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Official websites use. Share sensitive information only on official, secure websites. There is cultural support for opium in Iran, and also there is cultural tolerance for tobacco smoking, especially as water pipe smoking, in Iranian families. Alcohol, opium, and cannabis are the most frequently used illicit drugs, but there are new emerging problems with anabolic steroids, ecstasy, and stimulant substances, such as crystal methamphetamine. There is serious drug abuse problem among Iranian high school students. It could be due to role-modeling by parents — mainly fathers — and also cultural tolerance of some substances. Early onset of tobacco smoking, with a daily use rate between 4. Use of all types of drugs, except prescription drugs, is more prevalent among boys. Alcohol is the most frequently abused substance, with a lifetime rate of at least 9. Lifetime rates of opiate use — mostly opium — were between 1. As drug abuse is a frequent problem among Iranian high school students, it is necessary to design and implement drug prevention programs to protect them. Such programs, including life skills training and drug education, have been operating in recent years for Iranian students from kindergarten to the university level. There is a long history of opium use in Iran. Opium use as a recreational substance has been recorded for more than four centuries. One of the first scientific descriptions of opium use in Iran was written by Dr. Jacob Eduard Polak — , a Jewish Austrian physician who worked in Iran between and 1 among teachers of the first Iranian medical school. It is not forbidden and every Iranian who can afford its cost uses it daily. Adolescence is a particularly vulnerable period for initiation of drug use 2 , and younger age at first drug use significantly increases the likelihood of more serious drug problems 3. Iran has the highest rate of abuse of opiates in the world 6 , 7. In recent years, there has been increased use of heroin, crystal methamphetamine, and ecstasy. There is no direct standard survey for finding the prevalence of drug abuse in Iran. But there are surveys that help in estimating the drug use situation. The last nationwide survey of drug use in Iran, carried out in , was a rapid situational assessment RSA This study is based on interviews with drug abusers in treatment centers, the justice department system and prisons, as well as interviews with key informants. It is not a household survey and, therefore, interpretation of the data should consider their limitations. Unpublished data from this survey 8 showed that there are 1. Although traditional drugs of abuse in Iran are opium and cannabis, in recent years there has been more use of heroin, crystal methamphetamine, and ecstasy. In RSA , it is shown that The use of drugs by parents is a particular concern, as parental drug use is a risk factor for offspring Evidence has shown that family environment and mental health are inter-related in opiate addicts Spousal 13 and child abuse 14 are more frequent in drug abusers than the general population. Regarding age in this study, Main substances of use were opium all forms in Comparing these results with a previous RSA in , which found that the main substance was opium at This is the first time in the history of drug use in Iran that heroin use is more prevalent than opium use. Heroin is usually smoked, sniffed, or injected. In RSA , the usual way of drug use for Although the average Iranian drug-dependent person is likely to be married and employed, the average Iranian injection drug user is more likely to be unemployed and single or divorced RSA has shown that, compared with previous reports, there has been a decrease in cannabis use and an increase in crystal methamphetamine use as the main substance used among the total population of drug abusers. Crystal methamphetamine was the main substance in 3. In this article, we review published papers in international and domestic journals as well as existing unpublished data describing substance use by young people in Iran. There are four main studies on drug abuse in high school students in different parts of the country. Drug abuse in these studies is considered to be the use of any illicit substances, including alcohol, cannabis, opiates opium and heroin , ecstasy, and methamphetamine. Information about tobacco use is also included in these studies. In , Ziaaddini et al. This city is near the eastern border with Pakistan and Afghanistan and has a traditionally high rate of drug abuse. In this study Kerman Study , the rate for lifetime use of drugs in high school students was Also In another study, conducted in in Zanjan, a city in the northwest of the country Zanjan study , lifetime prevalence of drug abuse in high school students was The rate was significantly higher among boys than girls In this study, poor school performance, depression, and cigarette-smoking parents were associated with higher rates of drug abuse. Ahamdi and Hasani 21 in Shiraz — a large city located in the southern part of the country Shiraz study — have found rates of lifetime use and current use of drugs to be significantly higher among boys than among girls. In this study, pleasure seeking, modeling, and tension release were the most common reasons for drug use. In a study in Tabriz — another city in the northeast Tabriz study — among male high school students, There are two usual ways of using tobacco among Iranian adolescents: cigarette smoking and a water pipe. The latter has been a common practice for centuries, mostly in the Middle East, but its use appears to be widespread among high school students even in the United States 23 and European countries In the Zanjan study 20 , a history of water pipe tobacco smoking in high school students was twice that of cigarette smoking In Iran, like in most of the Middle Eastern and Islamic countries, there are traditional taboos and social behavioral limitations for girls. For example, in the Zanjan study 20 , lifetime history of cigarette smoking was more than three times higher for boys than for girls, but the sex difference