Isralowitz, R., & Rawson, R. (Eds). (2002). Drug Problems: Cross-Cultural Policy and Program Development.

Westport, CT: Auburn House.

[ISBN # 0-86569-299-8, hardcover, pp. 293, dimensions 91A "x 6"]

Drug issue is a complex problem that crosses geo-political boundaries, sections of populations, disciplines, and a myriad of potential stakeholders who both affect and are affected by this issue. The editors of this book took upon themselves the task of compiling different perspectives, policies, and practical strategies particularly derived from the experiences in the Middle East. The idea of adding international flavor from Asia in the published market of drug-related literature that is dominated heavily from the European or American vantage point is quite welcome and like a breath of fresh air.

The contributions in the book have been arranged around four themes, namely, the social context of reality, people in transition, drug prevalence estimation in Palestine and Israel, and perspectives on intervention strategies. The first theme on social context of reality begins by a chapter that delineates use of marijuana and opiate use in the Middle East. The chapter does a good job in bringing to the forefront the classical "finger pointing" phenomenon that is so pervasive in almost all cultures around the world. This phenomenon tends to focus on demerits and undermining of other cultures and shifting blame on others for their shortcomings. This is also the case in Israel and Palestine when it comes to drug problems. Rightly the author has pointed to the need for "communication, cooperation, and coordination" with which the world would indeed be a better place to live. The second chapter presents the case of "Palestinian and Israeli People against Substance Abuse (PIPASA)" project that has been initiated by international, peace, professional, and academic organizations in the region since 1997. The case study does a good job in explaining the genesis of the project and participation process. The efforts and documentation of international collaboration is also praiseworthy. However, it is somewhat disappointing to note that no impact variables have been studied. In the present age with advancement of methods available for data collection and evaluation, inability to track impact date by any project is no longer a valid excuse especially for a project that has been in existence for more than five years.

The second theme of the book on people in transition begins with an overview of the Palestinian situation with regard to drug abuse. The chapter does an excellent job in delineating the land and demography of Gaza, West Bank and Jerusalem and categorizing the reasons for increase in drug abuse among Palestinians. The next chapter presents the same situational analysis of drug abuse problem in Israel. It is heartening to note that the authors from Israel have provided some quantitative data in this regard. The next chapter in this section summarizes the findings from 12 epidemiological studies done in the region. Once again adding the quantitative evidence. However, most of these epidemiological studies have been descriptive in nature. The sixth chapter or the next chapter in this section focuses specifically to the issues of Russian speaking immigrants and describes the results from a study of 152 Russians speaking substance abusers in Israel. The last chapter in this section is about substance abuse among Bedouin Arabs in Southern Israel. On the whole, this section does an excellent job in presenting the epidemiological profile in diverse subsections of communities residing in the region. Practitioners interested in working in this region would find this needs assessment data both useful and practically helpful in their work. Researchers interested in designing studies in this region would also benefit by closely examining the methodological content of these studies to discern existing gaps in the literature, particularly the need for having more analytical data.

The next section on drug prevalence estimation in Palestine and Israel begins with a chapter on Rapid Assessment and Response (RAR) methodology as is applied to drug prevalence estimation. In the past two decades this methodology is becoming quite pervasive and had the "blessings" of several international and multilateral agencies. There are some practical advantages of this methodology and makes it particularly attractive for researchers from the developed countries to go and collect data in relatively short periods of time under challenging circumstances or within developing countries for elitist researchers to briefly travel to remote areas and have the data. However, in this book even elsewhere in the literature about this methodology, the urgency and the need for "rapid" data collection in this methodology has not yet been elucidated to public health practitioners actually at the grassroots level. The next chapter presents the epidemiological surveillance mechanisms in place in Israel and Palestine. The Middle East Drug Use Watch (MEDUW) project, Regional Alcohol and Drug Abuse Resource (RADAR) Stations organized in collaboration with the US-based Substance Abuse Mental Health Services Administration (SAMHSA), US-based National Institute of Drug Abuse (NIDA)-sponsored Community Epidemiological Work Group (CEWG), and US-based National Institute of Justice's Arrestee Drug Abuse Monitoring (ADAM) program have presented in this chapter. The next chapter presents the debate about international screening tests. Merits and demerits of both self and biological test have been debated and the Middle East situation has been presented as a case study. This is an excellent reading that many teachers who teach courses in drug education would find helpful for stimulating group discussion on this issue. Group work using this chapter will serve as an excellent teaching aid for both undergraduate and graduate students around the world.

The final section of the book is about drug abuse intervention strategies. The first chapter documents the measures that have been taken in Israel since 1936 and presents useful ideas for possible implementations in coming years. While some of these ideas such as expanding methadone in maintenance programs may be relatively easy to implement, other ideas such as, resource allocation for local governments might necessitate greater political will and pose greater challenges in implementation. The next chapter in this section presents a description of a behavioral theory-based program. It is quite a worthy attempt, however, the inability to document any empirical data validating the claims poses a threat to acceptance and recommendation. In chapter 13, authors Al-Krenawi, Graham, & Sehwail make an attempt at proposing an Islam-based intervention. While the idea is quite appealing, once again lack of empirical data tends to limit its applicability. The next chapter is about a study of personality characteristics and their role in overcoming addiction in Israel. This study found perceived social support as the most important contributor to abstinence. It can be argued whether perceived social support is a behavioral factor or a personality characteristic. Nevertheless, the chapter underscores the role of social support that is an important determinant and it needs to be modified in more alcohol and drug education interventions. The final chapter under this theme deals with evaluation of different treatment modalities. This chapter is the weakest link in the whole book as it does a perfunctory job at presenting the various approaches in very broad strokes. More specificity and focus would have made this chapter practically relevant.

The book concludes with three appendices. The first is about mandated responsibilities and services of the Department for Substance Abuse in the Israel Ministry of Health. The second is about the mandated responsibilities and services of the Division of Corrective Services in Israel Ministry of Labor and Social Services. The final appendix delineates the mandated responsibilities and services of Anti-Drug Authority of Israel. Parallel data in the Appendices from Palestinian context would have provided balance.

The book is an easy to read anthology of articles about the drug problem in the Middle East. The book attempts to present both Palestinian and Israeli points of view in an objective fashion and has been partly successful. However, at certain points it tends to weigh a little more on the Israeli side, such as the exclusion of Palestinian policies in the appendix or lack of quantitative studies from Palestine. Another glaring omission from the book has been the lack of empirically tested interventions. This could be due to the actual paucity of such interventions that behooves researchers to plan more intervention studies in the Middle Eastern settings. The book is particularly valuable for practitioners working in the Middle East who are designing policy or programmatic interventions. The book also has relevance for students and practitioners around the world. As indicated earlier, the debate about an "international screening test" would be a useful adjunct in any introductory or advance course in drug education. On the whole, the book is well written and will be useful resource for alcohol and drug educators.