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And certainly long before it, Iran experimented—perhaps more than any other country—with a wide range of policies to respond to widespread drug use and poppy cultivation, alternating between permissive and very harsh policies. What is perhaps most surprising is how little the Iranian revolution actually changed drug policies in Iran. And while the revolution did have pronounced effects on international drug markets, they were, once again, actually less than meets the eye. Importantly, for example, poppy production was bound to go up in Afghanistan regardless. From the 19th century up to the revolution, drug policy in Iran oscillated widely, running the gamut from legalization to harsh prohibition. Iranian narratives blame British machinations. It was for those economic reasons that Iran was loath to control its opium exports to China and elsewhere even though it had signed a variety of international commitments to that effect in the early 20th century. Even as China specifically banned the imports of Persian opium in , Iran encouraged its farmers and businessmen to export it there. Meanwhile, in the early part of the 20th century, opium abuse in Iran also dramatically increased. Still, by the s, Iran was estimated to have some 1. In , the shah imposed a total ban on cultivation and outlawed the possession and sale of opium. In a country where many rural areas had no medical facilities of any kind and opium was widely used as a universal medicine, the policy also severely impacted a wide range of medicinal practices. The economic and social hardships were great, even though use and addiction did not subside. Users and addicts were imprisoned for longer and longer periods: In , even the possession of poppy seeds, such as on bread, was criminalized with up to three years of imprisonment. Prohibition was systematically undermined by widespread smuggling of opium and heroin from Afghanistan and Turkey—an inevitable outcome, as the ban did not end demand and no treatment facilities and programs were in place. Thus, when they lost drugs to interdiction operations, they often looted Iranian rural settlements and dragged off villagers into Afghanistan. Once again under a state monopoly, poppy cultivation swung back to 20, ha. Some , addicts, those deemed unable to quit because of age or other physical conditions, were given registration cards to obtain state-provided opium. At least , officially estimated users , however, did not end up on the registration list, and the actual addiction rate was believed much higher. A notorious chief justice of the Revolutionary Tribunals and simultaneously head of the Anti-Drugs Revolutionary Council, Sadeq Khalkhali, previously a minor cleric, sentenced to death at least drug dealers during his month reign in , along with the hundreds of others whom he had arbitrarily executed for imagined offenses with zero due process. The use of capital punishment for drug crimes intensified after , and some 10, people have received the death penalty for drug-related offenses since then. The revolution also ended domestic experimentation with legal cultivation of poppy. Opium and methadone maintenance were discontinued, but no other treatment for widespread addiction was available. And once again, outsiders moved to supply the intense demand for drugs. By then, Turkey had effectively legalized its opium production and prevented diversion into the illegal trade, with the United States committing itself to buy a substantial portion of such legal Turkish opium. So drug smuggling into Iran shifted to Pakistan. Critically, opiate production switched robustly to Afghanistan and—along with CIA money from the mids on—funded the mujahideen who fought the invading Soviet Army. To starve the mujahideen and deprive them of food and shelter among the population, the Soviet Army adopted a scorched-earth policy. In order to drive the rural population into cities which they controlled , the Soviets burned orchards and fields and destroyed water canals. The consequence was a significant increase in poppy cultivation: Simply no other crop could survive the harsh weather and lack of water and fertilizers. Unlike legal goods that needed to be processed, and depended on good roads and legal value-added chains and markets, harvested opium resin would not spoil. It was of little comfort to the Afghan people that the heroin production flourishing in the destroyed land also got the Soviet Army extensively addicted. The s Taliban policy of taking an already impoverished and devastated country back to the 9th century—with systematic destruction of administration and socio-economic facilities—had one key outcome: more and more poppy. It has remained the dominant supplier of illegal organic opiates since. Seventeen years of U. Despite the dramatic political developments in and a series of wide policy swings for over a century, drug use in Iran has remained remarkably stubborn. Prisons abound with users: In , 78, people were imprisoned in Iran on drug-related charges; in , the number was , In the mids, Iran and the United States shared a similar rate of imprisonment for drug users, some of the highest rates in the world. The revolution transformed the socio-political context: Alcohol was prohibited for all other than religious minorities, severe restrictions were imposed on social interaction among unrelated men and women, and few opportunities existed for personal self-fulfillment. These developments likely exacerbated drug use. Perhaps the most significant and detrimental effect of greater penalties and intensified efforts at supply control after the revolution has been the switch to hard drugs. Because it is compact and easier to hide, heroin is easier to smuggle than opium. Thus, although the rate of addiction in Iran may be half of what it was in the s, the severity of addiction and its associated effects worsened. The failures of harsh policies periodically resurrect reforms. Methadone maintenance came back into vogue , with some , receiving methadone in Such progressive reforms, however, weakened during the Mahmoud Ahmadinejad years, and treatment facilities and harm-reduction support systems are still hard to come by, particularly for women , while social stigma and fear of law enforcement persist. In January , Iran raised the amount of drugs in possession that triggers the death penalty from a mere 30 grams of heroin, morphine, and cocaine, and 5kg of cannabis and opium, to more than 50kg of opium, 2 kg of heroin, and 3 kg of crystal meth. The change allowed around 5, people on death row to have their cases reviewed , with the prospect of having their sentences commuted to imprisonment or fines. The death penalty for marijuana possession and trafficking has been completely eliminated. And in the spirit of marijuana-legalizing times, a proposal even sought to decriminalize opium and marijuana and introduce state-controlled cultivation. With Afghan opium poppy blooming on its doorstep and its own addiction unabating, Iran has sought to prevent trafficking into the country. Annually, it carries out some to armed interdiction operations. Around 4, Iranian police officers and border guards have lost their lives in counternarcotics operations. Amid growing insecurity in Afghanistan and many economic and governance challenges to legal economic development, those efforts fared as well—or poorly— as U. But even as Iran has devoted vast resources to supply control, suffered widespread addiction, and railed against Western failures to end poppy cultivation in Afghanistan, a variety of state and Iran-sponsored actors have been implicated in drug trafficking. The U. As Felbab-Brown learned during interviews in Iraq in December , Iranian-sponsored paramilitary groups in Iraq are alleged to smuggle heroin from Iran and captagon from Syria into Iraq. Foreign Policy. Sections Sections. Sign Up. Vanda Felbab-Brown and. Bradley S. Related Books Militants, Criminals, and Warlords. Iran Reconsidered. Related Content Another embassy under siege. Pakistan Another embassy under siege Madiha Afzal January 24, More On. The power of Mexican cartels: In Mexico and abroad.

Profiling of Ecstasy Tablets Seized in Iran

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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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