Demand Reduction & HIV Control

Drug demand reduction includes advocacy preventing using drugs, treating individuals with problematic drug use and rehabilitation of individuals under treatment to facilitate their reintegration in the community.

Drug Demand Reduction: General Overview

Prior to 1999 and launching of UNODC Iran - Iranian Ministry of Health- Welfare Organization 1998-99 Rapid Survey Assessment (RSA), the number of drug users were estimated at 300,000 to 1,000,000. These statistics were based on various Iranian stakeholders guestimate without conduction of field survey.

This estimation was then increased to 1,200,000 regular users and 800,000 irregular users according to findings of the said RSA. This RSA revealed that the prevailing figures of opiates abuse varied between 1-2% of the general population. The sample group of the study included T&R centers (32%), prisons (35%), and in the streets (33%). It should be noted that the RSA was conducted in 10 major urban centers only, ignoring the small townships and rural communities where opiate abuse has become a ritual.

The Epidemiology of Drug Abuse in Iran was then carried out by joint cooperation of UNODC Iran and Iranian Ministry of Health in 2001-02. The research showed that drugs commonly abused are opium ( thariac), opium residue (shire and sukhte), cannabis (hashish), and Heroin. However, as previously noted, a shift is occurring among the youth and working class towards the use of synthetic drugs. The epidemiology findings showed a substantial increase in the number of the regular and irregular drug users in general. The same epidemiology survey showed an alarming rise in abuse of pharmaceuticals among all walks of life.

What table 16 illustrates is that in 2002 there were an estimated 2,210,000 regular and 2,208,000 irregular opiate users in Iran. In the same period, there were 393,000 hashish and 93,000 stimulant abusers. Hence, the same report shows the total number of opiate abusers at 4,418,000 and total number of all drug abusers at 4,904,000. This is contrary to what Ministry of Health refers to while quoting the figures of opiate users at 3,700,000 from the very same survey.

Dependence Age of Drug Abuse

The dependence age of opiate users is of great concern mostly for the fact that most abusers fell in to age category of 15-34.  The high rate of unemployment in the rural areas, especially among the youth (independent estimates put the figure at 40%) is the main cause of developing tendencies towards both abuse and illicit drug trade. Table 18 shows the age dependence to type of drug abuse of the target population.

Drug Abuse/Dependence by Age Group, Year 2002

Source: Epidemiology of Drug Abuse in Iran, p.149, 2002

Recently launched studies in 2003-04 shed more lights to the issue of drug abuse in Iran. In a recent study carried by the Ministry of Health involving a representative sample of 2050 persons (ages 15-29 years) from 8 major urban centers and 2 medium-sized cities, Ilam and Khoramabad (which are known for social pathology problems among youth), a little over 30% indicated that they have either tried one or more types of drugs, or have a few close friends who have done so.

The recent 2004 World Bank and the Ministry of Interior Local Development Fund Project field study preliminary findings from visits to 9 villages in Hamedan Province, 11 villages in Khorasan Province, 8 villages in Khuzestan Province, and 6 villages in Tehran Province, clarified how much opium abuse is spreading rapidly to such an extent that in every single gathering of relatives and friends, opium is expected to be offered especially from those who can afford it as a part of the gathering ritual.

Opiates were traditionally smoked in opium pipes in ancient Persia. But the most common method of smoking opium is now by self-made water pipes using ordinary glass, two uneven straws, a paper clip to hold the opium in a small plastic bag, and an elastic band. This takes little time to prepare and in this way the amount of opium consumed in order to get a "high" is 1/3 to 1/5 of what is consumed through opium pipes which are considered more harmful.

Opium is also taken orally, often dissolved in tea. A very small proportion of users inject opium by dissolving it, or its residue, in water (black-water opium). Because of its tradition, the general public considers use of opium as less serious not regarding the users as ''real drug addicts'' compared to the use of heroin and opium residue.

There are, however, significant regional differences as far as the spread of heroin abuse in the country is concerned. There are causes for alarm with the increased consumption of heroin which is sniffed, smoked or injected. In Kermanshah province (bordering Iraq) for instance, heroin abuse is reported to stand at 66.7% of total abusers population; but in Semnan, it stands at only 3.3%. The same applies to the number of IDUs which was reported to be particularly high in Mazandaran province (Caspian Sea) with a prevalence rate followed by Tehran. The most common reasons cited for the switch from opium to heroin and from smoking to injecting are:

1. "opium not giving enough high"
2. "opium becoming costly and unavailable"
3. "heroin is available and affordable"

Very recent research of Iranian Welfare Organization in 2004 called ''Profile of Drug Users Status in the Welfare Organization Clinics'' provides further information of profile of drug abuse in Iran.

Profile of Drug Abusers Marital Status, 2004

Source: Profile of Drug Users Status at Welfare Organization Clinics, 2004, Narenjiha etal,   p.50 and 51

                        Profile of Drug Abusers Occupation, 2004

Source: Profile of Drug Users Status at Welfare Organization Clinics, 2004, Narenjiha etal  p.37 and 38

Profile of Drug Abusers Education Background, 2004

Source: Profile of Drug Users Status at Welfare Organization Clinics, 2004, Narenjiha etal  p.42 and 43 

A review of the marital and occupation status at above tables once again indicates that the drug abuse is a social problem in Iran not limited to any particular sex, educational background, class, etc. However, what would increase or decrease the risk potential to drug addiction would be the environmental and social backgrounds of an individual or group; not to mention cross-cultural ethnicity, nationality, and the like.

Profile of Drug Abusers according to Sex, 2004

Source: Profile of Drug Users Status at Welfare Organization Clinics, 2004, Narenjiha etal  p.32 

Profile of Drug Abusers: Homogenous Background, 2004

Source: Profile of Drug Users Status at Welfare Organization Clinics, 2004, Narenjiha etal  p.33