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Iran Fights Scourge of Addiction in Plain View, Stressing Treatment
NAZILA FATHI
NY Times
6.27.08
TEHRAN — Ali blew out a candle on a small round cake. More than 200 people cheered, celebrating the first anniversary of his becoming drug-free.
“I was in an awful condition,” said Ali, describing 12 years of addiction to opium and alcohol. “I reached a state that I smashed our furniture and threw our television out of the window.”
Ali, 31, who has a wife and child and identified himself by only his first name to avoid possible embarrassment to his family, is among more than 800 addicts struggling to overcome their habits at a free treatment center in central Tehran.
More than a million Iranians are addicted to some form of opium, heroin or other opium derivative, according to the government, and some estimates run as high as 10 million.
In a country where the discussion of some social and cultural issues, like homosexuality, can be all but taboo, drug addiction has been widely acknowledged as a serious problem. It is talked about openly in schools and on television. Posters have encouraged people to think of addiction as a disease and to seek treatment.
Iran’s theocratic government has encouraged and financed a vast expansion in the number of drug treatment centers to help users confront their addictions and to combat the spread of H.I.V., the virus that causes AIDS, through shared needles.
The center in central Tehran, which is called Congress 60 and is run by a private nonprofit agency, is one of 600 centers that provide drug treatment across the country with help from government money. An additional 1,250 centers offer methadone, free needles and other services for addicts who are not ready to quit, including food and treatment for H.I.V. and other sexually transmitted infections.
Iran’s government, trying to curb addiction’s huge social costs, has been more supportive of drug treatment than any other government in the Islamic world, according to the United Nations Office on Drugs and Crime.
It was not always this way. After the 1979 revolution, the government tried a more traditional approach: arresting drug users and putting them in jail.
But two decades later, it recognized that this approach had failed. A sharp increase in the crime rate and the number of people infected with H.I.V., both directly linked to a surge in narcotics use, persuaded the government to shift strategies.
“We have realized that an addict is a social reality,” said Muhammad-Reza Jahani, the vice president for the Committee Combating Drugs, which coordinates the government’s efforts to fight drug addiction and trafficking. “We don’t want to fight addicts; we want to fight addiction. We need to manage addiction.”
No one knows for certain just how widespread addiction is. The official estimate is 1.1 million people, according to Esmail Ahmadi Moghadam, the leader of the security forces. Mr. Moghadam has banned the use of any other statistics on addiction, according to the state-run news agency IRNA.
But some experts put the number much higher. At a conference on addiction in 2005, Ahmad Kavand, an official in the Interior Ministry, put the number of addicts at 10 million, or about one in every seven people in Iran, the semiofficial Fars News Agency reported.
Southern Tehran has neighborhoods where homeless addicts can readily be found sleeping in parks or openly injecting drugs. The smell of opium in residential neighborhoods, even in affluent areas, is common.
Opium has deep cultural roots in Iran. It has long been considered an effective painkiller, and its use is socially acceptable. Many addicts start by smoking opium occasionally, and move on to heroin and other opium-based narcotics after becoming dependent.
In many cities, a bride brings the equipment for smoking opium as part of her dowry. Before the 1979 revolution, the government gave opium to addicts to enable them to avoid drug dealers.
“Opium in our culture is like Champagne in France,” said Dr. Ali Alavi, with the United Nations Office on Drugs and Crime. “Many use it for entertainment.”
Drug abuse is even more common outside Tehran and other large cities, particularly in the provinces along the drug-trafficking routes that run from Iran’s long eastern border with Afghanistan, where opium poppies are grown, to the northwest, where it is transported to Turkey and Europe.
More than 93 percent of the opium produced for the world’s illicit narcotics markets comes from Afghanistan, according to the United Nations Office on Drugs and Crime, and Iran is the main trafficking route for nearly 60 percent of the opium grown in Afghanistan.
With opium production skyrocketing in Afghanistan, some Iranian officials accuse the American military of ignoring poppy cultivation in Afghanistan, even though it is a major source of revenue for the Taliban and Al Qaeda.
“We think the Americans want to keep this source of infection near us,” said Mr. Jahani, the Iranian antidrug official. “Because of the animosity between Iran and the U.S., this is the best way to keep our resources and forces occupied.”
The government grew so concerned about drug trafficking that it spent $6 billion in 2006 to build a wall 13 feet high, with barbed wire, and a trench 13 feet deep and 16 feet wide along a third of Iran’s border with Afghanistan. Iran seizes more illicit opiates than any other country, the United Nations Office on Drugs and Crime said, and it burns tons of confiscated drugs in a ceremony every year.
