Matt Herbert, Emadeddin Badi, Amine Ghoulidi, 
Marie-Claire Van Hout, Caroline Rose, Sandra Halal and Patricia Haddad.

EMCDDA editorial group: Anne Bergenström, Andrew Cunningham, Paul Griffiths, Inês 
Hasselberg, Ilze Jekabsone, Thomas Nefau, Roumen Sedefov, Ionut Serbanica and 
Alexander Soderholm. 

EMCDDA contributors: Laurent Laniel, Marie-Christine Ashby and Renate De Neve.

The experts who provided data and information for the report: 

 § Algeria – Fateh Daoudi and Tahar Ait Mouheb

 § Lebanon – Tatyana Sleiman, Michelle Wazan, Elie Araj and the Middle East and North 

Africa Harm Reduction Association

 § Tunisia – Hafedh Thabet

The EMCDDA and EU4MD project team expresses gratitude to the national contact points 
in all project partner countries and the experts involved in the implementation of the 
EU4MD project activities between 2019 and 2022. These activities have both directly and 
indirectly contributed to the knowledge that forms the foundation for this report.

Introduction

Background

This report provides an overview of the drugs market 
across the Southern partnership of the European 
Neighbourhood Policy region (ENP-South) (1) and focuses 
on Algeria, Israel, Jordan, Lebanon, Libya, Morocco, 
Palestine (2), Syria (3) and Tunisia. The analysis provided 
here offers a top-level overview of drug production, 
trafficking, sale, use and harms, as well as exploring the 
drivers and facilitators of drug markets across the ENP-
South region. It highlights drug-related threats and their 
potential implications for security and health. Due to the 
proximity of and ties between the ENP-South region and 
the EU, developments in this region have the potential to 
have significant implications for the EU.

The findings detailed here are based on semi-structured 
interviews, conducted between November 2021 and 
January 2022, with key informants in the abovementioned 
nine countries of the ENP-South region. This is 
complemented by a review of the available scientific 
literature, other data available from governmental and 
non-governmental sources, and information from open 
sources, including the media. An important caveat is that 
there is an overall lack of detailed, recent and reliable 
information on the drug situation in the region. This means 
the information reported here must be interpreted with 
caution. It also highlights the importance of strengthening 
routine drug monitoring data systems and research 
activities in this region.

Methodology

A main source of information used here is qualitative data 
obtained from interviews with key informants in the 
ENP-South region. Global Initiative against Transnational 
Organized Crime (GI-TOC) staff and consultants 
conducted 70 field interviews between November 2021 
and January 2022. Interviewees included public health 
officials, customs and security officers, academics, staff of 

(1)  Egypt was a potential beneficiary of the EU4MD project but decided not to 

participate. Where appropriate for the regional context, references to the 
drug situation in Egypt are provided. No specific analysis of drug markets 
in Egypt was completed for the purpose of this report.

(2)  This designation shall not be construed as recognition of a State of 
Palestine and is without prejudice to the individual positions of the 
Member States on this issue.

(3)  The EU suspended all bilateral cooperation with the government of Syria; 
Syria has not been included in the EU4MD project; information related to 
Syria is derived from sources unrelated to the government of Syria.

non-governmental organisations (NGO) working in the field 
of harm reduction, people who use drugs, and people 
involved in drug market activities. The topics explored in 
the interviews included the respondents’ perceptions of 
drug availability, patterns in use and trends, and 
information related to the operation of the drug market 
(production, trafficking, sales and prices).

Using qualitative interviews as a primary source of data is 
both a strength and a limitation of this report. Interview 
data can provide valuable information in relation to new 
developments in the drugs situation as they are perceived 
by the interviewee, including insights that other sources 
may not have captured. Particularly in a region where other 
data sources are limited or of poor quality, conducting key 
informant interviews is to a large extent the only practical 
approach to reviewing the operation of the drug market 
and can shed light on developments that may otherwise be 
overlooked. However, a limitation is that the interviews 
provide subjective insights into the drugs situation based 
on the experience and expertise of the key informants that 
may be partial, biased or misinformed and are often not 
possible to verify. Having a large sample of interviewees 
helps manage this limitation but does not fully overcome it. 
Where possible, other sources have been used to validate 
or supplement the information gathered from the 
interviews; however, given the paucity of data available, 
findings from the qualitative interviews reported here 
should be regarded as a preliminary assessment that will 
necessarily require further follow-up and verification in 
future work.

To ensure that all available information was audited for this 
study, information requests were also made to GI-TOC’s 
field monitoring system, which consists of a network of 
over 150 journalists, researchers and academics spread 
throughout North Africa and the Sahel who participate in 
an ongoing monthly monitoring and research exercise.

A review of secondary sources was also conducted. This 
included media reports, open source material, academic 
publications and grey material produced by relevant 
governmental and non-governmental sources. This 
included some information from data archives collected by 
GI-TOC, for example press releases by government bodies 
detailing drug seizures. Documents were reviewed in 
English, French and Arabic. This review also used non-
public reports, presentations and communications 
generated through European Monitoring Centre for Drugs 
and Drug Addiction (EMCDDA) field assessments in the 
ENP-South region.

5

other opioids; cocaine; MDMA; new psychoactive 
substances (NPS); and diverted pharmaceuticals). The 
analysis explores issues related to production, trafficking 
and, to a lesser extent, what is known about availability 
and use. Data on drug use prevalence and its associated 
harms are particularly lacking and represent an important 
and acknowledged limitation to the analysis conducted 
here. The report concludes with a future-oriented review of 
the outlook for the regional situation, highlighting 
knowledge and response gaps.

Overview of drug markets in the European Neighbourhood Policy-South countries

Where available, data collected as part of routine 
monitoring or research activities was also analysed. This 
included some developmental data collection exercises 
supported by the EMCDDA and other international bodies 
as part of their capacity building activities. Data collection 
exercises supported by the EU4MD included the European 
Syringe Collection and Analysis Project Enterprise 
(ESCAPE), the European Drug Emergencies Network and a 
study using the European Facility Survey Questionnaire. 
These tools come with their own strengths and limitations, 
the discussion of which is beyond the scope of this report, 
but which can be examined on their respective website 
links (4).

Where possible, qualitative information on cross-border 
trafficking and supply has been triangulated with other 
information collected through EMCDDA core monitoring 
and non-routine data collection activities with EU Member 
States, Norway and Türkiye.

It is important to note that while attempts have been made 
to substantiate the information collected from qualitative 
interviews by using supplementary data sources, a key 
limitation of any analysis of this topic is simply the lack of 
detailed, timely and reliable information on the drug 
situation in the region. As such, significant knowledge gaps 
exist that are highlighted here. An overarching conclusion 
from this exercise is therefore the importance of 
strengthening drug monitoring capacity for collecting and 
disseminating reliable and comparable information on the 
drugs situation in this region.

Report outline

The report begins by providing an overview of key findings 
focusing on what is known about production, trafficking 
and organised crime networks. While the focus of this 
report is the operation of the drug markets and data on 
drug availability and use, its impact on public health is 
included where relevant information is available. The main 
drivers and facilitators of drug markets in the region are 
then discussed, drawing attention to the significant 
implications of the expansion of transport networks in this 
region, as well as identifying other key challenges such as 
economic insecurity, ongoing conflicts and the expansion 
of the operational activities of organised crime networks.

Overviews of each main drug type are also provided 
(cannabis; captagon and other amphetamines; heroin and 

(4)  For more information, see https://www.emcdda.europa.eu/topics/

escape_en and https://www.emcdda.europa.eu/publications/technical-
reports/european-facility-survey-questionnaire-efsq_uk. 

6

Key findings

Drivers and facilitators

  Political instability and ongoing conflict in some parts 
of the region represent a major challenge to good 
governance and the rule of law. A knock-on impact of this is 
that those areas facing social instability are likely to 
become more vulnerable to drug production, trafficking 
and associated criminal activity and also experience 
increased levels of domestic drug problems.

  The available information suggests that the COVID-19 
pandemic’s impact on drug trafficking in the region was 
both limited and short-lived, as those involved with drug 
market activities rapidly adapted their methods to respond 
to COVID-19 restrictions on movement or social contact. 
Border closures and mobility constraints on land travel 
appear to have resulted in maritime trafficking routes 
becoming more important during this period. This can be 
seen as accelerating a trend that was to some extent 
observable before the pandemic.

  Longstanding inadequacies in treatment provision in 
many parts of the region were also reported to have been 
made worse by the COVID-19 pandemic, which resulted in 
many treatment facilities either temporarily closing or not 
accepting new admissions. During the pandemic, reports 
also suggest that there was increased interest in the 
non-medical use of medicines in some countries; this is a 
relatively long-established problem for some countries but 
needs to be viewed within the context of providing 
adequate access to medicines for therapeutic purposes. A 
longer-term policy issue is therefore the need to ensure the 
adequate supply of medicines while at the same time 
strengthening measures to reduce the risk of their 
inappropriate use.

Production

  Some important global production areas for cannabis 
are located within the ENP-South region. These are 
concentrated in Morocco and Lebanon.

  Trends in cultivation of cannabis in recent years appear 
variable. Reports suggest that production has remained 
relatively stable on the North African side of the region; 
however, there are some indications of possible expansion 

of cultivation in Lebanon, Syria, Israel and to a lesser 
degree Palestine.

  Captagon (usually amphetamine) tablet production is 
reported to take place in Syria and is thought now to 
involve military groups, business and state actors as well 
as various non-state actors. This is a worrying 
development. The data available, including seizures made 
at the borders of neighbouring countries, suggest this has 
increased in recent years, possibly substantially. 
Production may have also increased slightly or diffused to 
Lebanon and to a lesser extent Jordan, although the latter 
appears to currently play only a minor role in production in 
the region at present. However, trafficking of captagon 
through Jordan is now considered a major cross-border 
threat by security officials within the country. Taken as a 
whole, the information available suggests that captagon 
production and trafficking linked to state and non-state 
actors is becoming a growing threat in the region, with the 
potential to exacerbate existing security-related 
challenges.

  Some generally small-scale production of synthetic 
substances (such as MDMA, amphetamines and NPS) has 
been reported in the region, with reports of production or 
processing sites being identified and dismantled. However, 
currently, the information available is not sufficient to 
understand the scale or dynamics of this. Given the 
potential significance of this development for the future of 
both the region and the EU, this represents an important 
issue for follow-up activities.

  Some opium poppy cultivation is also reported to take 
place in parts of this region.

Trafficking

  The ENP-South region contains several hubs for drug 
trafficking and their importance appears to be increasing.

  Transport networks and infrastructure are likely to 
expand rapidly in the coming years, given their importance 
to licit commercial activity and investment being made in 
this area. This is likely to create new opportunities for drug 
trafficking and new challenges for law enforcement.

7

Overview of drug markets in the European Neighbourhood Policy-South countries

  Herbal cannabis and cannabis resin are the substances 
most trafficked in the ENP-South region, with routes 
crossing every country in the region.

Latin America in the period that preceded the growth in 
drug-related violence that now afflicts many countries 
there.

  There are some indications of increased use of a more 
circuitous route for cannabis and captagon trafficking 
between Beirut and the Persian Gulf that runs through the 
West African coast, the Sahel and Libya.

 
In contrast to trafficking involving intermodal 
containers, the use of commercial air and maritime 
transport generally is associated with the trafficking of 
smaller volumes, but also a wider variety, of illicit drugs. 
Notably, trafficking by ferry boats appears to be bi-
directional, with cannabis resin transported to Europe, and 
MDMA and cocaine transported from Europe to North 
Africa.

  The data available, while limited, do suggest that the 
trafficking of MDMA, cocaine, heroin and diverted 
pharmaceuticals from Europe to countries in the ENP-
South region may have grown in recent years.

Organised criminal networks

  There are some indications of increased links and more 
integration in operational activities between national and 
regional organised crime networks and their international 
counterparts. As any developments in this area could have 
significant implications for the future, this topic should be 
regarded as a priority for further investigation and follow-
up.

  The drug economy appears to have provided an 
opportunity for income generation for some armed forces 
and groups involved in conflicts in the region. In areas of 
conflict, armed groups often appear to have pivoted 
towards production and trafficking of drugs as an income 
generation activity and established greater links with 
organised crime networks involved in drug market 
activities. In Syria, for example, there are reports that links 
exist between the production of captagon and several 
factions involved in the conflict in this country, as well as 
some involvement of the business sector and other state 
and non-state actors.

  Overall, violence directly related to drug production 
and trafficking is still reported as being relatively rare and 
generally of low intensity in this region but there are some 
worrying indications that this may be changing. Monitoring 
of the situation is needed as many of the current 
background conditions are similar to those observed in 

  An established but also growing challenge is 
entrenched corruption. Trafficking networks, to varying 
degrees, are thought to have infiltrated state structures in 
parts of this region. It is reported that organised crime 
networks have secured the complicity or complacence of 
high-ranking officials, both enabling drug flows and 
impeding attempts to disrupt them. Issues around 
penetration of state structures can be seen at multiple 
levels, ranging from small-value, yet ubiquitous, payments 
made to low-level officials, to deep and direct integration 
of state actors in criminal activity, including security 
officers and some military personnel.

Availability and use

  The ENP-South region is perceived by informants as 
representing a growing consumer market for drugs, 
although robust routine monitoring data on drug 
consumption prevalence or trends is largely lacking. It 
should be noted that demographic factors and 
urbanisation may also represent risk factors for an 
increase in future domestic drug demand.

  Although reliable data are limited, the information 
available does suggest that drug use across the region has 
increased. Use of methamphetamine and amphetamine in 
the form of captagon tablets, in particular, appears to have 
become popular in Syria, with Lebanon and Israel also 
reporting some signs of increased use of 
methamphetamine. Some signals of increased captagon 
use in Jordan have also been noted. Overall, however, 
cannabis remains the most-used illicit substance in the 
region.

  The use of prescription medicines and medicinal 
products for non-therapeutic purposes is not well 
understood but merits further follow-up as there are 
signals that this problem may be growing.

  There are signals that patterns of drug use are shifting 
towards a wider variety of substances. The use of 
synthetic stimulants such as methamphetamine, MDMA, 
some types of NPS and new types of diverted 
pharmaceuticals such as pregabalin are all reported as 
becoming more common. There are also some possible 
signs of limited but growing use of heroin. Given the 
perception that the current dynamics of drug use in the 
region could mean that consumption patterns have the 

8

potential to change, rapidly improving the surveillance of 
drug prevalence and patterns of drug use must be 
regarded as a priority for monitoring and research 
activities.

  There are strong indications of geographic 
heterogeneity in patterns of drug use within the region that 
require greater elaboration. The use of heroin, for example, 
appears to be very limited overall but entrenched pockets 
of use exist in some areas, including Algeria, Israel, 
Morocco and Tunisia. Use of cocaine, thought to be 
generally rare in the region, appears to be comparatively 
high in Israel and may be growing among some groups in 
other countries in the region, although this is poorly 
observed.

Responses to drug use

  The focus of this report is on the operation of the 
regional drugs market, and further work is required to 
analyse in more detail the impact of drug use on public 
health in the region. In general, however, it can be 
concluded that state responses to drug problems in the 
region are predominantly punitive, with a focus on law 
enforcement responses. While there has been some 
expansion of public health approaches in recent years, 
seen for instance in increased numbers of public and 
private treatment facilities, the information available 
strongly suggests current capacity remains considerably 
below what is required to respond to estimated needs.

Key findings

9

Overview of drug markets in the European Neighbourhood Policy-South countries

Main drivers and facilitators of drug markets

Changing trends around drug production, trafficking and 
use in the ENP-South region appear to be driven in part by 
a number of interrelated overarching factors. These 
include the growth in transport networks, economic 
challenges and social marginalisation, persistent internal 
conflict in some states, entrenched corruption and the 
expansion of criminal network operations in the region.

Expansion of transport networks

Transportation links – by intermodal container shipping, 
commercial air travel, cross-Mediterranean ferry travel or 
overland – have enabled current drug trafficking routes to 
expand through and from the ENP-South region. They have 
also played a role in connecting the region to key points in 
illicit drug trafficking commodity chains, including Europe, 
South America, Asia and West Africa. Intermodal container 
shipping and maritime travel in particular have been key 
means of transporting a wide variety of illicit substances 
and have facilitated trafficking into the EU (EMCDDA and 
Europol, 2019).

Transportation links are likely to grow in the future, given 
their importance to licit commercial activity and 
investments being made in this area. This may create new 
opportunities for criminal actors involved in illicit drug 
trafficking as well as creating new challenges for 
interdiction activities.

Drugs trafficked in intermodal container shipments are 
typically hidden among licit goods. When used to traffic 
drugs into the ENP-South region, intermodal containers 
are most typically associated with large volumes of 
cocaine shipped from South America or diverted 
pharmaceuticals, mainly tramadol (5), shipped from South 
Asia. Within the region, and from the region to other drug 
markets, trafficking using intermodal containers appears 
to be mainly of captagon (from Syria and Lebanon) and, to 
a lesser degree, cannabis resin (from Lebanon, Morocco 
and Syria).

