The illicit drugs trade in Iran has shaped countless lives, exacerbated by punitive and misguided policies that have left some of society’s most vulnerable in the cold. In an exclusive new series for IranWire, academic Dariush Farahani lifts the lid on an under-reported contemporary crisis.
The aim of this series is to provide an insight into the drugs trade in Iran, including the impact of government policy on the drugs market, and to give a voice to marginalized communities affected by drugs that have been demonized in the media and public discourse.
Across the world and not least in Iran, drug users have been criminalized, stigmatized and treated as sick and malformed elements on the margins of society — a stance that strips them of their humanity and justifies harsh interventions into their lives. In recent years the so-called global “War on Drugs” has been questioned by an increasing number of actors. New human-centered and human rights-oriented policies and interventions are urgently needed to protect the rights of these individuals, and to prevent drug policy from further exacerbating violence, insecurity, and poor health outcomes in affected communities.
This series brings the global drug policy debate to Iran. We begin with an exploration of global drug policy before examining Iranian domestic drug policy in closer detail. Follow-up articles take in the breadth of drug users’ lived experiences in Iran and the haphazard management by government and civil society actors, based on interviews with people in Iran affected by drugs, be it as a user of opium, heroin or methamphetamine (shisheh), or by their involvement in the production, trafficking or distribution of illegal substances.
In the final instalment in this series, Dariush Farahani speaks to experts on drug policy and treatment services in Iran try to make sense of what the future might hold, and explain how profiteering and an outdated approach to drugs policy is putting lives at risk.
From my inquiries into the clinics, treatment camps, and spaces where drugs are sold and used across Iran it has become apparent that the issues facing policymakers, medical practitioners and vulnerable drug users are becoming more complex and protracted, not less, over time: particularly as the country enters a new stage of economic and political turmoil.
The Iranian harm reduction model is on the decline. This has led to the proliferation of non-evidence-based forms of treatment, particularly the mandatory “camps” in which users are forcibly held under Article 16 of Iran’s 2010 anti-narcotics law. It is also unclear how other forms of treatment ought best to be financed in the future. Iran is moving increasingly towards a system in which drug users are expected to pay for their treatment themselves except when detained in the camps. For the most vulnerable, who live hand-to-mouth and rely on free support and harm reduction, these changes have had devastating consequences.
As the Iranian socio-economic system weathers a new phase of internal crisis, the “drugs problem” is likely to receive less and less attention from policy-making elites. On the positive side, this means some organisations working under the radar to provide life-saving interventions may be able to continue doing so without undue interference. But at the same time the entrenched corruption that exists across the landscape of Iranian drug policy, from the criminal justice system, prisons, police, and drug treatment camps, could also continue unabated.
"We Are Under Fire From Politicians": NGOs Struggle to Get Funding
Donya, a drug expert and senior NGO official, says experts are hamstrung in their ability to freely articulate their concerns. To debate or research drug policy in Iran, she says, can “jeopardise your career” or see those who speak out barred from joining the Academy of their discipline.
The problem of addiction in Iran, she believes, is a “socially constructed” one broadly understood from a medical perspective. But there are important socio-economic and structural concerns that need to be acknowledged.
“Currently more than one million children in Iran have no ID cards,” she says. “There are even more adults without these. This contributes to the drug problem. You can’t get a proper job without these cards; you can’t do anything.
“After the revolution, drugs became a social and cultural issue. The US and the West were construed as wanting to pollute our youth with drugs. There are always those who benefit from these discursive constructions. And there are several actors and institutions who benefit from this construction of this problem: for example, the Drug Control Headquarters (DCHQ). It has no real function, but has lots of employees at various levels of power within the government. If we reach a point where they do not function, or are perceived to have no function, lots of people would be without a job. And so, there is a strong institutional incentive here.
“It is the same with the police. Lots of them get salaries to fight the war on drugs. This is all from an employment perspective. Then there is the medical industry: those who produce and sell methadone, for example. For years we have trained medical professionals to be addiction specialists in Iran, and this is their living.
“Look at the sponsors of the annual addiction science conference in Tehran. The biggest sponsors are always pharmaceutical companies. The theme of the conference is always on the science of drug use and addiction. It is an enormous industry.”
The biggest problem faced by NGOs working with drug users, Donya says, is the lack of funding. “NGOs who do harm reduction and treatment need buildings and manpower. The costs of manpower have increased greatly. More money is needed for the same work. Because of inflation, the money we receive from the government is less and less in real terms each month, even though the budget remains relatively stable.
