Case Study of the Historical Experience of Opium Harm Reduction Using Controlled Supply Chain in Iran

Drug addiction is a multifactorial problem in which various political, economic, social, and cultural factors are involved. The controlled supply chain of narcotics has been introduced as one of the effective harm reduction solutions. This study aimed to evaluate the supply-oriented intervention for opium harm reduction in Iran with a focus on the historical experience of controlled distribution of opium at drug stores before the 1979 revolution.

In this study, we used a case study method with the Critical Incidence Technique (CIT) in which, we held 15 semi-structured face-to-face interviews with experts practicing in many related fields of policy-making, regulatory, research, and delivery of substances. The available documents were reviewed and all data were coded and categorized by thematic analysis.

After categorizing the codes, the data were divided into two groups :(1) The pre-revolutionary harm reduction state, which includes the opium situation from the stage of cultivation to primary and secondary distribution at drug stores, its strengths and weaknesses; and 2) The post-revolutionary harm reduction state, which includes examining the existing challenges, the actions taken by the government so far (including NGOs for harm reduction of opium, addiction treatment clinics, and regulations designed to reduce harm), its strengths and weaknesses, and proposed strategies.

According to the results, the re-distribution of opium at drug stores like what used to be is not a good remedy to reduce the harm. Desirable results may be obtained by performing some corrections in the current system.