In contrast to trafficking involving intermodal containers, 
trafficking by commercial air and maritime transport is 
generally associated with smaller volumes, but a wider 
variety, of illicit drugs.

(5)  Tramadol is a synthetic opioid analgesic with low abuse potential. Its 

major metabolite is O-desmethyltramadol, which has greater analgesic 
activity than the parent drug.

In trafficking attempts involving commercial air transport, 
drugs are typically carried by couriers, either concealed 
within luggage or ingested or hidden on the courier’s body. 
In some instances, a ‘shotgun’ method is reported to have 
been used by traffickers, with multiple couriers travelling 
on the same flight to increase the chances of some 
evading detection. Commercial air travel has been 
reported to have been used to traffic cocaine from South 
Africa, cocaine and herbal cannabis from West Africa, and 
cocaine, heroin, MDMA and various types of diverted 
pharmaceuticals from Europe.

Trafficking by ferry boats may involve couriers carrying 
drugs on their bodies or in their luggage, but as with 
commercial air travel, such shipments tend to be of small 
volume. Larger shipments of drugs are typically hidden 
either within vehicles or in trucks carrying licit goods. 
Trafficking by ferry is reported to occur mainly along routes 
linking Spain, France and Italy with Algeria, Morocco and 
Tunisia. Notably, trafficking by ferry boats is reported as 
sometimes being bi-directional, with cannabis resin 
transported to Europe, and on occasion MDMA or other 
substances , such as buprenorphine, trafficked to North 
Africa.

Economic challenges

Over the last decade, many states in the ENP-South region 
have experienced limited growth, relatively high rates of 
unemployment and persistent economic marginalisation in 
many rural and more remote areas (Herbert and Gallien, 
2020b; Hoogeveen and Lopez-Acevedo, 2021). In some 
cases, economic challenges have been substantial. 
Lebanon, for instance, has experienced a deteriorating 
economic situation and banking crisis since 2019 (Adal, 
2021).

Limited opportunities to participate in the legal economy 
have been a longstanding driver of participation in the 
region’s drug economy. Particularly in periods of economic 
hardship, when income-generating opportunities are 
limited, people may seek to replace or supplement their 
livelihoods by engaging in illicit activities including drug 
production, trafficking or sale. Additionally, periods of 
economic hardship may see an increase in demand for 
illicit substances as people may be more vulnerable to 
using drugs to cope with stress and mental health issues 
or as an escape from the realities of poverty and 
unemployment.

10

Main drivers and facilitators of drug markets

The COVID-19 pandemic and associated government 
responses placed further strain on the region. Many states 
recorded substantial economic contractions during this 
period, with increases in levels of unemployment. While an 
economic rebound occurred in some areas in 2021, overall, 
the economic recovery in the ENP-South region has been 
uneven, with some states, such as Lebanon and Tunisia, 
continuing to face substantial challenges (Amara and 
Mcdowall, 2022; Leonhardt and Yar, 2021).

These economic challenges may have contributed to the 
expansion of the drug economy in the ENP-South region, 
both in terms of heightened demand for illicit substances 
and as a driver for increasing participation in their 
production, trafficking and sale. In Lebanon, for example, 
some farmers appear to have switched from licit crops to 
cannabis cultivation to supplement their incomes. In 
Tunisia, key informant interviews suggest that the 
economic challenges linked to the COVID-19 pandemic 
may have pushed more unemployed individuals, or those 
with low incomes, into becoming involved with drug 
trafficking or drug sales.

Declining economic conditions in the region and related 
effects on government finances have also impacted the 
ability of regional states to respond to the production, 
trafficking and use of illicit drugs. Such challenges are 
arguably most acute in Lebanon, where the prolonged 
economic and political crisis is reported as having a major 
negative impact on many government activities, including 
efforts to address drug-related issues.

Conflict, violence and insecurity

Ongoing internal conflicts in Libya and Syria appear to 
have enabled the growth of drug economies; this 
development is not thought to be restricted to areas 
outside of government control and may also involve some 
state actors and political and business elites. There is little 
to indicate that the internal conflicts in Libya and Syria are 
likely to be resolved soon, with the result that the two 
states will likely continue to be important areas for 
sustaining drug economies within the region. There are 
also some signals to suggest that drug production, 
particularly captagon, is becoming a more important 
source of finance in Syria and is associated with growing 
operational alliances between networks in Syria, Libya and 
Lebanon. As such, a growing threat exists that drug 
production and trafficking will exacerbate future security 
challenges in the region as a whole and potentially fuel 
increased levels of domestic drug consumption.

The central location of Syria within the Middle East and 
North Africa region facilitates trafficking of illicit 
substances east, towards the Persian Gulf, and west 
towards Europe and North Africa. The Syrian conflict is 
also reported to have driven heightened levels of domestic 
drug use, due to rising availability of drugs as well as 
trauma faced by combatants and civilians impacted by the 
conflict.

In Libya, prolonged conflict is thought to have facilitated 
the expansion of drug trafficking while also placing citizens 
under severe stress, which could potentially increase the 
demand for illicit substances. The drug economy in the 
country has been substantially impacted by the 2019-
2020 war. The war reorganised the political landscape, 
concentrated power in some areas, and facilitated the 
development and use of new trafficking routes. This has 
had implications for creating new opportunities for drug 
flows from west to east across the region.

The drug economy also provides an opportunity for income 
generation for some of the armed forces or groups 
involved in conflicts in the region. The participation of 
some of these groups in drug production and trafficking 
activities appears to have resulted in violence associated 
with drug market activities and more generally poses a 
threat to security. In Libya, for example, some actors 
involved in the conflict have been reported as cooperating 
with criminal networks to generate revenue from drug 
trafficking. This in turn helps consolidate their position 
within the country, creating a vicious cycle which shows no 
sign of abating (Micallef and Reitano, 2017; Shaw and 
Mangan, 2014). In Syria, production of captagon has also 
been reported to be linked to some armed factions and 
other actors with alleged connections to the government 
(Rose and Soderholm, 2022).

More generally, drug trafficking activities have resulted in 
some reports of violent clashes between state security 
forces and criminal networks. Along the Jordanian border 
with Syria, for example, there have been serious clashes 
reported between security forces and captagon traffickers 
(Al Muheisen, 2021). Sporadic violent events linked to 
trafficking have also been reported on Israel’s border with 
Egypt and on the border between Algeria and Morocco. 
Although there is a perception that these types of events 
may be getting more common, it is also important to note 
that drug trafficking in the ENP-South region is broadly 
marked by its comparatively low level of violence.

11

Overview of drug markets in the European Neighbourhood Policy-South countries

Expansion of the activities and presence 
of criminal networks

It appears that over the last decade, increased levels of 
drug production, trafficking and drug use have had a 
negative impact on governance, security and the rule of 
law in the ENP-South region. This has also highlighted the 
challenges faced by many states in the region to respond 
to the growing challenge presented by drug market 
activities.

Part of the reason for this is that criminal networks are 
thought, to varying degrees, to have infiltrated state 
structures in many countries in the region. This has 
weakened institutional independence and thus enabled 
drug market activities through the creation of a state-crime 
nexus where the participants can include intelligence, 
military and law enforcement actors, as well as high-level 
business and political elites. Bribes as well as coercion are 
apparently being used to directly influence actors in the 
security and financial sectors. In some cases, criminal 
networks are reported to have exerted a negative influence 
on both the press and the judiciary through their alliances 
with political, military, security and business figures. This 
appears to have resulted in an increasing problem of 
officials ignoring the activities of criminal networks linked 
to the drug market. This may be due to direct pressure or 
inducement or because they are working in a system 
where they feel that a more proactive approach may not be 
supported by their hierarchy.

The financial returns that involvement in the drug market 
can generate appear to also be contributing to a situation 
in which criminal actors are thought to represent a growing 
challenge to economic stability and security in some 
countries in the region. Increased involvement by various 
criminal networks in the drug trade, and the income 
generated through such activities, were viewed by most 
key informants as having increased the influence, reach 
and interconnection between different criminal actors 
operating in the region.

Rising drug production, for example, is thought to have 
been one of the factors fuelling criminal activity – 
including actions by the armed forces – in Syria and, to a 
lesser degree, Lebanon (COAR, 2021). In some instances, 
this is reported to have led to previously unknown 
individuals or criminal networks rapidly assuming a more 
important role in local or global drug trafficking activities 
(Hubbard and Saad, 2021). In Jordan, the reach of 
trafficking networks appears to have grown, with new 
trafficking routes emerging in areas where it may be 
difficult for government forces to operate. Key informant 

interviews suggest that in some areas in the country, for 
example, drug trafficking groups have established strong 
relations with local tribal actors. This is reported as acting 
as a deterrent to law enforcement activities because of the 
threat of retaliation.

The domestic distribution of drugs is, however, probably 
the area where the power of criminal networks has grown 
most rapidly. In Israel, for example, some well-known 
criminal networks previously involved in other areas of 
illicit activity appear to have benefited from rising sales of 
drugs (GI-TOC, 2021). Competition between these actors, 
and with other smaller groups, in recent years appears to 
have also resulted in more violence associated with drug 
market activities, leading Israel to declare gang-related 
violence as a national emergency (Chafets, 2021; GI-TOC, 
2021). Despite this, drug-related violence overall in the 
region appears to remain relatively rare, even if many key 
informants believed it was a growing problem.

There also appears to be greater connectivity between 
criminal networks based in the ENP-South region and 
those based in other geographical areas, including Europe. 
In some cases, this appears to be linked to a more general 
expansion into the international arena of criminal networks 
originating in the region. In Israel, links have been reported 
between Israeli and Colombian, Mexican and Japanese 
criminal networks (Australian Federal Police, 2021; Breiner, 
2020; Ford, 2021; Jabali-Nash, 2011; Khalil, 2020; Stuff, 
2017; Tremlett, 2001). Similarly, in Morocco and Tunisia, 
foreign criminal networks active in the drug market are 
thought, at least to a limited degree, to have established an 
operational presence. Key informants suggested, for 
example, that Latin American, Italian and Balkan criminal 
networks now have a presence in Morocco, and there also 
appears to be a limited presence of Italian and French 
networks in Tunisia.

Criminal networks also sometimes exploit diaspora 
communities (predominantly in Europe) to facilitate drug 
market activities. Diaspora members, for example, may act 
as facilitators between networks on both sides of the 
Mediterranean for drug trafficking activities. A notable 
example of this is the ‘Mocro’ Mafia, a loose collection of 
crime groups founded by first- and second-generation 
Moroccan migrants in Europe. These groups are believed 
to have maintained close relations with Moroccan criminal 
networks involved in the trafficking and distribution of 
cannabis resin to Belgium and the Netherlands (Dahlkamp 
et al., 2021; Gormezano, 2021).

The Mocro Mafia are also thought to have played a role in 
increasing the involvement of Moroccan groups in the 
cocaine trade (Holligan, 2019). This group has been 

12

Main drivers and facilitators of drug markets

reported as being involved in cocaine trafficking activities 
in the ports of Antwerp and Rotterdam, both of which are 
important cocaine entry points for the European market 
(EMCDDA and Europol, 2019; Het Parool, 2020). The port 
of Antwerp in particular is currently regarded as one of the 
largest cocaine importation points in Europe, and 
trafficking activities there have been linked to five 
Moroccan criminal groups (EMCDDA and Europol, 2022a; 
Verplancke, 2020).

Overall, this points to one of the challenges posed by 
developments in drug trafficking to the ENP-South region: 
networks involved in the trafficking of drugs are now often 
part of a broader international supply chain that facilitates 
the import, transit and export of drugs as well as being 
involved in the domestic sale of drugs. The individual 
responses of states to the different challenges associated 
with the more transnational aspects of drug markets tend 
to lack integration at the regional level, and domestic 
responses can be undermined by corruption and the 
penetration of criminal networks into political and security 
structures.

13

Overview of drug markets in the European Neighbourhood Policy-South countries

Cannabis

Production

Cannabis production appears to take place, at least to 
some limited degree, in most countries in the region. 
Historically, the production of illicit drugs in the ENP-South 
region has been dominated by cannabis cultivation for the 
production of cannabis resin in Lebanon and Morocco, 
largely for onward trafficking and distribution in the EU or 
to markets in the Middle East.

enforcement campaigns, it has been suggested that due to 
cultivation being such an important source of income, 
governments have appeared at times hesitant to suppress 
it. More generally, and to some extent reflecting 
developments taking place elsewhere in the world, 
discussion is also currently ongoing that may lead to 
changes in the regulatory and legal approach taken to 
some forms of cannabis cultivation in these areas (see the 
box  ‘Conditional legalisation of cannabis cultivation in 
Lebanon and Morocco’).

In both countries, most cannabis cultivation has taken 
place in economically disadvantaged regions, with 
cannabis production historically representing an important 
source of income for some groups in Lebanon’s Bekaa 
Valley and Morocco’s Rif Mountains, where it has arguably 
played a role in supporting social stability in these areas. 
Despite some highly publicised eradication and law 

Morocco appears to have the largest area for cultivation of 
illicit cannabis in the region (Figure 1). However, official 
reports point to a long-term reduction in the area under 
cultivation. In 2019, the most recent year for which official 
data were available, Moroccan farmers were estimated to 
cultivate around 21 000 hectares of cannabis, down from 
47 500 hectares in 2017 (UNODC, 2021a). However, this 

FIGURE 1 
Cannabis cultivation areas in Morocco

SPAIN

Gibraltar  (UK)

Ceuta (Spain)

Tangier

Tétouan

Larache

Al Hoceima

Chefchaouen

Ouazzane

MOROCCO

Taounate

Rabat 

Fes

Taza

14

Cannabis

reported decline in the area under cultivation is not 
thought to have necessarily led to a reduction in cannabis 
resin production volumes. This is due to the growing 
adoption of cannabis hybrid strains that produce 
significantly higher yields (Chouvy and Afsahi, 2014) and 
appear to be associated with an increase in the THC (6) 
content of cannabis resin produced in this area. It is 
noteworthy that the average THC content of cannabis resin 
seized in the EU has increased in recent years and is now 
high by historical standards. A large proportion of the 
cannabis resin seized in the EU is likely to have originated 
in Morocco. 

In Algeria, where most cannabis production serves the 
domestic market, there is substantial annual variation in 
seizure levels, probably reflecting the success, or 
otherwise, of interdiction efforts over time (ONLCDT, 2011; 
2012; 2013; 2014; 2015; 2016; 2017; 2018; 2019; 2020; 
2021). However, there is no evidence to suggest any 
substantial increase in production since 2019.

In Libya, cannabis cultivation appears to remain relatively 
uncommon, with any production taking place intended for 
the domestic market. However, the 2019-2020 war for 

(6)  THC (tetrahydrocannabinol) is the main psychoactive substance in 

cannabis. 

Tripoli is reported to have facilitated an increase in 
farm-level cannabis production intended for sale on the 
local market in the greater Tripolitania area, the Western 
Mountains area, and the Fezzan region in the southwest of 
the country. There is little evidence available currently to 
suggest that cannabis production is taking place in the 
east of the country.

In other countries of the ENP-South region, illicit cannabis 
cultivation is reported to have expanded, driven by a 
variety of mostly local factors. Lebanon remains an 
important cannabis cultivator in the Middle East, with 
recent estimates suggesting between 20 000 to 40 000 
hectares of land are used for cannabis cultivation (Babin, 
2019; UNODC, 2021a). Between 2019 and 2021, the 
country’s intensifying economic crisis may have fuelled an 
expansion in cultivation, both because of a lack of 
resources for law enforcement activities and because 
farmers were trying to supplement their income through 
cannabis cultivation (AFP, 2021b). This appears to have led 
to a surplus of cannabis, indicated by a fall in farmgate 
prices for the drug (AFP, 2021b; Fitt, 2020; Hubbard, 2020; 
Khoder, 2019).

In Syria, cannabis cultivation is thought to have expanded 
since the start of the conflict in 2011 (Figure 2). By 2021, 

Conditional legalisation of cannabis cultivation in Lebanon and Morocco

The past decade has seen changes in the legal 
framework of some forms of cannabis cultivation in 
Lebanon and Morocco. While these changes have not 
yet been fully implemented, their possible impact on the 
cannabis market has raised a number of issues. Among 
these is that the transition from criminal to legal 
cultivation with permissible but low levels of THC 
concentration may result in the co-existence of licit and 
illicit crops, complicating or possibly even undermining 
efforts to identify and eradicate illicit cultivation.

from obtaining a licence, which may exclude many 
farmers in the Bekaa Valley, where prior offences are 
relatively common among those involved in cannabis 
production. In addition, much of the cannabis currently 
grown in Lebanon is thought to exceed the 1 % THC 
threshold, complicating efforts of existing farmers to 
become involved in the programme (Hubbard, 2020). At 
the time of writing, the impact of the new law on illicit 
production remains unclear.