for water pipe smoking was less see Table 1. It seems that smoking a water pipe is more tolerable in families compared with cigarettes, and its use does not bring the same degree of negative stigma for girls. One study in Lebanon has also shown a sex difference in cigarette smoking but not for water pipe smoking Smoking a water pipe is a socially acceptable practice for adolescents in Iran 20 , other Middle East countries 25 — 28 , and in western countries, even for athletes, who are traditionally considered at low risk for tobacco use 29 , and it appears acceptable for both boys and girls. Regular daily cigarette smoking was more prevalent than water pipe smoking The prevalence of daily smoking ranged from 4. There is also a study of middle school students grade 7 , with a mean age of 13 years, which shows 7. Although the purchasing of cigarettes is not allowed in Iran for people under the age of 18, clearly for many youth, the age of smoking onset is much younger. Age of smoking onset was Also there are studies that have shown an association between smoking and mental 35 and physical disorders In Iran, alcohol is considered an illicit drug and its use is banned for all age groups. Unfortunately this situation does not prevent its use among adolescents, and, in fact, alcohol is the most common illicit substance among Iranian high school students, especially among boys 20 — Two studies in Kerman have shown lifetime prevalences for alcohol between In RSA , in a cross-country study, the mean age of first alcohol use was In a study among high-risk grade 11students in Tehran, The rate of alcohol use was similar to the rate for tobacco smoking and much more than the rate for any other substance. In the Zanjan study, the lifetime history of alcohol use was 9. The rate was significantly lower in girls 3. In this study, 16 boys out of 6. Although alcohol consumption is illegal in Iran it is banned by Islam and unlike many other countries there is no alcohol advertising 39 to promote use by youth , it is customary to have alcohol at various parties and ceremonies. In the Kerman study, It seems that there is a tolerant atmosphere in these situations even for adolescents regarding alcohol use. In the Kerman study, among those students with lifetime experience of alcohol use, Whereas there is no comparative study between Muslims and other religious groups in Iran, some studies in Iran have shown that there is more tolerance for alcohol consumption among Christians than among Muslims Iran has a long border with Afghanistan, the biggest producer of opium in the world, and opium use has a centuries-old tradition in Iran Although there is negative stigma for heroin use, there is a traditional supporting culture for opium. In a household survey of people aged 15 and over, As Agahi and Spencer reported nearly three decades ago, the problem for Iranian adolescents is exposure to role models of drug abuse; such models are more likely to be an adult family member than an adolescent peer, a reversal of what is usually found in western countries Modeling is the second most common reason for drug use in the offspring of opium dependents Lifetime prevalence of opium and heroin use was 1. In this study, none of the high school students were current opiate users Ahmadi et al. In Kerman study, one fourth to one third of high school students who had lifetime experience of opiate use — opium or heroin — were daily users of it Although there is no cross-country study of youth drug use, it seems that the southeastern parts of the country, which border Pakistan and Afghanistan, show larger numbers of opioid users. In all studies, the rate of heroin use was far lower than the rate of opium use Table 2. Studies on the epidemiology of drug use in Iran show that all drugs are used more often by males than females 19 — 22 , The situation is the same for high school students. The Zanjan study reported that the lifetime prevalences of opium and heroin use in male students were 3. None of female students had a lifetime history of opium or heroin use. In the Kerman study, among high school students, lifetime history of opium use rates were The numbers for heroin use were 5. Cannabis is used in Iran in both the form of grass marijuana and hashish. Studies have reported lifetime history of cannabis use at 0. The Zanjan study showed a 2. The rate was 5. In the Kerman study, lifetime history of cannabis use was 8. Prevalence of daily cannabis use in this study was reported as 3. There is a lack of studies on methamphetamine or cocaine. Although the four most common substances used by high school students in Iran are tobacco, alcohol, cannabis and opium 19 — 22 , there have been some studies in recent years about other substances. Rates of lifetime and daily use of prescription sedatives mostly benzodiazepines were 2. In the Zanjan study, lifetime use rates for prescription narcotic drugs, including codeine and tramadol, were 9. Codeine is usually supplied and consumed as codeine-containing pain-killer tablets that mostly also contain acetaminophen. Both acetaminophen-codeine tablets and tramadol tablets are prescription drugs, but some pharmacies sell them without a prescription. Actually there are reports that acetaminophen-codeine tablets are one of the best selling drugs in Iran. Significant rates of use of prescription drugs by girls, who report very low rates of illicit drug use, suggest that prescription drug use is less stigmatized than illicit drug use. It is also an important concern that, like in other countries 47 , many users of these tablets are also abusing other substances. In the Zanjan study, the rate of lifetime and daily use of anabolic steroids was 6. Lifetime anabolic use was Shakeri et al. Sepehri et al. The prevalence of ecstasy use among 15—year-old people in Tehran was In another study on ecstasy use among high school students in Lahijan in the north of Iran, 2. The rate in boys 3. There is also one study that has shown that a large number of ecstasy users were high school or university students There are a large number of studies that have shown that various mental health disorders