“Meanwhile, we have to fight to keep harm reduction on the agenda. Back when harm reduction was first implemented, policymakers thought harm reduction would lead to drug-free people. But this is not the aim. Firstly, the aim is to reduce harm, and then, if possible, you can talk about weaning people off drugs. But now we are under fire now from politicians, who are questioning why to fund us anymore.
“On top of all of this, we are most likely going to see an increase in drug use and addiction due to the new sanctions and the desperate situation people are in. We might see an increase in injecting drug use as well as the purity of drugs decreases. This could lead to a new HIV epidemic or spread of other blood-borne diseases. We are not ready for this, as it stands.”
Corruption Pushing Drug Users Into Worse Crisis
On the other side of Tehran, Pedram, a senior drug treatment and policy expert who has worked in the field for decades, offers his take on the myriad allegations of corruption made by drug users and dealers, who claim it is the main reason they are involved in the trade.
Pedram is matter-of-fact. “Corruption is everywhere. When you talk about substance use management, it is corrupted unless it is proven not to be. It is strange in our country; you have to assume corruption is present unless proven otherwise.
“In prisons for example, you enter and they ask you what drugs you want. Then the dealers give you the drugs right there, on the spot. Methadone programmes in prison have also been a major source of corruption since prisoners had to start paying for their methadone. If you work for a gang inside prison, methadone is a lot cheaper and even free at times. But if you don’t work for a gang or don’t have the right contacts you can be excluded from the programmes.
“The government is a top-down organisation. No one else except those chosen by the government, such as civil society organisations, can truly be active in these issues. Those working for the government and receiving lucrative contracts do well. Everything is for money.
“There are large camps operating under Article 16 that serve thousands of clients. Many of the camp directors are retired senior police officers. They are paid by the government for each client they have in the camp, but there is no control over how they spend the money they receive from the state. As a director of one of these camps, I could potentially spend a tenth of what I get from the government on services and amenities inside these camps, such as bedding and food. I can maximise my profits and provide people with the bare minimum.
“Money is funnelled from the government but it does not go towards treatment. This is why the system continues the way in which it does.”
Support for harm reduction policies, Pedram says, has also waned because of the manner in which HIV/AIDS infection and transmission in Iran has changed. The spread of HIV/AIDS used to be primarily due to intravenous drug use but nowadays is mainly from sexual transmission.
“This, however, does not mean that the success will continue,” he says. “We need harm reduction policies in place so that no new epidemics arise. It has now been 10 years since harm reduction was the dominant paradigm in Iranian drug policy.”
Decriminalisation or at least a relaxation of criminal law, he adds, was seriously considered three to four years ago. “But based on the current situation, this won’t happen. We have so many social problems now, and so drugs have been marginalised as an issue of focus.”
Should We Really Be "At War"?
Just around the corner is the owner of a small clinic, Dawood, who sells methadone, buprenorphine and opium tincture to paying clients. He also occasionally goes to open-air drug markets in northern Tehran to provide treatment and harm reduction to drug users there.
“There are two discourses present in our society,” he says. “The first is framing drug use and thus addiction as a disease. The second is framing the challenge against drug supply as a war on drugs.
“At one point in our society, harm reduction was gaining a lot of ground and support. But after some years the DCHQ and political entities became critical, and a securitised approach increased in importance. As practitioners and scientists, whenever we can we try to undermine this securitised approach. Look at Portugal, for example – we could learn a lot from their model. But this requires political buy-in and a base of political support.
“Interventions might be great in theory but you need to consider the context, so it is up to each country to find the model that works best for them. Consider Article 16 and the compulsory drug treatment camps. These might work for one out of 100 drug users. And so, is it cost-efficient and worthy of a massive budget? Meanwhile, each government ministry has its own approach and workflows. The State Welfare Organisation does one thing, the Ministry of Health does another – they do different things and work against each other.
We had a revolution, then we had 8 years of war, then we had sanctions, then the JCPOA, then it was withdrawn and new sanctions were put in place. The system does not have time for these things. After 40 years, we still have not reached post-revolution stability. What are we? What society do we have? We wanted freedom, azadi, but the current system is all about money.”
Epilogue: A Word of Caution
On leaving Dawood’s clinic, I happen to bump into Faramarz: a PhD student studying under a prominent addiction science professor in Tehran. Throughout our brief conversation, Faramarz is careful with what he says, covering his mouth occasionally and frequently looking over his shoulder and my own. He gives me a warning that hangs heavy after all that I have been told.
“You need to be careful with doing any form of research in Iran currently,” he says. “In a totalitarian state, the ruling regime can do anything it wants as long as it has control of the money. Besides, how do we rise up when we Iranians have been beaten down so many times? Our nerves and lives are destroyed from the current situation.
“Be careful, Dariush jaan.”