The secretary of the Anti-Addiction Committee of the Supreme Council of Cultural Revolution says that at least one-sixth of our country’s population is affected by the issue of drug use. In November of this year, a fire in a rehabilitation camp in Langroud took the lives of 36 people. However, this incident did not receive as much attention from the public as it should have; it seems that no one cares much about the deaths of addicts.

In light of the addiction situation in the country and the bitter event of the Langroud addiction camp, the monthly magazine “Khat-e-Solh” went to interview “Farid Barati Sadeh”, a psychologist and expert in addiction prevention and treatment, to ask about addiction camps and his opinion on this problem; a problem that Barati Sadeh considers to be a major social and medical issue in Iran.

Dr. Barati, who has a background in responsibilities such as being the general manager of prevention and treatment development at the Welfare Organization of Iran, stated in response to a question about addiction treatment centers and camps that “these centers are not bad for the government system, because they do the work that the government and government treatment systems – such as the Ministry of Health – should do; meaning they relieve the government and treatment systems of their burden and the costs are paid by the people.”

According to this addiction expert, who also has experience in the field of addiction, tackling the problem of addiction is not an easy task. It is not as simple as saying why we can’t stop using drugs or why we can’t treat it. Dr. Barati has straightforwardly described this approach as simplistic.

You can read the explanation of the interview with Dr. Farid Barati Sadeh, a psychologist and expert in addiction prevention and treatment, and former director of the Prevention and Treatment of Addiction Office of the Welfare Organization of Iran, in the following.

Why are people with addiction kept in closed camps?

There are two types of people who go to these camps. Some are those who go voluntarily and are self-referred. These are people who have a desire to quit and go to these camps. There are also some centers that only serve these types of people. The other group are addicts who are addicted on the streets. We have a law passed by the Islamic Consultative Assembly for combating drugs, which states that these individuals must be kept in special centers. Below that, there is a well-known article called Article 16 of the Law on Combating Drugs, which states that if there are no well-known centers, existing centers should be used to keep addicts. By centers, we mean places that have overnight accommodations. In fact, the discussion is about residential centers. Although a judge can refer them to daily centers such as Methadone Maintenance Treatment (MMT) centers or centers that provide treatment by giving methadone and medication, the main purpose is residential centers, places like camps that we

According to the law, the arrival of such individuals to these centers and their release must be ordered by a judge. The officials of the centers also monitor and strictly control their comings and goings; meaning that if strict measures are taken, it is for this reason and not for something else.

According to what you said, in your opinion

Basically, has this approach been influential and have any research been conducted in this area?

Regarding the issue of addiction, every method has limited effectiveness all over the world. I recently read an article that stated that even in America, addiction treatment is only effective for less than ten percent. This means that even in the best centers and with the best teams and medications, the effectiveness is low. The same applies to Iran, and this issue does not have a high success rate.

In the 1980s, there was a system in place to create community-based centers made up of recovered addicts. Each institution was supposed to have its own treatment protocol and treat patients according to that protocol. For example, one institution might say that their treatment protocol consists of five sessions. In these five sessions, they would first give the addicts a different drug than the one they were addicted to and gradually reduce its use. Another institution might say that they do not want any drugs involved at all and from the beginning, they focus on complete detox and rehabilitation. The idea was to utilize the abilities of these recovered addicts and have the Welfare Organization supervise the institutions that granted them licenses. Unfortunately, with external pressure, this plan was abandoned. They came and said to increase the number of centers and give licenses to anyone who comes. This approach deviated from the original plan and the program that was initially prepared by the Welfare Organization was to use the abilities of recovered addicts to treat others like themselves. Something

But aside from the issue of therapeutic effects, these centers have an impact in another aspect. We know that the main burden of addiction is not on the government, nor on the addict, nor on the traffickers and drug dealers; the main burden of addiction in our country falls on families. When such centers exist, families have a chance to breathe, be happy, and recharge. For example, when an addict spends three months in a camp, their family is somewhat rejuvenated. In this regard, these centers are effective.

Also, let’s consider that the government addiction treatment system in our country is not complete. This means that in our country, due to the use of substances such as stimulants, amphetamines, crystal meth, and the like, we do not have government emergency treatment centers specifically for the use of crystal meth. Imagine a person who may want to physically harm others and their family due to the use of stimulants and crystal meth. In this case, this person should be sent to emergency centers and kept there. These centers compensate for the shortcomings of addiction treatment systems in the country.

