Drug Abuse in Iran Essays

Drug Abuse in Iran Essays Drug Abuse in Iran Essay Drug Abuse in Iran Essay Abstract : purpose of this paper is to inform my classmates the rate of substance abuse for Iranian high school students. High school students who are either experienced being prison or awaiting a trial for a crime that they made, either with HIV or without it. This research has been done by me, Dr. Arash and Kamiar Alaei 5 years ago in Iran. Dr. Kamiar Alaei spent over 3 years in prison and his brother Dr. Arash is still in prison for their phenomenon research on AIDS in Iran. I will discuss about the risk factors and social background of 3 Islamic countries, Iran, Kuwait and Iraq. The rate of HIV, and variety of drugs. Just from one high school in Tehran, we had this result, (300 boys) 40. 5 % abused substances at some time in their lives. Among the substance users, the use of cigarette ranked first (36. 9%), followed by alcohol (24. 2%), opium (12. 7%), hashish (8. 7%), Marijuana (8. 2%), heroin (2. 5%), cocaine (2. 5%), hallucinogens (1. 7%), morphine (1. 4%). Only 22. 5 % of the students were still using substances: cigarette 18%, alcohol 13. 5%, opium 2. 3 %, marijuana 2%, hashish 1. 7%, heroin 0. 8%, cocaine 0. 5%, morphine 0. 3% and hallucinogens 0. 3% (Some were using more than one substance). Pleasurable purposes, habit and release of tension were the most common motivations reported for using substances. Introduction I am writing about substance abuse in adolescence in Iran and also how it effects youth when they enter to their early adulthood. A number of research studies of substance use among adolescents, especially students have been carried out in different countries and different levels of educations. Substance use among the youth of Iran especially students is a major concern among researchers and policy makers. In Iran there is a centuries – old tradition of substance use and abuse. For instance opium was known to ancient Persians and has traditionally been used for treating physical and mental stress as well as for pleasurable and social purposes. Use of alcohol is both religiously and legally prohibited in Iran, but use of other substances are legally prohibited, except cigarette, which is not prohibited. the three most common reasons of opiate use among Iranian opiate addicts were enjoyment , physical pain and sedation . Causes, history and background After the narcotics shipments cross the Iranian border they usually are broken up into smaller units so they are more difficult to intercept. 60 percent of the drugs that enter Iran pass on into Turkey, the Caucasus, and the Persian Gulf. The remaining 40 percent stays in the country. The number of people using drugs- from addicts to casual users- is estimated to be around 8 million, ( about a quarter of them are under 19) although the head of the Drug Control Headquarters believes that the real figure could be much higher because most drug abusers want to avoid the stigma of being identified as addicts. 25 The average age of users is falling. A government official says the average addiction age has fallen to 10-19, whereas it used to be 25-29, and the head of the Drug Control Headquarters ascribed the increase in young drug abusers to the country’s population explosion. Drug abuse has led to a growing prison population. Forty percent of all crimes in Iran are drug-related felonies. The head of the Prisons, Security, and Correction Organization said in July 2005 that out of the 3 main juveniles prisons in Iran, Kuwait and Iraq 32,000 were imprisoned for drug addiction. The economy, and especially the high rate of joblessness, tops the list of reasons given by Iranians for drug abuse. Unemployment stands at 14 percent officially and is estimated by outside experts to be in the 25 percent range. This grievance combines with general boredom and a lack of options. A young People always say, â€Å"We’re all jobless. We have nothing to do. We try to do a little bit of business here and there and we get arrested as troublemakers. That’s why there are so many drug addicts here. It’st he despair. †3Another addict said that he had been in combat for forty months during the Iran-Iraq War since he was 14, but when he returned the regime abandoned him. He supported his drug habit with odd jobs and charity, and he warned, â€Å"The youth are becoming drug addicts. hey have no freedom, no jobs, nowhere to go and have fun. So we are all addicts. †National and community leaders are aware of the relationship between jobs and drug abuse. Young people turn to drugs because of â€Å"unemployment, depression, and neglect,† a parliamentary representative said, adding that â€Å"no hope for the future or social joy† are contributory factors7 A Frid ay prayer leader said that unemployment and poverty are among the root causes of drug abuse, and he urged the government to create job opportunities. The availability of drugs also makes an impact. In the words of an individual who deals with addiction treatment and prevention at the Welfare Organization, â€Å"the purchase of heroin has become easier than the purchase of a bottle of milk. To buy bread, we are forced to wait in a line for a long time, but to purchase drugs, no problem exists. †When a war veteran who was describing the lack of alternatives to taking or dealing drugs complained that the local park only has four trees, an opium addict chimed in, â€Å"Instead of trees in our parks, all you find are drug dealers. † There are also other factors contributing to drug abuse in Iran. A member of parliament who also happens to be secretary of the Antidrugs Society attributed drug abuse to the way individuals are treated in society: â€Å"In our society, human beings are not looked upon with dignity and respect, otherwise people who are socially accepted would not turn to drugs. †41 Another parliamentarian explained that culture is behind the demand for drugs: â€Å"Today, the youth are bored with what they have and wish for things they haven’t got. This is rooted in Western culture and should be confronted with the use of cultural tools. †4A supervisor at Shiraz University’s Cultural Center said that culture- not enough sports, depressing and overcrowded dormitories- is a significant reason for the prevalence of drug abuse. 