can be concordant with drug abuse problems. Zanganeh 53 stated that social isolation and lower socio-economic status can be associated with psychiatric disorders, including drug abuse. Emami et al. The frequency of such problems was higher in girls than in boys. Alcohol and drug use can be associated with high risk sexual behavior 55 and other risk-taking behaviors in Iranian adolescents 56 and can be a risk factor for HIV transmission. There is evidence that substance-using adolescents in Iran 19 and other countries 57 have greater psychological dysfunction. Childhood and family adverse events are also associated with more drug abuse problems in Iran and other countries 58 — Drug abuse is also reported in association with impulsivity 30 and delinquent antisocial behaviors in Iran 22 as well as other countries 61 — Adolescent drug use in Iran shows co-morbidity with mental disorders, especially depression and anxiety disorders. The Zanjan study, using the Beck depression inventory, found that Pathological anxiety was also more prevalent in high school students with a history of drug abuse, but it did not reach the significance threshold. Drug abuse also has been shown to be associated with academic problems There are very important drug problems among youth in Iran. As drug abuse and addiction are biopsychosocial problems, we should keep in mind relevant cultural factors and co-morbidities. It seems that parents and schools fail to play a significant role in primary prevention in Iran, and families in which the father is a drug user pose a very significant risk factor. Nearly half of drug-using university students in one study had been familiar with drugs since their adolescence Considering this fact and also the rule that earlier first drug use leads to more drug problems later in life, it is necessary to initiate preventive programs as early as possible. Adaptive motivational structure is important 67 , and it has been shown that behavioral control can help Iranian adolescents to resist drugs There are youth and family counseling programs in Iran that can be effective for behavior problems and, as DeJong et al. Although in Iran there are not yet comprehensive family-based or school-based drug prevention programs as in developed countries, some recent programs appear promising. Such programs include drug related life-skills training in kindergartens and primary schools, life skills training and drug education packages in high schools and universities, and parenting skills training programs promoting family bonding. Papers of particular interest, published within the annual period of review, have been highlighted as:. As a library, NLM provides access to scientific literature. Curr Opin Psychiatry. Published in final edited form as: Curr Opin Psychiatry. Find articles by Saeed Momtazi. Find articles by Richard A Rawson. PMC Copyright notice. The publisher's version of this article is available at Curr Opin Psychiatry. Cigarette Water pipe Girls Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Ziaaddini et al. Mohammadpoorasl et al. Nakhaee et al. Momtazi et al.
Setting the policy agenda for the treatment of substance use disorders in Iran
Kermanshah buying Heroin
Federal government websites often end in. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. NCBI Bookshelf. Ghiabi M. Prohibition \[of opium\] was motivated by prestige reasons. At a time of modernization, which in most developing countries means imitation of Western models, the use of opium was considered a shameful hangover of a dark Oriental past. It did not fit with the image of an awakening, Westernizing Iran that the Shah was creating. What does the history of drugs consumption tells us of the life and place of Iranians in the modern world? Narcotics, themselves a quintessential global commodity, figured prominently in the history of Iran. It all started with opium in ancient times. Panacea painkiller, lucrative crop, poetic intoxicant and sexual inhabitant, in the course of the twentieth century traditional opium users found themselves in a semantic landscape populated by the announcement of modernity. Availability of psychoactive drugs had become entrenched in the socio-economic fabric of the modern world, complementing the traditional use of drugs, opium in particular, as a medical remedy. Iran, for that matter, produced large amounts of opium since the commercialisation of agriculture, which occurred in the late nineteenth century. Old rituals turned into modern consumption, which was technological, through the use of hypodermic needles and refined chemicals; stronger, with more potent substances; and, crucially, speedier. This chapter provides the background to the transformations that drug policy experienced before the Islamic Revolution. It describes processes of state formation, drugs politics and addiction during the pre period. This is situated in a period of great political transformation, corresponding to the Constitutional Revolution —11 and the slow demise of the Qajar dynasty — American sociologist Harry Levine argues that the category of addiction is an invented concept dating back to the late eighteenth century. Its immediate relation is not to the idea of inebriation, as one might think, but to that of individual freedom, and therefore, to liberal governance. This idea, generated in the medical knowledge of late nineteenth century Europe, gained prominence in Iran when foreign-educated students returned to their country and started using the lexicon, images and aetiology of Western medicine. Incidentally, Iranian intellectuals had relied almost exclusively on the accounts of foreign travellers in order to narrate the history of drugs, thus orientalising the life of the drug itself. The emergence of a discourse on prohibition signed a moment of modernity in the political life of the early twentieth century, a modernity which was, nonetheless, at odds with the everyday life of Iranians. Opium had the reputation of making people acquire powerful oratorical skills. Conviviality, business, relaxation and therapy converged in the practice of opium smoking. Opium was a normative