Lebanon

In April 2020, Lebanon’s parliament approved a law 
legalising the cultivation of cannabis containing less 
than 1 % THC for medical and industrial use. The law 
also made provisions for the establishment of a 
regulatory body and detailed licensing criteria for 
different stages of production, such as the importation 
of seeds and juvenile plants, planting and harvesting. 
These criteria prevent anyone with a criminal record 

Morocco

In August 2021, the legal provisions for the cultivation of 
cannabis for medical, cosmetic and industrial purposes 
and industrial use were established. As of July 2022, 
the law (legislation 13-21) is yet to be approved by the 
King of Morocco and has not been put into effect. It can, 
however, be seen as responding to longstanding 
demands by farmers and political authorities in northern 
Morocco and could potentially offer advantages to 
farmers over involvement with the illicit market.

15

Overview of drug markets in the European Neighbourhood Policy-South countries

FIGURE 2 
Cannabis cultivation in Syria and Lebanon

TÜRKIYE

Amuda

Ya’robiyah

Al-Hasakeh

Aleppo 

Latakia

 Mediterranean
Sea

Tartus

Homs

S Y RI A

Euphrates

Deir ez-Zor

LEB ANON

Beirut

Bekaa Valley

Damascus

As-Sweida

Daraa

WEST
BANK

cultivation was reported throughout the northeast, 
northwest, southwest and centre of Syria, both in areas 
under government control and those held by various 
anti-regime armed groups (Syrian Observatory for Human 
Rights, 2021a, 2021b, 2021c). 

In Israel, illicit cannabis cultivation is reported to have 
increased between 2019 and 2021, due in part to the 
tightening of border security in the country and the 
construction of a fence along the Egyptian border, which, 
by limiting trafficking, is thought to have stimulated 
domestic production (Lamers, 2020; Singer, 2021). 
Tightened Israeli border security with Egypt has also been 
linked to rising cannabis production in Palestine, 
particularly in the West Bank (Abdel-Hamid, 2019; Al-Afifi 
et al., 2019; Melhem, 2017).

16

N

I RAQ

0

100 km

Trafficking

Most established cannabis trafficking routes in the region 
originate in the main illicit cultivation areas in Lebanon, 
Morocco and Syria. Herbal cannabis and cannabis resin are 
the substances most trafficked in the ENP-South region, 
with routes transecting almost every country in the region.

The COVID-19 pandemic and associated restrictions to 
movement appear to have had only a relatively limited 
impact on herbal cannabis and cannabis resin trafficking 
routes, despite the enhanced border security provisions 
put in place. Trafficking groups did not appear to have 
been seriously disrupted by any new measures put in 
place. Although some countries reported a temporary 
reduction in drug trafficking activities in the early months 
of the pandemic, it is believed that activities soon recovered. 
In some countries, however, heightened internal mobility 
controls appear to have led to re-routing of trafficking, 
particularly from overland to maritime routes. However, this 
is a trend that preceded the COVID-19 pandemic, as 

Cannabis

increased security measures generally introduced at land 
borders in recent years have led to increased importance of 
maritime cannabis trafficking routes.

It is believed that cannabis resin trafficking in the ENP-
South region may be using new routes through West Africa 
to evade security force presence, or as a response to 
insufficient capacity on established routes. In Libya, for 
instance, it has been suggested that maritime trafficking 
has increased to such an extent that existing ports appear 
saturated, leading traffickers to search for alternative routes.

Shipments from Morocco to southern Europe

The main cannabis trafficking route from Morocco is from 
northern areas, and to a lesser degree from the south-
central coastal area, directly to Europe (Figure 3). The 
shipments depart from northern ports and beaches, and 
head mainly to Spain but also to France and Portugal. A 

small amount of trafficking also appears to occur through 
Agadir and other ports in the centre of the country, 
reportedly driven by heightened security controls linked to 
COVID-19 movement restrictions in northern Morocco 
(Eljechtimi, 2020).

Across the Sahel towards Libya

Cannabis resin produced in Morocco may also transit 
overland across the Sahel towards Libya (Figure 3). 
However, this route is thought to have become less 
attractive to traffickers in 2020 and 2021. Increased 
tension between the Polisario Front (Frente Popular para la 
Liberación de Saguía el-Hamra y Río de Oro) and the 
Moroccan government led to impediments in movement, 
and the coup d’état in Mali appears to have disrupted 
established relations between security actors and 
traffickers and led to a surge in seizures, impacting the 
volume of resin trafficked along this route (Herbert and 
Fereday, 2021; UN, 2021).

FIGURE 3
Cannabis trafficking routes in North Africa

FRANCE
FRANCE

PORTUGAL
PORTUGAL

SPAIN
SPAIN

Tangier
Tangier
Asilah
Asilah
Laarache
Laarache
Mehdia
Mehdia

Salé
Salé

Bouyafer
Bouyafer

Hoceima
Hoceima

Arekmane
Arekmane

Tlemcen
Tlemcen

Maghnia
Maghnia

Oujda
Oujda

Chefchaouen
Chefchaouen

MOROCCO
MOROCCO

Agadir
Agadir

WESTERN
WESTERN
SAHARA
SAHARA

Ain Ben Tili
Ain Ben Tili

Bir Moghrein 
Bir Moghrein 

Figuig
Figuig

Bechar
Bechar

ALGERIA
ALGERIA

ITALY
ITALY

Jendouba
Jendouba
El Kef 
El Kef 
Kasserine
Kasserine

Tebesa
Tebesa

El Oued
El Oued

Ghardhia
Ghardhia

Ouargla
Ouargla

Zuwara
Zuwara

Tripoli
Tripoli

TUNISIA
TUNISIA

GULF OF
GULF OF
SIDRA
SIDRA

Sebha
Sebha

Qatrun
Qatrun

Jaghbub
Jaghbub

LIBYA
LIBYA

EGYPT
EGYPT

Al Wigh
Al Wigh

Tazirbu 
Tazirbu 

Rebiana
Rebiana

Taoudenni
Taoudenni

Salvador Pass
Salvador Pass

Guerguerat
Guerguerat

MAURITANIA
MAURITANIA

Arouane
Arouane

Kidal
Kidal

NIGER
NIGER

Assamaka
Assamaka

Agadez
Agadez

El Arneb
El Arneb

Gao
Gao

MALI
MALI

CHAD
CHAD

Toumour
Toumour

17

Overview of drug markets in the European Neighbourhood Policy-South countries

Through the Morocco-Algeria border to multiple 
destinations

Other routes move from cultivation points in Morocco to 
the Algerian border. Trafficking across the Morocco-Algeria 
border is thought to mainly occur in the north between 
Figuig and Saidiya, and Naâma and Béchar, and slightly 
further south, moving through Tindouf (AFP, 2021a; 
Herbert and Gallien, 2020a). Once in Algeria, cannabis 
resin is moved east. Some is destined for major urban 
areas, such as Oran and Algiers, either for sale on the 
domestic market or to be loaded onto ferries going to 
Europe. Other shipments appear to move further east 
towards the Tunisian or Libyan borders (Herbert and 
Gallien, 2020a).

Cannabis resin arriving in Tunisia through Algeria is 
reported to be transported to local markets in Tunis and 
coastal tourist areas, or to Europe along the country’s 
northern shore (Herbert and Gallien, 2020b). Quantities 
destined for onward transport to Libya are transported 
along the north-south highway to the Libyan border 
(Herbert and Gallien, 2020a). A smaller proportion of resin 
transiting through Algeria is smuggled directly into Libya, 
through overland routes in the vicinity of the Algerian city 
of Debdeb and on to the Libyan border city of Ghadames, 
or deeper south through Illizi province in Algeria and on to 
the Libyan town of Ghat (Herbert and Gallien, 2020a).

Once in Libya, some shipments appear to be moved 
further east into Egypt, and in some instances from there 
across the border into Israel, either by the Nitanza and 
Taba crossings or over the border fence separating the two 
countries (Gross, 2021; Hartman, 2013; Hartman and Okbi, 
2014; Rosenberg, 2017). Other shipments are destined for 
Europe and moved to coastal areas, such as the city of 
Tobruk.

Eastbound along the Mediterranean coastline

Trafficking from Morocco also moves along the North 
African coastline. Shipments appear to be moved to 
vessels stationed just offshore and sail east through 
Moroccan, Algerian and Tunisian territorial waters (Herbert 
and Gallien, 2020a). Large cargo vessels are reported have 
been used in such smuggling in the past, but fishing and 
leisure vessels are thought to be more commonly used 
because of the large number of vessels of this type present 
in these waters. Some shipments are reported to be 
handed over to local networks in Algeria and Tunisia by 
ship-to-ship transfer or are deposited offshore. The resin is 
packed into sealed plastic bags and sometimes further 
stuffed into car tyres, a method known in Tunisia as Ajal 

18

(meaning wheel in Arabic). Each tyre can contain up to 
20 kilograms of cannabis resin and in some cases larger 
quantities of other substances such as cocaine.

Other shipments transit directly to Libya, where the 
protection apparently enjoyed by criminals allows 
shipments to be processed regularly through formal ports, 
particularly in al-Khums and Tobruk in the east. Ship-to-
ship transfers and deposits offshore are also reported to 
be occasionally used.

Lebanon-Syrian cross-border trafficking

Trafficking routes originating in cultivation zones in 
Lebanon and Syria appear equally diverse (Figure 4). One 

FIGURE 4
Cannabis trafficking routes in Lebanon, Jordan and Syria

T ÜRKI Y E

Latakia

0

100 km

N

 Mediterranean

Sea

Tartus

Tripoli

S Y RI A

LEB ANON

Ras Baalbek 

Beirut

Damascus

Metula

Ghajar

Al Kiswah

Daraa

Irbid

 Mafraq

JOR DAN

Amman

WEST
BANK

Jerusalem 

ISR AEL

Cannabis

main set of routes runs across the Syria-Lebanon border, 
moving cannabis grown in the Bekaa Valley into Syria for 
onward transport overland to Jordan and Iraq, or through 
Syrian ports to markets outside the region. Nearly all 
shipments out of the country seem to involve cannabis 
resin, although there is some internal distribution and 
consumption of herbal forms of the drug. Cannabis may 
also flow in the opposite direction with some Syrian 
cannabis believed to be trafficked into Lebanon for onward 
movement through its ports (Bulos and Yam, 2020; COAR, 
2021). There also seems to be some trafficking of herbal 
cannabis, primarily to Iraq and Jordan. Like Lebanon, there 
is substantial consumption of herbal cannabis in Syria, 
highlighting that internal trafficking of that form of the drug 
is important to criminal networks in the country.

Several important cross-border routes have been 
identified, including the Shebaa and Rakhlah crossings 
around Mount Hermon, the Masnaa crossing on the 
Beirut-Damascus road, and the crossing between the 
Syrian town of Serghaya and the Lebanese town of 
Maarboun in the Bekaa Valley (Adal, 2021; Arbid, 2017; 
Ezzi, 2020). The Syrian town of al-Qusayr and the broader 
western Qalamoun region have emerged as important 
drug production and trading points in recent years, raising 
the likelihood that trafficking also occurs along the road 
linking it to Qaa in Lebanon (Boulos, 2021). 

Overland routes towards Jordan and Iraq

Once in Syria, trafficking routes appear to spread either 
south-east, towards Jordan (similarly to captagon 
trafficking), or east towards Iraq, often by the al-Bukamal 
border crossing (Adal, 2021; Kittleson, 2021). In the north, 
shipments of cannabis resin are trafficked across the 
border in Al-Hasakeh governorate’s Ya’robiyah district 
(COAR, 2021). However, it is unclear if the drugs trafficked 
are grown locally in Syria’s north-east, or are transported 
there from cannabis growing areas in western Syria or 
Lebanon.

Maritime routes from Lebanon and Syria

There are signals of substantial maritime trafficking of 
cannabis and cannabis resin from Lebanon and Syria. In 
Lebanon, most trafficking departs from the port of Beirut, 
although some trafficking is also reported to be channelled 
through the northern port of Tripoli (Euronews and AP, 
2021; Kotcherga, 2017). Shipments are typically hidden in 
larger licit commercial or industrial cargoes, and mostly 
head towards Cyprus, Egypt, Libya and Türkiye, destined 
for the Middle East and Europe (INCB, 2018, 2020).

There are also some signals of a new route emerging 
through West Africa through ports such as Lomé or 
Cotonou, over the Sahel, and into eastern Libya (GI-TOC, 
2021). From there, shipments may be dispatched to Egypt 
or Europe.

In Syria, maritime trafficking is reported to depart primarily 
from the ports of Latakia and Tartous. Similar to drugs 
trafficked from Lebanon, substances are often hidden 
within large, licit commercial shipments. In some cases 
cannabis resin and captagon have been shipped together, 
as illustrated by a number of seizures in Greece (three 
million captagon tablets and six tonnes of cannabis resin 
at Port Heraklion in December 2018; see Reuters, 2018), 
Italy (one million captagon tablets and 2 800 kilograms of 
cannabis resin at the port of Salerno in June 2020; see 
Amante, 2020), and Egypt (eight million captagon tablets 
and eight tonnes of cannabis resin at Port Said in January 
2021; see El Sawy, 2021). Such patterns suggest an 
association between captagon and cannabis resin 
production and smuggling operations.

Southward overland routes from Lebanon

An overland trafficking route runs east from Lebanon to 
Israel despite the heavy militarisation of the border. A key 
trafficking zone is the north-eastern Alawite town of Ghajar 
(Figure 4). Drug traffickers appear to have exploited the 
town since the end of the 2006 Israel-Lebanon war, using 
it as a point through which to move cannabis resin into 
Israel (Jerusalem Post, 2021a; The Times of Israel, 2019b; 
Yaakov, 2012). Another zone that saw recurrent seizures in 
2021 is nearby Metula, suggesting the continued 
importance of the area for trafficking (Ahronheim, 2021; 
Fabian, 2021a, 2021b).

Availability and use

Available data and key informant interviews suggest that 
cannabis, particularly cannabis resin, is the most widely 
available and used substance in the ENP-South region 
(Abazid et al., 2020; MedSPAD, 2014a, 2016, 2018a; WHO, 
2017).

A lack of recurrent surveys in the region prevents claims of 
rising prevalence from being assessed quantitatively. 
However, there is a widespread perception in the region 
that use of herbal cannabis and cannabis resin has grown 
in recent years (GI-TOC, 2021). This trend, although 
predominating in urban areas, is also reported to be seen 
in rural areas. A possible exception appears to be northern 

19

Alcohol and other Drugs’), the prevalence of lifetime 
cannabis use was reported as 13.1 % on average (boys, 
16.2 %; girls, 10.4 %). The ENP-South region countries 
report lower lifetime prevalence ranging between 4.3 % in 
Egypt and 14.8 % in Israel for boys, and 0.8 % in Egypt and 
Tunisia and 4.5 % in Israel for girls. 

Overview of drug markets in the European Neighbourhood Policy-South countries

Syria, where some field reports suggest that demand for 
cannabis may have reduced as the popularity of stimulant 
drugs, such as captagon tablets and methamphetamine, 
has grown (Abu Shams and Hammadi, 2020).

Although some localised shortages of cannabis were 
reported by key informants between 2019 and 2021, 
including in southern Algeria and Israel, this appeared to 
have an impact on trafficking and production patterns 
rather than leading to a decline in use (Singer, 2021). The 
prevalence of cannabis use in the region is reported to 
have been increasing before the COVID-19 pandemic, and 
the perception is that this situation has not changed since 
then.

Data on emergency department presentations with acute 
toxicity from sentinel hospitals in Algeria, Israel and 
Tunisia, while not representative and reporting on only a 
small number of cases, show that cannabis is frequently 
identified in acute toxicity presentations (see the box 
‘Emergency department presentations with acute drug 
toxicity’, page 35).

Some data are available on the prevalence of use of 
cannabis among adolescents, but comparisons are 
hindered by the use of different methods and so caution is 
needed in the interpretation of results. Based on 
MedSPAD data (2019) on the prevalence of substance use 
among adolescents in 13 countries in the Mediterranean 
region (see the box ‘Mediterranean School Survey on 

Mediterranean School Survey on Alcohol and other Drugs

The MedSPAD project is set up, designed and funded 
by the Pompidou Group of the Council of Europe. This 
project, which is an adaptation of the European School 
Survey Project on Alcohol and Other Drugs (ESPAD), 
aims to build capacity and develop effective tools for 
monitoring youth substance use and risk behaviours in 
countries of the southern Mediterranean region. 
MedSPAD school surveys targeting 16-year-old 
adolescents in school have been carried out in five 
countries of the ENP-South region: Algeria (2016); Egypt 
(2016, 2020); Lebanon (2008); Morocco (2009, 2013, 
2017, 2021); and Tunisia (2013, 2017, 2021).

prevalence of the use of alcohol, tobacco and illicit 
drugs. Thirteen countries in the Mediterranean region 
contributed to this report: Algeria, Croatia, Cyprus, 
Egypt, France, Greece, Israel, Italy, Malta, Morocco, 
Portugal, Spain and Tunisia. Data from Israel were 
drawn from the 2019 Health Behaviour in School-age 
Children report.