These centers are not bad for the government system, because they do the work that the government and government and medical systems – such as the Ministry of Health – should do; meaning they relieve the burden on the government and government and medical systems and the costs are paid by the people. These centers also have very low costs for the government; at most, in the form of assistance to families who have nothing and want their child to be in these camps, and that too as a subsidy. It is not covered by insurance. So in this regard, these centers are beneficial for the government system.

As I am talking to you right now, there are around 38,000 people in these centers. If these centers did not exist, these 38,000 people would either be openly addicted on the streets or causing harm to their families at home. Therefore, it can be argued that these centers are effective economically and socially. However, in terms of addiction treatment, as mentioned before, they are not. This is just another method, like other addiction treatment methods. No method can claim to be completely and significantly effective in treating addiction.

Why do the addiction treatment policies in Iran not seem successful? Of course, you mentioned earlier that addiction treatment policies have limited impact worldwide, but it cannot be denied that the addiction situation in Iran is concerning compared to many other parts of the world.

Addiction is not just a medical issue that can be addressed within the medical field. It is not like diseases such as diabetes or other illnesses. Addiction is a social, medical, ethical, psychological, and other problem. Therefore, there are multiple factors that contribute to it. Not all of these factors are controllable. This issue is also related to the economic and social conditions of societies. In our society, the most important issue is our proximity to the world’s largest producer of narcotics. At the same time, Afghanistan has become the largest producer of stimulants. Iran is also a very good route for exporting these substances to various parts of the world, including Europe, which has a high demand for them. These substances are smuggled into the country. There are also other economic and social issues in the country that can exacerbate this problem. It is not realistic to expect addiction to disappear from our society. Moreover, addiction has been a historical issue in our country; at least since the

Do the policies in Iran regarding the issue of drugs align with the United Nations’ programs in fighting addiction?

The United Nations has programs in place to reduce addiction, address medical issues such as HIV, tuberculosis, and hepatitis for addicts, and Iran is currently cooperating with these efforts. However, when it comes to Iran, more is expected from the United Nations and organizations like it. As an expert, I believe the United Nations can play a more active role in providing logistical, technical, support, and educational assistance to specialists, therapists, and policymakers. In the past, this has been done and has shown positive results. For example, in regards to this expert program, after visits by experts from official agencies, the Drug Control Headquarters, the Welfare Organization, the Ministry of Health, and the Prison Organization to European countries and seeing their programs, these programs were implemented in Iran and have achieved significant success, particularly in reducing harm in prisons. Therefore, in my opinion, the United Nations can be more proactive and involved in this area and in regards to Iran, and this pursuit will undoubtedly have significant results and impacts

In the discussion about closed camps, you mentioned people-based institutions.

What is your opinion about the privacy of Turkish addiction camps?

I presented that it is an economic issue. The government cannot spend more on this area and does not spend any money. Therefore, the non-governmental sector, meaning civil institutions, people and the private sector, enter this issue. Essentially, in our country, three to four percent of the addiction treatment issue is government-related. The rest – meaning about 97 percent of this matter – is in the hands of the private sector. Meaning, the residential centers and centers where doctors operate through medication, methadone, etc., are private. Therefore, there is no pressure on the government in this regard. The pressure is more on the people and they themselves accept the expenses.

In my opinion, if the Ministry of Health and Welfare were to establish at least a few government-run residential and 24-hour centers (which are necessary according to the law) as examples, or if such government centers were even established in hospitals, it could have been much better. Currently, in government hospitals, if you want to admit someone as an addict, they do not admit them. Usually, addicts have other psychological disorders along with addiction and are admitted to psychiatric centers as their other illness. The Ministry of Health and the government have not paid enough attention to this issue.

One part that, for example, the Anti-Drug Headquarters pursues as a higher and governmental institution, is related to Article 16. This means the open addicts who are homeless and mentioned in the law. They say that just being in the country is enough to provide for their needs and there is no need for anything else.

In 1397, a video was released from the drug rehabilitation camp in Langroud, which showed the disturbing conditions behind the walls of the facility, which was supposed to play a role in treatment. In November of this year, we also witnessed a tragedy there, resulting in the death of more than thirty people. Despite this information, why have responsible institutions and oversight bodies, including the Welfare Organization, not taken action to shut down this camp in recent years?

The center that you mentioned was closed in the year 1397, but with the commitment of the responsible person for the camp and other issues, this camp was reopened. This recent issue has been a personal matter and the result of a conflict between the responsible person of the camp and an outsider who caused the incident by pouring gasoline. Therefore, this recent incident was not caused by a lack of supervision.

