Iran’s Alcoholics: Anonymous, Neglected & Stigmatized

Aug. 14, 2014, 12:22 p.m.

Islam forbids the drinking of alcohol and Iran has very tough laws against buying, selling and consumption of it. But instead of ensuring that alcohol is completely absent from Iranian society, and that Iranians are free from the problems that come from alcohol abuse, these laws have made the situation worse, driving the alcohol trade underground and branding alcohol addiction as a taboo subject. 

Iran has one of the most serious alcohol problems in the world. Although it ranks number 166 in alcohol consumption per capita, when looking at figures for people who drink 35 liters or more alcohol over the course of a year, the country comes in at 19th in the world. In other words, the number of alcoholics per capita puts Iran ahead of Russia (ranked 30), Germany (83), Britain (95), the United States (104) and Saudi Arabia (184).

The Islamic Republic is for the most part in denial. The government refuses to acknowledge or address the problem. Though figures suggest that alcoholism has been a problem in Iran for decades, the Ministry of Health only recently granted a permit to a clinic that deals with alcohol-related issues. The center, based at Tehran’s Medical School, offers counseling for individuals, groups or families dealing with alcohol-related problems. Health Ministry officials have yet to say whether it will provide a detox unit or limit itself to the rehabilitation of people who have already begun to tackle their addiction. Whatever its focus, the benefits of such a center will be minimal: it will only be open one day a week and will not employ medical workers or physicians to work on site.

The state-run clinic is a new initiative, but Alcoholics Anonymous (AA) has operated in Tehran for a number of years. One former alcoholic, Alireza, regularly attends AA meetings. When I ask him about his alcoholism— he has been “clean” for six years—he says he was “bad tempered, uneasy and dissatisfied.” “Things that make other people happy—money, fame, a job and what have you—cannot satisfy an alcoholic,” he says.

According to Alireza, detoxification is a long process, lasting about three weeks and requiring the supervision of a specialist doctor. In the private sector, there are still very few centers aimed at helping alcoholics give up drinking. “If you are lucky and are friends with a caring doctor, he can come to your home and attend to you,” says Alireza. “Otherwise you have to go through the whole three weeks by yourself and without any help. There are many camps and clinics for drug detox, but there are none for quitting alcohol.” Alireza says that he knows at least three people who have died trying to kick their addiction.

A specialist doctor at Tehran’s Bahman Hospital confirms this. “Unfortunately, everything in Iran has become ideological,” he tells IranWire. This includes medical protocols, which are “not deemed important,” he says. When a person suffering from alcohol addiction stops drinking, “there is a high probability of seizures and heart failure, especially for those who have been alcoholics for a long time.”  Side effects can include severe depression and even hallucinations. “All these symptoms can be treated and controlled by medicine and through the close supervision of a physician”, the specialist says. In his view, Iran should follow U.S. and European models for treating alcoholics, where patients are sent to hospitals or private clinics.

“It is very dangerous if the patient suddenly stops taking drugs and there is no medical supervision,” he warns. “If there is any good judgment remaining in this country, then it should be used to set up thousands of clinics to cater to those who want to give up alcohol.”

Breaking Taboos: Just the Beginning

According to Article 265 of the new Islamic Penal Code adopted in 2013, drinking alcohol is punishable by 80 lashes, regardless of whether the offender is a man or a woman. Still, this punishment has not managed to reduce the popularity of drinking alcohol, particularly among young people.

Because alcohol is illegal in Iran, reliable statistics for its consumption and abuse are understandably difficult to come by. However, in a seminar earlier this year, Dr. Reza Afshari, Assistant Professor and Physician of Clinical Toxicology at Mashhad University, reported that more than a million Iranians consume alcohol regularly, of which 70 percent are men and 30 percent women.

Former alcoholic Alireza says the Health Ministry center is not much of a practical step forward. “Alcoholics Anonymous sessions, patterned after the same association that Bill Wilson created in 1930s America, are tried and true,” he says, so opening other types of consulting centers does “not amount to much.”

But Alireza admits that the establishment of the center “it is a big and significant step” when it comes to breaking taboos. It’s possible, he says, that some authorities are emerging from their state of denial and acknowledging that “the old policies do not work.” But he believes that if people were able to go somewhere and drink a glass of wine or beer without it being illegal or considered anti-Islamic, many Iranians “would not have the urge to become alcoholics like mad men.”

Because alcohol is illegal, it’s also extremely expensive. It takes a lot of money to buy a bottle of smuggled-in whiskey, so many people resort to drinking home-distilled alcohol or ethanol. “Such a clandestine and pathological way of drinking increases the chances of becoming an alcoholic exponentially,” Alireza says.

Even with some of the recent shifts in attitudes towards alcohol, it’s still hard to imagine that people seeking a cure would be allowed to check into clinics and hospitals in Iran without getting into some sort of legal trouble, or suffering social stigma. It’s almost impossible to imagine that drinking alcohol in Iran would ever be legalized, responsible drinking would be taught in schools and the media would be able to discuss the issue openly.

So, although things are changing in some sections of Iranian society, it’s happening at too slow a pace for those with alcohol problems in Iran today. The trend of uncontrolled, dangerous alcohol consumption is likely to continue. Those wishing—or needing—to give up will be forced to do so on their own, without the support of formal medical care. And in too many cases, the outcome can be potentially fatal.