The data, while valuable, need to be interpreted 
cautiously as national data sets were compiled in 
different years, using different sampling types and, in 
the case of Israel, different survey questionnaires.

In addition to country reports, a MedSPAD report 
published in 2019 combines raw data from national 
surveys estimating the perceived availability of 
substances, early onset of substance use, and 

MedSPAD available at: https://www.coe.int/en/web/pompidou/
mednet/medspad.

20

Captagon and other amphetamines

Production

The ENP-South region is a production area for 
amphetamine, particularly in the form of captagon 
tablets (7). Production appears to be overwhelmingly 
concentrated in Syria (Figure 5). Available data mostly 
based on seizures of shipments from Syria, and largely 
destined for the Gulf States, suggest that production may 
be increasing, but existing data are not sufficient to 
confirm this assumption. Production is also thought to 
have diffused to some extent to Lebanon and possibly 
Jordan, although the latter appears to remain a relatively 
minor producer at present. Taken as a whole, the 
information available suggests that captagon production 
and trafficking linked to state and non-state actors is 
becoming a growing threat in the region, with the potential 
to exacerbate existing security related challenges. This 

(7)  Originally, Captagon was the main brand name for a medicinal product 

containing fenetylline as its active ingredient. It is no longer produced 
today or used for therapeutic purposes. In this report, the term captagon 
is used to refer to illicitly produced tablets that are described as captagon, 
and not to the original pharmaceutical product.

FIGURE 5
Captagon production in Syria and neighbouring countries

requires ongoing assessment and appropriate follow-up 
measures.

In Syria, most captagon production is thought to be 
concentrated in regime-controlled areas, in particular in 
Tartous and Latakia, around Damascus and Eastern Ghouta, 
and in Homs, Aleppo and al-Qusayr governorates (Dettmer, 
2021; Rose and Soderholm, 2022). Some production is 
also reported to take place in areas in which non-state 
armed groups are dominant (Hubbard and Saad, 2021).

It is possible that, from 2011 onwards, the conflict in Syria 
had an impact on captagon production, although this is 
difficult to substantiate empirically. However, the 
combination of weak jurisdiction, increased demand by 
combatants or conflict-affected populations, and various 
factions seeking to generate funds may all have resulted in 
a greater incentive to increase production of captagon 
(EMCDDA and Europol, 2016; GI-TOC, 2016; Rose and 
Soderholm, 2022). There are also signals from non-public 
sources that production of captagon in the country has 
increased, possibly substantially, in recent years with the 

Latakia

 Mediterranean

Sea

Tartus

LEB ANON

Beirut

Aleppo 

Idlib

S Y RI A

Homs

Al-Qusayr

Euphrates

Bekaa Valley

Damascus

IRAQ

N

0

100 km

JOR DAN

WEST
BANK

Muaqablein

Amman

Jerusalem 

21

Overview of drug markets in the European Neighbourhood Policy-South countries

increased involvement of some state actors, and business 
and political elites. There is a suggestion that drug 
production is not only becoming more important as a source 
of income within Syria, it is also encouraging the formation 
of operational alliances with groups in Libya and Lebanon.

(Odeh et al., 2018). There are also reports of some 
trafficking through formal border crossings, in particular 
the crossings at Shebaa, Rakhlah and Masnaa, and 
between the Lebanese town of Qaa and the Syrian city of 
al-Qusayr (Adal, 2021; Arbid, 2017; Boulos, 2021; Ezzi, 
2020).

In Lebanon, the production of captagon appears to be 
growing, both in the Bekaa Valley and to a lesser degree in 
urban coastal areas (Figure 5). A large facility in the Bekaa 
Valley town of Hor Ta’la was reported to have been raided 
by the Lebanese Army in August 2021 (Taha, 2021). A 
former chief of the anti-narcotics department of the 
Lebanese Internal Security Forces stated that around 20 
large-scale captagon production facilities exist in Lebanon 
(Arab News, 2021). There is also some evidence of more 
small-scale, artisanal production, strongly suggesting that 
the number of production locations could be higher overall 
(Browne, 2021).

Some methamphetamine production has also been 
reported in the region, mostly located in Lebanon and 
Palestine. In Lebanon, organisations providing harm 
reduction services to people who use drugs report that 
their clients indicate that crystal methamphetamine is 
increasingly produced in Beirut, Tripoli and Baalbek. In 
Palestine, between 2019 and 2021, four methamphetamine 
laboratories were discovered and dismantled (Palestinian 
Police – Drug Enforcement Administration, 2019; UNODC, 
2021b). However, production in the territory is believed to 
be limited, with the dismantled facilities being regarded as 
‘primitive’ and capable of producing only small quantities 
of the drug.

Trafficking

Trafficking routes for amphetamine, and to a far lesser 
degree methamphetamine, appear to be mainly 
concentrated in the eastern areas of the ENP-South 
region. Mostly, they concern the movement of captagon 
tablets from Syria and Lebanon to consumer markets in 
the Persian Gulf (Figure 6). Such trafficking appears to be 
fairly robust, with little indication that the COVID-19 
pandemic or conflict dynamics within Syria have had an 
impact on the activity. 

Overland routes

Trafficking from Lebanon to Syria typically involves 
overland transport through the Qalamoun Mountains in a 
similar manner to the cannabis trafficking described above 

Three main overland routes are reported to be used to 
traffic captagon tablets from Lebanon and Syria to the 
Persian Gulf (Figure 6). These routes start from eastern 
Syria, where production is concentrated and where 
shipments from Lebanon are believed to be stored (Eid 
and al-Sayed, 2021; Odeh et al., 2018).

One route goes from eastern Syria to Jordan and then 
either to Iraq or Saudi Arabia. Along the Syria-Jordan 
border, trafficking is reported to occur in a number of 
formal and informal crossing points. The Jaber-Nasib 
crossing located on the Damascus-Amman highway in 
Mafraq governorate has emerged as a key point for 
traffickers. It is interesting to note in this context that 
within 24 hours of the crossing’s re-opening in August 
2021, Jordanian authorities seized 500 000 captagon 
tablets hidden inside a commercial shipment (Middle East 
Monitor, 2021). Trafficking of captagon through Jordan is 
now considered a major cross-border threat by security 
officials within the country and has been linked to an 
increase in domestic drug use.

Once in Jordan, shipments of captagon tablets are moved 
east towards the Saudi and Iraqi borders, or south to the 
Wadi Araba region on the Israeli border (Oweis, 2021). 
Trafficking to Saudi Arabia occurs through formal border 
crossings (al-Qaisi, 2020; al-Sulami, 2017; Jordan News 
Agency, 2018; Jordan Times, 2016) or overland through 
remote areas and typically using off-road vehicles 
(Albawaba, 2019).

Another overland route links to Iraq, following a similar 
pattern to that of cannabis resin (Rahima et al., 2022). At 
the Syria-Iraq border, shipments move both through the 
al-Bukamal border crossing and overland, towards the Iraqi 
city of al-Qa’im and town of Rutba (Adal, 2021; Kittleson, 
2018, 2021; Syrian Observatory for Human Rights, 2021b).

A third key route runs through Syria’s northern border with 
Türkiye, although the volumes are not thought to be 
particularly large at present. The Turkish border was a 
popular route for captagon trafficking in the early 2010s, 
but heightened border security enforcement – particularly 
at formal border crossings – limited its use (COAR, 2021). 
A degree of trafficking continues, however, with occasional 
large seizures reported (Anadolu Agency, 2020).

22

Captagon and other amphetamines

FIGURE 6
Major captagon trafficking routes in Syria and neighbouring countries

TÜRK I YE

Euphrates

Deir ez-Zor

S Y RI A

Al Bukamal

al-Q’aim 

IRA Q

Rutba

N

0

100 km

Latakia

Tartus

 Mediterranean

Sea

Ras Baalbek 

LEB ANON

Beirut

Damascus

Al Kiswah

Al Suwayda 

 Mafraq

Daraa

Irbid

WEST
BANK

Amman

Jerusalem 

Al Omari Border Crossing

ISR AEL

S AU DI
A RA BIA

J OR D AN

Durra
Border Crossing

Al Mudawara

There are some indications of captagon trafficking in other 
regions. Some reports suggest that Lebanese traffickers 
may be using West Africa as a transit location for captagon 
shipments. In January 2022, 12 tonnes was shipped in 
boxes of powdered juice to Sudan. In the same month, a 
substantial quantity of captagon tablets was hidden and 
mixed in tea boxes destined initially for Togo (Houssari, 
2022). Given the fragility of the states in these regions and 
the historical cross-Sahel trafficking of Moroccan 
cannabis, the use of this route could increase in the near 

future. There is also some trafficking between Palestine 
and Israel (Witty, 2021).

Maritime routes

In addition to overland routes, substantial maritime 
trafficking of captagon tablets has been noted over the last 
five years either from the Syrian ports of Latakia and 
Tartous or the Lebanese port of Beirut. While the ultimate 

23

uncommon. In part, this has been linked to people who 
turn to methamphetamine when they are no longer able to 
afford cocaine.

In Syria too, rising methamphetamine use is also reported, 
particularly in the eastern provinces in Homs and Palmyra. 
The drug is reported to be smuggled there both from 
Lebanon and Iran (NPA, 2015). In Jordan and Palestine, 
the use of methamphetamine is also believed to be 
increasing, fuelled both by domestic manufacture and 
some cross-border trafficking. However, in both countries 
use is thought to remain uncommon overall.

In Libya, use of liquid methamphetamine (known locally as 
kotcha, deriving from the Italian word goccia, meaning 
drop) was popular in the immediate aftermath of the 
revolution but has since apparently declined. There is also 
a reported increase in use of crystal methamphetamine in 
the Libyan capital Tripoli, part of a broader rise in drug use 
in these areas that also encompasses amphetamine and 
MDMA (Aaraj et al., 2021; Papadopulos, 2021). 

Overview of drug markets in the European Neighbourhood Policy-South countries

destinations of these shipments are countries along the 
Persian Gulf, some shipments have been uncovered quite 
far afield, suggesting the existence of circuitous routes 
possibly intended to limit the risk of detection. There has 
been a noticeable uptick in large shipments of captagon 
tablets uncovered in ports in Egypt, Greece, Italy, Saudi 
Arabia, the United Arab Emirates, and even outside of 
transit routes in Myanmar’s port Klang (Barzoukas, 2017; 
Rose and Soderholm, 2022). Captagon tablets are typically 
hidden within large containers of licit goods. Recent 
examples include pomegranates, grapes, oranges, 
professional pizza ovens and household appliances (Al 
Jazeera News, 2021).

Availability and use

There is a perception that the availability and use of 
amphetamine and methamphetamine appear to be rising 
overall in the ENP-South region, although this dynamic is 
not evenly distributed across countries, with most of the 
use occurring in the eastern countries of the region. Apart 
from Syria, regular use remains relatively limited in most 
countries despite possible production in Syria and 
Lebanon and the presence of trafficking routes existing in 
Jordan and Libya.

Captagon tablets are reported to be readily available 
throughout Syria. Tablets can be acquired through local 
dealers, warlords, commanders of armed forces and 
groups involved in the conflict, but can also be found in 
some pharmacies.

In Jordan and Lebanon, the use of captagon tablets is 
reported to remain quite limited but possibly rising. In 
Lebanon, for example, key informants suggest use is 
mainly reported among armed groups near the Lebanon-
Syria border, although there are indications of rising use in 
some Palestinian refugee camps (Papadopulos, 2021). A 
similar dynamic is observed in Libya, which has seen 
substantial trafficking in recent years, and where 
prevalence of use is thought to be mainly limited to 
combatants and in the east of the country. Seizures of 
captagon tablets in the West Bank suggest there may be a 
small consumer market there and in the Gaza Strip.

There also appears to be a growing market for 
methamphetamine in the ENP-South region; however, as 
with captagon tablets, this appears currently to be mostly 
concentrated in the Middle East. In Lebanon, there were 
some accounts that locally manufactured crystal 
methamphetamine seems to be gaining greater market 
share, although overall its use is still reported to remain 

24

Cocaine

Production

Coca cultivation has not been found in the ENP-South 
region, and there are no data to suggest this occurs. 
Cocaine is trafficked through the region, however, and 
there is the perception that a growing market for this drug 
may exist in some countries. In Algeria, in January 2021, 
one crack cocaine production facility was detected 
(Bouarissa, 2021). While this is the only recorded case of 
crack production in Algeria, it is a potentially worrying 
signal if this drug, particularly associated with problematic 
use, may be becoming available. In this context there has 
also been a media report of the arrest of a trafficking group 
in Algeria who were alleged to have been distributing both 
cocaine and crack cocaine (El Watan, 2021). 

FIGURE 7
Cocaine trafficking routes from South America to North Africa

Trafficking

Most cocaine trafficked into the region comes directly 
from South America, or from South America through West 
Africa (Figure 7). Once in the region, most cocaine is 
thought to move along the coast, shuttled from point to 
point by smaller craft, primarily fishing vessels, although 
some is also probably trafficked overland, along similar 
routes described in the cannabis section above (Herbert 
and Gallien, 2020a; Jewish News Syndicate, 2021; The 
Times of Israel, 2021). On the roads, there is some 
transportation from Algeria into Tunisia and Tunisia to 
Libya, but the volumes appear to be relatively small. 
Because of the closed border between Algeria and 
Morocco, legal crossings by road are not possible there, 
but small volumes are trafficked clandestinely across the 
border, likely by the cannabis resin trafficking networks 
which operate between the two countries. While 

FRANCE

SPAIN

Tangier

Casablanca 

Oran

MOROCCO

ITALY

Tunis

TUNISIA

ALGERIA

LIBYA

Beirut

Ashdod

GUINEA-BISSAU
GUINEA

Conakry

South
Atlantic Ocean

ECUADOR

Guayaquil

N

North
Atlantic Ocean

BRAZIL

Sao Paulo
Santos 

Paranaguá

25

Overview of drug markets in the European Neighbourhood Policy-South countries

information is sparse and interpretation is hampered by 
the lack of recent or reliable data there are some 
indications, mostly from the detection of large seizures, 
that the importance of the region for cocaine trafficking 
into Europe may be growing.

water-tight bags and thrown into the sea, sometimes with 
GPS trackers, to be recovered later. This has led to reports 
of relatively large shipments of cocaine washing up on the 
coast on a few occasions, in both Algeria and Israel 
(Herbert and Gallien, 2020a; The Yeshiva World, 2019).

The trafficking of cocaine from Europe to the region has 
also been reported; however, this tends to be related to 
small quantities of the drug carried by migrants from the 
region when visiting their country of origin. A few larger 
shipments have been intercepted (Ben Nessir, 2021; 
Kasraoui, 2020). Moroccan officials have also reported 
that vessels employed for transporting cannabis resin to 
Europe have on occasion returned containing shipments of 
cocaine and heroin.

Maritime routes

By volume, most trafficking has involved direct shipments 
from South America to North Africa, mainly hidden in 
intermodal containers carrying other licit cargoes, although 
sailing vessels have also been intercepted carrying 
cocaine on some occasions.

Much of the cocaine trafficked to Algeria and Morocco 
departs from Brazilian ports, in particular the port of 
Santos (Babas, 2019; Duarte et al., 2019; Herbert and 
Gallien, 2020a). However, recent seizures intercepted in 
the port of Paranaguá suggest that traffickers may be 
diversifying their embarkation points (Agência Lusa, 2021).

Recent seizures suggest that trafficking routes to Libya, 
and to a lesser degree Tunisia, tend to depart from the port 
of Guayaquil in Ecuador. Between December 2020 and 
December 2021, for instance, two large shipments 
destined for Libya and one for Tunisia linked to Guayaquil 
were seized by Ecuadorian or Maltese authorities (Dixon, 
2021; Reyes, 2021).

A third cocaine trafficking route involving intermodal 
containers connects South and Central America with 
Israel. In 2020, a multi-tonne shipment destined for Israel 
was seized by Paraguayan authorities. In the same year, 
Israeli security forces at Ashdod port uncovered 
750 kilograms of cocaine arriving from Guatemala 
(Delgado, 2020; Reuters, 2020; Siegal, 2021). Reports 
suggest there is also some intermodal trafficking of 
cocaine to the Syrian port of Tartous, destined for 
Lebanon; however, the departure point is unclear.

Most cocaine trafficked within the region appears to use 
the same coastal maritime routes used to traffic cannabis 
resin. Some shipments of cocaine have been placed in 

Air routes

Small volumes of cocaine are also known to have been 
carried from South America to the ENP-South region by 
couriers travelling on commercial aircraft. Brazil seems to 
be the main point of origin, with commercial air routes from 
São Paolo to Casablanca, Morocco, and to a lesser extent 
Beirut, Lebanon, seeing routine arrests of couriers upon 
arrival (GI-TOC, 2016; Herbert and Gallien, 2020a; Rose, 
2021).

