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Business is good,' Bijan winks as he flashes his big, gap-toothed smile. Bijan is a cook and dealer of sheesheh — crystal meth — which has exploded on the Iranian drug market and, for the first time, overtaken heroin to become the country's second most popular drug opium still tops the list. Meth production in the country has been expanding at an astonishing rate. According to a study by the United Nations Office on Drugs and Crime, the Iranian government first reported manufacture of the drug just six years ago , when four production facilities were seized. By , though, Iran was the world's fourth highest importer of pseudoephedrine , the main precursor chemical used in the production of crystal meth. Research carried out by the State Welfare Organisation shows that over half a million Tehranis between the ages of 15 and 45 have used it at least once. The country's drug problem is not new; Iran has one of the highest rates of addiction in the world and the interior minister, Abdolreza Rahmani Fazli, announced recently that some six million Iranians are affected by problems related to drug addiction. In Tehran, drugs are everywhere. At one popular spot north of the city, queues of cars pull up to be served under a motorway flyover. Dealers trade on a layby with lookouts and security dotted around them. The peak time is 2am and all are catered for. Cocaine has become a regular feature at parties among Tehran's richer residents; young people throughout the city smoke marijuana and pop ecstasy pills; opium — viewed as an older person's drug — is still widely considered to be culturally acceptable. In seedy corners of south Tehran, addicts gather to inject heroin, as they always have done. But when crystal meth hit the streets it managed to transcend social divides, and could be found everywhere in the city. In a graffiti-daubed side street in the centre of Tehran, a teenager with an emo haircut and a leather jacket pulled over a grey hoodie stands in a doorway, his pockets stuffed with small plastic bags of crystal meth. He has been caught countless times by the police but has always paid his way out of prison. Most of my customers are regular kids like me, students, or they've got office jobs. But rich kids use it too — I either deliver it to their houses, or they turn up in their flash cars,' he says. One of Peyvand's friends, who is also a regular customer, smokes sheesheh once every couple of days. It's much stronger than heroin, much more intense. And it's safer; there's no risk of overdosing. Sheesheh is just a great high. Peyvand says he sells crystal meth at his local gym to bodybuilders and athletes who use it to give them energy while they train, and to a growing number of young women who buy it to lose weight. A few miles north of where Peyvand deals, a queue of women sit on white plastic chairs in a beauty salon set up in a marble-clad apartment block. Drawn by the salon's reputation as a purveyor of the finest Hollywood bikini waxes, they flick through hairstyle magazines and a few outdated copies of Hello! There are housewives, students, a women with her black chador hanging open around her shoulders and a group in their mids with Botox-smooth foreheads clutching Louis Vuitton handbags. The place fizzes with gossip. A fortune-teller works her way up the line, dispensing advice with the flick of a card and extracting generous tips. Also a hit with some of these women are the under-the-counter methamphetamine pills. A couple of years ago, meth was widely available at beauty salons, until a member of parliament called for a clampdown. Even though many places stopped stocking it, demand is still high. It's not like smoking bags of it, which is bad for you. For me, it's like medicine, it's not for enjoyment. Bijan, who is from a family of gangsters, ditched selling more conventional drugs like heroin and opium in favour of crystal meth three years ago. And unlike heroin, you don't have to deal with Afghanistan and all the middle-men along the way, so there's less chance of being caught and fewer people to deal with,' he says. He runs his operation out of a ragged, industrial town just outside the capital. It is a poor, forgotten place surrounded by factories. Here grocery stores still sell blocks of pungent black opium alongside staples such as milk and slabs of white ewe's cheese. Most of the residents are either unemployed or work as day labourers and in recent years it has become home to many paperless Afghan migrants. Even though this is not Bijan's patch — he only sells to dealers in Tehran — the changing face of drug use in the town is emblematic of what is happening in the rest of the country. Ironically, the rapid growth in sheesheh is partly due to the falsely held belief that it is less addictive than heroin. While the country's economy is flailing in the wake of stricter sanctions and the damage wreaked by the populist policies of the former president Mahmoud Ahmadinejad that sent the Rial tumbling and the inflation rate soaring, the illegal drugs trade is booming. Iran has long been one of the busiest transit countries for drugs traffickers moving heroin from Afghanistan to the West and it has the highest rate of opium and heroin seizures in the world. Punishments