By Soulava Gabr and Dave Achonu, Baldwin High School, Baldwin, New York, United States
Abstract
Prescription medications, though useful for pain relief and treatment, can also serve as gateways to opioid misuse and subsequent heroin addiction. Approximately two million Iranians are addicted to illicit drugs, particularly heroin, which has detrimental effects on physical and mental health. This is a significant problem, especially for those living in poverty. The euphoric and peaceful feelings induced by heroin make it an attractive choice for those in difficult living conditions, exacerbating the drug abuse problem. The high prevalence of mental illness in the working population and those in poverty further emphasizes the need for effective solutions to address drug abuse in Iran.
Prescription Medication or Gateway Drug?
Individuals who utilize prescription medications as treatment greatly benefit from them. Without painkillers and stimulants, day-to-day life would be difficult for people who have undergone surgery or have pre-existing conditions or injuries (MedlinePlus, 2016). Despite this, prescription drugs can serve as "gateways" to opioid use by increasing the risk of consumption of narcotics. An overreliance on prescribed medications fosters opioid addiction, due to prolonged exposure creating a tolerance. Consequently, individuals begin consuming more potent opioids, namely heroin (Dasgupta, et al., 2018).
Additionally, there has been a surge in physicians treating various conditions conveniently rather than effectively, by prescribing drugs that target pain rather than the illness (Marlowe, 2014). Occasionally, doctors will change a patient's prescription to more powerful pain killers if the patient feels that their treatment is inadequate. This occurs frequently in Iran given opium’s accessibility. This is more common is the working population as they are more likely to request this change as they need to be able to carry out their work.
Physical and Mental Health
Studies have used opiates as a pharmacological intervention for various illnesses, providing favorable outcomes (Güttinger, 2003). This emphasizes the importance of moderation and how opioids can be beneficial, given that they are administered in appropriate doses (Brink, et al., 2003). In 1998, a study in the Netherlands found that ninety-four percent of participants had excellent outcomes after heroin treatment for pain relief. However, numerous other factors come into play in real-world situations, including culture-specific factors.
The lack of development and increased poverty in Iran can encourage drug abuse (World Population Review, 2023). Many describe the feeling of being under the influence of heroin as euphoric or peaceful (Kaiko, et al., 1981). When people are living in poor conditions, that sense of relief can be incredibly valuable. Though a multitude of substances can elicit these feelings of relaxation, heroin seems to be the prevailing choice because it has the greatest effect on people’s moods (Akhgari, et al., 2011). This potency is due to the synergistic effect of opium and morphine, which can increase the risk of complications such as liver and kidney disease, blood clots, infection of the heart lining and valves, insomnia, depression, and antisocial personality disorder (National Institute on Drug Abuse, 2022). A study from the Journal of the American Medical Association found that the greatest impact of long-term heroin use was on sleep and social activity (Babor, et al., 1976).
In 2015, approximately twenty-three percent of Iranians aged fifteen years and older were suspected of having a mental disorder (Noorbala, 2022). Given the age range, this statistic would apply to the working-age population, further proving that there could be a strong correlation between mental health and drug abuse. Addiction and mental illness can often be in a positive feedback loop in which both either one of them increases the risk of the other (Stimmel, 1993).
Conclusion
Although finding an adequate solution to this problem would be difficult, it is not impossible. Millions of people in Iran are falling victim to drug abuse each year and no form of concrete action is being taken. Developing a resolution is crucial to better Iranian society because this is not a matter of the economy or politics, but rather human lives.
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