Some cocaine trafficking from Sub-Saharan Africa to the 
region by commercial air travel has also been reported. 
Based on analysis of drug seizures between 2019-2021 
undertaken by GI-TOC and supplementary reporting, 
examples of routes include those between Conakry, 
Guinea, and Tunis, Tunisia, and between Johannesburg, 
South Africa, and Tel Aviv, Israel (The Times of Israel, 
2019a).

Availability and use

Compared with parts of Europe and the Americas, 
prevalence of use of cocaine has historically been very low 
in most countries in the ENP-South region, and this 
appears to remain the case today. A caveat here is that 
Israel and Morocco may possibly be exceptions, as some 
data suggest that prevalence rates are relatively higher 
than in other countries in the region. Limited availability of 
cocaine in the region accompanied by high retail prices is 
thought to be a factor limiting use to individuals with 
higher levels of disposable income.

Although some data are available on prevalence of use 
among adolescents, comparisons between countries need 
to be made with caution because of methodological 
differences and because both response and non-response 
biases are likely to be relatively high. In MedSPAD data 
(2019) on the prevalence of substance use among 
adolescents in 13 countries in the Mediterranean region 
(see the box ‘Mediterranean School Survey on Alcohol and 
other Drugs’, page 20), the prevalence of lifetime 
cocaine use was reported as 1.9 % on average (boys, 
2.4 %; girls, 1.5 %). The five ENP-South region countries 
report lower lifetime prevalence rates, ranging between 
0.7 % in Tunisia and 2 % in Algeria for boys, and 0 % in 

26

Tunisia and Algeria and 1.1 % in Morocco for girls. Lifetime 
prevalence of cocaine use for Israel was not available from 
this study. The UNODC (2022) estimates that the 
prevalence of cocaine use among the general population 
(aged 15-64) was around 0.20 % in 2020 in Israel. Some 
studies have also reported relatively high values for 
cocaine use among adolescents. Although the data overall 
are difficult to compare, they do suggest that the 
prevalence of cocaine use, especially among younger 
populations, is probably higher in Israel than in other 
countries in the region (Benedetti et al., 2019).

In Algeria, Egypt, Morocco and Tunisia last year prevalence 
of cocaine use reported in adolescents in school surveys 
(Benedetti et al., 2019) was 0.5 %, 0.6 %, 0.4 % and 0.2 %, 
respectively. These are lower than the average values 
reported by MedSPAD for the Mediterranean region as a 
whole (1.7 %). The UNODC estimated that the prevalence 
of cocaine use among the general population (aged 15-64) 
in Morocco was 0.43 % in 2017, which would be the 
highest prevalence in the region (UNODC, 2022). However, 
given the overall lack of robust prevalence data and 
methodological differences in the studies that do exist, 
this suggestion should be interpreted with caution.

While there is some perception of increased availability 
and use of cocaine in some countries in the region, use is 
likely to remain relatively low in comparison with Europe or 
the Americas. Expert opinion data from interviews 
conducted for this study and some media reports and 
publicly available information from government sources 
detailing seizures of supply-level quantities of cocaine 
suggest the possibility that availability may be increasing 
in Algeria, Morocco and Tunisia; however, further data are 
needed to explore this possibility (Herbert and Gallien, 
2020a, 2020b).

In Lebanon, the country’s post-2019 economic challenges 
appear to have led to a significant increase in the price of 
cocaine, with retail prices rising from LBP 60 000-120 000 
per gram (EUR 34.42-68.85/g) in 2017 (Ministry of Public 
Health, 2017) to LBP 1 200 000-1 600 000 per gram 
(EUR 696.63-928.84/g) in 2021, based on an informal 
price survey conducted by GI-TOC. In addition, cocaine 
dealers are said to demand payment in US dollars, which 
are increasingly difficult to access. Use of cocaine is thus 
thought to have decreased, potentially leading those who 
can no longer afford cocaine to experiment with other 
substances, principally methamphetamine.

In Libya, key informants suggest that use of cocaine has 
increased over the last decade, particularly in the 
northwest and northeast of the country. Use still remains 
mostly confined to middle classes and members of 

Cocaine

militias. Key informants also reported that attitudes 
towards the use of the drug were changing among some 
social groups, with wealthier groups beginning to see it as 
more socially acceptable. 

27

Overview of drug markets in the European Neighbourhood Policy-South countries

Heroin and other opioids

Production

Availability and use

The ENP-South region has an established history of poppy 
cultivation and the production of heroin and other opiates. 
The main historic cultivation points in Lebanon and Syria, 
however, are no longer believed to be active. Some limited 
cultivation of poppies is still thought to take place in 
Algeria and Egypt (the latter is not covered in this report).

In Algeria, according to national reporting 12 793 poppy 
plants were seized between 2011 to 2021, suggesting that 
cultivation is relatively limited. A review of recent seizure 
data suggests that production has decreased, with only 83 
plants seized in the first eight months of 2021 (ONLCDT, 
2021). However, cultivation could be more widespread 
than indicated by government data. In some years, no 
seizures are recorded and, in others, thousands of plants 
have been identified. Most cultivation appears to involve 
small growing sites, primarily located in Adrar, Ghardaïa, 
Ouargla, Béchar and Béjaïa provinces (Herbert and Gallien, 
2020a). 

Trafficking

There is limited trafficking of heroin and other opioids to 
and through the ENP-South region.

In the east of the region, some heroin trafficking linked to 
the main Balkan route may now be branching off through 
Syria (EMCDDA, 2017). The routes into Syria are unclear, 
with some shipments thought to be entering Syria through 
Damascus, Aleppo and the north-western coast (GI-TOC, 
2016; Kalin, 2014). There may also be some cross-border 
movement into Lebanon, where processing takes place 
before being moved back into Syria (Habash, 2021). Heroin 
is also supposedly stockpiled in Syria, destined for 
trafficking through Jordan, Lebanon and Türkiye, for 
ultimate resale in Europe or the Persian Gulf.

In North Africa, there is also some evidence of heroin 
arriving directly by the Balkan route. In Tunisia, for 
example, there have been several cases of couriers 
arrested upon arrival from Istanbul by commercial aircraft, 
based on an analysis of publicly available and confidential 
reports. Most heroin destined for the region, however, is 
believed to be trafficked into Morocco and Tunisia from 
Europe, usually by aircraft or ferry boats (MAP, 2021).

Use of heroin remains uncommon in the ENP-South region, 
but some pockets of use are reported to exist, in particular 
in Algeria, Israel and Tunisia. Overall, prevalence of use 
appears to be at a low level and relatively stable. Heroin 
and other opioids are primarily used by injecting (see 
Figure 8), which in turn is linked to a heightened risk of 
transmission of blood-borne infections, such as HIV and 
hepatitis B (HBV) and C viruses (HCV).

Israel reports the highest population prevalence of 
injecting drug use in the region (0.50 % in 2016). Expert 
perceptions analysed by the UNODC indicate that heroin 
and other opioids are, after cannabis, the illicit drugs most 
prevalent in the country.

Egypt reports the second highest rate of injecting drug use 
in the region, but the estimate is from 2001. Algeria reports 
the third highest rate (0.28 % in 2019); however, the 
available data would suggest that heroin and other opioids 
appear to be the fifth-most prevalent illicit drugs in the 
country.

Estimates of the prevalence of injecting drug use in Tunisia 
are now old, but it was estimated that 0.13 % of the 
population had injected in 2014. More recent interviews 
and arrest data in Tunisia point to some rural pockets of 
heroin use in Gafsa province. An interviewee who uses 
heroin indicated that the price of heroin there was 
relatively low, at TD 20 per gram (EUR 6.10/g), and such 
low prices could be encouraging use. It is of note that most 
of the syringes collected in Tunis and Nabeul contained 
residues of buprenorphine rather than heroin (see the box 
‘Analysis of residual content of used syringes in Lebanon 
and Tunisia’, page 30).

Heroin use is reported to be limited in Lebanon, but the 
perceived poor quality of heroin on the market may be 
encouraging the use of larger quantities. In Lebanon, 
population prevalence of injecting drug use was estimated 
at 0.08 % in 2015, with heroin and other opioids the 
third-most prevalent illicit drugs, after cannabis and 
cocaine. The analysis of used syringes collected from 
Beirut detected the presence of heroin in almost half of the 
syringe residues, often in combination with codeine or 
buprenorphine, although it is not clear if the substances 
were used simultaneously or the syringes were reused (see 
the box ‘Analysis of residual content of used syringes in 

28

FIGURE 8
Available estimates of prevalence of HCV, HBV and HIV among people who inject drugs

Heroin and other opioids

Percent
100

90

80

70

60

50

40

30

20

10

0

Algeria

Egypt

Israel

Lebanon

Libya

*

*
Morocco Palestine

*

Syria

Tunisia

HCV

HIV

HBV

* Some data are unavailable for Morocco (HCV and HBV) and Palestine (HCV).
Source: UNODC estimates of people who inject drugs living with HIV, HCV, HBV, available at https://dataunodc.un.org/dp-drug-use-characteristics. Note: 
Country and year of estimates: Algeria: 2019 (HCV, HIV and HBV); Egypt: 2014 (HCV, HBV), 2010 (HIV); Israel: 2015 (HCV, HIV and HBV); Lebanon: 2016 
(HCV and HBV), 2015 (HIV); Libya; 2010 (HCV, HIV and HBV); Morocco: 2017 (HIV); Palestine: 2010, 2013 HIV; 2010 (HBV); Syria: 2014 (HCV, HIV and HBV); 
Tunisia: 2016 (HCV and HBV), 2017 (HIV).

Lebanon and Tunisia’). The cost of heroin appears to have 
risen in recent years, from LBP 15 000-30 000 per gram 
(EUR 8.60-17.21/g) in 2017 (Ministry of Public Health, 
2017) to LBP 200 000-700 000 per gram (EUR 116.10-
406.37/g) in December 2021 based on an informal price 
survey conducted by GI-TOC.

While there are no recent data on injecting drug use in 
Libya (prevalence of injecting drug use was last estimated 
at 0.05 % in 2001), data available from 2010 suggested 
there was a high prevalence of HIV and HCV infection 
among people who inject drugs (over 85 %). 

29

Overview of drug markets in the European Neighbourhood Policy-South countries

Analysis of residual content of used syringes in Lebanon and Tunisia

A study to analyse residues in used syringes has been 
implemented in Lebanon and Tunisia. The study was 
conducted following the generic protocol established by 
the ESCAPE network. The ESCAPE project seeks to 
complement existing data by providing timely and local 
information on substances injected derived from the 
analysis of used syringes handed in to needle and 
syringe exchange programmes (more information see 
the ESCAPE topics page on the EMCDDA website). 
There are, however, important limitations to this method. 
The number of syringes collected and tested cannot be 
translated into a number of individual users, and 
therefore this approach does not measure the prevalence 
of injecting nor does it necessarily provide the relative 
prevalence of use for different substances among people 
who inject drugs. In addition, drug residues may degrade 
over time to the point of being undetectable. There may 
also be several potential selection biases, so caution is 
needed when interpreting these findings.

Sampling

A total of 101 syringes were collected in Lebanon 
between January and February 2022. The syringes 
came from three different needle and syringe 
programmes, one in Beirut and two in Matn district, in 
the Mount Lebanon Governorate in the east of Beirut.

In Tunisia, 156 syringes were collected at three mobile 
needle and syringe units in Tunis by the Tunisian 
Association for Information and Guidance on AIDS and 
Addiction. The clients who frequent those sites are 
typically men aged between 25 and 35.

Analysis

In Beirut, psychoactive substances that are not 
considered adulterants or metabolites were detected in 
46 of the 101 syringes tested. Among those, the main 
psychoactive substance detected was heroin (48 %) 
followed by buprenorphine (39 %), codeine (24 %), 
morphine (20 %) and cocaine (17 %). Caffeine was 
detected in 42 syringes (91 %) that contained one or 
more psychoactive substances, in combination with 
morphine (28 syringes) or alone (23 syringes). 
Paracetamol and theophylline, other cutting agents, 
have also been found in numerous samples, 
respectively 30 and 24 syringes.

In Tunis, the main psychoactive substances (except 
adulterants, metabolites and degradation products) 
detected in 124 of the 156 syringes tested were 
buprenorphine (60 %), tramadol (27 %), amphetamine 
(24 %) and zolpidem (10 %). It is of note that synthetic 
cathinones were also found: pentylone in eight syringes, 
buphedrone in one syringe, and mephedrone in 
one syringe. Finally, the powerful synthetic opioid 
fentanyl was identified in eight syringes, whereas heroin 
was found in one syringe.

In both cities, the analysis shows a high proportion of 
syringes containing more than one substance, 
indicating the reuse of syringes, and possibly sharing, 
with a risk of blood-borne virus contamination. It may 
also indicate the injection of a mixture of drugs.

Beirut

Tunis

Heroin

48 %

Buprenorphine

Buprenorphine

Cocaine

Tramadol

2 %

27 %

39 %

60 %

1 %

Heroin

2 %

Metamphetamine

Alprazolam

2 %

2 %

Atropine

9 % 2 %

Prazepam

MDMA

2 %

MDA

2 %

24 %

Bupivacaine

Amphetamine

Lorazepam

5 %

10 %

Zolpidem
Mephedrone

1 %

1 %

1 %

6 %

6 %

Pentylone

Buphedrone

Fentanyl

Ephedrine

20 %

24 %

17 %

Meconin

13 %

Morphine

Cocaine

Codeine

30

MDMA 

Production

There are some reports that low-volume MDMA production 
may have taken place in Algeria’s urban areas, although 
this appears uncommon. Most reports available refer to 
ecstasy without forensic analysis to confirm the exact 
nature of the substance purportedly being produced.

Trafficking

The trafficking of MDMA into and through the ENP-South 
region is thought to have grown in recent years, potentially 
driven by increasing demand for use in recreational 
settings within the region. Trafficking of the drug into the 
region appears to originate from Europe, a main global 
production hub for this drug. MDMA, believed to originate 
from Spain and the Netherlands, has been found in small 
shipments by couriers in ferry boats and commercial air 
travel from destinations in Spain, France and Italy (Bladi, 
2021; El Hamraoui, 2018; Herbert and Gallien, 2020a). 
There are also some reports of bulk shipments of MDMA 
tablets smuggled with legitimate goods (Tunisian Customs 
and Ministry of Interior press releases, 2019-2021; Herbert 
and Gallien, 2020a).

The use of international postal systems to traffic drugs from 
Europe into North Africa and the Middle East has also been 
identified. In one 24-hour period in 2018, for example, Israeli 
customs authorities were reported to have intercepted 38 
postal shipments of illicit substances, including MDMA, 
cannabis, cocaine and methamphetamine, primarily coming 
from Spain and the Netherlands (The Times of Israel, 
2018). In Tunisia, a similar report exists from Tunisian 
Customs and Ministry of Interior press releases, with 
MDMA, heroin and other substances having been found in 
packages sent from Europe.

Availability and use

While informants interviewed for this report perceived that 
MDMA use is becoming more common in the ENP-South 
region, there is very little empirical evidence available to 
support this claim. There is also a perception that the 
availability of MDMA in the ENP-South region has 
increased over the last decade, leading to a drop in retail 

prices and a growing market for this drug in the region. 
However, this is difficult to substantiate empirically.

The MedSPAD surveys (see the box ‘Mediterranean School 
Survey on Alcohol and other Drugs’, page 20) on the 
prevalence of substance use among adolescents 
estimated that 3.5 % of boys and 0.3 % of girls aged 15-17 
years in Algeria have used MDMA at least once (MedSPAD, 
2016). In Tunisia, lifetime prevalence rates among students 
were lower but had increased from 0.2 % in 2013 to 1.4 % 
in the 2017 survey (MedSPAD, 2018b). A study carried out 
in 2021 at a sentinel hospital site in Tunis in 2021 reported 
MDMA as the second most frequently encountered 
substance in drug-related emergency presentations (see 
the box ‘Emergency department presentations with acute 
drug toxicity’, page 35).

In Morocco, there is little empirical data on the prevalence 
of MDMA use, although some recent qualitative data 
suggest increasing use of the drug (Herbert and Gallien, 
2020a). This opinion was also expressed in interviews 
conducted for this study, and some media reports and 
publicly available information from government sources 
also suggest this as a possibility. In the Middle Eastern 
countries of the ENP-South area, MDMA use appears to be 
highest in Israel, where seizures of MDMA in supply-level 
quantities continuing during the COVID-19 pandemic. It 
has also been suggested that use may be increasing in 
Jordan and Lebanon (Council of the European Union, 
2015; Shehadi, 2021).

31

different street names, including Joker, Mr Nice Guy and 
Spice/K2 (Damiri et al., 2018). A relatively high proportion 
of drug seizures (reportedly 27 %) in the country involved 
these substances (Damiri, 2020).

In Israel, there are some reports that people who 
experience homelessness and inject drugs switched from 
heroin to NPS during the COVID-19 pandemic (EMCDDA, 
2020). In general, the use of a variety of NPS may have 
increased, including substances such as Mr Nice Guy (also 
known as Mastulon and Mabsuton) and Hagigat (Bonny-
Noach and Ronel, 2018; Bonny-Noach and Toys, 2018; 
Jerusalem Post, 2021b; Mell, 2018).

