Opioid use,treatment and harm reduction services: the first report from the Persian Gulf region

Objective: The objective was to review all the available published studies and reports with particular emphasis on the prevalence of opioid use and the availability of opioid treatment and harm reduction services for adults in nine countries of the Persian Gulf region. The countries are the members of the Middle and North Africa Harm Reduction Association (MENAHRA).

Methods: Data were collected by searching Pub Med, Med line and EMBASE, by reviewing the reports of the United Nations Office on Drugs and Crime (UNODC), World Health Organization (WHO), Ministries of Health (MoH) in each country, regional databases, conference presentations and annual AIDS progress reports over the last one decade.

Results: We found that with an exception of Iran, there is a paucity of research on opioid use in the region. With an exception of Iran, opioid substitution therapy (OST) is not developed but in some countries, needle and syringe programs (NSPs) are slowly emerging. Voluntary counselling and testing (VCT), HIV testing and antiretroviral therapy (ART) have been widely addressed. Non-governmental organizations (NGOs) are generally inactive. Islamic prohibitions against opioid use and stigma have prevented developing opioid treatment and harm reduction in the region.

Conclusion: An exchange of knowledge and experience on opioid use prevention, treatment and harm reduction is required between Iran and the region. Collaborations among religious leaders, mass-media, clinicians and policy makers are rigorously suggested to remove Islamic prohibitions and stigma and make opioid treatment a social norm.