Skip to main content

Coping With Addictive Opioid Markets

  • 424 Accesses


Opioid dependence is a global issue that tears through the social, legal, and economic fabrics of society, and its effects on public health and years of life lost due to death/disability are concerning. Addiction poses a risk to national security, especially in regions devastated by war and natural disasters. Thus, there needs to be action on both a national level and an international level to help curb this epidemic. Evidence-based methods that focus on preventing and treating opiate misuse and addiction have been shown to be far more effective in reducing demand, mortality, and morbidity associated with addictive markets as compared to punitive tactics, such as criminalization, interdiction, and incarceration. Iran and Portugal provide case examples of countries that have found success in taking progressive approaches in intervening with the opioid crisis. Analysis of their approaches, along with discussion of other modalities, is paramount to understanding how this global issue can be contained.


  • Opioid dependence
  • Addiction
  • Criminal justice
  • Harm reduction
  • Drug use
  • Substance use disorder
  • Public health
  • Infectious disease
  • Overdose deaths
  • Addiction rates

This is a preview of subscription content, access via your institution.

Buying options

USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-030-66296-7_12
  • Chapter length: 13 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
USD   79.99
Price excludes VAT (USA)
  • ISBN: 978-3-030-66296-7
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   99.99
Price excludes VAT (USA)
Hardcover Book
USD   139.99
Price excludes VAT (USA)


  1. Afghanistan opium survey 2018: Challenges to sustainable development, peace and security. (2019). Retrieved from

  2. Annual report on the state of the drugs problem in the European Union. (2000). Retrieved from

  3. Birnbaum, H. G., White, A. G., Schiller, M., Waldman, T., Cleveland, J. M., & Roland, C. L. (2011). Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain Medicine, 12(4), 657–667.

    CrossRef  PubMed  Google Scholar 

  4. Data and statistics. (2019). Retrieved from

  5. Degenhardt, L., Charlson, F., Mathers, B., Hall, W. D., Flaxman, A. D., Johns, N., & Vos, T. (2014). The global epidemiology and burden of opioid dependence: Results from the global burden of disease 2010 study. Addiction, 109(8), 1320–1333.

    CrossRef  PubMed  Google Scholar 

  6. Degenhardt, L., Whiteford, H. A., Ferrari, A. J., Baxter, A. J., Charlson, F. J., Hall, W. D., et al. (2013). Global burden of disease attributable to illicit drug use and dependence: Findings from the Global Burden of Disease Study 2010. Lancet, 382(9904), 1564–1574.

    CrossRef  PubMed  Google Scholar 

  7. Estratégia Nacional de Luta Contra a Droga: Relatório da Comissão para a Estratégia Nacional de Combate à Droga. (1998). Retrieved from

  8. Executive summary. (2019). Retrieved from

  9. Ferreira, S. (2017). Portugal’s radical drugs policy is working. Why hasn’t the world copied it?. Retrieved from

  10. Fielding, J. E., Tye, G., Ogawa, P. L., Imam, I. J., & Long, A. M. (2002). Los Angeles County drug court programs: Initial results. Journal of Substance Abuse Treatment, 23(3), 217–224.

    CrossRef  PubMed  Google Scholar 

  11. Florence, C. S., Zhou, C., Luo, F., & Xu, L. (2016). The economic burden of prescription opioid overdose, abuse, and dependence in the United States, 2013. Medical Care, 54(10), 901–906.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  12. Global overview of drug demand and supply. (2018). Retrieved from

  13. Hanna, F. (2017). Alcohol and substance use in humanitarian and post-conflict situations. Eastern Mediterranean Health Journal, 23(3), 231–235.

    CrossRef  Google Scholar 

  14. Hedegaard, H., Miniño, A. M., & Warner, M. (2018). Drug overdose deaths in the United States, 1999–2017. Hyattsville: National Center for Health Statistics, Centers for Disease Control and Prevention. Data Brief No. 329.

    Google Scholar 

  15. Hughes, C. E., & Stevens, A. (2010). What can we learn from the Portuguese decriminalization of illicit drugs? British Journal of Criminology, 50(6), 999–1022.

    CrossRef  Google Scholar 

  16. National drug threat assessment. (2018). Retrieved from

  17. Pardo, B., Taylor, J., Caulkins, J., Kilmer, B., Reuter, P., & Stein, B. (2019). The future of fentanyl and other synthetic opioids. Santa Monica: RAND.

    CrossRef  Google Scholar 

  18. Relatório annual 2008: a situação do país em matéria de drogas e toxicodependências, vol. I – Informação estatística. 2009. Lisbon Portugal: Instituto da Droga e da Toxicodependência

    Google Scholar 

  19. Schwetz, T. A., Calder, T., Rosenthal, E., Kattakuzhy, S., & Fauci, A. S. (2019). Opioids and infectious diseases: A converging public health crisis. The Journal of Infectious Diseases, 220(3), 346–349.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  20. Syrian refugee crisis: Aid, statistics and news: USA for UNHCR. (n.d.). Retrieved from

  21. Walley, A. Y., Xuan, Z., Hackman, H. H., Quinn, E., Doe-Simkins, M., Sorensen-Alawad, A., et al. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. BMJ, 346, f174.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  22. Walsh, L. (2019). Medication and counseling treatment. Retrieved from

  23. Wodak, A., & Cooney, A. (2004). Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users. Geneva: World Health Organization. Retrieved from

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Amir A. Afkhami .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Afkhami, A.A., Fatollahi, J.J. (2021). Coping With Addictive Opioid Markets. In: Dyer, A.R., Kohrt, B.A., Candilis, P.J. (eds) Global Mental Health Ethics. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-66295-0

  • Online ISBN: 978-3-030-66296-7

  • eBook Packages: MedicineMedicine (R0)