Still, plenty gets through, and drug abuse remains widespread. The drugs have been getting stronger, too. Four years ago, dealers introduced a further refinement of heroin known here as crack. Unrelated to crack cocaine, the drug is mostly smoked, is vastly more powerful than raw opium and has caught on rapidly.
Four years ago, 54 percent of addicts in Iran used opium, according to a survey by the Committee Combating Drugs. Only 30 percent of addicts now use opium, the survey found, with many having switched to crack.
Some people who become addicted to crack are unaware that it is made from heroin. Samira, 21, who said she had been smoking crack for four years, dragged herself to the House of Sun, a drug treatment center for women in Tehran, trying for the seventh time, she said, to find a way to quit.
She said she started smoking opium when she was 15 to relieve the pain of a broken leg.
“My sister is married to a drug dealer, and he told me that crack was not addictive,” she said, struggling to keep her eyes open. “I have to smoke at least every two hours now.”
In dealing with opiate addiction, the government has also had to begin addressing AIDS, which had long been considered a Western problem. The front line has been prisons, where heroin addiction and needle-sharing are rampant. After a 25 percent surge in H.I.V. cases, the government began distributing free needles in prisons in 2000.
The government insists that there are only about 17,000 people with H.I.V. in Iran, but it has also ordered drug treatment centers not to disclose how many of their clients have AIDS.
At one Tehran center, Ali Yaghoubi, 47, with hollow cheeks and eyes, said he became infected with H.I.V. while serving a 25-year prison sentence for robbery and selling drugs. “We had to share something called a pump for injecting heroin,” he said. “It was a thick needle hooked up to a pump.”
The number of addicts taking methadone has increased to 100,000 from 5,000 in two years, Kamran Bagheri Lankarani, the minister of health, said in May, according to Iran-e-Pak, a magazine about addiction.
Almost all of the alternative treatment centers are subsidized by the government, but still have a relatively free hand in choosing their methods.
“There are so many options that no addict can claim that there is nowhere to go for help,” said Dr. Mohammad-Reza Haddadi, a physician and researcher at the National Center for Addiction Studies. “It is much cheaper and healthier for them to go to these centers for methadone than to drug dealers.”
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NAZILA FATHI
NY Times
6.27.08
TEHRAN — Ali blew out a candle on a small round cake. More than 200 people cheered, celebrating the first anniversary of his becoming drug-free.
“I was in an awful condition,” said Ali, describing 12 years of addiction to opium and alcohol. “I reached a state that I smashed our furniture and threw our television out of the window.”
Ali, 31, who has a wife and child and identified himself by only his first name to avoid possible embarrassment to his family, is among more than 800 addicts struggling to overcome their habits at a free treatment center in central Tehran.
More than a million Iranians are addicted to some form of opium, heroin or other opium derivative, according to the government, and some estimates run as high as 10 million.
In a country where the discussion of some social and cultural issues, like homosexuality, can be all but taboo, drug addiction has been widely acknowledged as a serious problem. It is talked about openly in schools and on television. Posters have encouraged people to think of addiction as a disease and to seek treatment.
Iran’s theocratic government has encouraged and financed a vast expansion in the number of drug treatment centers to help users confront their addictions and to combat the spread of H.I.V., the virus that causes AIDS, through shared needles.
The center in central Tehran, which is called Congress 60 and is run by a private nonprofit agency, is one of 600 centers that provide drug treatment across the country with help from government money. An additional 1,250 centers offer methadone, free needles and other services for addicts who are not ready to quit, including food and treatment for H.I.V. and other sexually transmitted infections.
Iran’s government, trying to curb addiction’s huge social costs, has been more supportive of drug treatment than any other government in the Islamic world, according to the United Nations Office on Drugs and Crime.
It was not always this way. After the 1979 revolution, the government tried a more traditional approach: arresting drug users and putting them in jail.
But two decades later, it recognized that this approach had failed. A sharp increase in the crime rate and the number of people infected with H.I.V., both directly linked to a surge in narcotics use, persuaded the government to shift strategies.
“We have realized that an addict is a social reality,” said Muhammad-Reza Jahani, the vice president for the Committee Combating Drugs, which coordinates the government’s efforts to fight drug addiction and trafficking. “We don’t want to fight addicts; we want to fight addiction. We need to manage addiction.”
