Demand Reduction

Categorization of ordinary and high-risk addicts, considering addicts as patients, observing medical standards, applying the best methodology, defining and delineating the best modern scientific and applied mechanisms regarding treatment and harms reduction are aimed at containing the spread of addiction in the society. Applying a specialized and committed team of medical staff, observing every individual's privacy and post-treatment care are among the basic principles for materializing the process of treatment and harms reduction.

Measures:
The Islamic Republic of Iran with the population of approximately 70 million has provided coverage for 438341 drug addicts within the framework of treatment and harms reduction programs in 2007. In a population of one million people on an average nearly 6262 addicts have referred to treatment centers and have undergone treatment, rehabilitation and harms reduction programs. The figure is more than eight times the global average rate putting Iran among the best developed countries in the field of treatment of addicts. (Based on UNODC annual report, the worldwide average number of addicts that undergo treatment in a population of one million is 584 persons).

Figure 5.Methadone Maintenance Treatment

To name some of the measures carried out in Iran in the past year one can refer to the following:

Treatment:
Production of methadone at a sufficient amount in the form of pills and syrup, production of Buprenorphine and its administration at treatment centers, the considerable rise in the number of government and private treatment centers, further contribution of NGOs, paying more attention to long-term maintenance treatment instead of short-term treatment, offering training to specialized staff, paying more attention to psychological interferences in the treatment of addicts, implementing treatment and harms reduction programs in prisons throughout the country, reducing the spread of HIV/AIDS due to the implementation of harms reduction programs by distributing more than four million syringes in the first nine months of 2007, developing harms reduction programs and setting up the national harms reduction committee, promoting public awareness particularly among the youths concerning HIV virus, increasing the budget allocated to treatment and harms reduction since 2005 and further convergence among the Police force and the Judiciary with respect to treatment and harms reduction programs.
 

The equipping of government and private centers active in the field of treatment in different parts of the country, adopting necessary measures for harms reduction and further access by intravenous drug users (IDUs) to treatment centers within the framework of DIC centers, Methadone maintenance treatment (MMT), outreach centers as well as centers known as Shelter, offering financial support to some addicts within the framework of reducing treatment costs, allocating treatment subsidy, implementing social security insurance for addicts, offering counseling services to addicts and their families, establishing governmental and private clinics, conducting post-treatment care in order to prevent relapse, developing TC centers and expanding triangular clinics inside prisons aimed at reducing high-risk behavior among prisoners.

NEJAT
Drug addicts as the victims of drug trafficking have been given a top priority in the country's harm reduction and demand reduction activities.
A new project known as NEJAT (salvation) was implemented in 2007 by adopting a new approach which considers addicts as patients as well as a Police-oriented treatment based on article 15 and paragraph six of the general policies of the system. The aim of the project is to make maximum use of the Police capacity for directing the patients to treatment, counseling and vocational training centers. The project also seeks to implement the following goals:
1- Controlling HIV/AIDS;
2- Increasing referrals to treatment centers;
3- Implementing harm reduction plans (distribution of syringes and condoms);
4- Managing the drug abuse trends;
5- Cutting the links between drug consumers and distributors;
6- Eliminating the presence of IDUs in streets.
The project was initially implemented in 10 provinces with the aim of covering 30000 high-risk IDUs who have not yet referred to treatment centers. In the meantime, the project was aimed at boosting the capacities of treatment centers such as allocating more space and obtaining the required facilities, offering training to physicians, psychiatrists, nurses, social workers, counselors and obtaining pharmaceutical needs. The project proved to be successful in its initial stage so much so that during 9 months of 2007 more than 20000 addicts referred to the aforementioned centers.
In summary, the project has had the following outcomes:
1- Increasing drug addicts' trust in the Police force leading to more eagerness among addicts for cooperating with counselors, social workers and physicians;
2- Possibility of making accurate assessment of the number of street addicts;
3- Rise in the number of addicts who have referred to treatment centers several times in the course of the implementation of the project. This indicates the limited number of street addicts.
4- Fostering interaction and successful cooperation among different sectors involved in supply reduction, treatment and harms reduction.
 

Outcome of NAJAT in 2007

On-going projects and plans:
- Developing DIC and MMT centers in the government and private sectors, outreach teams, triangular clinics, Shelter and TC centers;
- Mandatory treatment of homeless IDUs (NEJAT project);
- Expanding the allocation of subsidies through NGOs;
- Offering specialized training to medical staff as well as counseling services and providing treated addicts with vocational training and installing automatic machines for delivery of syringes and condoms;
- Offering assistance for conducting the pilot project for the treatment of addicts using Opitink texture
- Holding the regional seminar on harms reduction in 2008;
- Developing the existing facilities for diagnosis, treatment, rehabilitation and harms reduction as well as making comprehensive and broad-based arrangements for containing drug abuse and preventing the change of consumption pattern from low-risk substances to high-risk ones.