Advertisement

An Overview of Iran Drug Treatment and Harm Reduction Programs

  • Saeed MomtaziEmail author
  • Alireza Noroozi
  • Richard A. Rawson
Reference work entry

Abstract

The opioid addiction rate in Iran is among the highest in the world. One contributing factor is Iran’s long border with the world’s main opium producer, Afghanistan, with consequent extensive availability of opium and heroin. Following the 1979 Islamic revolution, drug policy employed in Iran was primarily based on a supply reduction rationale, with an aggressive criminal justice/incarceration response. This began to change as harm reduction programs in Iran were initiated in 2003. After an alarming increase in HIV infection among injection drug users and following a pilot study in 2002, methadone maintenance treatment became an accepted health policy and has been extensively implemented in Iran. Success of the Iranian harm reduction approach is based on attitudinal changes by policy makers, a rapid dissemination throughout the country, and implementation of programs by private sector people and NGOs. After successful implementation of methadone maintenance program in the country, buprenorphine maintenance was started since 2006. In 2011, opium tincture maintenance was initiated for those who are dependent to opium. Iran also has one of the most extensive methadone maintenance treatment programs within the prisons throughout the country. Currently, there are more than 2,500 agonist maintenance treatment units available in almost all large cities, providing treatment to more than 300,000 patients. In addition to the agonist maintenance centers and prisons, agonist therapy is available in drop-in centers and triangular clinics which are health centers run by public sector, where drug users have a free, voluntary HIV consulting and testing, free antiretroviral treatment, and needle syringe exchange program.