element of life in Iran. At the time of modernisation, such practices contributed to the demonization of the popular classes workers and peasants in the public image, describing their methods as irresponsible and not in tune with modern nursing practices. Reformists and radicals in the early twentieth century, either inspired by the Constitutionalist paradigm or because they effectively took part in the upheaval, called for a remaking of Iranian society and of national politics, starting from the establishment of a representative body, the Parliament Majles and the adoption of centralised, administrative mechanism in health, education, language, social control and the like. Constitutionalists represented a wide spectrum of ideas and persuasions, but their common goal was reforming the old socio-political order of Qajar Iran. Modernisation, whatever its content implied, was the sole and only medium to avoid complete subjugation to the imperial West. By then, opium had come to play an important role in the economy of Iran, known at the time as Persia. In the Qajar economy, the poppy was a cash crop that provided steadfast revenues in a declining agricultural system. With commercialisation of agricultural output, opium became omnipresent and with it the habit of opium eating, supplanted since the early s with opium smoking. Constitutionalists referred to opium addiction as one of the most serious social, political ills afflicting the country. They were actively advocating for a drastic cure of this pathology, which metaphorically embodied the sickness of late Qajar Iran. The first of these meetings happened in Shanghai in , the milestone of the prohibitionist regime in the twentieth century. Iran participated in the meeting as part of its bid to join the global diplomatic arena of modernity. Even though this decision did not mean prohibition of the poppy economy, it signified that the new politics triggered by the Constitutionalist Revolution followed lines tuned with global trends towards the public space and therefore with modern life style. Whether opium prohibition was inspired and reproduced under the influence of Western countries or it had indigenously emerged, is a debate that extends beyond the scope of this chapter. The formation of modern Iranian state machinery made possible a steady intrusion, though fragmentary, into the life of opium users and of opium itself. The Shahs themselves have been known, in popular narratives, as divided into those fighting against, or those indulging in, the use of opium. At times, the rulers would indulge in drug use so heavily as to destabilise their reign. The reformers of this period used the failure of past sovereigns to warn against the danger of intoxication, marking clearly that modernity did not have space for old pastimes. Genealogically, reformers interpreted opium and addiction to it as the cause of national backwardness, a leitmotif among revolutionaries during the Islamic Revolution of Figure 2. Donkey Smoking Opium in a Suit. The small statue dates back to the late s, early s. When the old Qajar monarchy fell apart and the military autocrat Reza Khan rose to power, the priorities of the Constitutional Revolution narrowed down to the imperative of state building, centralisation, control over the national territory and systematic taxation. For this and other reasons, the poppy maintained its firm place as a key asset in the national economy. Opium represented a major source of state building for the newly established Pahlavi state from onwards. It contributed directly to the creation and upgrading of the national army, a fact that, by , pushed Reza Shah to create the Opium State Monopoly. Opium, as such, constituted a vital source of capital, which made poppy growers or better, their capitalist patrons the wealthiest class. Beside the international trafficking networks, the opium economy produced a social life of its own, one in which, well into the Pahlavi era, the presence of the state remained a latency. With the creation of the Opium Monopoly, the state required all the opium produced locally to be stocked into governmental warehouses, which were administrated by state officials. Yet, much of the opium sap never reached these locations or, when it actually did, it did so only at face value, with quantities much inferior to the actual production. Concealed during the harvest period, opium was then sold at a higher price to smugglers who would resell abroad at higher rates. The list of those involved in the opium economy was not restricted to landowners, cultivators and smugglers. Labourers, commission and export merchants, brokers, bazaar agents, chiefs, clerks, manipulators, packers, porters, carpenters, coppersmiths, retailers, and mendicants were part of this line of production. The village mullahs, who might have blessed the event with a salavat eulogy to the prophet and his family were given sap of premium opium as tokens of gratitude. In the first decades of the century, among the 80, inhabitants of Isfahan, about one quarter gained their living directly or indirectly in the opium economy. It is plausible to think that many of these categories joined forces with the widespread associations of smugglers which had enriched the informal economy ever since. It is reported that between the late s and the early s, more than 10, traffickers were arrested per year, prompting the government to acknowledge that there were more people smoking contraband opium than government opium. Reza Shah himself was a regular user of opium, although it is said, perhaps hagiographically, that he smoked twice a day standing on his feet — as opposed to those laying on their side indulging in poetry, conversation and day-dreaming. Together with the Islamic veil, the traditional hat, nomadic life and sufi practice tasavvof , opium smoking was in fact seen as a habit that would have little space in the making of modern Iran. Restrictions started to be applied to opium, as other allegedly customary elements such as ethnic attire, the veil and traditional hats were banned from being used in public. Reza Shah banned the use of opium for