4There also are the kinds of reasons one expects to hear from Iranian officials. One cleric said that weak religious faith is the main reason why people are attracted to drugs. 44 Another cleric said that Iran’s enemies are encouraging the youth to consume drugs. Islamic countries increasingly confront a set of social problems affecting their youth, such as teenage runaways, violence in the family, drug addiction, high risk behavior, crime, prostitution, alcohol abuse phenomena associated with modernity, urbanization, population growth and economic strain. Some Middle Eastern countries initially find it difficult to acknowledge, let alone address, such problems. On the level of values, there appear to be three principle obstacles preventing an open acknowledgement of the kinds of social problems listed above: The belief that these are problems an Islamic society should not have. The posture that if they do occur, they should be dealt with privately by the family/clan, neighborhood or community. The fear is that by helping the affected person, you are validating their conduct and thereby encouraging others to imitate them. This is changing, of necessity. Families and communities are not able to absorb and manage problems as they did in the pa st, in part because traditional structures are no longer intact, and in part because the traditional solutions are increasingly overlaid by new beliefs about what is legal, ethical and appropriate. At the same time, the scope of the problems does not allow them to continue to be swept under the rug. Concepts of human rights, combined with legal reforms and exposure to international debate of the relevant issues, are impacting regional perceptions of these problems. The increased willingness to acknowledge and address sensitive social problems is reflected both in official government reporting, which includes the recognition that these problems exist and are significant, and in public discussion of formerly taboo issues in popular media. See examples at right on teen runaways and family violence from Zanan, an Iranian Womens magazine. ) The Islamic Republic of Iran has become relatively open in its discussion of youth drug addiction, teenage runaways and underage prostitution. Speaking openly about such problems is a first step to recognise the problem. . Fortunately, now we see a greater degree of realism. 1 Theory If I want to describe a theory to explore this problem, I woul d want to go by Erik Erickson theory. The core concept of Eriksons theory is the acquisition of an ego-identity, and the identity crisis is the most essential characteristic of adolescence. Although a persons identity is established in ways that differ from culture to culture, the accomplishment of this developmental task has a common element in all cultures. In order to acquire a strong and healthy ego-identity the child must receive consistent and meaningful recognition of his achievements and accomplishments(Muuss, 1975, p. 55). Adolescence is described by Erikson as the period during which the individual must establish a sense of personal identity and avoid the dangers of role diffusion and identity confusion (Erikson, 1950). The implication is that the individual has to make an assessment of his or her assets and liabilities and how they want to use them. Adolescents must answer questions for themselves about where they came from, who they are, and what they will become. Identity, or a sense of sameness and continuity, must be searched for. Identity is not given to the individual by society, nor does it appear as a maturational phenomenon; it must be acquired through sustained individual efforts. Unwillingness to work on ones own identity formation carries with it the danger of role diffusion, which may result in alienation and a lasting sense of isolation and confusion. The virtue to be developed is fidelity. Adhering to ones values contributes to a stable identity. Based on this theory, identities are lost in Iran, youth are looking to find themselves in their life. They have no hope and future from their perspective is very dark. They hate religion, blame their parents for 1979 revolution, they can adjust between their two worlds, one is the one they see over satellite, western life and one is the one they watch on daily bases. They are lost. So either they study very hard to get an admission from respected universities in other countries and run away from middle east or lose themselves in drug, prostitution, AIDS and unawareness. Establishment of the Triangular Clinic After reporting a huge number of HIV/AIDS youth patient in drug abusers, the estimated age of patients are between 15-19 all males, Medical University and Health Department decided to give an appropriate response to prevent this problem. Initially a large HIV center affiliated to the University hospital was planned. However, fearing that such a move would stigmatize Iran as the epicentre of HIV in the country, this suggestion