Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n？=？810) in MMT. The Chi-square test and t-test served for statistical analyses.A clear majority of the participants were men (96%), more than 60% of whom were between 25 and 44？years of age, educated (89% had more than elementary education), and employed (>70%). The most commonly reported main drugs of abuse prior to MMT entry were opium (69%) and crystalline heroin (24%). The patients’ lifetime drug experience included opium (92%), crystalline heroin (28%), cannabis (16%), amphetamines (15%), and other drugs (33%). Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction.Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.Drug abuse is among the most challenging and costly health problems that lead to a broad range of physical, mental, and psychiatric consequences, and poses a huge public health problem worldwide [1]. Opioids are the third most widely used group of drugs after cannabis and amphetamine-type stimulants. Among opioids, opiates are the most problematic and harmful substances consumed by 12 to 21 million people worldwide. The highest consumption rate of opiates is in countries in Southwest Asia [2].Iran, located along the opium trade route, has the highest rate of opiate drug use worldwide [3]. Based on the most recent national survey of drug abuse in Iran, the number of addicts in need of treatment services exceeds 1.2 million [4]. Opiates, mostly opium and crystalline heroin (heroin hydrochloride) [5], are the main drugs of abuse [6-8]. Recent years have seen a substantial shift from opium use towards using crystalline heroin: some new