those in the army and in the bureaucracy. To demonstrate that the real concern of the government was alignment with Western models of governance and behaviour, in the government approved the Opium Restriction Act, which made opium cultivation legitimate only after government certification through the State Opium Organisation. The Organisation supervised all opium exports as agreed by the Geneva Agreement; together with the Ministry of Finance, it collected the opium residue sukhteh from public places and managed the sale of cooked opium residue shirehye matbukh to the smoking houses shirehkesh khaneh. This shift in governmental policy had a lasting effect on drug consumption over the following decades. Earlier that year, the government had, in a populist push, banned opium production in twenty-two regions — but not Isfahan — in a move that would have had drastic consequences were Iran not occupied by the Allied Forces. Cultivators in these regions protested by selling their opium at very cheap prices, in order to empty their stock so that the government had to allow cultivation again in order to refill the national opium reservoir, a strategic asset in periods of conflict. However, the consequences of their defiance were catastrophic; cheap prices combined with the perception of opium as an essential source of relief from pain and protection against illnesses, incited large numbers of Iranians to consume it and, in some cases, to set up small opiate factory-shops to cook and sell the opium residue. It is with the setting up of these small opium-cooking factories that an opium derivate gained popularity among the working class: shireh. Considered more detrimental and addictive than opium, with a higher morphine content, shireh was sought by longer-term smokers. Mostly smoked by working-class men in specific factory-shops, it had a greater stigma, often making it comparable to that of the brothels in the moralising public narratives. In one instance, a bus operated as a peripatetic smoking house on the Karaj road to avoid police raids aimed at closing them. In , the government of the United States circulated a joint resolution signed by Congress among all opium-producing countries, which urged these countries to effectively eradicate or reduce poppy cultivation and to limit their opium production to legitimate medical needs. The reality on the ground, in fact, spoke of a stupendous flow of opium out of Iran, much to the concern of Western powers — a concern that was mostly an expression of concern the threat of opiate addiction against the nation , without real concern the embeddedness of opiates in popular practice. Poppy Cultivation, Production and Consumption — By the end of World War II, a small number of US narcotics officials, many of whom had been previously working as intelligence officers, helped the Pahlavi state to re-produce a prohibitionist regime in Tehran, which, in their strategy had to embody a global model for the rest of the region and beyond. For their part, the Iranian authorities had repeatedly played the opium card to convince the United States to provide development assistance funds, by highlighting the threats of opiates and Soviet communism. In this setting, Iranian authorities remained purposefully ambivalent, refusing to provide clear information to the FBN officials, convinced also of the geopolitical relevance that Iran had acquired in respect to the Soviet anathema. Knowledge about the drug situation came mostly from non-governmental sources, which at times concocted a distorting image of opium consumption and culture in Iran. The emergence of the Society for the Fight against Alcohol and Opium, created in , proved tactical to this situation. In its first three years, it distributed around 80, information leaflets, participated in more than a hundred public meetings and intervened regularly on national radio. Their influence operated in a discursive way towards the public, but it also affected the perception of the drug problematique among the authorities, including American officials. Instead, it was instrumental in introducing legislations that targeted public intoxication among the popular classes. The new anti-drug propaganda described opium as a primary impediment to labour, although Iranian workers had traditionally used opium for its tonic effect. The teriyaki was inherently weak and its place in the post public discourse condemned as underserving. Associated with lying, the addict was unreliable in the workplace, a perception that was widespread in the rural as much as the urban centres. The new bureaucratic apparatuses of the state, bolstered by the ideological and logistical support of the US anti-narcotic officials endowed the Anti-Opium Society with unprecedented clout over this issue. On January 28, , hence, a deputy from Hamadan, Hassan Ali Farmand, who had previously opposed the Opium Monopoly in , introduced a bill for the total prohibition of cultivation of poppies and use of opium. Prohibitionist rhetoric gained further momentum during the oil nationalization under Mosaddeq when the parliament voted unanimously to ban alcohol and opium use within six months. Even government officials had very little belief in the effectiveness of this law. For the FBN and its chief Anslinger, this meant that Iran had to become a global model of the prohibitionist regime. He argued that there were around 1. After all, health crises are moments of reconfiguration of the political and social order. Following the debate, the bill passed to the Majles , which approved it and added to its text an article on the prohibition of alcohol sale and procurement, much to the astonishment of the royal court and the modernist elites. If found with fifty grams of opium or one gram of any other narcotic, the offender could face up to ten years of solitary confinement, and later the death sentence. Opium use in public places, such as cafes and hotels, could incur hefty fines and between six months to one year imprisonment, with recidivists seeing the weight of the sentence increased. The target of this new policy was not the international drug networks that