was at first opposed. However in October 2000 the Triangular Clinic was established. This center is very accessible for patients. The concept of the Triangular Clinic is to tackle three important issues: addressing injecting drug abuse through a harm reduction approach; the treatment of STDs; and care and support for patients. The problems of drug dependence, STDs and HIV are all behavioral in nature and hence, the clinic is a center for the treatment of behavioral disease. By grouping the three together, it is possible to organize a comprehensive and integrated service to the patients. Moreover, avoiding direct reference to HIV alone minimizes any associated stigmatization. This center has provided the patients with, medical services, nursing services and a lot more. The basic diagnosis and recommendation would be how to reduce HIV/AIDS in community and how other people can use the Triangle outside of Iran. Drug abuse treatment In my opinion the first thing which should be considered as the most important strategy would be treating the drug abusing itself and then we can concentrate on HIV/AIDS. tudies have consistently shown that participation in drug abuse treatment is associated with lower rates of drug injection. Treatment for drug addiction has been shown to be effective as an HIV prevention strategy, especially when it is available to the drug user at the time when he or she seeks help. Therefore a comprehensive approach toward IDUs should includ e flexible, accessible and caring treatment systems. Within these systems, drug substitution programs are the most commonly used for IDUs who are addicted to opiates, and within the developed world, methadone is the preferred prescription. It may be used for gradual withdrawal of various age groups or for long term maintenance in populations of older chronic users. Substitute programs do not cure the addiction, but by removing IDUs from lifestyles in the criminal world and attracting them to socially acceptable clinical surroundings, there are better opportunities to decrease injecting and needle sharing behaviors, thereby contributing to a decrease of HIV transmission. This service could be distributed to all population, such as women, children, people who cannot afford because all treatments are for free of cost. Fortunately equitable distribution of health service is accessible to all, but most of the people in community do not will to participate in the program or treatment sessions. HIV primary prevention Primary prevention activities include the training of student when they are still in elementary school. volunteers to raise HIV warned among their families, friends, neighbors and the general public. The volunteers make referrals to individuals seeking help. Seminars and workshops are held for targeted groups such as soldiers, health workers and teachers. Clinic staffs are also involved in raising HIV awareness through mass media campaigns on radio, television and in the local press. In addition, peer education programs and some limited outreach is conducted. Harm reduction and sterile syringe access programs and nursing roles The Clinic (individual and community volunteers) provides risk reduction materials free of charge- condoms, bleach, needles and syringes. Thousand of these materials have been distributed. Serodiscordant couples are provided with condoms on a regular basis from the time of registration at the Clinic and none have seroconverted as yet. Counselling sessions have also been provided to serodiscordant couples to help keep families together and prevent divorce. Unfortunately average age of marriage in lower class family is very low, by the time they are 15, they may even have kids. When implemented as part of a comprehensive HIV/AIDS prevention strategy, sterile syringe access programs play a unique role in engaging hard-to-reach populations at high risk for HIV infection in meaningful prevention interventions and treatment opportunities. Evaluations of these programs indicate that they are an effective part of a comprehensive strategy to reduce the injection drug use-related spread of HIV and other blood-borne infections. In addition, they do not encourage the use of illicit drugs. For example, one study in juvenile prison showed 80 percent decrease in HIV incidence attributed to sterile syringe access programs. The cumulative research shows that sterile syringe access programs are effective in reducing the further spread of HIV among drug abusers, their sexual partners, and their children. Furthermore, these programs help to:  ·increase the number of drug users who enter and remain in detoxification and drug treatment programs if they are available to them;  ·disseminate HIV risk reduction information, materials for behavioural change, and referrals for HIV testing and counselling and drug treatment services;  ·reduce injection frequency and needle-sharing behaviors;  ·reduce the number of contaminated syringes in circulation in a community; and  ·Increase the availability of sterile injection equipment, thereby reducing the risk that new infections will spread. Spouse Issue ( Gender) Consider some of the ways in which young women may be implicated in drug use. Women are centrally involved as sexual partners of male IDUs, as careers of people with HIV/AIDS and as people who may be vulnerable, in their own right, to the risk of HIV through drug injecting. The links between drug use, HIV and gender in developing regions are not yet well understood and need further exploration. It is clear however that the problems surrounding HIV and gender are greatly compounded when drug use