title: Captagon: use and trade in the Middle East.
abstract: Fenetheylline, a psychostimulant drug, often branded as Captagon, is a combination of amphetamine and theophylline. Since the cessation of its legal production in 1986, counterfeited products have been produced illicitly in south-east Europe and far-east Asia. Its profitable trade has been linked to terrorist organizations, including Islamic State of Iraq and the Levant. This study aims to reach up-to-date data, concerning the Captagon e-commerce and use in the Middle East.
  
  
  
  A multi-staged and multi-lingual literature search was carried out. A list of prespecified keywords was applied across medical and paramedical databases, web and Dark web, search engines, social communication media, electronic commerce websites, media networks, and the Global Public Health Intelligence Network database.
  
  
  
  The use of Captagon as a stimulant in terrorist settings has been marginally covered in the literature. Data can widely be retrieved from Google and AOL search engines, YouTube, and Amazon e-commerce websites, and to a lesser extent from Alibaba and eBay. On the contrary, Middle Eastern e-commerce websites yielded almost no results. Interestingly, the Dark web generated original data for Captagon e-commerce in the Middle East.
  
  
  
  Further investigations are needed on the role that psychoactive drugs play in terrorist attacks and civil war zones. Unless a comprehensive methodological strategy, inclusive of unconventional methods of research, is implemented, it will not be feasible to face such a threat to humanity.
authors.affiliation: School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.|Faculty of Medicine, University of Baghdad, Baghdad, Iraq.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Imam
authors.affiliation: Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Santacroce
authors.affiliation: Cambridge Institute of Public Health, Cambridge, UK.
authors.forename: Andres
authors.initials: A
authors.lastname: Roman-Urrestarazu
authors.affiliation: School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Chilcott
authors.affiliation: Sapienza University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bersani
authors.affiliation: School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.|Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.affiliation: School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.|Sapienza University of Rome, Rome, Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Corazza
mesh_terms: D000662:Amphetamines / Q000009:adverse effects* / Q000191:economics; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000191:economics; D003132:Commerce / Q000191:economics / Q000639:trends*; D058110:Counterfeit Drugs / Q000009:adverse effects*; D006801:Humans; D020407:Internet / Q000639:trends; D008877:Middle East / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D013806:Theophylline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics
chemical_list: D000662:Amphetamines; D000697:Central Nervous System Stimulants; D058110:Counterfeit Drugs; D013806:Theophylline; C004518:fenethylline
keywords: ISIL; NPS; amphetamine; captagon; fenethylline; terrorism