operated throughout Iran. Instead, subaltern groups, such as paupers, sex workers, vagrant mendicants and members of tribes that operated smuggling routes, paid the highest price, in the guise of prison and stigmatisation. It is no coincidence that the institutionalisation of a national system of incarceration took place during these years. Anslinger regarded cannabis as the drug of the perverted jazz milieu. That meant targeting — unsystematically — a good many outside the modernist city-dwellers. Concomitant to the militarisation of the drug assemblage here an anti-narcotic assemblage , in , a cabinet decree re-instated the capital penalty for those engaging in drug trafficking following the signing of the Single Convention on Narcotic Drugs Announced by the Shah as the new deal for Iranian agriculture, the reform sought to overhaul the century-old pattern of land possession and cultivation. Beside manoeuvring limited land redistribution to middle and small land-owners, the White Revolution facilitated the creation and expansion of large agribusiness, at detriment of all other cultivators. It was severely repressed and Khomeini was sent into exile, the start of a long journey that would see him return to Iran only in February The sale of heroin must indeed be prohibited but the punishment must be in proportion to the crime. Heroin was more difficult to detect, easier to transport for long distances, more lucrative with higher margins of profit and at the same time, with a much stronger effect than opium. It required no specific space for its use and, unlike opium, did not have a strong smell, which could attract unsolicited attention. The words of Jalal Al-e Ahmad, without referring to heroin directly, echoed the way heroin gained popularity among the urban modernist milieu. Life changed, together with a change in epoch, and life, at least for those exposed more directly to these changes. Inevitably, consumption patterns including that of psychoactive, narcotic substances changed in favour of modern substances. According to Al-e Ahmad, Westoxification occurred through the impotency of indigenous models of consumption and production faced with Western supremacy in technology, industry and trade. Upper-class young people often embraced the nascent counterculture of the s, where it also coincided with the ascent of heroin culture in Europe and North America. Heroin use in Iran did not enter into the practice of the ordinary people at least up to the end of the Pahlavi era, but remained a rather elitist pastime, given the higher price and its availability in urban areas. Hamid, who prior to the encounter with morphine used to wear impeccable black suits, suddenly metamorphoses into a southern Tehrani luti , with an unclean shirt and facetious mannerisms. From being a gifted classical piano player, he is transformed into a moustached baba karam , who drinks black tea and plays only folk music Figure 2. During this period, the problem of drug ab use experienced an evolution and a complication. New drugs and new social groups entered the illegal economy, blurring the boundary of legality. Secret laboratories mushroomed across the country, with the northwest Tabriz and Malayer, becoming a key production zone. Prohibition made the business of opiates highly profitable and persuaded groups of ordinary people who previously had little contact with the opium economy to set up production lines of morphine and heroin. In the police accounts, bakers, butchers and other ordinary workers used their workplace, house or farmhouse to produce amounts of opium derivatives and to sell it to traffickers. At times, heavy armed confrontations occurred, especially when the traffickers were members of tribes or Afghans. For example, in , an eleven-hour shooting battle broke out between the Gendarmerie in charge of anti-narcotics and the Kakavand Tribe, in the Kurdish town of Kermanshah, leaving eighteen tribesmen dead and forty-five wounded. Increased confrontation signified also that the financial bonanza of heroin trafficking had soon established international connections between local drug business and a transnational network of associates that reached the wealthy markets of the West. The road to hell is paved with good intentions. That is not the case for the Pahlavi state. Because of her diplomatic immunity, she was not prosecuted, but the international media covered the event in-depth, causing a scandal. Swiss and French newspapers spread the news about the incident, although official accounts have so far remained contested, especially by supporters of the Pahlavi monarchy. Ashraf sued Le Monde for these allegations and eventually won her libel case, having the story retracted. Two other high-ranking officials had already been involved in a similar case. In , the Swiss authorities warned of an Iranian national, Hushang Davvalu, suspected of shipping heroin into Europe. Ten years later, the police searched his house in Switzerland, where they found narcotics. Davvalu, who suffered from heart problems, was allowed to return home to Tehran. The document describes also the involvement of high officials in the army who at times escorted the prince in his business trips. Hamid-Reza reached considerable fame to the point that the best heroin available in Tehran, in the s, was known as heroin-e hamid-reza. The other brother of the Shah, Mahmud-Reza, had also been caught up in the business. A bon vivant with a habit for opium and heroin, his relation with the Shah was strained and he was forbidden to participate in events at the royal court. As previously said, US regional interest in the Middle East and the ongoing Cold War priorities prevented the FBN from disclosing the vast network of international heroin trafficking that operated under the Pahlavi family. The state itself remained in a paradoxical position: it hardened its drug laws, it militarised its drug control strategy and expanded its intelligence networks through anti-narcotic cooperation with the USA, but it acquiesced in not interfering with high-calibre heroin trafficking networks, often connected or known to the royal court. Iran