is an added factor. The relationships between sexual behavior and IDU are quite complex. Women IDUs, who are dependent on men, may fear rejection by their partners if they do not inject drugs. Some people use drugs because they believe the drugs will increase pleasure during sex. Others engage in sex in order to obtain drugs or money to purchase them. Factors placing women drug users at high HIV risk  ·Being drug users themselves  ·Sexual relations with drug using partners  ·Engaging in commercial sex to support drug use  ·Being (girl) children of injecting drug users Lack of education and vocational skills. Women have increasingly become involved in all forms of drug-related problems and are likely to suffer more severe consequences than men as a result of this involvement. Women IDUs are at increased risk of HIV infection over male IDUs for several reasons, but principally because of their generally subordinate status in society. When drug-using women are also involved in sex work, the risk of acquiring HIV infection through unprotected sex, compounds the existing risk of transmission through the reuse of needles and syringes. Women may also be introduced to drug use by sexual partners who inject their drugs for them. If the sexual partner becomes ill or is imprisoned, these women are at risk for overdose if they are unaware of the dosage they have been injecting, and at risk for HIV, if they must rely on others to inject them. There is less documentation about women drug users than their male counterparts. In most literature specific attention is not devoted to female drug users as a distinct group; consequently in the perception of the general public, female drug users are mostly invisible. As a result of these gender-specific perceptions of drug users, female and male users may differ with regard to their backgrounds, reasons for using drugs, psycho-social problems and resulting needs. Although the ratio of female to male drug users is still low, it has been steadily increasing. This phenomenon coincides with the rise of population mobility, broken families, and collapsing communities. While society in general does not look kindly on drug users, it is even harsher in viewing women who use drugs. A woman who uses drugs for whatever reason and who is infected by HIV seldom receives the sympathy and support that she needs. Also from traditional expectations of women as wife, mother and nurturer. Most of provinces, for example, do not have drug-treatment facilities for pregnant or HIV positive women, nor do they make provisions for child care, even though many women who use drugs are single, separated or divorced. Women who use drugs are often hidden from public view. However, women who are partners of drug users and girls who are daughters of drug users are even less visible and accessible. Non-using women with drug-using partners have different problems, especially if their partners are so heavily addicted as to be unable to function normally. Women often endure verbal, physical and sexual abuse, poverty and deprivation of material comfort and facilities, lack of emotional and social security, concern about the future not only for themselves but also for their children. Some women eventually turn to using drugs as a way of escaping from the harsh realities of their lives. Many women are forced into egging or prostitution to earn money to buy drugs for their partners. Of course, through these activities their risk of HIV infection may rise still further. . Prevention of mother to child HIV transmission and post-exposure prophylaxis HAART (highly active anti-retroviral therapy) prophylaxis is provided for pregnant mother, although so far few women have received it. Health workers occupationally exposed to HIV and wives who have had unprotected sexual contact with their H IV infected husbands have also been given HAART prophylaxis. Due to lack of access to appropriate technology in poor provinces in Iran, sometimes the proper treatment cannot be done for them, and they have to be sent to bigger cities to which have access to technology. Young People Young people are particularly vulnerable to the risks posed by drugs and HIV. Children aged 10 and younger are using illicit drugs in many cities and communities around the world. These young people may live on the streets where risks to health are high and welfare support critically low or in households where information about HIV and illicit drugs is taboo. Young people may be initiated into injecting by more experienced drug users in a greater position of power or trust. This is the main issue which needs to be thought of seriously. The children of drug users are often forced to share the burden of the impact of parental (particularly paternal) drug use, and both boys and girls may be forced into child labour or prostitution in order to support parental drug use. The needs of such children are seldom taken into consideration in program planning or policy formulation exposed to HIV. Access to Treatment and Rehabilitation People with drug abuse problems have different needs. Women, the young, the poor, refugees and religious minorities need easier access to early intervention and services. Once in treatment, drug abusers may need job training and referral, assistance in finding housing and reintegrating into society. Drug abusers who commit crimes require alternative treatment in order to break the cycle of drug abuse and crime. Supportive therapist for PLWHA and the families and nursing roles Psychosocial support (psychotherapist and nurse) for is provided for PLWHA, including support for PLWHA group. Affected