Epidemiology Department Projects – National Center for Addiction Studies
Introduction
The Epidemiology Department of the National Center for Addiction Studies focuses on national and international research addressing various aspects of addiction and its social and health consequences. Our projects range from clinical trials of innovative treatments and digital health interventions, to the establishment of national registries, systematic reviews and meta-analyses, and pioneering work on behavioral addictions. The overarching goal is to generate robust scientific evidence to inform policy, improve addiction treatment, and promote public health in Iran.
Ongoing Projects
1. Clinical Trials of Novel Treatments
- Effectiveness of Long-acting Depot Buprenorphine in Opioid Dependence
This multicenter cohort study evaluates the effectiveness, safety, and acceptance of long-acting depot buprenorphine administered as a monthly subcutaneous injection. By eliminating the need for daily dosing, this approach aims to improve treatment retention and quality of life for patients. Participants are followed for 12 months across several treatment centers, providing locally relevant evidence for addiction treatment policies in Iran.
- Effectiveness of Long-acting Injectable Naltrexone in Opioid Use Disorder
This study assesses the safety and effectiveness of monthly intramuscular long-acting naltrexone, a non-agonist treatment option, in preventing relapse among patients with opioid use disorder. Eligible patients are followed for six months, with outcomes including abstinence, craving intensity, quality of life, depression, and treatment satisfaction. Findings will guide the development of non-agonist therapeutic options in Iran.
- Systematic Review and Meta-Analysis of Global Opium Use Prevalence (2010–Present)
This study aims to estimate the global prevalence and dependence rates of opium use among the general population and students, disaggregated by gender and various indicators (current, past-year, lifetime use, and dependence). Conducted as a systematic review and meta-analysis following the PRISMA 2020 guidelines, it compiles quantitative data published since 2010 from international databases to provide a comprehensive global overview of opium use patterns, supporting evidence-based public health policymaking.
2. National Epidemiological Studies
- Alcohol-related Mortality in Iran
Using official data from the Legal Medicine Organization, this project identifies patterns of alcohol-related deaths across provinces and time periods. The impact of the COVID-19 pandemic on alcohol-related fatalities is analyzed, along with correlations with alcohol consumption rates and provincial economic indicators. Results provide a comprehensive picture of the health and social burden of alcohol poisoning in Iran.
- Design and Implementation of a National Substance Use Disorder Registry
This national initiative, led by Tehran University of Medical Sciences in collaboration with Bam, Jiroft, and Rafsanjan Universities, is establishing Iran’s first registry of substance use disorders. In the pilot phase, data are collected from outpatient treatment centers, residential facilities, drop-in centers (DICs), and self-help groups. The registry enables monitoring of trends, evaluation of treatment outcomes, and supports clinical research and evidence-based policy making. - Youth Cohort Study (2015–2025)
The Youth Cohort Study is one of the most comprehensive longitudinal projects in Iran, conducted over a decade from 2015 to 2025 across four provinces: Mazandaran (Sari), Kerman (Rafsanjan), Fars (Fasa), and Kermanshah (Ravansar). The study population included young people aged 15 to 34, who were followed through four in-person phases and three telephone follow-up phases. The study was designed to monitor multiple dimensions of youth health, covering a wide range of areas such as psychological disorders, substance and alcohol use, medication use, physical illnesses, sleep problems, and other indicators of physical and mental health. Findings from the Youth Cohort provide invaluable insights into trends in youth health over time and offer critical evidence to inform national strategies for prevention, treatment, and the promotion of public health in Iran.
- National Mental Health Survey (2021–2022)
The National Mental Health Survey is one of the largest population-based studies ever conducted in Iran. Implemented between 2021 and 2022 with the participation of all medical universities across the country, it targeted individuals aged 14 to 64 years. Data were collected using internationally standardized tools to ensure reliability and comparability. The survey aimed to determine the prevalence of neurological and psychiatric disorders, assess the economic burden of treatment—particularly catastrophic health expenditures—and evaluate access to and utilization of mental health services nationwide. Beyond prevalence estimates, the dataset also enables analysis of the associations between socioeconomic factors and mental health status. Results from this national survey provide a precise and comprehensive overview of mental health in Iran and serve as a scientific foundation for national planning in mental health care, improving service accessibility, and reducing the burden of psychiatric disorders.