for people caught are severe. There have been extensive public awareness campaigns, with adverts on the television and radio warning of the dangers of crystal meth. These appear to have had some impact, as unlike opium, sheesheh use is becoming increasingly taboo, especially in the more affluent parts of the city. The government, predictably, says it is stemming the surge in crystal meth production, with Fazli announcing the seizure of 3,kg of crystal meth last year and that meth labs had been discovered — more than double the number in They are definitely putting more resources into fighting it. But for every meth lab they destroy, another lot spring up,' says Bjijan. To keep one step ahead of the authorities, Bijan says he bribes police officers. In return for a small cut of his profits and 'hush' money, the policemen tip him off about raids and investigations that may involve him, and they promise to destroy any files on him, should they materialise. As long as you know a few powerful heavyweights, you'll be fine. It's one rule for the rich and one rule for everyone else. I'm lucky in that I've got money and I know people. That way, you stay out of the noose,' he says, dragging on a cigarette as he makes a hanging gesture with his free hand. In south Tehran there seems to be little indication that the crystal meth craze is abating. Outside a charity for sex workers, two women are slumped on the pavement, their faces scratched and covered in sores and their eyes sunken; the tell-tale signs of crystal meth addiction. One of the women cries as she explains that she is now hooked on sheesheh as well as heroin. Outreach workers here say that the area's most vulnerable and severe addicts have little access to services and are unaware of public campaigns; they complain bitterly that sanctions have halted funding for their rehabilitation programmes. Bijan does not live far from the community of sex workers who are struggling to feed their habits. He has no moral conscience about what he does and blames the selling and buying of drugs on being forced to live in a repressive country. But he prides himself on making pure, safe crystal meth and he is now considering expanding his operation to Malaysia and Thailand, where he says associates are making even more money — the average price of meth pills in Malaysia is at least five times that in Iran. And for those of us who sell it, well, there are no jobs, and if you're not from a rich family, you will never have opportunities in this country. At least making crystal meth has given me the chance to look after my family. Women at a crystal meth rehab centre on the western outskirts of Tehran. Photograph: Maryam Rahmanian. This article is more than 10 years old. Cheap, widely available and used by students and housewives alike, crystal meth is taking the Iranian capital by storm. The author of a new book about the country reports on an addiction that even the repressive regime is struggling to control. Reuse this content. Comments … Sign in or create your Guardian account to join the discussion. Most viewed.

Breaking bad in Tehran: how Iran got a taste for crystal meth

Buy Cocaine Tehran

Iran J Psychiatry Behav Sci. The illegal use of amphetamine-type stimulants ATS is a global health concern with medical, psychiatric and social impacts. The use of ATS is a major health concern amongst the Persian population. The traditional pattern of illicit drug use in Iran is opium and the main route of drug use is smoking 1. However, in the recent years i. Although Iran has the only universal methadone treatment system in Western Asia 2 , ATS use is a health problem in Iran, which cannot be treated with methadone maintenance treatment 3 , 4. Amphetamine-Type Stimulants include a group of many drugs such as methamphetamine, ecstasy, and methylphenidate Ritalin tablets. Some ATS such as methylphenidate are prescribed for the treatment of medical and psychiatric problems such as attention deficit and hyperactivity disorder yet they can be misused with no medical prescription. This issue can result in dependence 2. Amphetamine-Type Stimulants dependence such as methamphetamine dependence is a relapsing condition with no approved pharmacotherapies 4 , 5. Furthermore, ATS-dependence is associated with high-risk behaviors such as violence, psychosis and suicide 1 - 5. Researches attempting to find an effective medication are ongoing and cognitive-behavioral treatments have remained as the main treatment options for ATS dependents 4. Amphetamine-Type Stimulants dependence has numerous reasons. For example, a recent study of males and females injecting methamphetamine users in Tehran indicated that methamphetamine dependence was associated with living with sexual partners, long duration of dependence, and lack of participation in step meetings and psychological sessions 6. Literature is not well documented on the prevalence of ATS dependence and the reasons associated with this problem in Iran. Furthermore, ATS treatment barriers have not been documented in Iran. To address this gap in the literature, this study aimed to investigate the prevalence of ATS dependence, the reasons associated with this problem and the treatment barriers in a group of general adult population in 22 districts of