family members of PLWHA are offered counselling support to enhance their coping abilities and they are wiling to receive this help. They are counselled to provide support to PLWHA, with an emphasis on improving communication, disclosure and relationship. Recreational activities for PLWHA and their families and friends are also organized. Community- based outreach workers in Kermanshah Triangular Clinic and nursing roles Community-based outreach workers are on the front line in the local community, and they know where, when, and how to contact even the most difficult-to-reach drug users in their neighborhoods. As a trusted and recognized source of information, an outreach worker can help drug users understand their personal risks for HIV and other blood-borne diseases and identify the preventive steps they need to take. As a peer, the indigenous outreach worker can encourage drug users to stop or reduce using and injecting drugs and enter drug abuse treatment. They can provide referrals to drug users for drug-abuse treatment, for testing and counseling for HIV/AIDS and other infectious diseases, and for sterile syringe access programs. Outreach workers (nurses) are a vital link to:  ·educational and risk-reduction information on HIV/AIDS, HBV, HCV, and other STDs;  ·information and materials for behavioral change, including the HIV/AIDS risk-reduction hierarchy, bleach kits to disinfect injection equipment, condoms for safer sex, and instructions for proper condom use and disposal; and  ·Services for testing and counseling for HIV, HBV, HCV, and other STDs; drug abuse treatment; and other community health, prevention, and social programs. Team work As it is concluded from the above paragraphs, none of these strategies and planning can be done without having a good team work. Some of can be achieved by health care professionals, some by community workers, some by supporting their feelings. Coordination of services between the sectors One of the significant aspects of Triangular Clinic is that various services in sectors are coordinated. The Clinic has been taken enormous pains to establish this mechanism, which has ensured that the infected, affected and members of high-risk groups receive the maximum benefits. Key sectors coordinated other than ministry of health (government, which is main system) with include the Red Crescent Society, Imam Welfare Committee and the State Welfare Organization. How drug use and HIV are viewed may also depend on the sector of government concerned with the issue:  ·Health departments may see HIV and drug overdose as the fundamental problems posed by injecting drug use  ·The Police may be more concerned with crime associated with illicit drugs  ·Home Ministries or Patrols may be primarily concerned with suppressing the supply of drugs  ·Chief Ministers may be concerned with the overall impact of drug problems on the community Whatever approaches governments and other policy making agencies take towards illicit drug use, it is important that they carefully consider the full implications of their decisions. Declaring stringent bans on drug use, or advocating imprisonment for all offenders may sound like strong leadership, but in isolation from other public health measures, may simply result in more harm. Red Crescent Society The international organization provides several services in middle east related to the above strategies: financial and material support to PLWHA, HIV counselling for those engaged in high-risk behaviour and a volunteer training program in primary prevention. The Triangular Clinic supports this by facilitating the training and providing information. Volunteers attend the Clinic to help with referrals. . State Welfare Organization The state Welfare Organization provides inpatient and outpatient treatment and rehabilitation services for drug abusers. The Triangular Clinic regularly makes referrals to their abstinence-oriented treatment program. Government The second component of the Comprehensive Drug Control Program of the Islamic Republic of Iran focuses on drug demand reduction (DDR). In this area, the program will develop and enhance the national capacity for preventing drug abuse, as well as for the treatment and rehabilitation of drug addicts. In line with the guidelines of the National Five-Year Drug Demand Reduction Strategy, the project focuses on the consolidation of the Prevention Department of the State Welfare Organization and the Ministry of Health, Treatment and Medical Training, and on the decentralization of drug abuse control initiatives by strengthening local monitoring and control plans of action. The project will contribute to the development of national specialized technical skills and capabilities at central and local levels by providing training to specialists, NGOs and other voluntary organizations. Subsequently, the project will provide financial support and technical guidance for the first steps of drug demand reduction initiatives launched at local levels. A special emphasis will be placed on initiatives of NGOs that promote children s and women s rights. The problem of drug abuse in the penitentiary system will be addressed through ad-hoc activities introducing drug treatment and rehabilitation to the system. Finally, with regard to drug consumption prevention, the project will focus on raising public awareness of the dangers of drug abuse, and it will foster civil society s involvement in the need for the treatment and rehabilitation of addicts. Indicators a) Achievement of the sectoral objectives of the National Five-Year Strategy; ) Capability of the project to respond to new