became the regional machinery of US anti-narcotic strategy, through intelligence and information sharing, but also one of the main hubs for illegal narcotics in the region. The means of enforcement of the drug laws improved steadily, the number of people punished for drug offenses increased dramatically, and prison populations reached unprecedented levels with administrative costs becoming a burden in budgetary allocations. Welfare for drug rehabilitation remained weak and the promise to uproot drugs from society sounded like a farce. In , however, the government overturned the opium prohibition and established a regulated system of opium distribution and poppy cultivation. The second half of twentieth century saw prohibition of drugs turning into a central issue in the global political debate. Intermingling of domestic and foreign affairs in drugs politics was the rule. Indeed, US domestic politics had its leverage over international narcotics control. In his bid to win the US election, Richard Nixon had to defeat two enemies: the black voter constituency and the anti-war left, both galvanised by the vibrant movements of the late s. As the United States embraced a more systematic prohibition, its close ally the Shah seemed to go in another direction. Counterintuitively, the Iranian government introduced a groundbreaking policy, which had few systematic precedents globally and which apparently defied, on its own terms, the prohibitionist regime. In , the Iranian government re-introduced state-supervised poppy cultivation and opium production and, crucially, opium distribution programmes on a mass-scale. Payment for opium depleted the gold reserves over the s. Moreover, the government sought to decrease the economic burden of its anti-narcotic strategy, which had caused hardships for families whose breadwinner had been incarcerated for drug offences. An eightfold increase in heroin confiscation occurred between and , prompting the government to reconsider the feasibility and effectiveness of the prohibition of opium. Heroin, a more dangerous substance but easier to transport and to consume, had become popular among an increasing number of citizens. The new law granted consumption rights to two main groups. The first one was that of people over the age of sixty who would receive their ration after approval of a physician. The other group was that of people between the age of twenty and fifty-nine, who manifested medical, psychological symptoms for which opium could be used or who could not give up their opium use, for which the state assumed the responsibility to supply them with opium. The symptoms for which one could receive the coupon, included headache, rheumatism, back pain, depression, arthritis, etc. A consumer could purchase a daily dose of opium between two and ten grams from a licenced pharmacy or drug store. The public had access to two kinds of opium. With the comfort of guaranteed availability of opium, the registered user could walk to a convenient pharmacy and, at a price intended to annihilate the competition of the illegal market, purchase the highest quality of opium, worldwide. By , there were about , registered people out of an estimated total population of ca. The illegal market did not disappear overnight; in areas in which the state had limited presence, people kept on relying on their networks. People living in villages, for instance, witnessed very little change after the policy or, for that matter, any previous policy. Distances were great, physicians few and distribution networks weak. Women, too, had a tendency not to register although they did in some case , mostly due to the negative perception of female opium smokers, especially when young. In reality, bourgeois classes benefited from the distribution network too. But only a small proportion of the total population registered. Treatment and rehabilitation facilities were also insufficient. The majority of registered users were in the urban centres of the north, in particular in Tehran and the Caspian region, whereas areas with a historical connection to opium and the poppy economy had significantly lower numbers of registered patients see Kerman. People with access to opium without the mediation of the state opted for the illegal market. By the mid s, drugs and politics intertwined because the royal court had firstly been accused of operating an illegal network of drug trafficking and, now, had become the main legitimate provider of narcotics to the population Table 2. Socially and culturally, the presence of drugs was also conspicuous. The International Conference of Medicine, which took place in the northern city of Ramsar in , dedicated its entire convention to the issue of addiction. Its proceedings advised the government to ban poppy cultivation or to keep it at a minimum required for essential medical needs for the certified drug addicts. Moreover, it suggested stopping the coupon system out of the risk of opium diversion to the general population and the widespread over-prescription practiced by doctors. The drug law, however, was not dissonant with global prohibitionist discourse. Since the s, UK doctors had prescribed heroin to patients who were dependent on the substance. In , the Ministry of Health instructed doctors to continue this practice to prevent the spread of heroin trafficking in the UK, despite increasing pressures against it. The fundamental difference in the s was the quantitative dimension of the Iranian programme, which numbered hundreds of thousands of people, compared to the UK model which accounted for a mere in Neither it was a move towards drug legalisation or comprehensive medicalisation of the drug use. Instead, it embodied a different form of prohibition, the effect of which touched mostly on poorer communities. The law disposed that drug trafficking crimes needed to be judged, not by civilian courts, but by military courts. In practice, competing groups with close ties to the state — one could call them the rhizomes of the state? The birth of the drug control machinery in Iran dates back to the aftermath of the Constitutional Revolution —11 and forms