Azam Rastegari
1 
, Mohammad Reza Baneshi
1,2* , Ahmad Hajebi
3,4* , Alireza Noroozi
5 , Mohammad Karamouzian
6,7 , Mostafa Shokoohi
7 , Ali Mirzazadeh
7,8 , Toktam Khojasteh Bojnourdi
9, Naser Nasiri
7 , Saiedeh Haji Maghsoudi
1 , Ali Akbar Haghdoost
7 , Hamid Sharifi
7 1 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
2 Center for Longitudinal and Life Course Research, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
3 Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
4 Department of Psychiatry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
5 Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
6 Centre On Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada.
7 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran.
8 Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
9 Ministry of Health and Medical Education, Tehran, Iran.
Abstract
Background: Estimating the number of people using illicit drugs and alcohol is necessary for informing health policy and programming. However, it is often challenging to reliably estimate the size of these marginalized populations through direct methods. In this study, we estimated the population size of these groups using the indirect Network Scale-Up (NSU) method in Iran from 2015 to 2016.
Methods: Using a self-administered questionnaire, we asked 15 124 individuals (54% men) about the number of people they know who used different types of drugs at least once in the past 12 months. Prevalence estimates were reported per 100 000 population. The uncertainty level (UL) was calculated using the bootstrap method.
Results: The average age of the respondents was 33 years old, and 35.1% of them were unmarried. The most common drugs and their prevalence were as follows: opium (2534 [95% UL: 2467-2598]), hashish (849 [95% UL: 811-886]), stimulants (methamphetamine, ecstasy pills, cocaine, and Ritalin) (842 [95% UL: 802-879]), heroin/crack (578 [95% UL: 550-607]), and drug injection (459 [95% UL: 438-484]). Additionally, we estimated the prevalence of alcohol use as 2797 (95% UL: 2731-2861). On average, substance use was 5.23 times more prevalent among men than women. Opium use was more prevalent among individuals aged >50 years old. Moreover, alcohol use was more prevalent among participants between 18 and 30 years old (5164 per 100 000 population).
Conclusion: Although opium continues to be the most prevalent illicit drug in Iran, the patterns of illicit drug use are heterogeneous among different age groups, genders, and provinces. Age-gender specific and culturally appropriate interventions are warranted to meet the needs of people in different subgroups.