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These include its autonomy in Lebanon, the Lebanese government’s low level of governance, and the massive political, military and economic assistance the group has received from Iran since its establishment in the 1980s.In our 2013 study, we found that the decision to focus on counterfeiting and sale of medications to supplement or even replace income from the organization’s drug trafficking was apparently the result of a decision by senior Hezbollah officials and their Iranian patrons to exploit the great profitability of this criminal activity to finance the organization’s activities and amass a fortune.The Hezbollah leaders and operatives involved in the manufacture and distribution of Captagon have even absolved themselves of any moral, legal, or religious responsibility by claiming that such activity does not fall within the definition of drug trafficking and is legitimate marketing of medications. In this context, Sheikh Mohamad Yazbek, Hezbollah’s spiritual leader in the Beka’a Valley region and a member of the group’s Supreme Shura Council, published a fatwa allowing the production and sale of counterfeit Captagon tablets on condition that they not be used by members of the Shi’ite community. The first machines for producing Captagon were sent to Hezbollah operatives in Lebanon in 2006 at the end of the Second Lebanon War by Iran’s Revolutionary Guards. Since then, the phenomenon has spread, and Captagon production laboratories have been built in various villages in the Beka’a Valley, Beirut, and northern Lebanon. In 2012, Lebanese law enforcement authorities launched an operation against Captagon manufacturers, seizing two machines for producing the drug in the port of Tripoli, two in Baalbek, two in Nabi Chit, two in Beirut and several in Britel. In addition, they made arrests throughout the Beka’a Valley and Beirut. Nevertheless, some suspects involved in the case managed to avoid arrest through Hezbollah’s protection and to smuggle out several Captagon manufacturing machines.Despite these arrests, the discovery of production labs and the seizure of machines, Captagon manufacturing in Lebanon has not ceased. On the contrary, it seems to have increased from hundreds of thousands of capsules per day to millions. The civil war in Syria has served as a catalyst for increased production and smuggling of Captagon from Lebanon. Before the war, most of the tablets manufactured in Lebanon were smuggled to the Gulf States, especially Saudi Arabia. However, since the war began, millions of pills manufactured in Lebanon have found their way to combat zones in Syria, Iraq and other parts of the Middle East.Captagon was manufactured until the 1980s, primarily as a treatment for ADHD (Attention Deficit Hyperactivity Disorder). It contains the stimulant fenethylline and is metabolized by the liver to produce amphetamine and theophylline, which travel through the bloodstream to the brain and act as a stimulant. This effect, as well as Captagon’s function as an appetite suppressant, has turned it into a very popular commodity in the Gulf States and especially Saudi Arabia, which until the outbreak of the Syrian civil war was the primary distribution destination for the pills. When the battles began in Syria and Iraq, the various fighting groups, including Islamic State (IS), the al-Nusra Front, Assad’s forces, and even Hezbollah operatives, discovered that the counterfeit Captagon pills kept the fighters alert.Some claim that they also reduce the sensation of pain, neutralize inhibitions and create a feeling of ecstasy mixed with euphoria that causes extreme and wild behavior. The use of Captagon, coupled with religious jihadist radicalism, could explain the extreme barbarity of IS operatives, their acts of cruelty, their killing and raping sprees, their beheadings, their mass hangings and their mass attacks on men, women, and children.As Captagon use in the Middle East increased drastically, production of counterfeit pills increased as well. Criminal elements, terrorist organizations and fighting groups began to manufacture the tablets in primitive labs, both stationary and mobile, including pharmaceutical labs they had taken over in different combat zones. According to reports by various Lebanese officials, the Captagon production rate in Lebanon supposedly dropped significantly in recent years because alternative production lines were opened in Syria. (In several cases, it was claimed that the volume of Captagon production in Lebanon had decreased by 90 percent since 2011.) However, in actuality, it seems that the situation is very different. Based on the number of arrests and exposed attempts to smuggle counterfeit Captagon from Lebanon to the Gulf States and Syria in recent years, it appears that the involvement of Lebanese in the production, processing and distribution of the counterfeit pills has greatly increased in recent years. Thus, for example, while some 680,000 counterfeit Captagon pills were confiscated in raids in Lebanon in 2010, in 2011 it was approximately 500,000, in 2012 some 460,000, in 2013 12.3 million and in 2014 55 million. Since these are absolute numbers of pills discovered and confiscated, we can assume that the volume of production, processing