Characterizing substance users and risk profiles across treatment centers: insights from Iran

Substance use remains a pressing global public health concern and has shown a marked increase in recent years. This study investigates the characteristics and risk behaviors of individuals who use substances across various treatment centers in the city of Kerman, Iran.

This descriptive cross-sectional study was conducted in May 2023 across multiple treatment centers in Kerman. A total of 470 participants were recruited from Methadone Maintenance Treatment (MMT) centers, Therapeutic Community (TC) centers, Article 16 compulsory treatment centers, and Drop-in Centers (DICs). Data were collected using the Maudsley Addiction Profile (MAP) questionnaire and laboratory tests, and analyzed using STATA software.

Ninety percent of participants were male, with the most common age range being 26 to 45 years. More than 70% reported initiating substance use after the age of 18. Approximately 64.89% had attempted to stop using substances fewer than two times, while 13.62% had made more than six unsuccessful attempts. Patterns of alcohol, opium, and methamphetamine use varied across treatment settings. The highest rates of syringe sharing, unprotected sexual activity, and criminal activity were reported in the Article 16 center, whereas MMT centers reported the highest levels of spousal conflict. TC centers had the lowest levels of methamphetamine and morphine use.

The majority of participants were male and began using substances after the age of 18. Patients in the Article 16 center exhibited the highest levels of high-risk behaviors, including injection-based substance use, unprotected sexual activity, and criminal involvement. In contrast, MMT centers showed the highest levels of familial conflict, and TC centers had the lowest prevalence of methamphetamine and morphine use. These findings highlight the need for context-specific harm reduction and treatment strategies tailored to the distinct substance use patterns and risk profiles within each treatment setting. Given the structural and demographic differences-such as voluntary enrollment in MMT versus mandated treatment in Article 16-comparative interpretations should remain descriptive and cautious.