part of the wider global inception of prohibitionist policies in the early twentieth century. Sponsored by the United States, the Shanghai Conference in represented a first global effort to draw homogenising lines of behaviour sobriety, temperance, order: legibility — haphazardly — into the body politic of the world system. Opium, as such, symbolised an anti-modern element, a hindrance in the modernisation destiny of any country. Opium, and addiction as its governmental paradigm, embodied a life handicapped by dependence, impotency, apathy and above all, slavery. Within a matter of decades, the adoption of this discourse produced apparatuses of narcotic control and prohibition. Accordingly, Iran went through a period of inconsistent experimentation, both for the state as a governmental machinery, and the people as interlocutors of and experimenters with the phenomenon of illegal drugs. This setting provided the contextual prelude to subsequent socio-political and cultural transformations that accompanied and followed the Islamic Revolution of In the opium popular mythology, an apocryphal story narrates the discontinuities described at the close of this chapter. With the revolution in and the closure of the Opium Desk, all four of them died because of khomari hangover for the lack of opium. Courtwright, Forces of Habit , Introduction. This does not mean that psychoactive substances were not used prior to the twentieth century. It is the consumeristic dimension of drugs use that is unique to this period. Smoking itself is a practice requiring sophistication, compared to eating. It enables speedier intake of the substance. More technological are pills and needles, which emerge over the twentieth century. Courtwright, Forces of Habit , p. Bryan Page. A similarly argument was made for the Chinese immigrant community in California. In Musto, The American Disease , p. I avoid discussing pre-modern history of drugs in Iran, which would necessitate a whole other chapter. McLaughlin and Thomas M. Anthony R. Alemi and M. Berridge interestingly shows how these practices were widespread also among upper class families, but this never became a concern in the public debate; In , Arthur C. On the first drug conventions, see William B. Memorandum on Persian Opium: Prepared for Dr. Iranian opium was known as having a higher morphine value 12 per cent compared to Indian, Turkish and Balkan opium. Bulletin of the School of Oriental and African Studies 49, no. Arthur C. I Geneva, November 17, — February 19, , Interestingly enough, sufism has regularly been associated with drug taking and often vilified on this ground. In times of war, morphine reservoirs represent a strategic asset for their analgesic virtue. Schayegh, Who Is Knowledgeable , —7. On cannabis as tonic for Jamaican workers, cf. Courtwright, Forces of Habit. Schayegh, Who Is Knowledgeable , passim. New York Times , May 7, See McAllister, Drug Diplomacy , Amir H. A change of mind occurred when Khomeini came to power. A baba karam is a folkloric character in vogue during the Pahlavi period, and since the late s, which derives its notoriety from a popular dance raqs-e baba karam usually performed by moustached men in the bazaar or around fountains. While the materials provided by the SAVAK documentation on the regime appears to be reliable, albeit at times with lacunae, some of the claims in the above-mentioned memoires remain dubious. For this purpose, Ashraf also requested support from the US government. Belmonte ed. Pol 15—1 Iran. See A. Mehryar and M. Several accounts of elderly users living in Arak, Isfahan, Kerman and Tehran. Sarah G. Amir A. After , military courts ceased to judge drug crimes. Their role was overtaken by the new revolutionary courts established under the Islamic Republic judicial reform. All versions of this work may contain content reproduced under license from third parties. Permission to reproduce this third-party content must be obtained from these third-parties directly. This work is in copyright. It is subject to statutory exceptions and to the provisions of relevant licensing agreements; with the exception of the Creative Commons version the link for which is provided below, no reproduction of any part of this work may take place without the written permission of Cambridge University Press. An online version of this work is published at doi. You may not distribute derivative works without permission. Monographs, or book chapters, which are outputs of Wellcome Trust funding have been made freely available as part of the Wellcome Trust's open access policy. Turn recording back on. Help Accessibility Careers. Show details Ghiabi M. Search term. Modernity and Addiction American sociologist Harry Levine argues that the category of addiction is an invented concept dating back to the late eighteenth century. Figure 2. State Building on Drugs When the old Qajar monarchy fell apart and the military autocrat Reza Khan rose to power, the priorities of the Constitutional Revolution narrowed down to the imperative of state building, centralisation, control over the national territory and systematic taxation. Table 2. In , the law was further tightened, outlawing the possession of poppy seeds with punishments of up to three years, despite these seeds being widely used in foodstuff, including bread. The authorities turned this model into a special Iranian fetish, a model for the supporters of ever-harsher punishments against drug consumers worldwide. The side effects surfaced promptly. With harsher punishments against opium and drugs in general , harder drugs gained popularity, with their accessibility, too, widening. The appearance of heroin signalled the changing social life of drugs over this period and in the following years. Iranizing Prohibition? See Harandi Park, in Chapter 7. Groseclose, Introduction to Iran , —9. MacCormack et al. Data extrapolated from Bulletin of Narcotics 1, 1 Referred to the author in several instances by long-term opium smokers. In this Page. Other titles in this collection. Recent Activity. Clear Turn Off Turn On. Follow NCBI.
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