Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran

Farnia, Marziyeh; Ebrahimi, Bahman P.; Shams, Ali; Zamani, Saman

doi:10.1016/j.drugpo.2010.03.008

Cited by 32 publications

(24 citation statements)

References 13 publications

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“…In other words, to understand methadone therapy completely, common objectives of withdrawal programs must be also taken into account: 1) Eliminating or reducing withdrawal symptoms, 2) Eliminating or reducing the craving for drugs, 3) Preventing recurrence of addiction, 4) Restoring the physiological activity level which has been lost due to drug abuse, and 5) Reducing criminal behaviors and improving behaviors that affect social and psychological health (27,(41)(42)(43). Iran is considered as one of the most successful countries in the field of methadone therapy as a method of harm reduction (44), however, various studies conducted in other countries have also shown the success of methadone therapy in harm reduction, especially in reducing high-risk behaviors such as shared injection (15,19,28,41,45,46). Thus, according to the results of the present research, the weaknesses extracted from these programs can be a guide to review and continue MMT programs in Iran prisons.…”

Section: "Methadone Users Who Do Not Inject Drugs Anymore Could Intermentioning

confidence: 99%

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran

Moradi

Farnia²,

Shokoohi

et al. 2015

Int J Health Policy Manag

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Background: As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT) has been initiated in prisoners since 2003. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran. Methods: On the basis of grounded theory and through conducting 14 Focus Group Discussions (FGDs), 7 FGDs among physicians, consultants, experts, and 7 FGDs among directors and managers of prisons (n= 140) have been performed. The respondents were asked about positive and negative elements of the MMT program in Iranian prisons.Results: This study included a total of 48 themes, of which 22 themes were related to advantages and the other 26 were about shortcomings of MMT programs in the prisons. According to participants' views "reduction of illegal drug use and high-risk injection", "reduction of potentially high-risk behaviors" and "making positive attitudes" were the main advantages of MMT in prisons, while issues such as "inaccurate implementation", "lack of skilled manpower" and "poor care after release from prison" were among the main shortcomings of MMT program. Conclusions: MMT program in Iran's prisons has achieved remarkable success in the field of harm reduction, but to obtain much more significant results, its shortcomings and weaknesses must be also taken into account by policy-makers.

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Section: "Methadone Users Who Do Not Inject Drugs Anymore Could Intermentioning

confidence: 99%

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran

Moradi

Farnia²,

Shokoohi

et al. 2015

Int J Health Policy Manag

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“…Prevalence of HIV infection among adult prisoners in Tehran was an average of 4%. 6 Iranian prisons, like in many other countries, contain a disproportionate number of individuals with drug use problems. It is estimated that a little less than half of the prison population in Iran are convicted of drug-related charges, with the majority of them related to illicit drug use.…”

Section: Introductionmentioning

confidence: 99%

“…The number of drug-using prisoners under maintenance treatment with methadone has increased from 100 people to more than 25,400 between 2002 and 2008. 6 Considering the challenges in regard to the prevention of blood-borne infection transmission and the implementation of extensive preventive measures against drugrelated harm in Iran, there is still very limited research-based evidence to document the behavioral and health situation of prisoners in the country. This study is part of a larger project initiated by the United Nations Office on Drugs and Crime (UNODC) Country Office of the Islamic Republic of Iran and was conducted to determine baseline measurements before the introduction of the MMT program for opioid-dependent prisoners in Karaj Central prison, Iran.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Drug Use and HIV-Related Risk Behaviors among Incarcerated People in a Prison in Iran

Zamani

Farnia²,

Torknejad³

et al. 2010

J Urban Health

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Previous research indicates that prisoners in Iran are at risk of drug-related harm, including acquisition of blood-borne infections. In response, several prevention interventions have been introduced into prisons in Iran, such as methadone maintenance treatment (MMT). MMT is now provided to opioid-dependent prisoners in 142 of the 230 prisons and correctional settings in Iran. A baseline behavioral survey was conducted in Karaj Central prison which mainly holds prisoners with drug-related charges. Overall, 203 male prisoners from randomly selected rooms in two prison blocks were interviewed using a structured questionnaire in 2007, just before the introduction of MMT program in this prison. Among participants, 7% reported never having used illicit drugs in their lifetime, but 51% had used non-injecting illicit drugs, and as high as 42% reported having injected an illicit drug. Up to 79% (160/203) of all participants reported using drugs, and about 6% (12/203) reported drug injecting during their current incarceration term. Same-gender sexual practice during current incarceration term was reported by 2.5% (5/203) of all male prisoners. Comparison between injecting and non-injecting drug-using prisoners indicated that drug injectors had higher rates of previous incarcerations, commenced drug use at a younger age, were more likely to have used illicit drugs in the previous week, were more likely to have been treated by a physician for drug addiction, had higher rates of registration for methadone treatment inside prison, and were more likely to have been tested for HIV infection. These study findings provide a behavioral profile of prisoners in regard to drug-related harm and can be considered in any plan to introduce or improve provision of MMT in prisons in Iran or other countries with similar features.

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“…There was widespread use of pharmacotherapy (naltrexone and methadone maintenance) in hospitals (2000), outpatient clinics (2002), and prison clinics (2002). By 2010, Iran's treatment efforts in the prisons resulted in the largest population (25,000) of prisoners maintained by methadone in the world (Afkhami, 2009;Farnia, Ebrahimi, Shams, & Zamani, 2010;Tanner, 2013). Other milestones included the opening of the first therapeutic communities in Iran (2001;Mokri, 2002) and establishing the Iranian National Center for Addiction Studies (INCAS; to conduct addiction-related research and professional education and networking (INCAS, 2007).…”

Section: Introductionmentioning

confidence: 99%

Congress 60: An Addiction Recovery Community within the Islamic Republic of Iran

White

2015

Alcoholism Treatment Quarterly

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The Islamic Republic of Iran, in response to the highest rate of opium consumption in the world, has devoted substantial resources to reduce drug availability and address addiction-related problems. Demand-reduction activities have included residential rehabilitation centers, outpatient treatment centers, and support for addiction recovery mutual aid organizations such as Narcotics Anonymous. The growing role of voluntary nongovernmental organizations (NGOs) in supporting addiction recovery in Iran has not been fully described in the professional literature. This report describes one such NGO, Congress 60, which was founded in 1998 and has since grown to 38 branches in Iran with more than 20,000 members. Included in the review are the history, governance, philosophy, and recovery support methods of Congress 60.

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Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran

Cited by 32 publications

References 13 publications

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran

Patterns of Drug Use and HIV-Related Risk Behaviors among Incarcerated People in a Prison in Iran

Congress 60: An Addiction Recovery Community within the Islamic Republic of Iran

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