3. International Collaborations and Innovative Tools
- Feasibility Testing of the WHO Flexible Interview for ICD-11 (FLII-11) in Iran
In collaboration with the World Health Organization, this project focuses on the translation, cultural adaptation, and validation of the Persian version of the FLII-11, a structured interview for assessing mental and behavioral disorders. Translations are reviewed by multidisciplinary experts, followed by cognitive interviews and field pilot studies in addiction clinics, primary care centers, and psychiatric hospitals. Data collection is carried out via the digital Qualtrics platform to ensure standardized and scalable implementation. - Blended Smartphone Intervention for Patients in Opioid Maintenance Treatment (Iran–Switzerland Project)
This international randomized controlled trial is being conducted jointly with the University of Zurich (ISGF) and funded by the Swiss National Science Foundation. The study evaluates the effectiveness of adding a blended mobile-based intervention (PROMPT) to standard opioid agonist therapy (methadone or buprenorphine). PROMPT includes a monitoring dashboard, craving and use diary, and self-help modules based on motivational and cognitive-behavioral approaches. The trial, conducted across eight clinics in Tehran, aims to develop a sustainable and scalable model for Persian-speaking populations.
4. Behavioral Addictions (Emerging Field)
- Establishing a Behavioral Addictions Clinic
This project focuses on creating a specialized clinic for behavioral addictions at INCAS. Services include structured assessments, evidence-based psychological treatments, family education, and follow-up care. The clinic addresses conditions such as gaming disorder, gambling disorder, compulsive sexual behavior, and problematic social media use. Outcomes will inform the standardization of treatment protocols and expansion of national services.
- Comorbidity of Behavioral Addictions in Patients with Substance Use Disorders
This study screens for the prevalence and patterns of behavioral addictions among patients with substance use disorders at INCAS. Using internationally validated tools, a wide range of addictive behaviors—including gaming, gambling, compulsive sexual behaviors, and problematic social media use—are assessed alongside demographic and mental health indicators. Findings will support the design of clinical interventions and referral pathways to specialized behavioral addiction clinics.
5. Systematic Reviews and Meta-analyses (International Knowledge Base)
- Global Epidemiology of Methanol Poisoning (Systematic Review and Meta-analysis)
This project synthesizes global data on methanol poisoning through a systematic review and meta-analysis. It provides estimates of incidence, mortality, complications, temporal trends, and geographic patterns. Findings will fill critical knowledge gaps and inform global prevention and treatment strategies.
- Treatment Outcomes of Opioid Agonist Therapy in Iran (Systematic Review and Meta-analysis)
This systematic review and meta-analysis examine treatment outcomes and patient characteristics in opioid agonist therapy programs in Iran, including methadone, buprenorphine, and opium tincture. By combining data from multiple studies, the project offers a comprehensive understanding of treatment effectiveness and patient wellbeing, supporting improvements in national addiction treatment systems.
6.Urban Drug Use Surveillance
- Estimation of Substance Use Through Wastewater-Based Epidemiology in Southern Tehran, Iran: A Feasibility Study
This study assessed the feasibility of using wastewater-based epidemiology (WBE) to estimate methadone and methamphetamine consumption in southern Tehran. Wastewater samples were collected over three days and analyzed using GC-MS and LC-MS/MS methods. The estimated daily consumption of methadone and methamphetamine was approximately 29–37 mg and 16–24 mg per 1,000 population, respectively. The findings indicate that WBE is a reliable approach for monitoring drug use at the city level and can serve as a foundation for developing a national surveillance system.
- Monitoring the Purity and Composition of Illicit Substances Among Clients of the National Center for Addiction Studies
This project collects drug samples provided by individuals seeking treatment at the National Center for Addiction Studies to analyze their chemical composition and purity levels. The main goal is to detect changes in substance composition, identify emerging psychoactive substances, and supply data for the Drug Early Warning System.
Samples are analyzed using colorimetric methods, TLC, GC, and, when necessary, GC-MS. The primary substances examined include heroin, opium, cocaine, methamphetamine, amphetamine, and cannabis. The results of this ongoing monitoring will support rapid response to new drug-related threats and inform evidence-based policy decisions in the national health system.
Conclusion
The Epidemiology Department’s projects span from cutting-edge clinical trials and innovative international collaborations to national epidemiological research and systematic reviews. Together, they create a solid foundation for evidence-based policy, the development of effective treatments, and the advancement of addiction science in Iran. By integrating local data with global knowledge, the department plays a vital role in shaping health policy, improving clinical services, and reducing the burden of addiction at both national and regional levels.