A decade of change: trends in drug and alcohol use in Iran (2010-2019)

Drug and alcohol use poses critical public health challenges. This study estimated the prevalence of drug and alcohol use in Iran for 2019 and assessed its trends over the last decade, comparing 2019 data with our previous estimates in 2013 and 2016.

In 2019, 16,733 individuals from 31 provinces were recruited. Network scale-up methodology was applied to estimate the annual prevalence of drug and alcohol use. Results were adjusted for popularity, visibility, and recognition biases. Data from three successive national surveys conducted in 2013, 2016, and 2019 were used to analyze the trend of drug and alcohol use.

Alcohol was the most commonly used substance, with an annual prevalence of 4,470 (4,370-4,570) per 100,000 population, and 41.7% of users reported frequent use. Among opioids, codeine (4,840 per 100,000), opium (2,220 per 100,000), and tramadol (1,830 per 100,000) were the most prevalent, with frequent use reported in 38.5% of codeine and 58.0% of tramadol use. Nearly 75.0% of individuals using opium, heroin, or methamphetamine engaged in frequent use. Methamphetamine (450 per 100,000) and Ritalin (390 per 100,000) were the most commonly used stimulants. Between 2013 and 2016, alcohol use increased by 6.6%, with another 16.9% rise from 2016 to 2019. Nonprescribed methadone use increased by 4.2% annually between 2016 and 2019. Opium use declined by 4.3%, while heroin and drug injection showed an increasing trend from 2013 to 2016, followed by a decline from 2016 to 2019.

The increasing prevalence of drugs and alcohol is alarming. Understanding these trends is essential for shaping public health policies and interventions.