Background Substance use is a major global health concern, influenced by cultural perceptions. In Iran, illicit drugs rank among the top health issues, contributing nearly 2% to the disease burden, especially impacting youth. The increase in the use of substances such as cannabis and methamphetamine raises significant concerns about public safety. Public perception of substance use disorder in Iran is largely characterized by stigma and discrimination rather than understanding and support. Although Iranian culture may exhibit a degree of tolerance towards substance use itself (not the disorder), this acceptance could inadvertently increase the risk of developing substance use disorders among individuals. Aims This study explores the views ofpeople with substance use disorders in Iran regarding substance use. Methods This study employed a qualitative content analysis approach. A sample of 31 individuals who used substances voluntarily participated in the research. These participants were recruited from five major Iranian cities: Tehran, Mashhad, Shiraz, Isfahan, and Kerman. These cities were selected due to their high prevalence of drug use and their strategic location along Iran's drug trafficking routes. Participants were selected through purposeful sampling until data saturation was reached. Semi-structured, open-ended interviews were tape-recorded and transcribed verbatim. The text was open-coded, and concepts were regrouped into abstract categories. Data were sorted, compared, and contrasted the categories systematically. A non-linear coding analysis was applied, ensuring alignment between the original recordings and the extracted categories and themes. Results Most of the participants were males, and their age range was 31–50 years. 'Historical traces of opium cultivation and consumption among today's consumers' was the first category which explained the historical background of drug use in Iran and its relationship to the current situation of the participants. 'Drug use; a traditional recommendation of different subcultures in Iran' was the other category which included three subcategories (using drugs for self-medication, using drugs in the family as a norm, and drug use for social integration) explaining how the drug use is embedded within the participants' cultural context. Discussion This study provided Iranian drug users’ perspectives on the influence of cultural context on their drug use disorder. Increasing knowledge and awareness about the cultural contexts of drug use in Iran and considering cultural sensitivity are essential for developing drug use prevention programs in different cultures. Culturally responsive policymaking and community engagement for drug use disorder prevention are key to addressing drug use among Iranians.

Assessing Substance Use with a Cultural Lens in Iran

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发表日期：

2026年6月17日

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Masoomeh Maarefvand,
Maziyar Ghiabi

摘要

Background

Substance use is a major global health concern, influenced by cultural perceptions. In Iran, illicit drugs rank among the top health issues, contributing nearly 2% to the disease burden, especially impacting youth. The increase in the use of substances such as cannabis and methamphetamine raises significant concerns about public safety. Public perception of substance use disorder in Iran is largely characterized by stigma and discrimination rather than understanding and support. Although Iranian culture may exhibit a degree of tolerance towards substance use itself (not the disorder), this acceptance could inadvertently increase the risk of developing substance use disorders among individuals.

Aims

This study explores the views ofpeople with substance use disorders in Iran regarding substance use.

Methods

This study employed a qualitative content analysis approach. A sample of 31 individuals who used substances voluntarily participated in the research. These participants were recruited from five major Iranian cities: Tehran, Mashhad, Shiraz, Isfahan, and Kerman. These cities were selected due to their high prevalence of drug use and their strategic location along Iran's drug trafficking routes.

Participants were selected through purposeful sampling until data saturation was reached. Semi-structured, open-ended interviews were tape-recorded and transcribed verbatim. The text was open-coded, and concepts were regrouped into abstract categories. Data were sorted, compared, and contrasted the categories systematically. A non-linear coding analysis was applied, ensuring alignment between the original recordings and the extracted categories and themes.

Results

Most of the participants were males, and their age range was 31–50 years. 'Historical traces of opium cultivation and consumption among today's consumers' was the first category which explained the historical background of drug use in Iran and its relationship to the current situation of the participants. 'Drug use; a traditional recommendation of different subcultures in Iran' was the other category which included three subcategories (using drugs for self-medication, using drugs in the family as a norm, and drug use for social integration) explaining how the drug use is embedded within the participants' cultural context.

Discussion

This study provided Iranian drug users’ perspectives on the influence of cultural context on their drug use disorder. Increasing knowledge and awareness about the cultural contexts of drug use in Iran and considering cultural sensitivity are essential for developing drug use prevention programs in different cultures. Culturally responsive policymaking and community engagement for drug use disorder prevention are key to addressing drug use among Iranians.