Overview of drug markets in the European Neighbourhood Policy-South countries

New psychoactive substances

Production

There is some evidence to suggest that the processing of a 
variety of NPS takes place across the ENP-South region. In 
Algeria, there is some processing of methylone and 
butylone, with laboratories appearing to have become 
more common since 2016. Key informant interviews in 
2021 point to the eastern city of Constantine as an 
important area in which production may be occurring. 
Some production of the drug, mainly for local markets, is 
believed to take place in small-scale processing 
laboratories located in low-income neighbourhoods. Law 
enforcement are thought to have difficulties operating in 
these neighbourhoods.

In Jordan, the processing of synthetic cannabinoid 
products, often referred to locally as Joker, is believed to 
be increasing. Such products appear to be composed of a 
variety of chemicals, either imported through the port of 
Aqaba, or already available on the Jordanian market 
(EMCDDA, 2019). In Palestine, the demand for synthetic 
cannabinoids is thought to be driving increased local 
processing. In Lebanon, small volumes of salvia (Salvia 
divinorum) adulterated with other substances, mainly 
ketamine, are reported to be produced in Tripoli and 
Baalbek.

Availability and use

Existing data, although limited, are suggestive of an 
increase in the use of NPS within the region, with 
prevalence of use higher in the Middle Eastern states than 
in North African countries. The specific types of NPS 
products used differ by country and include Salvia, 
synthetic cannabinoids and injectable synthetic 
cathinones, such as methylone and butylone, as well as 
phenethylamines.

In Jordan, use of synthetic cannabinoids is reported to be 
relatively high. A recent study of patients being treated for 
drug-related problems found that 39 % of respondents 
reported use of these substances (Albals et al., 2021). 
Synthetic cannabinoids are inexpensive, with reports 
suggesting small retail quantities, such as a bundle of 
three ‘cigarettes’, are sold for JOD 1-3 (EUR 1.23-3.70).

Use of synthetic cannabinoids is also reported to be high 
in Palestine, with products sold under a number of 

32

Diverted pharmaceuticals

Trafficking

Trafficking of diverted pharmaceuticals in the ENP-South 
region is perceived to have increased significantly in recent 
years. Pharmaceuticals are diverted from pharmacies or 
hospitals in the region or trafficked from neighbouring 
regions, such as West Africa and Europe.

By volume, most diverted pharmaceuticals trafficked into 
the region arrive by maritime transportation. In Libya, for 
example, substantial volumes of tramadol continue to be 
trafficked into the country through the ports of al-Khums, 
Tripoli and Misurata in the west, and the port of Tobruk in 
the east. The drug is typically sourced in India, where it is 
manufactured. In 2016 and 2017, there were two large 
seizures of tramadol coming from India, one in Tobruk of 
45 million tablets, and the other in Genoa of 4 million 
tablets destined for Libya (Assad, 2016; Willan, 2017). 
There are also indications of some ship-to-ship transfers 
outside Libyan waters and transport by intermodal 
shipping (Macri, 2017; Vella, 2020). Some diverted 
pharmaceuticals arrive through commercial travel or ferry 
boats, largely coming from Europe and linking to North 
African states (Herbert and Gallien, 2020a).

Within the ENP-South region, most trafficking occurs 
overland, although routes may differ depending on the 
type of pharmaceutical. Tramadol in Libya, for example, 
typically is trafficked east into Egypt, and from there 
onwards to the Gaza Strip (Micallef et al., 2021). 
Pregabalin, in contrast, appears to be trafficked from Libya 
west to Tunisia, Algeria and Morocco.

In some instances, networks trafficking cannabis resin or 
captagon tablets also transport diverted pharmaceuticals. 
On the Syria-Jordan border, authorities have reported 
pregabalin transported alongside these drugs (Jordan 
News Agency, 2021; The National, 2022). On the Morocco-
Algeria border, trafficking networks sometimes barter 
cannabis resin (for onward trafficking to Algeria) for 
diverted pharmaceuticals (intended for major urban areas 
on the Moroccan coast) (Herbert and Gallien, 2020a).

The COVID-19 pandemic appears to have has led to a shift 
in some trafficking methods in North Africa. Before 2020, 
most diverted pharmaceuticals trafficked into Algeria went 
through official border crossings, typically hidden on 
couriers or in vehicles (Herbert and Gallien, 2020b). Based 
on key informant interviews, traffickers appear to have 

responded to border closures during the COVID-19 
pandemic by moving shipments between border crossing 
points, employing similar techniques to those used in the 
trafficking of cannabis resin. An increase in trafficking 
overland using off-road vehicles may also be happening 
along the Libyan border.

Availability and use

There is a widespread perception in the region that over 
the last decade, the use of diverted pharmaceuticals has 
increased substantially. In part, this is due to changing 
patterns of use among youths, with both young men and 
women allegedly favouring diverted pharmaceuticals due 
to their relative low cost, availability and perceived social 
acceptability. Diverted pharmaceuticals are reportedly 
viewed by young people as easier to hide, not requiring any 
‘preparation’ before use, and they can be stored relatively 
safely at home without drawing undue attention.

Although some data are available on the prevalence of use 
among adolescents, again, comparisons are hindered by 
the use of different methods and therefore caution is 
needed in the interpretation of results. Based on 
MedSPAD data on the prevalence of substance use among 
adolescents in school aged 15-16 (see the box 
‘Mediterranean School Survey on Alcohol and other Drugs’, 
page 20), the prevalence of lifetime non-medical use of 
medicines was 4.7 % in Morocco in 2017 (MedSPAD, 
2018a), 3.4 % in Algeria in 2016 (MedSPAD, 2016) and 
1.9 % in Tunisia in 2013 (MedSPAD, 2014b). In Israel, 
where data on lifetime prevalence have not been collected, 
the most recent survey available estimated last month 
prevalence at 4.4 % in 2014 (Muscat et al., 2017), which is 
higher than in Morocco, Algeria and Tunisia (2.3 %, 1.4 % 
and 0.5 %, respectively).

Tramadol

An estimated 200 000 individuals in the Gaza Strip use 
tramadol. Dependence to tramadol has also been recorded 
in the West Bank (Al-Afifi et al., 2019; Balousha, 2019; 
Damiri et al., 2018; Massad et al., 2016; Palestinian 
National Institute of Public Health, 2017a; Progler, 2010; 
Thabet and Dajani, 2012; Van Hout et al., 2019). The price 
of tramadol is reported to have increased substantially in 
recent years, rising from ILS 10-20 (EUR 2.72-5.45) for 

33

Overview of drug markets in the European Neighbourhood Policy-South countries

10 tablets in 2014, to ILS 20 (EUR 5.45) per tablet in 2019 
(Balousha, 2019; Eldar, 2016). Tramal, a brand name of 
tramadol, is reported to be substantially cheaper (The 
Times of Israel, 2019c).

Barakat, 2020). Data from emergency acute toxicity 
presentations at one hospital in Tunis in 2021 did not 
detect pregabalin in any of the cases analysed (see the box  
‘Emergency department presentations with acute drug 
toxicity’).

There also appear to be pockets of heavy use of tramadol 
in Egypt, Libya and Syria. In Libya, tramadol is reported to 
be used by a wide cross-section of people of different age 
groups, gender and socio-economic backgrounds, with 
demand especially high in the southwest region of the 
Fezzan. Prices appear to have generally increased from 
around LYD 100 (EUR 18) to between LYD 150 and 
LYD 200 (EUR 27-36) for 10 tablets, each of which 
reportedly containing 100 mg.

In Syria, the non-medical use of tramadol among wounded 
Syrian fighters and injured civilians, to cope with pain, has 
been reported (Wedeman and Khadder, 2019). In Idlib 
province, hospitals have reported a monthly average of 30 
to 40 cases of substance misuse (Syrian Observatory on 
Human Rights, 2021a) thought to be linked to this drug.

Data from the analysis of residual contents of used 
syringes collected from four sites in Tunis in 2021 detected 
tramadol in almost a third of the analysed syringes (see the 
box ’Analysis of residual content of used syringes in 
Lebanon and Tunisia’, page 30).

Pregabalin

Diversion and use of pregabalin is reported to be 
increasing rapidly across a number of ENP-South region 
countries, including Algeria, Jordan, Libya, Morocco, 
Palestine and Tunisia. Pregabalin appears to be readily 
available, either trafficked from Europe and neighbouring 
countries, or sourced from local pharmacies. It is also 
reported to be inexpensive, with a single tablet costing 
between DZD 300 and DZD 1000 (EUR 1.5-6) in Algeria, 
although prices may vary according to the strength, the 
brand and the region (EMCDDA, 2021; Herbert and 
Gallien, 2020a). Data from emergency presentation with 
acute toxicity at two sentinel hospitals in Algeria in 2021 
identified a relatively large number of cases where 
prescription medicines were detected, with pregabalin as 
the most prevalent of these (see the box ‘Emergency 
department presentations with acute drug toxicity’).

In Tunisia, pregabalin is locally known as saroukh. Pregabalin 
may be acquired through fraudulent prescriptions bought 
from doctors. Lyrica (a brand name of pregabalin tablets) is 
produced in Tunisia, which ensures it is usually available in 
large quantities in pharmacies, with a packet of the 
medication costing around TD 90 (EUR 30) (Sajal and 

34

Diverted pharmaceuticals

Emergency department presentations with acute drug toxicity

A study to collect data on non-fatal acute emergencies 
related to drug use has been implemented in five sites 
(hospital emergency departments) in four countries of 
the South-ENP region. The study has been conducted 
following the protocol established by the European Drug 
Emergencies Network. The study involves the collection 
of data on emergency department presentations with 
acute drug toxicity from sentinel centres or hospitals. 
The data are not nationally representative but may serve 
as an indicator of high-risk drug use trends. In particular, 
the data may provide a window on the characteristics of 
some sub-populations of people who use drugs, or may 
be useful for detecting new patterns of use (for more 
information see the hospital-emergencies topics page 
on the EMCDDA website). 

The details relating to the presentations to each centre 
are shown in the first table below.

Prescription medicines as a reason for non-fatal acute 
emergencies were most commonly reported by two 
sentinel centres in Algeria. Pregabalin was reported in 
64 (49.2 %) and 7 (24.1 %) presentations in the Babl El 
Oued and Oran centres respectively. In Tunis, Tunisia, 
cannabis was the most frequent illicit drug, reported in 
55 presentations (65.5 %), followed by MDMA in 38 
presentations (43.7 %). Haifa (Israel) listed just over half 
(50.6 %) of the reported drugs as unknown (in 41 
presentations) (see the second table below).

Details of presentations to each centre

Centre

Months
data collected

Number
of months

Number of 
presentations

Median (range) age, 
years

Male (%)

Bab El Oued, 
Algeria

Feb-Oct 2021

Oran, Algeria

Mar-Sep 2021

Haifa, Israel

Jan-Jun 2021

Beirut, Lebanon

Apr-Sep 2021

Tunis, Tunisia

Apr-Oct 2021

9

7

6

6

7

130

26.2 (17-58)

76.9

29

60

5

87

28.5 (16-52)

40.7 (18-89)

29.8 (18-40)

26.5 (15-57)

55.2

70.0

100.0

89.7

Substances reported in emergency presentations

Centre

Bab El Oued, 
Algeria

Number of 
presentations

Illicit 
drugs (%)

Prescription 
medicines (%) 

Unknown 
(%)

Top 4-5 drugs 

130 

19.2

82.1

1.3

0.0

1. Pregabalin
2. Clonazepam
3. Cannabis
4. MDMA = tramadol

1. Pregabalin
2. Bromazepam
3. Cocaine = MDMA

Oran, Algeria

29 

26.3

73.7

Haifa, Israel

60 

21.0

23.4

50.6

Tunis, Tunisia

87 

90.2

9.8

0.0

1. Unknown
2. Cannabis
3. Cocaine = methadone = fentanyl

1. Cannabis
2. MDMA
3. Cocaine
4. Buprenorphine
5. Heroin

35

Overview of drug markets in the European Neighbourhood Policy-South countries

Outlook

Responses

Illicit drug use in the ENP-South region poses a challenge 
to the countries that make up the region. Historically, most 
have employed punitive law enforcement and supply 
reduction-focused approaches to addressing illicit drugs 
(Benedetti et al., 2019). In Morocco, for example, 25 % of 
the prison population in 2019 had committed drug 
offences, although such cases constituted less than 10 % 
of the total number of substantive cases before the courts 
(Alyaoum24, 2020).

While law enforcement-centred approaches have 
continued, there has been an increase in the 
implementation of public health approaches to address 
drug use, including prioritisation of prevention (for more 
information, see EMCDDA, 2022) and expansion of public 
and private treatment facilities. Although positive, efforts 
to take a more public health-focused approach often face 
capacity issues; for example, the number of beds available 
in treatment centres remains limited and appears unlikely 
to be sufficient to meet demand.

The most developed treatment system in the region is 
found in Israel. The country has 12 public units and 6 
private clinics for opioid agonist treatment (8), albeit most 
being abstinence-focused (EMCDDA, 2015). The most 
recent data available indicate that, in 2016, about 14 000 
patients received treatment through this system, out of 
which more than 5 000 were treated specifically for 
cannabis (Israel Ministry of Social Affairs and Social 
Services, 2016; Shabi, 2018).

Algeria reflects more of the norm for the region. The 
country has 4 inpatient hospital units (out of a planned 13) 
offering rehabilitation services to people who use drugs, 
with other support delivered through 53 health centres 
(EMCDDA, 2021). Information from the Ministry of Health 
indicates that the centres can accommodate up to 20 000 
patients, although these numbers are below estimated 
needs (APS, 2021). In the first half of 2021, the facilities 
admitted 6 799 people, nearly all of whom were male 
(Benfodil, 2021). Most treatment facilities are 
concentrated in large urban areas in the north of the 
country (EMCDDA, 2021).

(8)  The term ‘opioid agonist treatment’ is used here as the preferred term to 
cover a range of treatments involving the prescription of opioid agonists 
to treat opioid dependence. The reader should be aware that this term 
includes opioid substitution treatment, which may still be used in some of 
the EMCDDA’s data collection tools and historical documents. 

36

This scenario of care facilities clustered together can be 
seen in Algeria and other states as well, including Tunisia 
and Libya. In Libya, treatment facilities are concentrated in 
the capital, Tripoli, the coastal city of Misurata, in the west 
of the country, and the eastern city of Benghazi. The lack 
of wider access to treatment facilities poses a challenge to 
people who need these services in rural and remote areas. 
This is a particularly acute challenge in geographically 
large countries, such as Algeria and Libya, or those where 
movement restrictions or conflict impede internal mobility.

A further challenge in the region is the limited capacity of 
national healthcare systems, which impacts on referrals, 
rehabilitation and in-community post-rehabilitation care. In 
Palestine, for example, fragmented and disrupted health 
services, particularly during times of conflict and travel 
restrictions, impede the ability of individuals to enter 
treatment (Massad et al., 2016; Palestinian National 
Institute of Public Health et al., 2017b).

Treatment gaps were further exacerbated by the COVID-19 
pandemic, which forced centres to temporarily close, halt 
new admissions or curtail treatment across most of the 
region.

In Palestine, the COVID-19 pandemic led to the closure of 
many drug treatment and general health facilities, which 
may contribute to higher rates of relapse among people 
undergoing treatment, including opioid agonist treatment. 
The National Treatment Centre of the Ministry of Health 
was closed for the treatment of clients with substance 
abuse issues on 2 April 2020. The Palestinian National 
Rehabilitation Centre was closed and used as a COVID-19 
hospital. It also cancelled daily opioid agonist treatment 
administration following the introduction of curfew 
measures. Data provided by the Ministry of Health 
indicates that between March and May 2020, there were 
only two new admissions to the opioid agonist treatment 
programme (down from 14 in 2019).

In some cases, for example in Jordan, treatment centres 
were emptied at the beginning of the pandemic to 
decrease the transmission of COVID-19. In others, former 
treatment facilities were converted into COVID-19 isolation 
centres. Regardless of the rationale, the net effect in many 
places was to limit the ability of people to seek drug 
treatment even as social stresses were increasing the use 
of illicit drugs.

Finally, the pronounced impact of economic difficulties in 
Lebanon on drug treatment efforts, which pre-date the 

COVID-19 pandemic, underline the risks for other states in 
the ENP-South region facing rising economic difficulties. In 
Lebanon, the deteriorating economic situation impacted 
negatively on drug treatment, and has been linked to a 
medication shortage (mainly buprenorphine), which is 
dispensed exclusively by the Ministry of Health. A fourfold 
increase in the price of opioid agonist medication was 
reported in interviews conducted for this study, from 
LBP 28 000 to LBP 108 000 (EUR 16.36 to EUR 63.11). 
During previous shortages, some people in opioid agonist 
treatment are thought to have begun using heroin again for 
cost reasons. An increase in the use of benzodiazepines 
was also noted. These sorts of developments highlight the 
importance for the region as a whole in providing 
affordable access to opioid agonist treatment for those in 
need of it.