Tehran. Rapid situation assessment RSA was selected as the main study design in This was because of efficiency, cost-effectiveness and using a mixed quantitative-qualitative methodology 7. Furthermore, conducting a comprehensive survey in Tehran was time-consuming and expensive because the city is vast and populous. This guideline has been developed by the United Nations office for drug control and crime prevention as a standard method for conducting RSA 7. The study sites included 22 districts in Tehran; via the following official information resources, 22 districts with considerable rates of illegal use of ATS in the past two years were identified. After determining the study population, Open-Epi software was used to determine the sample size in each district. After determining the total required sample size using this software, convenience sampling was used as the main method of sample taking in each district of Tehran. Eligibility criteria included age of 18 - 65 years old, male or female gender, living in the same districs where the participants were recruited for at least three months prior to recruitment and taking any stimulant with no medical prescription. Dependence on ATS was defined as the daily use of any ATS within the past twelve months for a purpose not consistent with legal or medical purposes in Iran. This definition was based on the recent American diagnostic and statistical manual of mental disorders 8. Based on the study guideline 7 , to increase the chance of finding ATS dependents in each district, 10 to 12 former ATS users with good communication abilities were recruited and trained. This group facilitated finding eligible participants in each district. Overall, 35 well-trained interviewers were recruited to collect quantitative and qualitative data. They were general practitioners, social workers or registered psychologists with high qualifications in interview techniques. A checklist was designed with the collaboration of three senior drug researchers at the Substance Abuse and Dependence Research Centre in Tehran. The checklist included details of demographics, illegal use of ATS and qualitative questions about the reasons of ATS use and treatment barriers. The checklist was piloted on 30 ATS dependents before conducting the study. The validity of the checklist was considered with reviewing the relevant literature in the field of ATS use 5 , 6. The study was conducted between September and January Participation was confidential and voluntary. Consent forms were signed by participants. The study had one quantitative section, which included participants and one qualitative section, which included 60 interviews. All interviews were conducted in pre-allocated interview rooms in the districts. The FGDs consisted of six to ten people. Key informant interviewing was also conducted. Audio-taping was implemented with prior permission. Overall, ten key informants KIs were interviewed. Key Informants included health professionals, who worked with ATS dependents at drug treatment centers or other professionals such as the police. Quantitative data were analyzed using Chi-square test, independent samples t-test and logistic regression in SPSS version Qualitative data were analyzed using Atlas-ti qualitative software. Of the 22 districts, districts one and three were of high socio-economic status. Overall, seven districts 2, 4, 5, 8, 9, 13 and 22 were middle class and the remaining districts had low socio-economic status. Overall, participants were recruited from 22 districts. District 11 had the lowest reported prevalence rate of ATS use 1. More than half of the participants were males The age range and the mean age SD of all participants were 18 to 60 years and 32 SD 11 years, respectively. Overall, participants 4. Overall, A considerable number of participants reported that they experienced low mood The qualitative analyses of the interviews showed multiple reasons associated with the illicit use of ATS and different treatment barriers as follows:. A theme that repeatedly emerged from the narratives was a desire to increase a performance. Participants repeatedly described the roles of physical energy, concentration, and job-related performances as their reasons associated with current ATS use. Some guys use ecstasy for energy and sex. Furthermore, participants repeatedly explained how their misconceptions of ATS as non-addictive drugs resulted in self-treatment for psychiatric problems. I have some clients, who misuse ATS for low mood or anxiety at this clinic. Participant accounts indicated how beauty-related issues resulted in current ATS use. In addition, further data analysis highlighted that some beauty salons had recommended ATS as a way to improve quality of skin. Some people think Shisheh is good for skin. Participant narratives underscored how some ATS users used opiates before initial ATS use and believed that only opiates such as opium, opium residues and heroin were addictive. Further qualitative analyses of narratives indicated that most participants did not have an adequate amount of information about the addictive effects of ATS. As a result, some of them used ATS to substitute them with opiate use. Among participants, who were dependent on illicit ATS use, narratives described how poor knowledge of