and smuggling of Captagon tablets from Lebanon to other Arab states is 10 times larger.The enormous amount of counterfeit Captagon confiscated in Lebanon casts heavy doubt on claims by Lebanese spokespeople that production and smuggling of this medication from Lebanon have decreased drastically in recent years. Operations targeting the largescale smuggling of counterfeit Captagon have been carried out over the last two years in the Beirut airport and seaport.In addition, many operations have been conducted to seize stationary and mobile Captagon production labs and warehouses holding counterfeit medications and to arrest those involved in the production, processing and smuggling of these pills in the central and northern Beka’a Valley. These operations have taken place in Baalbek, Britel, Younine, Saadnavel, El Ain, Zahlé, Barr Elias and Majdel Aanjar, among other places.In connection with these arrests, over the past two years labs and machines for producing the counterfeit medication have been seized in at least six different cases, including in Younine, Baalbek, Britel, Zahlé, Barr Elias, and Majdel Aanjar.It should be noted that in the 21 months between August 2013 and May 2015, approximately 30 operations were reported to have been carried out to arrest suspects and uncover smuggling in Lebanon or in countries in which Captagon shipments originating in Lebanon were caught, such as Saudi Arabia, Sudan and Dubai. During this period, in at least two cases Captagon shipments were seized that had made their way from Lebanon to Syria, and not just from Syria to Lebanon, as was claimed. This indicates that Lebanon in general, and the Beka’a region in particular, are not only being used as transit points for Captagon smuggled from Syria into Lebanon and from there to the Gulf States, but that the drug is being produced in the Beka’a region and exported to the entire Middle East, including Syria.It is important to note that these areas are under Hezbollah’s exclusive control, and it would be impossible to carry out such large-scale criminal activity in them without the knowledge, approval and active involvement of the organization’s leaders. In a significant number of the arrests carried out in these areas and others in Lebanon, those taken into custody included not only Lebanese operatives but many Syrian citizens and even some Palestinians and other foreign nationals.These include a Bulgarian chemist named Karbozov, an expert in Captagon production, who was arrested in November 2014 in Lebanon. This could indicate that Hezbollah operatives are creating smuggling networks with Syrian, Saudi and other criminal elements and using these connections to export millions of Captagon pills to Saudi Arabia, the other Gulf States and Syria or to move counterfeit Captagon produced in Syria via Hezbollah- controlled territories in Lebanon to other countries by air or sea. The geographic proximity to the Syrian border of the Hezbollah-controlled towns in the Beka’a where Captagon production labs and warehouses were seized makes it relatively easy for these elements to move from Syria to Lebanon and back to Syria.The scope and nature of the arrests in Lebanon seem to indicate that Iran and Hezbollah have only increased their efforts to manufacture and smuggle millions of Captagon tablets and to flood the Middle East, the Gulf States and Saudi Arabia with this stimulant.The question is, why is Saudi Arabia the main distribution destination for counterfeit Captagon produced in or smuggled through Lebanon? On the face of it, the number of Captagon tablets distributed to Saudi Arabia is above and beyond the quantity needed for local consumption. It is possible that Saudi Arabia is only a way station from which the pills are then distributed to other countries. (Terrorist and criminal networks may be assisted by the mass movement of believers who travel to Saudi Arabia each year to fulfill the religious duty of hajj, the pilgrimage to Mecca).In this context, it should be noted that according to a UN report from 2013, 30% of the amphetamines confiscated around the world come from Saudi Arabia.Another explanation could be that Hezbollah does not just produce and distribute counterfeit Captagon for economic reasons – it is the main source of funding for its activities and the personal fortunes amassed by its leaders – but also to advance Iran’s strategic goals. This process is part of the Iranian-Shi’ite aim to undermine the stability of pragmatic Sunni regimes in the Middle East, especially the Saudis. Flooding Saudi Arabia with counterfeit Captagon is another, parallel way to promote Shi’ite hegemony in the Middle East, along with the military struggle and civil wars stirred up by Iran and its proxy, Hezbollah.Professor Boaz Ganor is the Founder and Executive Director of the International Institute for Counter-Terrorism (ICT), the Dean and Ronald Lauder Chair for Counter-Terrorism at the Lauder School of Government, Diplomacy and Strategy at IDC Herzliya.Dr. Miriam Halperin Wernli is Vice President, Deputy Head Global Clinical Development, Head of Global Business and Science Affairs at Actelion Pharmaceuticals Ltd, Switzerland & Senior Research Fellow at the International Institute for Counter-Terrorism (ICT) at the IDC Herzliya.