Keywords

Inject Drug User Methadone Maintenance Treatment Opioid Dependence Harm Reduction Program Methadone Maintenance Treatment Program 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Ahmadi J, Bahrami N (2002) Buprenorphine treatment of opium-dependent outpatients seeking treatment in Iran. J Subst Abus Treat 23(4):415–417CrossRefGoogle Scholar
  2. Ahmadi J, Babaee-Beigi M, Alishahi M, Maany I, Hidari T (2004) Twelve-month maintenance treatment of opium-dependent patients. J Subst Abus Treat 26(1):363–366CrossRefGoogle Scholar
  3. Bayanzadeh SA, Bolhari J, Noori R, Lavasani F, Karimi E (2007) The role of pharmacotherapeutic and psychosocial interventions in reducing drug related harm among addict prisoners. J Iran Univ Med Sci 14(55):47–55 (in Farsi)Google Scholar
  4. Center for Education and Research of Prison Organization (2002) Assessment of drug abuse in Iranian prisons. Drug Control Headquarter Publications, Tehran (in Farsi)Google Scholar
  5. Farnia M, Ebrahimi B, Shams A, Zamani S (2010) Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran. Int J Drug Policy 21(5):422–424. doi:10.1016/j.drugpo.2010.03.008PubMedCrossRefGoogle Scholar
  6. Haghdoost AA, Mostafavi E, Mirzazadeh A, Navadeh S, Feizzadeh A, Fahimfar N, Kamali K (2011) Modelling of HIV/AIDS in Iran up to 2014. J AIDS HIV Res 3(12):231–239CrossRefGoogle Scholar
  7. International Narcotics Control Board (INCB) (2009) China hosts centennial commemoration. Focus on international drug control. Newsletter 2Google Scholar
  8. Lawrinson P, Ali R, Buavirat A, Chiamwongpaet S, Dvoryak S, Habrat B, Jie S, Mardiati R, Mokri A, Moskalewicz J, Newcombe D, Poznyak V, Subata E, Uchtenhagen A, Utami DS, Vial R, Zhao C (2008) Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS. Addiction 103(9):1484–1492. doi:10.1111/j.1360-0443.2008.02249.xPubMedCrossRefGoogle Scholar
  9. Matthee R (2005) The pursuit of pleasure: drugs and stimulants in Iranian history. Princeton University Press, PrincetonGoogle Scholar
  10. McGovern PE (2003) Ancient wine: the search for the origins of viniculture. Princeton University Press, PrincetonGoogle Scholar
  11. McLaughlin GT (1976) The poppy is not an ordinary flower: a survey of drug policy in Iran, vol 44. Fordham L. Rev, New York, 701Google Scholar
  12. Ministry of Health and Medical Education (2010) Islamic Republic of Iran country report on monitoring of the United Nations General Assembly Special Session on HIV and AIDS (UNGASS report), MOH, Health Deputy, CDC, February 2010. http://data.unaids.org/pub/Report/2010/iran_2010_country_progress_report_en.pdf. Accessed 8 Feb 2013
  13. Ministry of Health and Medical Education (2012) Islamic Republic of Iran progress report- on monitoring of the United Nations General Assembly Special Session on HIV and AIDS. National AIDS Committee Secretariat, Ministry of Health and Medical Education. http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/IRIran%20AIDS%20Progress%20Report%202012%20English%20final1_1.pdf. Accessed 8 Feb 2013
  14. Mokri A (2002) Brief overview of the status of drug abuse in Iran. Arch Iran Med 5:184–190Google Scholar
  15. Mokri A, Schottenfeld R (2008) Drug abuse and HIV transmission in Iran- responding to public health challenges. In: Celentano D, Beyrer C (eds) Public health aspects of HIV/AIDS in low and middle income countries- epidemiology, prevention and care, 1st edn. Springer, New York, pp 581–599Google Scholar
  16. Mokri A, Shahraki MA, Yaghouni M (2007) Substitution treatment with tincture of opium: preliminary results of an open label clinical trial in Iran. Abstract book of International Harm Reduction Association (IHRA) conference. Warsaw, pp 115–116Google Scholar
  17. Momtazi S, Rawson R (2010) Substance abuse among Iranian high school students. Curr Opin Psychiatry 23:221–226PubMedCentralPubMedCrossRefGoogle Scholar
  18. Noroozi A, Shamshiri A, Gilanipour M, Ahmadzad-Asl M, Saberi-Zafarghandi MB, Naserbakht N et al (2011) The geographical distribution of psychosocial disorders and addiction- resources and services in Iran: 2007. Issue of substance use disorders. Bureau of Psychosocial Health and Addiction. Ministry of Health and Medical Education Publications, TehranGoogle Scholar
  19. Noroozi A, Radfar SR, Alam Mehrjerdi Z, Motevalian SA, Haghdoost A, Nematollahi P (2012) Bio- behavioral survey of injecting drug users and their sexual partners in three provinces in Iran. Final report. Iranian National Center for Addiction Studies (INCAS) & Iran Office of United Nation Office on Drug and Crime, TehranGoogle Scholar
  20. Razzaghi EM, Mokri A, Vazirian M (2005) Effectiveness of methadone maintenance program in reducing illicit drug use and HIV related high-risk behavior: a multi-center study. Report to UNODC. http://www.unodc.org/pdf/iran/publications/. Accessed 8 Feb 2013
  21. Razzaghi EM, Rahimi-Movaghar A, Haghdoost AA, Bashti SH, Safarcherati A, Noroozi A et al (2009) The spatial distribution of psychosocial disorders and health facilities in Iran, 2005. Bureau of Psychosocial Health & Applied Research Office. Ministry of Health and Medical Education Publications, TehranGoogle Scholar
  22. Shekarchizadeh H, Ekhtiari H, Khami MR, Virtanen JI (2012) Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran. Harm Reduct J 9(1):18. doi:10.1186/1477-7517-9-18PubMedCentralPubMedCrossRefGoogle Scholar
  23. Substance Abuse Prevention and Treatment Office (SAPTO) (2004) Treatment protocol of opioid dependence with opioid agonist medications, 1st edn. Ministry of Health and Medical Education Publication, Tehran (in Farsi)Google Scholar
  24. Substance Abuse Prevention and Treatment Office (SAPTO) (2006) Treatment protocol of opioid dependence with opioid agonist medications, 2nd edn. Ministry of Health and Medical Education Publication, Tehran (in Farsi)Google Scholar
  25. United Nations Office on Drugs and Crimes (UNODC) (2005) Effectiveness of methadone maintenance program in reducing illicit drug use and HIV related high-risk behavior: A multi-center study https://www.unodc.org/pdf/iran/publications/MMT%20Pilot%20report%20for%20UNODC%20final%20(March%202005).pdf
  26. United Nations Office on Drugs and Crimes (UNODC) (2009a) Addiction, crime and insurgency: the transnational threat of Afghan opiumGoogle Scholar
  27. United Nations Office on Drugs and Crimes (UNODC) (2009b) World drug reportGoogle Scholar
  28. Zamani S, Farnia M, Tavakoli S, Gholizadeh M, Nazari M, Seddighi AA et al (2010) A qualitative inquiry into methadone maintenance treatment for opioid-dependent prisoners in Tehran, Iran. Int J Drug Policy 21(3):167–172PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Saeed Momtazi
    • 1
    • 2
    Email author
  • Alireza Noroozi
    • 3
  • Richard A. Rawson
    • 4
    • 5
  1. 1.PsychiatryZanjan University of Medical SciencesZanjanIran
  2. 2.UCLA Integrated Substance Abuse Programs, Semel Institute, Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  3. 3.Iranian National Center for Addiction Studies (INCAS)TehranIran
  4. 4.Department of Psychiatry and Biobehavioral SciencesUCLALos AngelesUSA
  5. 5.Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human BehaviorDavid Geffen School of Medicine at UCLALos AngelesUSA

Personalised recommendations