At a specialized panel discussion at Tehran’s University of Social Welfare and Rehabilitation Sciences on Monday, NGOs, international experts and officials from relevant state organizations discussed the pros and cons of the mobile centers launched by the charity organization ‘Rebirth’ that scout Tehran city highways in an initiative called ‘social harm reduction.’
It is over a year since the mobile centers started working in Tehran with the objective of harm reduction among injection drug users (IDUs), the Persian-language daily ‘Etemad’ reported.
Rebirth works in drug abuse prevention and treatment, harm reduction and drug demand reduction and provides help to an estimated 140,000 addicts each year. Its activities include a myriad of services to those grappling with addiction such as drug awareness and prevention programs, rehabilitation and counseling.
The services include outreach programs (two-person teams), drop-in centers (DICs or daily sheltering facilities), shelters (for staying overnight), and mobile centers, all aimed to help reduce the social consequences of drug abuse and other harm.
The non-profit NGO has seven shelters and DICs in Tehran Province alone, mostly in south of the capital where the drug addiction problem is said to be more acute.
“The program designed to reduce or minimize negative health consequences related to substance use among IDUs started in 2014 following similar efforts across the world where teams of social workers are trained to locate ‘hot spots’ and provide clean syringes, food, clothing, and first aid,” says Sara Esmizadeh, who heads the charity’s planning department.
Harm reduction was seen as an approach after the threat of HIV spreading among and from injecting drug users appeared large. It complements other methods that seek to prevent or reduce the overall level of drug consumption.
Esmizadeh said expanding such services to all substance abusers across the city is an arduous task, mainly because the hangouts change rapidly. Secondly, the two-member mobile teams cannot carry a lot of equipment with them, and are understaffed to cater to the whole lot of addicts.
“We have assigned four vans in two daily shifts on major highways in Tehran to identify drug users,” Abbas Deilamizadeh, CEO of the charity, told the Financial Tribune by phone.
Advantages
The vans are active over the main hot spots on Hemmat, Kordestan, Chamran, Niayesh, and Hakim highways and cover “an average of 1,040-1,060 abusers on a daily basis,” he said.
The advantage of mobile centers is the easy access to abusers in short time, and better monitoring and supervisory control. “The mobile facilities are economical and can easily move to the hangouts in different locations.”
For drug users too, this is advantageous and encouraging as they are spotted and reached out by the mobile centers; not the other way around.
Deilamizadeh, who also chairs the Asian Drug Demand Reduction NGOs Association, added the rise in use of amphetamine-type stimulants (ATS) began about four years ago.
“Our concern is how we can help restrain addicts’ from high risk behavior in consumption patterns such as injection of heroin or use of ‘shisheh’ (high purity crystalline methamphetamine).
Plagued with drug addiction and trafficking, despite massive efforts to eradicate the trade, Iran has one of the highest rates for opium and heroin use, according to this year’s World Drug Report published by the UN Office on Drugs and Crime.
It is not clear why despite the best efforts of and claims by Rebirth and several other NGOs, state-run bodies and charities the number of junkies and drug pushers is of the ascending order and the ‘drug epidemic’ keeps on taking a high toll in Iran with new killer narcotics entering the market on a regular basis.
Mohsen Roshan Pajouh, deputy of addiction prevention and treatment at the State Welfare Organization stressed the need for a variety of services concerning the problem of substance abuse, since “addiction is a versatile system.”
“It adapts itself with the number and level of users’ needs that is why we have to think of diverse plans and create new counter strategies.”
The mobile centers are part of a range of global public health policies designed to reduce the harmful consequences associated with various risky human behaviors. Harm reduction refers to policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs.
However, critics of harm reduction typically believe that tolerating risky or illegal behavior sends a message to the community that such behaviors are acceptable and that some of the actions proposed by proponents of harm reduction do not actually reduce harm over the long term.
Scientific Approach
Roshan Pajouh said harm reduction is a scientific approach that is in line with safeguarding public health and government policies support it. There are 200 safe injection centers for drug users already functioning in the country under the guidance of the Health Ministry.
“The needle exchange program has drawn criticism from some sections of the people and therefore the plan needs to be carefully studied,” IDCH deputy chief Alireza Jazini had earlier stated.
Anti-Narcotics Police Chief Ali Moayedi had also said the police force is cooperating with the supervision of safe injection centers for drug users.
Alireza Noruzi, head of substance abuse prevention department at the Health Ministry, present at the debate, said, “International studies on mobile centers indicate that even if such facilities are more costly than regular centers, as they need a well-equipped vehicle and other infrastructure, the process itself triggers less resistance among abusers and can reach out to a larger number of addicts.”
Given that the junkies hangouts and composition change depending on the time of day, with women making up the bulk of addicts during the daytime, while men overall constituting the majority of drug users, the panelists were in consensus that mobile centers play an important and complementary role to transitional (fixed) needle-exchange centers.
Rebirth, founded in 2001 and initially run by former drug addicts, provides treatment and rehabilitation services to drug addicts using a 12-step program.
In the area of prevention, the charity organizes information sessions in schools on the negative effects of drug abuse. Family members of drug users and at-risk individuals are also targeted at these sessions. For the general public, Rebirth promotes drug-free lifestyles in the community through sports, cultural and recreational activities.
The Rebirth Charity Organization (Islamic Republic of Iran), the Bogota Children’s Shelter (Colombia) and Mothers against Drugs (Belarus) were the 2005 winners of the United Nations Vienna Civil Society Award.