No one knows for certain just how widespread addiction is. The official estimate is 1.1 million people, according to Esmail Ahmadi Moghadam, the leader of the security forces. Mr. Moghadam has banned the use of any other statistics on addiction, according to the state-run news agency IRNA.
But some experts put the number much higher. At a conference on addiction in 2005, Ahmad Kavand, an official in the Interior Ministry, put the number of addicts at 10 million, or about one in every seven people in Iran, the semiofficial Fars News Agency reported.
Southern Tehran has neighborhoods where homeless addicts can readily be found sleeping in parks or openly injecting drugs. The smell of opium in residential neighborhoods, even in affluent areas, is common.
Opium has deep cultural roots in Iran. It has long been considered an effective painkiller, and its use is socially acceptable. Many addicts start by smoking opium occasionally, and move on to heroin and other opium-based narcotics after becoming dependent.
In many cities, a bride brings the equipment for smoking opium as part of her dowry. Before the 1979 revolution, the government gave opium to addicts to enable them to avoid drug dealers.
“Opium in our culture is like Champagne in France,” said Dr. Ali Alavi, with the United Nations Office on Drugs and Crime. “Many use it for entertainment.”
Drug abuse is even more common outside Tehran and other large cities, particularly in the provinces along the drug-trafficking routes that run from Iran’s long eastern border with Afghanistan, where opium poppies are grown, to the northwest, where it is transported to Turkey and Europe.
More than 93 percent of the opium produced for the world’s illicit narcotics markets comes from Afghanistan, according to the United Nations Office on Drugs and Crime, and Iran is the main trafficking route for nearly 60 percent of the opium grown in Afghanistan.
With opium production skyrocketing in Afghanistan, some Iranian officials accuse the American military of ignoring poppy cultivation in Afghanistan, even though it is a major source of revenue for the Taliban and Al Qaeda.
“We think the Americans want to keep this source of infection near us,” said Mr. Jahani, the Iranian antidrug official. “Because of the animosity between Iran and the U.S., this is the best way to keep our resources and forces occupied.”
The government grew so concerned about drug trafficking that it spent $6 billion in 2006 to build a wall 13 feet high, with barbed wire, and a trench 13 feet deep and 16 feet wide along a third of Iran’s border with Afghanistan. Iran seizes more illicit opiates than any other country, the United Nations Office on Drugs and Crime said, and it burns tons of confiscated drugs in a ceremony every year.
Still, plenty gets through, and drug abuse remains widespread. The drugs have been getting stronger, too. Four years ago, dealers introduced a further refinement of heroin known here as crack. Unrelated to crack cocaine, the drug is mostly smoked, is vastly more powerful than raw opium and has caught on rapidly.
Four years ago, 54 percent of addicts in Iran used opium, according to a survey by the Committee Combating Drugs. Only 30 percent of addicts now use opium, the survey found, with many having switched to crack.
Some people who become addicted to crack are unaware that it is made from heroin. Samira, 21, who said she had been smoking crack for four years, dragged herself to the House of Sun, a drug treatment center for women in Tehran, trying for the seventh time, she said, to find a way to quit.
She said she started smoking opium when she was 15 to relieve the pain of a broken leg.
“My sister is married to a drug dealer, and he told me that crack was not addictive,” she said, struggling to keep her eyes open. “I have to smoke at least every two hours now.”
In dealing with opiate addiction, the government has also had to begin addressing AIDS, which had long been considered a Western problem. The front line has been prisons, where heroin addiction and needle-sharing are rampant. After a 25 percent surge in H.I.V. cases, the government began distributing free needles in prisons in 2000.
The government insists that there are only about 17,000 people with H.I.V. in Iran, but it has also ordered drug treatment centers not to disclose how many of their clients have AIDS.
At one Tehran center, Ali Yaghoubi, 47, with hollow cheeks and eyes, said he became infected with H.I.V. while serving a 25-year prison sentence for robbery and selling drugs. “We had to share something called a pump for injecting heroin,” he said. “It was a thick needle hooked up to a pump.”
The number of addicts taking methadone has increased to 100,000 from 5,000 in two years, Kamran Bagheri Lankarani, the minister of health, said in May, according to Iran-e-Pak, a magazine about addiction.
Almost all of the alternative treatment centers are subsidized by the government, but still have a relatively free hand in choosing their methods.
“There are so many options that no addict can claim that there is nowhere to go for help,” said Dr. Mohammad-Reza Haddadi, a physician and researcher at the National Center for Addiction Studies. “It is much cheaper and healthier for them to go to these centers for methadone than to drug dealers.”
Link!
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
