Addiction Recovery in the Islamic Republic of Iran

Like the United States, the Islamic Republic of Iran has faced critical challenges from rising opioid addiction. And like the U.S., Iran has experimented with a wide variety of remedial responses, ranging from supply reduction efforts and harsh punishment of users to expansion of harm reduction, treatment, and recovery support services. The latter include the explosive growth of Narcotics Anonymous meetings, which now constitutes 28% of all NA meetings worldwide, and the growth of other indigenous recovery communities, such as Congress 60.

Congress 60 was founded by Mr. Hossein Dezhakam in 1998 and has since grown to 38 branches across Iran with more than 50,000 members. Over the past decade, I have had the privilege of regularly communicating with Mr. Dezhakam and members of Congress 60. Several aspects of Congress 60 commend it to international readers interested in addiction treatment and recovery, including:

• A theory of addiction (the X theory) that parallels much of what is being learned within modern studies of the neurobiology of addiction,
• A theory of recovery as a sustained process of physical, mental, emotional, and spiritual (worldview) rejuvenation and self-discovery,
• Decelerating doses of reparative medicine (opium tincture) through the first eleven months of recovery initiation and stabilization,
• Sustained and saturated involvement in a vibrant recovery community, with its own recovery-focused language, literature, values, symbols, and rituals,
• Intense involvement of members in competitive sports, music, the arts, and community service activities,
• Integration of smoking (tobacco) cessation within the larger rubric of addiction recovery, and
• Sustained involvement of family members in the treatment and recovery processes.

Medication-assisted and psychosocial approaches to addiction treatment have historically existed as isolated, competing, and often mutually antagonist silos in the United States. Discussions have begun about the potential value of uniquely combining and sequencing these approaches across the stages of long-term addiction recovery. With programs like Hazelden Betty Ford taking the lead in such explorations, it would be of value for us to also look beyond the borders of the United States for models of such integration. Congress 60 offers one such approach that should be closely examined for potential replication and adaptation across cultural contexts. Congress 60 integrates theoretical constructs and practices from both approaches and adds elements not found in either.

I recently published a photoessay describing the Congress 60 recovery community. Those interested in learning more about their methods may review this essay HERE. The translated publications of Mr. Hossein Dezhakam and my posted interviews with him are available HERE and HERE.