Abstract
OBJECTIVES: Syria has undergone significant socio-political turmoil since 2011 as internal conflict displaced portions of the population, destroyed infrastructure, and destabilized the economy. In the context of multilevel healthcare system disruptions, there have been increasing reports of substance use. This study seeks to evaluate patterns of substance use in Northwestern Syria. METHODS: Trained staff administered questionnaires to community members in Azaz, Syria. Questions focused on the substance use prevalence, societal and public health impacts, and perspectives on treatment availability. RESULTS: 480 individuals were surveyed (80·88% male, 19·12 % female; 43·39% were 18-25 yrs, 11·5% reported personal substance use). H-booz (amphetamines), hashish (cannabis), and tramadol were the top 3 used. Displaced individuals exhibited twice the odds of substance use compared to non-displaced, with higher education and age demonstrating strong protective effects. CONCLUSIONS: The current sociopolitical and economic situation shaped patterns of substance use within Syria, with reported prevalence likely an underestimate given social desirability bias. Those commenting on their use met the criteria for substance use disorder. Results underscore the need for improved access to treatment options in the region.