In Iran, people living with substance use disorders who engage in public drug use may be subjected to court-mandated compulsory treatment in compulsory drug detention and rehabilitation centers (CDDRC). This study aims to assess residential CDDRC’s effectiveness in promoting sustained abstinence among people who use drugs (PWUD) in Kerman, Iran.
Between October 1, 2021, and September 30, 2022, 1,083 adult PWUD with a diagnosis of substance use disorders and a history of engagement in public drug use were admitted to the CDDRC in Kerman. They were followed-up for 12 months after discharge. The relationship between baseline variables and abstinence, assessed using rapid urine tests, was examined using crude logistic regression models.
Most PWUD were 30 or older (n=876, 80.9%) and had a history of previous CDDRC admission (n=638, 58.9%). At the end of the 12-month follow-up, only 2.6% (95% CI: 1.7-3.7) were abstinent. Individuals with limited education (OR = 3.43; 1.50-7.95) and those with a prior history of admission to the CDDRC (OR = 3.73; 1.55-9.89) had increased odds of relapse.
The effectiveness of CDDRC in promoting abstinence among the participants was minimal. This highlights the necessity of reassessing support and investment in these interventions and considering more evidence-informed alternatives in Iran.
Mohammad Karamouzian is an infectious disease epidemiologist. A former veterinarian (DVM) turned public health researcher, he holds a PhD in Population and Public Health (2021) from the University of British Columbia where he had the Vanier and Pierre Elliott Trudeau Foundation doctoral scholarships. Before joining the Centre on Drug Policy Evaluation, he was a Banting postdoctoral fellow at Brown School of Public Health. He is also affiliated with the BC Centre on Substance Use (BCCSU) and the WHO Collaborating Centre for HIV Surveillance (HIVHUB) in the Middle East and North Africa. Mohammad’s research focuses on addressing health inequities faced by marginalized populations, such as female sex workers, people who inject drugs, and people who are incarcerated. He is committed to translating his research into policies that will improve the health of marginalized populations.