illicit ATS treatment services in the community prevented them from treatment entry. Further qualitative analyses of the narratives demonstrated that although, ATS treatment was a necessity for some participants, poor information about ATS treatment centers hampered treatment entry. I know I need treatment but who can help me? Among participants, who were dependent on ATS use, their narratives described how poor knowledge of the side effects of ATS use prevented them from treatment entry. Further qualitative analyses of the narratives indicated that although ATS treatment was a necessity for some of them, poor information of the addictive nature of ATS use and ignoring treatment primarily hampered treatment entry. I can quit any time I want. Participant narratives suggested that stigma prevented treatment entry for ATS use. The study findings demonstrated that some participants perceived the necessity of treatment but social stigma prevented them from treatment entry. I want treatment but what will happen to me if I go for treatment. The study indicated that ATS dependence was present in the study regions in Tehran. This was a new trend of illicit drug use at the time of conducting the study 2. The study results indicated that ATS dependents were more likely to be younger, single, educated, unemployed and with more unstable living conditions compared with non-ATS users. Such characteristics were likely to predispose this group to misuse of ATS. A research study indicated that participants with ATS dependence were more likely to be single and jobless than recreational ATS users 3. These demographic characteristics should be considered in designing and implementing prevention and educational programs for this group in Iran. Studies have indicated that cognitive-behavioral interventions are effective in the treatment of ATS users 9 , Such treatment interventions should be provided for this group in Iran. In fact, it was likely that most of them had no actual knowledge of the side effects of ATS use. Their misconceptions were likely to originate from lack of knowledge or poor ATS education. Poor knowledge of the side effects of ATS can be a strong motivation to self-treatment with ATS use or its common use in the community 11 - Therefore, the provision of educational programs is suggested for this group. Key Informants repeatedly emphasized the roles of mass-media in ATS education and prevention. Health policy makers should consider ATS education as a health priority. Studies have shown that drug education is necessary to prevent the epidemic of any type of drug 17 - Furthermore, law enforcement and police efforts should target ceasing ATS production and distribution in the Persian community on a large scale. Poor knowledge of available ATS treatment services was frequently reported as an important barrier to treatment entry. A study on Puerto Rican injecting drug users found that perceived barriers to drug treatment played strong roles to treatment entry Opiate use treatment is available in Iran but ATS use was a new health concern at the time of conducting the study. Therefore, participants were likely to not know about the availability of ATS treatment in the community. On the basis of the study findings, we suggest policy recommendations for increasing access to treatment for ATS users in the community. It is important for people to have access to appropriate ATS treatment facilities in the Persian community. The role of mass-media, especially television in informing people about the treatment facilities for ATS use treatment in the community, is emphasized. Schools, universities, educational centers and hospitals should also contribute to informing people about the side effects of ATS use and available treatments in the community. Poor knowledge of the side effects of ATS use and considering ATS as non-addictive drugs were strong barriers to treatment entry. A study indicated that poor knowledge of the side effects of illicit drug use was associated with its easy use Participants were likely to traditionally consider opiate use as a health problem only while ATS use was a new concern in Iran at the time of conducting the study. To improve service delivery, treatment services should re-orient their services to better address the needs of ATS users in Iran. People should be informed that ATS use could be as addictive as opiate use. Finally, the study results indicated that stigma had a detrimental impact on ATS treatment entry. This issue was due to the new nature of ATS use at the time of conducting the study in Iran. A study in the USA indicated that stigma among people with substance use disorders hampered treatment entry These study results highlight the need for more work on stigma due to its important role in preventing treatment entry for the ATS use problem. The results of this RSA highlight the importance of understanding the reasons associated with ATS dependence and treatment barriers. As the first report from Western Asia, especially the Persian Gulf region, the findings of this study highlight the necessity of the provision of effective laws against ATS producers and vendors, as well as ATS education, prevention and treatment programs for the population of Tehran. The use of ATS without medical prescription was a