AIDS Crisis Brings Radical Change in Iran's Response to Heroin Use
July 6, 2005
Alarmed by the potential for an AIDS epidemic fueled by injection drug use, Iran's theocratic government is offering drug users cheap needles and methadone treatment. In a Jan. 24 letter, Ayatollah Mohammad Esmail Shoshtari, head of the judiciary, issued an executive order embracing "such needed and fruitful programs" as needle exchanges and methadone maintenance. He instructed prosecutors to ignore laws on the books and defer to Iran's Health Ministry for the control of AIDS and hepatitis C.
"This was a very crucial step," said Ali Hashemi, director of the cabinet-level Drug Control Headquarters. "Inevitably we have to do this in order to reduce the risk of AIDS."
"It's ironic that Iran, very fundamentalist, very religious -- very religious -- has been able to convince itself" to adopt such policies, said Bijan Nasirimanesh, who runs a drop-in needle, bleach and methadone dispensary in south Tehran.
In surveys of HIV-positive Iranians, two-thirds were infected through needle sharing. Nasirimanesh's Persepolis clinic found an HIV infection rate of 25 percent in a survey of 900 drug users. And researchers found 13 percent of users were infected at the National Center for Addiction Studies (NCAS) treatment center.
In response, the government subsidizes needles -- so that they are cheap enough to discourage re-use -- and makes them available without a prescription. "You pay less than five cents a syringe," said Azarakhsh Mokri of NCAS. "People purchase up to 100 at a time."
This spring, the conservative-dominated Parliament voted to allow any doctor to dispense methadone, though under tight monitoring guidelines.
However, public health experts caution that these policies have yet to be enacted on a large scale. "The policies are very good," said Gelareh Mostashari, a UN Office on Drugs and Crime physician. "But there are practical applications that have to be executed."
07.05.05; Karl Vick
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.