drug abuse trends and unpredicted related phenomena. constraints and policy issue The lack of a supportive policy environment is perhaps the greatest obstacle and challenge for controlling HIV among injecting drug users. Despite the fact that drug use drives the HIV epidemic in the country, the relationship between HIV and drug use is particularly neglected in terms of national policies on both HIV and drugs. Policy dialogue and policy reform are generally lacking with respect to injecting drug use and HIV. This lack of supportive policies makes it extremely difficult for programs to implement the activities necessary to reduce drug-related harm, especially HIV. While some progress is being made, national responses are generally inadequate and are not integrated into national development strategies, poverty reduction strategies and other key areas of development policy and planning. This has particular relevance to government looking to integrate concepts of sustainable human development into policy making processes, thus building the institutional capacity of governments for policy development and implementation. Drugs and HIV policy frameworks often develop at different times through different processes, so it is no surprise that they have often evolved with different goals and approaches. Drug policies in the country do not focus on public health issues such as HIV. Conversely, HIV policies often do not address injecting drug use. Instead, governments and development agencies place priority on finding long-term solutions to problem, rather than addressing the more immediate harm caused by drug use, most notably, HIV. In the absence of effective a correct and effective policies and programs to prevent HIV among IDU, community-based organizations are often the only agencies to implement responses. However the development of effective programs is often inhibited by government policies which prevent the implementation of interventions that have been proven successful elsewhere, such as needle exchange programs and drug substitution. This situation is changing, but often not until HIV has already begun to spread among IDUs. The challenge therefore is to identify ways of engaging governments, local programs and policy makers to develop policies that will support prompt implementation of effective responses to the epidemic among IDUs. To do this, governments and development agencies need better understanding of the nature and extent of the HIV epidemic among IDUs, exposure to different strategies, and examples of programmatic and policy responses for consideration West Kuwait Health Centre Triangular Clinic The Triangular Clinic in West Kuwait Health Center formerly operated as a hepatitis prevention and treatment clinic, but now offers HIV care, STD care and harm reduction services for drug abusers. Patients at the Clinic are largely referred from drug abuse treatment centers and are primarily referred for HIV counseling and care. there was just very minor report ( less than 10 males) from Kuwaiti, but their government was very cooperative with the new idea of opening a free clinic to help their youth, so the third triangular was in Kuwait. unfortunately, they did not provide us with the correct number of IDU North Basra (Iraq) Health Centre Triangular Clinic In July 2000, Iraq was among the countries having reported the large number of AIDS in its IDU adolescence in its prison, 8847 males. So The Clinic was established recently in an existing health center in North Basra. The centre provides family planning, mother and child care, and vaccination services during the mornings and services for drug abusers and their families in the afternoon. The Clinic was established at the health centre to provide better access for patients seeking services and to address the stigma attached to HIV and drug abuse. The Clinic primarily offers voluntary counseling and testing, and provides care and support services for HIV positive injecting drug abusers and their partners. Conclusion The HIV epidemic inIdrug abuser teenager is very complex and involves a mix of social, political, economic and ethical factors that are specific to each location In Iran injecting is a relatively new way of transmitting infectious disease. It is also behavior about which relatively little is known. HIV infection among injecting drug users is a new phenomenon in many places and current policies and programs may be insufficiently relevant to the specific challenges posed by contemporary drug use. We need to understand there are reasons for people to go after drugs. Partially reasons for increasing the Population of adolescence are:  ·Widespread stigma and marginalization in the community  ·Poor health status  ·Unemployment and poverty  ·Lack of access to health and community services  ·Lack of commitment from policy makers  ·Lack of information about risks of drug injecting Which is without government support and committed sectors is not achievable. Although individual groups and private organizations are trying to reduce the problem. References Ahmed R (1998) UNDP Co-Administrator, UN General Assembly Special Session on the World Drug Problem, New York, 9 June 1998 Anderson, E, McFarlane,E. (1996)Community as partner, theory and practice in nursing Ahmadi J, Fakkor A, Malekpour A. Current substance use among psychiatric patient. Archives of Iranian Medicine 2002;8 (5): 223-286. Drug Control Bureau. Annual report of drug control. Tehran: 2001. May Gott, M. , O’Brien-Peterson,L. , (1990). The roles of nurse in health promotion. HIV/AIDS in Iran. 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