Internationalisation of organised crime 
networks

As noted above, there are some indications that 
international organised crime networks may be becoming 
established in the region or developing partnerships with 
local and regional networks. Similar developments have 
been noted in the most recent EU drug markets reports 
(EMCDDA and Europol, 2022a, 2022b), whereby Latin 
American drug trafficking organisations have established 
links to the EU to facilitate the production and trafficking of 
drugs. The establishment of international crime networks 
in the ENP-South region poses a significant threat to 
security and health and requires ongoing monitoring and 
response.

A rising challenge in the region is entrenched corruption. 
Trafficking networks are thought to have infiltrated state 
structures in most countries in the region, although to 
varying degrees. Organised crime networks secure the 
complicity or complacence of high-ranking officials, 
enabling drug flows and impeding attempts to disrupt 
them. Issues around state penetration can be seen at 
multiple levels, ranging from low-level, yet ubiquitous, 
payments, to deep and direct integration of state actors in 
criminal activity, including security officers and military 
personnel (GI-TOC, 2021; Herbert and Gallien, 2020a, 
2020b).

Knowledge gaps

The main knowledge gap related to the regional drugs 
situation stems from the lack of systematically collected, 
factual, objective, reliable and comparable data. The lack 

Outlook

of routine drug monitoring data makes it challenging at 
country and regional level to develop any reliable trends-
based analyses. While some data may be collected by 
individual government departments or states, such data 
are not generally made publicly available.

Further, the EMCDDA-led studies and surveys drawn upon 
for supplementary data are only carried out in a limited 
number of countries in the region. Other data collection 
methods remain limited, which is clearly an area where 
improvements can be made.

37

Overview of drug markets in the European Neighbourhood Policy-South countries

Abbreviations

EMCDDA 

European Monitoring Centre for Drugs and Drug Addiction

ENP 

European Neighbourhood Policy

EU4MD  

EU4Monitoring Drugs project

ESCAPE  

European Syringe Collection and Analysis Project Enterprise

ESPAD 

GI-TOC 

HBV 

HCV 

NGO 

NPS 

European School Survey Project on Alcohol and Other Drugs

Global Initiative against Transnational Organized Crime

hepatitis B virus

hepatitis C virus

non-governmental organisation

new psychoactive substances

38

References

Aaraj, E., Haddad, P., Khalife, S., Fawaz, M. and Van Hout, 
M. C. (2021), ‘Understanding and responding to substance 
use and abuse in the Palestinian refugee camps in 
Lebanon prior to and during COVID-19 times’, International 
Journal of Mental Health and Addiction, pp. 1-17 (https://
www.ncbi.nlm.nih.gov/pmc/articles/pmc8628828/).

Abazid, H., Abou-Isba, S., Abu Farha, R. and Al-Jomaa, E. E. 
(2020), ‘Drug abuse in Syria: pattern of use, causes and 
perception as perceived by Syrian addicts’, Journal of 
Pharmaceutical Health Services Research 11 (2), pp. 
183-188, https://doi.org/10.1111/jphs.12345.

Abdel-Hamid, H. (2019), ‘Illegal cannabis production in 
West Bank rises as economy tanks’, Aljazeera, 23 May 
2019 (https://www.aljazeera.com/videos/2019/5/23/
illegal-cannabis-production-in-west-bank-rises-as-
economy-tanks).

Abu Shams, M. and Hammadi, D. (2020), ‘Increase in 
narcotics in northern Syria’, Aljum Huriya, 18 November 
2020 (https://www.aljumhuriya.net/ar/content/تزايد-
المواد-المخدرة-في-الشمال-السوري).

Adal, L. (2021), Organized crime in the Levant: conflict, 
transactional relationships and identity dynamic, Global 
Initiative against Transnational Organized Crime, Geneva, 
Switzerland.

AFP (2021a), ‘Manifestation contre des expulsions de 
cultivateurs à la frontière Maroc-Algérie’, Voa Afrique, 19 
March 2021 (https://www.voaafrique.com/a/maroc-
manifestation-contre-des-expulsions-de-cultivateurs-
%C3%A0-la-fronti%C3%A8re-
alg%C3%A9rienne-/5820690.html).

AFP (2021b), ‘Lebanon’s crisis-hit farmers turn to growing 
hashish’, France24, 20 April 2021 (https://www.france24.
com/en/live-news/20210420-lebanon-s-crisis-hit-
farmers-turn-to-growing-hashish).

Agência Lusa (2021), ‘Brasil apreende 481 quilos de 
cocaine que seriam enviados para a argelia’, Diário de 
Notícias, 14 December 2021 (https://www.dnoticias.
pt/2021/12/14/288761-brasil-apreende-481-quilos-de-
cocaina-que-seriam-enviados-para-a-argelia).

Ahronheim, A. (2021), ‘IDF concerned crisis in Lebanon 
could have repercussions along the border’, The Jerusalem 
Post, 15 July 2021 (https://www.jpost.com/israel-news/
idf-concerned-crisis-in-lebanon-could-have-repercussions-
along-the-border-673917).

Al Jazeera News (2021), ‘Saudi Arabia seizes 4.5m 
amphetamine pills hidden in oranges’, Al Jazeera, 30 June 
2021 (https://www.aljazeera.com/news/2021/6/30/

saudi-arabia-seizes-4-5m-amphetamine-pills-hidden-in-
oranges).

Al Muheisen, R. (2021), ‘Jordan records ‘notable increase’ 
in drug-related cases – AND’, The Jordan Times, 5 
September 2021 (https://www.jordantimes.com/news/
local/jordan-records-%E2%80%98notable-
increase%E2%80%99-drug-related-cases-%E2%80%94-
and).

Al-Afifi, M., Abushams, L., Sakka, M., Shehada, M., Afifi, R., 
Alloush, M., Rabee, A., et al. (2019), ‘Perspectives of 
frontline professionals on Palestinian children’s 
experiences of parental and sibling drug abuse in the West 
Bank and Gaza’, International Journal of Mental Health and 
Addiction 18, pp. 1097-1112.

Albals, D., Yehya, A. and Wazaify, M. (2021), ‘Psychoactive 
substances use in Jordan: descriptive study of data from 
Anti-Narcotic Department (AND) 2014-2018’, Journal of 
Substance Use, doi:10.1080/14659891.2021.1941354.

Albawaba (2019), ‘Dreamscapes and drug towns: Jordan’s 
Aqaba is the future of segregation’, 10 July 2019 (https://
www.albawaba.com/insights/dreamscapes-and-drug-
towns-jordans-aqaba-future-segregation-1296455).

Al-Qaisi, E. (2020), ‘Probing Jordan’s covert drug war’, 
Oman Net, 15 September 2020 (https://ammannet.net/
english/probing-jordan%E2%80%99s-covert-drug-war).

Al-Sulami, M. (2017), ‘191,000 narcotic pills seized at 
Saudi-Jordanian border’, Arab News, 16 April 2017 
(https://www.arabnews.com/node/1085206/saudi-
arabia).

Alyaoum24 (2020), 25% من السجناء سببهم المخدرات وارتفاع 
قضايا غسل الأموال, 24 December 2020 (https://alyaoum24.
com/1488525.html).

Amante, A. (2020), ‘Italian police seize record amount of 
amphetamines shipped from Syria’, Reuters, 1 July 2020 
(https://www.reuters.com/article/us-italy-drugs/italian-
police-seize-record-amount-of-amphetamines-shipped-
from-syria-idUSKBN2425EG).

Amara, T. and Mcdowall, A. (2022), ‘Economic pain 
threatens social and political chaos in Tunisia’, Reuters, 3 
February 2022 (https://www.reuters.com/world/africa/
economic-pain-threatens-social-political-chaos-
tunisia-2022-02-02/).

Anadolu Agency (2020), ‘Some 220,000 drug pills seized 
in southern Turkey’, Daily News, 17 February 2020 (https://
www.hurriyetdailynews.com/some-220-000-drug-pills-
seized-in-southern-turkey-152138).

39

Overview of drug markets in the European Neighbourhood Policy-South countries

APS (Algérie Presse Service) (2021), ‘Lutte contre la 
toxicomanie: élargir le traitement de la méthadone’, 27 
June 2021 (https://www.aps.dz/sante-science-
technologie/124158-journee-mondiale-contre-la-
toxicomanie-elargissement-du-traitement-de-la-
methadone).

Arab News, (2021), ‘Explained: how Hezbollah built a drug 
empire via its “narcoterrorist strategy” ’, 3 May 2021 
(https://www.arabnews.com/node/1852636/middle-
east).

Arbid, J. (2017), Captured by Captagon? Lebanon’s 
evolving illicit drug economy, Global Initiative against 
Transnational Organized Crime, Geneva, Switzerland.

Assad, A. (2016), ‘45 million Tramadol pills seized in Tobruk 
port’, The Libya Observer, 28 February 2016 (https://www.
libyaobserver.ly/inbrief/45-million-tramadol-pills-seized-
tobruk-port).

Benfodil, M. (2021), ‘L’inquiétante hausse du trafic des 
drogues dures’, El Watan, 23 December 2021 (https://
www.elwatan.com/a-la-une/linquietante-hausse-du-trafic-
des-drogues-dures-23-12-2021).

Bladi (2021), ‘Arrestations pour trafic de drogue entre Las 
Palmas et Laâyoune’, Bladi.net, 5 February 2021 (https://
www.bladi.net/trafic-drogue-laayoune-las-palmas,79426.
html).

Bonny-Noach, H. and Ronel, N. (2018), ‘Everyday 
substance insecurity among homeless injection drug users 
in Israel’s largest open drug scene’, Journal of Drug Issues 
48(4), pp. 645-656.

Bonny-Noach, H. and Toys, S. (2018), ‘Injecting drug use, 
sex work and differential harm reduction approaches for 
women: ethnographic study in Israel’s largest open drug 
scene’, Heroin Addiction and Related Clinical Problems 
20(43).

Australian Federal Police (2021), ‘Israeli national 
extradited to Australia to face court on drug charges’, 1 
November 2021 (www.afp.gov.au/news-media/media-
releases/israeli-national-extradited-australia-face-court-
drug-charges).

Bouarissa, C. (2021), ‘Démantèlement d’un laboratoire de 
fabrication de crack’, Liberte Algerie, 19 January 2021 
(https://www.liberte-algerie.com/l-algerie-profonde/
demantelement-d-un-laboratoire-de-fabrication-de-
crack-352659).

Babas, L. (2019), ‘Brazil discovers 1.3 tons of cocaine in a 
ship that was headed for Morocco’, Yabiladi, 27 November 
2019 (https://en.yabiladi.com/articles/details/86080/
brazil-discovers-tons-cocaine-ship.html).

Babin, J. (2019), ‘Medical marijuana for Lebanon? More 
complicated than it sounds’, Commerce du Levant, 3 
January 2019 (https://www.lecommercedulevant.com/
article/28807-medical-marijuana-for-lebanon-more-
complicated-than-it-sounds).

Balousha, H. (2019), ‘The human cost of the drug crisis 
sweeping Gaza’, Arab News, 13 January 2019 (www.
arabnews.com/node/1434596/middle-east).

Barzoukas, G. (2017), Drug trafficking in the MENA: the 
economics and the politics, European Union Institute for 
Security Studies, Paris (https://www.iss.europa.eu/
content/drug-trafficking-mena-%E2%80%93-economics-
and-politics).

Ben Nessir, C. (2021), ‘La Douane Tunisienne frappe fort: 
Saisie de 17 kg de cocaïne au port de La Goulette’, La 
Presse, 18 August 2021 (https://lapresse.tn/106541/
la-douane-tunisienne-frappe-fort-saisie-de-17-kg-de-
cocaine-au-port-de-la-goulette/).

Benedetti, E., Resce, G., Molinaro, S. (2019), An insight into 
alcohol, tobacco and other drugs in the Mediterranean 
region: socio-economic, policy context and patterns of use 
among adolescents, MedSPAD Committee, Council of 
Europe (https://rm.coe.int/2019-ppg-medspad-
committee-report/1680992c0e).

Boulos, T. (2021), لماذا انتقلت «السوق الحرة» للمخدرات إلى 
الحدود السورية المحاذية للبنان؟, Independent Arabia, 22 
February 2021 (https://www.independentarabia.com/
node/195811/تحقيقات-ومطولات/لماذا-انتقلت-السوق-الحرة-
للمخدرات-إلى-الحدود-السورية-المحاذية-للبنان؟).

Breiner, J. (2020), ‘Israel police arrest 57 in major drug and 
arms raid, including crime family heads’, Haaretz, 25 May 
2020 (www.haaretz.com/israel-news/.premium-israel-
police-arrest-57-in-major-drug-and-arms-raid-including-
crime-family-heads-1.8871037).

Browne, G. (2021), ‘Smugglers’ paradise: Captagon 
production thrives in Lebanon’s lawless Bekaa valley’, The 
National News, 25 October 2021 (https://www.
thenationalnews.com/mena/captagon-crisis/2021/10/25/
smugglers-paradise-captagon-production-thrives-in-
lebanons-lawless-bekaa-valley/).

Bulos, N. and Yam, M. (2020), ‘Lebanon’s economy is going 
to pot – in a good way, it hopes’, Los Angeles Times, 29 
September 2020 (https://www.latimes.com/world-nation/
story/2020-09-29/lebanon-approves-marijuana-cannabis-
crops-economy).

Chafets, Z. (2021), ‘Israel’s gang violence has become 
endemic’, Bloomberg, 15 October 2021 (www.bloomberg.
com/opinion/articles/2021-10-15/israeli-gang-violence-
has-become-endemic).

Chouvy, P. and Afsahi, K. (2014), ‘Hashish revival in 
Morocco’, International Journal of Drug Policy 25, pp. 
416-423.

40

References

COAR (Center for Operational Analysis and Research) 
(2021), The Syrian economy at war: Captagon, hashish, 
and the Syrian narco-state, COAR (https://coar-global.
org/2021/04/27/the-syrian-economy-at-war-captagon-
hashish-and-the-syrian-narco-state/).

Council of the European Union (2015), Regional report on 
the Near East, Council document ST 13947/15, Brussels 
(https://data.consilium.europa.eu/doc/document/
st-13947-2015-init/en/pdf).

Dahlkamp, J., Diehl, J. and Lehberger, R. (2021), ‘The 
slippery Dutch slope from drug tolerance to drug terror’, 
Spiegel International, 20 October 2021 (https://www.
spiegel.de/international/europe/narco-state-netherlands-
the-slippery-dutch-slope-from-drug-tolerance-to-drug-
terror-a-4c064859-9faf-495f-b1f7-c74900910568).

Damiri, B. R. (2020), ‘The use of psychoactive substances 
in a conflict area in the West Bank: drug use risk factors 
and practices in Palestinian refugee camps’, International 
Journal of Mental Health and Addiction 18, pp. 1507-1520.

Damiri, B., Sayeh, W., Odeh, M. and Musmar, H. (2018), 
‘Drug use and possession, emerging of new psychoactive 
substances in the West Bank, Palestine’, Egyptian Journal 
of Forensic Sciences 8(1), p. 42.

Delgado, J. (2020), ‘Paraguay carries out record cocaine 
seizure’, Diálogo Americas, 20 November 2020 (https://
dialogo-americas.com/articles/paraguay-carries-out-
record-cocaine-seizure/#.YgJ_ZfVBw6F).

Dettmer, J. (2021), ‘Amphetamine seizures highlight the 
role of Syria in trafficking’, Voice of America News, 4 
August 2021 (https://www.voanews.com/a/middle-east_
amphetamine-seizures-highlight-role-syria-
trafficking/6209145.html).

Dixon, G. (2021), ‘Shipowners warned over new cocaine 
smuggling route through Libya’, Tradewinds, 13 January 
2021 (https://www.tradewindsnews.com/containerships/
shipowners-warned-over-new-cocaine-smuggling-route-
through-libya/2-1-944007).

Duarte, E., Marcondres, D. and Carneiro, C. (2019), ‘Facing 
the transnational criminal organizations in the South 
Atlantic’, in Duarte, E. and Correia de Barros, M. (eds), 
Maritime security challenges in the South Atlantic, 
Palgrave Macmillan, London, pp. 11-40.

Eid, A. and al-Sayed, M. (2021), ‘Death funded by death: 
Southern Syria lost in the drug limbo’, Enab Baladi, 22 
March 2021 (https://english.enabbaladi.net/
archives/2021/03/death-funded-by-death-southern-syria-
lost-in-the-drug-limbo/?so=related )

El Hamraoui, M. (2018), ‘Arrestation d’un Marocain résidant 
en Belgique à Nador pour trafic d’MDMA’, Le Courrier del 
Atlas, 4 January 2018 (https://www.lecourrierdelatlas.

com/maroc-arrestation-d-un-marocain-residant-en-
belgique-a-nador-pour-trafic-d-ecstasy-10171/).