Does monitoring these camps satisfy you? There are discussions about the frequency of such incidents.

See, these events are happening. Are hospitals and centers that provide medical services not immune?! Keep in mind that over the years, the number of deaths in these camps and centers has been less than the number of deaths in the best hospitals in the country.

“Leave aside the discussion of the Langroud event. Part of the deaths in addiction treatment centers may be caused by other diseases that addicts who are arrested on the streets and handed over to these centers may have. Diseases that existed before and were not paid attention to, and then showed themselves here (in an addiction treatment center) and caused problems. Of course, my statements do not mean that there should not be supervision or that supervision is complete. Supervision should be more serious and stronger. But these centers, like any other place, have their own consequences.”

However, it seems that the fire in an addiction camp was not just a coincidence and happened exclusively in the “First Step to Freedom” camp in Langroud. There have been similar cases as well…

No one claims that these issues do not exist. But don’t government hospitals report their number of deaths every month? My point is that there should be supervision, but it is not right to expect that nothing will happen. Anything can happen at any moment. In any case, this type of treatment also comes with its own problems. Let’s not forget that most of the people who go to these centers, even compared to other addicts, are individuals with more anti-social traits. I’m not saying that they all have anti-social personalities, but they have more anti-social characteristics. Someone with such characteristics may set fire to a place to escape. We have had such cases in the past. Or someone who is working there and has anti-social traits may behave badly. While in all guidelines it is stated that the right to misbehavior, insult, disrespect, and use of unconventional methods does not exist. Surely a doctor must be present as the technical supervisor in these centers. Supervision must be carried out

Apart from the officials, it seems that the families of these victims did not support them. Do you agree with this issue? And why does such a problem occur?

Yes, that is correct. Unfortunately, due to the problems these individuals create for their families and loved ones, it feels like families have less emotions towards them and there are less reactions in such situations and emotions are not stirred up much.

Not only families, but also at the level of civil institutions and society, they expect the reactions to be stronger than they are. The reason is the oppression of addicts. Although we do not want to deny individual responsibility of an addict and reject it, these individuals are social victims. Because these individuals are social victims, there must ultimately be empathy and compassion towards them. However, even at the level of institutions and civil institutions that support these individuals, this empathy and compassion is not seen as it should be.

Why is society so indifferent towards addicts and even their deaths?

In my opinion, it mostly relates to the addicts’ personalities and the general understanding of them. You may even hear in private conversations and gatherings that people say they are relieved by the death of these addicts, meaning that people justify their lack of reaction and feeling and show their emotional numbness and freeze towards addicts.

Of course, the news of this particular incident in Langaroud may have been influenced by the news of the special conditions in the region and the Middle East. But in any case, your words are correct and the society is not very sensitive towards these individuals, which is regrettable.

What can be done, in your opinion as an expert, to increase the sense of empathy and attention of society towards addicts and their problems?

The main task is to prioritize the issue of education and rehabilitation of addicts. We have this issue of stigmatization for all mental illnesses, including addiction, which creates problems for them and their families. This is one of the most serious responsibilities of health and treatment institutions and responsible organizations in the country. Some parts of society still do not accept that addiction is a disease. Whenever they are told that addiction is a disease, they mock it. Another issue is that addiction treatment should be integrated into our healthcare systems. If this is done, the stigma will be eliminated to some extent. However, not only for addiction, but also for other mental illnesses, we have not yet reached the stage where their treatment is integrated into the country’s healthcare system.

Can reforming government policies and approaches have a significant impact on improving healthcare conditions and supporting individuals with addiction?

It is necessary for the law to have more flexibility in this area. Responsible health and education institutions should also take their duties more seriously in this field. Despite the fact that addiction is a major social and health problem in our country, when the lower levels of our health pyramid are directly involved in the issue of addiction, they are not very familiar with it. Perhaps it is necessary for us to have addiction counselors and addiction psychologists, for example.

Our healthcare system, due to economic issues and shortages of medication and the like, only focuses on a small part of the problem and neglects the rest, not taking responsibility. In my opinion, even if the Ministry of Health took on its main responsibility as the main supervisory body in treating all psychological and psychiatric problems, including addiction, and these centers also took the issue of healthcare more seriously, we might have seen more profound changes. Therefore, the officials of the healthcare and medical system of the country must consider and accept their responsibility in a more comprehensive and complete manner regarding these centers and incorporate them into the structure of the country’s healthcare and medical systems. This approach is more suitable and better.

Thank you for the time you have given us in the monthly magazine of the Peace Line.