hidden activity in Iran during years and As a result, it was difficult to conduct a household survey. Therefore, the study was limited to a RSA. Conducting household surveys is suggested. Drug use treatment and harm reduction programs in Iran: A unique model of health in the most populated Persian Gulf country. Asian J Psychiatr. Methamphetamine use and treatment in Iran: A systematic review from the most populated Persian Gulf country. Methamphetamine use among Iranian heroin kerack-dependent women: implications for treatment. Alam Mehrjerdi Z. Crystal in Iran: methamphetamine or heroin kerack. Djamshidian A. Neurobehavioral Sequelae of Psychostimulant Abuse. Int Rev Neurobiol. Correlates of shared methamphetamine injection among methamphetamine-injecting treatment seekers: the first report from Iran. The guidelines for the development and implementation of drug abuse rapid situation assessments and responses. Diagnostic and statistical manual of mental disorders. Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Methamphetamine use and methadone maintenance treatment: an emerging problem in the drug addiction treatment network in Iran. Int J Drug Policy. Quality of life among treatment seeking methamphetamine-dependent individuals. Am J Addict. Lashkaripour K, Torbati E. Methamphetamine dependency. Current research on methamphetamine: epidemiology, medical and psychiatric effects, treatment and harm reduction efforts. Addict Health. Methamphetamine use among patients undergoing methadone maintenance treatment in iran; a threat for harm reduction and treatment strategies: A qualitative study. Prevalence and complications of drug-induced seizures in Baharloo hospital, Tehran, Iran. Iran J Toxicol. The methamphetamine problem in the United States. Annu Rev Public Health. Will the methamphetamine problem go away? J Addict Dis. Methamphetamine dependence and human immunodeficiency virus risk behavior. J Subst Abuse Treat. Porter J. Subst Use Misuse. Treatment utilization and barriers to treatment: results of a survey of dependent methamphetamine users. Subst Abuse Treat Prev Policy. J Addict Behav Ther Rehabil. We use cookies to provide you with the best possible experience. They also allow us to analyze user behavior in order to constantly improve the website for you. However, there are no literature reports on ATS dependence in the community. Objectives: The current study aimed to investigate the prevalence of ATS-dependence, the reasons associated with this problem and the treatment barriers among a group of adults in 22 districts of Tehran. Materials and Methods: A rapid situation assessment was conducted. A mixed quantitative-qualitative methodology was applied. A researcher-made checklist was designed to collect data. Results: In total, individuals were randomly recruited and interviewed. Among them, participants were ATS-dependent. A desire to increase performance and reduce psychiatric problems, beauty-related issues and a desire to stop opiate use were the main reasons for the illegal use of ATS. Poor knowledge of ATS treatment services in the community, poor knowledge of the side effects of the illegal use of ATS and stigma were the main current treatment barriers. Conclusions: The study results indicated that ATS-dependence was present among the study participants. This issue necessitates treatment, which should be considered by health policy makers. Prevention programs should be provided on the large scale in the Persian community to prevent ATS use and dependence. Background The illegal use of amphetamine-type stimulants ATS is a global health concern with medical, psychiatric and social impacts. Objectives Literature is not well documented on the prevalence of ATS dependence and the reasons associated with this problem in Iran. Materials and Methods 3. Study Site and Sample Collection The study sites included 22 districts in Tehran; via the following official information resources, 22 districts with considerable rates of illegal use of ATS in the past two years were identified. Hospitals especially emergency rooms, 2. Drug treatment and harm reduction canters, 3. Courts, 4. Prisons, 5. Police reports of arrest figures and ATS confiscation, 6. Official reports of ATS-related deaths, 7. Crime-related reports, 8. Police reports of ATS use and vending and 9. Interview Team Based on the study guideline 7 , to increase the chance of finding ATS dependents in each district, 10 to 12 former ATS users with good communication abilities were recruited and trained. Study Measures A checklist was designed with the collaboration of three senior drug researchers at the Substance Abuse and Dependence Research Centre in Tehran. Study Procedure The study was conducted between September and January Data Analysis Quantitative data were analyzed using Chi-square test, independent samples t-test and logistic regression in SPSS version Results 4. Participants in Each Study Site Of the 22 districts, districts one and three were of high socio-economic status. Table 1. Table 2. Table 3. Variables Characteristics No. References 1. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4. Leave a comment here:. Cookie Setting We use cookies to provide you with the best possible experience.

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