Cannabis and stimulants surge in Middle East as treatment gaps widen

To situate Jordan within evolving Middle East and North Africa (MENA) substance-use dynamics and summarise national patterns of substance use, related harms, and policy responses, with attention to transit-to-consumption transitions, surveillance limitations, and vulnerable populations. Structured regional synthesis of government reports, peer-reviewed literature, and data from the Ministry of Health, the Anti-Narcotics Department, and international agencies. The review integrated national statistics (2019-2025) with findings from population, student, and clinical studies to outline prevalence, treatment, and regulatory contexts. Across MENA, conflict, displacement, demographic pressure, and shifting trafficking routes have coincided with expanding stimulant and pharmaceutical markets. In Jordan, a comparatively stable setting with a large youth population, available estimates suggest national substance use disorder [SUD] prevalence of ~0.9-1.7%, but substantially higher levels among students (7-17%), indicating concentrated risk and likely underestimation in population surveys due to stigma and underreporting. Cannabis and amphetamine-type stimulants (including Captagon) feature prominently in seizures and treatment presentations, alongside rising nonmedical use of benzodiazepines and gabapentinoids linked to regulatory gaps and pharmacy access. Tobacco use remains extremely high (66% of men), while alcohol consumption appears low in population surveys yet disproportionately represented in clinical and forensic data, highlighting hidden harm and surveillance constraints. Treatment is largely centralised in two public centres; opioid agonist therapy is limited (methadone primarily for inpatient detoxification in private settings). Harm-reduction coverage (e.g., needle-syringe programming, overdose prevention) remains low and shaped by legal, funding, and human-rights considerations. The 2022-2026 National Mental Health and Substance Use Action Plan prioritises integration into primary care. Jordan is progressing toward a coordinated national response to substance use and substance use-related problems, yet major gaps persist in epidemiological surveillance, harm-reduction, and gender- and youth-specific interventions. Continued investment in research and evidence-based policy evaluation remains essential for sustainable progress. Jordan's trajectory reflects broader shifts across the Middle East and North Africa (MENA) region, where traditionally low-prevalence settings are confronting rising stimulant markets, prescription drug misuse, and constrained harm-reduction capacity.