El Sawy, N. (2021), ‘Egypt cracks down on scourge of 
Captagon and crystal meth’, The National, 24 October 
2021 (https://www.thenationalnews.com/mena/
captagon-crisis/2021/10/25/rising-captagon-
consumption-in-egypt-a-major-concern/).

El Watan (2021), ‘Oran: Démantèlement d’un réseau de 
trafiquants de drogue’, El Watan, 9 February 2021 (https://
www.elwatan.com/regions/ouest/oran/oran-
demantelement-dun-reseau-de-trafiquants-de-
drogue-09-02-2021).

Eldar, S. (2016), ‘Is Gaza facing an opioid epidemic?’, 
Al-Monitor, 5 August 2016 (https://www.al-monitor.com/
originals/2016/08/tramadol-gaza-strip-pain-killer-siege-
israel-hamas.html#ixzz7k7nrjhlc).

Eljechtimi, A. (2020), ‘Moroccan smugglers embark on long 
new route to ship drugs to Europe’, Reuters, 18 May 2020 
(https://www.reuters.com/article/us-health-coronavirus-
morocco-crime-iduskbn22u1rs).

EMCDDA (European Monitoring Centre for Drugs and Drug 
Addiction) (2015), Network of outpatient treatment 
facilities – 2015, Publications Office of the European 
Union, Luxembourg.

EMCDDA (2017), European drug report 2017, Publications 
Office of the European Union, Luxembourg (https://www.
emcdda.europa.eu/publications/edr/trends-
developments/2017/html_en).

EMCDDA (2019), ‘EU4Monitoring Drugs – country 
technical visit: Hashemite Kingdom of Jordan’, 
unpublished.

EMCDDA (2020), Impact of COVID-19 on drug markets, 
drug use, drug-related harms and responses in south 
European Neighbourhood Policy area, Trendspotter 
briefing December 2020, Publications Office of the 
European Union, Luxembourg (www.emcdda.europa.eu/
publications/ad-hoc-publication/impact-of-covid-19-on-
drug-markets-drug-use-drug-related-harms-and-
responses-in-south-european-neighbourhood-policy-
countries_en).

EMCDDA (2021), ‘EU4Monitoring Drugs – virtual country 
technical visit: Algeria’, unpublished.

EMCDDA (2022), Mapping prevention systems in the 
European Neighbourhood Policy area: a baseline for future 
monitoring and responses, EU4MD briefing, Publications 
Office of the European Union, Luxembourg (https://www.
emcdda.europa.eu/publications/ad-hoc-publication/
mapping-prevention-systems-european-neighbourhood-
policy-area_en).

41

Overview of drug markets in the European Neighbourhood Policy-South countries

EMCDDA and Europol (2016), EU drug markets report: 
in-depth analysis, EMCDDA-Europol Joint publications, 
Publications Office of the European Union, Luxembourg.

France24, 2 October 2021 (https://www.france24.com/
en/europe/20211002-dutch-pm-under-protection-as-the-
mocro-mafia-drug-cartel-sows-fear-in-the-netherlands).

EMCDDA and Europol (2019), EU drug markets report 
2019, Publications O ffice of the European Union, 
Luxembourg.

EMCDDA and Europol (2022a), EU drug markets: cocaine 
– in-depth analysis (https://www.emcdda.europa.eu/
publications/eu-drug-markets/cocaine_en).

EMCDDA and Europol (2022b), EU drug markets: 
methamphetamine – in-depth analysis (https://www.
emcdda.europa.eu/publications/eu-drug-markets/
methamphetamine_en).

Euronews and AP (2021), ‘Four tonnes of cannabis found 
in cupcake-making machines’, Euronews, 23 April 2021 
(https://www.euronews.com/2021/04/23/four-tonnes-of-
cannabis-found-in-cupcake-making-machines).

Ezzi, M. (2020), Lebanese Hezbollah’s experience in Syria, 
Wartime and Post-Conflict in Syria (WPCS), Research 
Project Report, European University Institute.

Fabian, E. (2021a), ‘IDF foils attempt to smuggle drugs, 
ammunition into Israel from Lebanon’, The Times of Israel, 
20 November 2021 (https://www.timesofisrael.com/
idf-foils-attempt-to-smuggle-drugs-ammunition-into-israel-
from-lebanon/).

Fabian, E. (2021b), ‘IDF troops conducting search near 
Metula on Lebanon border’, The Times of Israel, 12 
September 2021 (https://www.timesofisrael.com/
liveblog_entry/idf-troops-conducting-search-near-metula-
on-lebanon-border/).

Fitt, E. (2020), ‘Lebanon economic crisis: hashish farmers 
tap into wellness industry’, Middle East Eye, 22 November 
2020 (https://www.middleeasteye.net/news/lebanon-
economic-crisis-hashish-farmers-wellness-baalbek).

Ford, A. (2021), ‘Middleman linked Colombian gangs with 
Israeli, Japanese mafia’, InSight Crime, 6 January 2021 
(https://insightcrime.org/news/brief/israeli-middleman-
colombian-gangs/#:~:text=An%20Israeli%20national%20
suspected%20of,in%20the%20country%27s%20
criminal%20circles).

GI-TOC (Global Initiative against Transnational Organized 
Crime) (2016), ‘Arrested and expelled: drug trafficking and 
terrorism fears rising in Lebanon’, 16 August 2016 (https://
globalinitiative.net/analysis/arrested-and-expelled-drug-
trafficking-and-terrorism-fears-rising-in-lebanon/).

GI-TOC (2021), Global organized crime index, GI-TOC 
(https://globalinitiative.net/analysis/ocindex-2021/).

Gormezano, D. (2021), ‘Dutch PM under protection as the 
‘Mocro Mafia’ drug cartel sows fear in the Netherlands’, 

Gross, J. A. (2021), ‘Turning to crime-fighting, IDF steps up 
efforts against drug running from Sinai’, The Times of 
Israel, 12 July 2021 (https://www.timesofisrael.com/
turning-to-crime-fighting-idf-steps-up-efforts-against-
drug-running-from-sinai/).

Habash, M. (2021), ‘Drug roads are passable from and to 
Qamishli’, North Press Agency, 20 May 2021 (https://
npasyria.com/en/59561/).

Hartman, B. (2013), ‘Customs stops 320 kilograms of 
hashish in massive seizure at Egypt border crossing’, The 
Jerusalem Post, 7 October 2013 (https://www.jpost.com/
national-news/customs-stops-320-kilograms-of-hashish-
in-massive-seizure-on-egyptian-border-crossing-328089).

Hartman, B. and Okbi, Y. (2014), ‘Israeli-Arab mobster 
arrested as part of alleged cocaine smuggling ring’, The 
Jerusalem Post, 26 April 2014 (https://www.jpost.com/
national-news/drug-trafficking-route-between-paraguay-
and-israel-uncovered-350488).

Herbert, M. and Fereday, A. (2021), Strange days for 
hashish trafficking in Niger, Global Initiative against 
Transnational Organized Crime, Geneva, Switzerland.

Herbert, M. and Gallien, M. (2020a), A rising tide: trends in 
production, trafficking, and consumption of drugs in North 
Africa, Global Initiative against Transnational Organized 
Crime, Geneva, Switzerland.

Herbert, M. and Gallien, M. (2020b), Divided they fall – 
frontiers, borderlands and stability in North Africa, The 
Institute for Security Studies, Pretoria, South Africa.

Het Parool (2020), ‘Razzouki vermomde zich als oudere, 
verliet amper zijn huis’, Het Parool, 10 February 2020 
(https://www.parool.nl/nederland/razzouki-vermomde-
zich-als-oudere-verliet-amper-zijn-huis~bd254885/).

Holligan, A. (2019), ‘Is the Netherlands becoming a 
narco-state?’, BBC News, 19 December 2019 (https://
www.bbc.com/news/world-europe-50821542).

Hoogeveen, J. and Lopez-Acevedo, G. (eds) (2021), 
Distributional impacts of COVID-19 in the Middle East and 
North Africa Region, MENA Development Report, World 
Bank, Washington, DC.

Houssari, N. (2022), ‘Lebanon highlights drug seizures as 
PM ‘smooths rough edges’ of response to Kuwaiti 
initiative’, Arab News, 28 January 2022 (https://www.
arabnews.com/node/2014051/middle-east).

HRC (The Harm Reduction Consortium) (2021), The global 
drug policy index 2021, London(http://fileserver.idpc.net/
library/2021-10-gdpi-analytical-report-pages-en.pdf).

42

References

Hubbard, B. (2020), ‘If there were no hashish here, you 
wouldn’t see a single house’, New York Times, 19 October 
2020 (https://www.nytimes.com/2020/10/19/world/
middleeast/lebanon-hashish-cannabis.html).

Kalin, S. (2014), ‘War has turned Syria into a major 
amphetamines hub’, Reuters, 12 January 2014 (https://
www.businessinsider.com/war-has-turned-syria-into-a-
major-amphetamines-hub-2014-1?ir=t).

Hubbard, B. and Saad, H. (2021), ‘On Syria’s ruins, a drug 
empire flourishes’, The New York Times, 5 December 2021 
(https://www.nytimes.com/2021/12/05/world/
middleeast/syria-drugs-captagon-assad.html).

INCB (2020), INCB annual report 2020 – Chapter III Asia, 
United Nations, Vienna (https://www.incb.org/documents/
publications/annualreports/ar2020/annual_report_
chapters/10_ar_2020_chapter_iii_asia.pdf).

INCB (International Narcotics Control Board) (2018), 
Report of the International Narcotics Control Board for 
2017, United Nations, Vienna (https://www.incb.org/
documents/publications/annualreports/ar2017/annual_
report/e_2017_ar_ebook.pdf).

Israel Ministry of Social Affairs and Social Services (2016), 
Review of social services, Israel Ministry of Social Affairs 
and Social Services, Jerusalem.

Jabali-Nash, N. (2011), ‘Top Israeli drug lords extradited to 
U.S. after six-year investigation, say reports’, CBS News, 12 
January 2011 (www.cbsnews.com/news/top-israeli-drug-
lords-extradited-to-us-after-six-year-investigation-say-
reports/).

Jerusalem Post (2021a), ‘IDF thwarts smuggling of NIS 
300,000 worth of drugs along Lebanon border’, 1 July 
2021 (https://www.jpost.com/breaking-news/idf-thwarts-
smuggling-nis-300000-worth-of-drugs-along-lebanon-
border-672526).

Jerusalem Post (2021b), ‘Israeli dies from poisoned ‘Nice 
Guy’ drug’, 28 September 2021 (www.jpost.com/breaking-
news/israeli-dies-from-poisoned-nice-guy-drug-680483).

Jewish News Syndicate (2021), ‘IDF seizes 120 kilos of 
cocaine and marijuana on the border with Egypt’, 21 
November 2021 (https://www.jns.org/idf-thwarts-drug-
smuggling-attempts-on-egypt-and-lebanon-borders/).

Jordan News Agency (2018), ‘Drugs seized, suspected 
dealers arrested in Aqaba’, 8 October 2018 (https://petra.
gov.jo/Include/InnerPage.
jsp?ID=10734&lang=en&name=en_news).

Jordan News Agency (2021), ‘Army foils smuggling, 
infiltration attempts’, 5 July 2021 (https://petra.gov.jo/
Include/InnerPage.jsp?ID=35879&lang=en&name=en_
news).

Jordan Times (2016), ‘Anti-narcotics agents seize 20,000 
Captagon pills at border’, 17 September 2016 (https://
www.jordantimes.com/news/local/anti-narcotics-agents-
seize-20000-captagon-pills-border%E2%80%99).

Kasraoui, S. (2020), ‘Morocco seizes nearly 16kg of 
cocaine on board ferry from France’, Morocco World News, 
2 August 2020 (https://www.moroccoworldnews.
com/2020/08/313750/morocco-seizes-nearly-16-kg-of-
cocaine-on-board-ferry-from-france).

Khalil, Z. (2020), ‘Israeli criminal groups begin activities in 
UAE: report’, AA, 6 December 2020 (www.aa.com.tr/en/
middle-east/israeli-criminal-groups-begin-activities-in-
uae-report/2067660).

Khoder, P. (2019), ‘In Lebanon, producers of hashish are 
victims… of overproduction’, L’Orient Today, 29 September 
2019 (https://today.lorientlejour.com/article/1188610/
in-lebanon-producers-of-hashish-are-victims-of-
overproduction.html).

Kittleson, S. (2018), ‘Iraqi border eyes Iran influence as US 
plans Syria pullout’, Al-Monitor, 26 December 2018 
(https://www.al-monitor.com/originals/2018/12/iraq-
anbar-syria-us-isis.html#ixzz7KUxQSRWR).

Kittleson, S. (2021), ‘Iraq urged to ‘starve’ those profiting 
from rising drug trade’, Al-Monitor, 27 December 2021 
(https://www.al-monitor.com/originals/2021/12/iraq-
urged-starve-those-profiting-rising-drug-trade).

Kotcherga, S. (2017), ‘Lebanese ro-ro ship seized with 
cannabis, 10 crew arrested, Turkey’, Maritime Bulletin, 22 
July 2017 (http://www.maritimebulletin.net/2017/07/22/
lebanese-ro-ro-ship-seized-with-cannabis-10-crew-
arrested-turkey/).

Lamers, M. (2020), ‘Israel medical cannabis patient count 
hits record as imports soar’, MJ Biz Daily, 23 September 
2020 (https://mjbizdaily.com/israel-medical-cannabis-
patient-count-hits-record-as-imports-soar/).

Leonhardt, D. and Yar, S. (2021), ‘Lebanon’s crisis: the 
world isn’t paying much attention’, The New York Times, 14 
October 2021 (https://www.nytimes.com/2021/10/14/
briefing/lebanon-financial-crisis-lira.html).

Macri, C. (2017), ‘Sequestrato carico di ‘droga del 
combattente’: “Traffico gestito da Isis” ’, Corriere Della 
Sera, 3 November 2017 (https://www.corriere.it/
cronache/17_novembre_03/gioia-tauro-sequestrato-
carico-droga-combattente-traffico-gestito-isis-bc235e58-
c06a-11e7-8b75-0df914d10fe2.shtml).

MAP (Morocco News Agency) (2021), ‘Nador: 
démantèlement d’un réseau de trafic international de 
drogue’, 5 October 2021 (https://www.mapoujda.ma/fr/
nador-demantelement-dun-reseau-de-trafic-international-
de-drogue/).

43

GETTING IN TOUCH WITH THE EU

In person
All over the European Union there are hundreds of Europe Direct information 

centres. You can find the address of the centre nearest you online (european-

union.europa.eu/contact-eu/meet-us_en).

On the phone or by e-mail
Europe Direct is a service that answers your questions about the European 

Union. You can contact this service 

— 

 by freephone: 00 800 6 7 8 9 10 11 (certain operators may charge for 

these calls) 

— 

 at the following standard number: +32 22999696 or

—  via the following form: european-union.europa.eu/contact-eu/write-us_en.

FINDING INFORMATION ABOUT THE EU

Online
Information about the European Union in all the official languages of the EU is 

available on the Europa website (europa.eu). 

EU publications
You can view or order EU publications from at op.europa.eu/en/publications.  

Multiple copies of free publications may be obtained by contacting Europe 

Direct or your local documentation centre (european-union.europa.eu/

contact-eu/meet-us_en).

EU law and related documents
For access to legal information from the EU, including all EU law since 1951 in 

all the official language versions, go to EUR-Lex (eur-lex.europa.eu).

Open data from the EU
The portal data.europa.eu provides access to open datasets from the EU 

institutions, bodies and agencies. These can be downloaded and reused for 

free, both for commercial and non-commercial purposes. The portal also 

provides access to a wealth of datasets from European countries.

About this publication

This report presents an analysis of the drug markets in the European 
Neighbourhood Policy-South region covering Algeria, Egypt, Israel, Jordan, 
Lebanon, Libya, Morocco, Palestine (*), Syria and Tunisia. Focused on 
providing insights into drug production, trafficking, sale, use and harms, the 
report contains data and information from a review of publicly available 
information and selected studies conducted between 2019 and 2022 in the 
framework of the EU4Monitoring Drugs project, funded by the European 
Commission. It concludes with an outlook on key areas for policy and 
practice to address emerging drug market challenges.

(*) This designation shall not be construed as recognition of a State of Palestine and is without 
prejudice to the individual positions of the Member States on this issue.

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is 
the central source and confirmed authority on drug-related issues in Europe. 
For over 25 years, it has been collecting, analysing and disseminating 
scientifically sound information on drugs and drug addiction and their 
consequences, providing its audiences with an evidence-based picture of 
the drug phenomenon at European level.

The EMCDDA’s publications are a prime source of information for a wide 
range of audiences including policymakers and their advisors; professionals 
and researchers working in the drugs field; and, more broadly, the media and 
general public. Based in Lisbon, the EMCDDA is one of the decentralised 
agencies of the European Union.