title: National population size estimation of illicit drug users through the network scale-up method in 2013 in Iran.
abstract: For a better understanding of the current situation of drug use in Iran, we utilized the network scale-up approach to estimate the prevalence of illicit drug use in the entire country.
  
  
  
  We implemented a self-administered, street-based questionnaire to 7535 passersby from the general public over 18 years of age by street based random walk quota sampling (based on gender, age and socio-economic status) from 31 provinces in Iran. The sample size in each province was approximately 400, ranging from 200 to 1000. In each province 75% of sample was recruited from the capital and the remaining 25% was recruited from one of the large cities of that province through stratified sampling. The questionnaire comprised questions on demographic information as well as questions to measure the total network size of participants as well as the network size in each of seven drug use groups including Opium, Shire (combination of Opium residue and pure opium), Crystal Methamphetamine, heroin/crack (which in Iranian context is a cocaine-free drug that mostly contains heroin, codeine, morphine and caffeine with or without other drugs), Hashish, Methamphetamine/LSD/ecstasy, and injecting drugs. The estimated size for each group was adjusted for transmission and barrier ratios.
  
  
  
  The most common type of illicit drug used was opium with the prevalence of 1500 per 100,000 population followed by shire (660), crystal methamphetamine (590), hashish (470), heroin/crack (350), methamphetamine, LSD and ecstasy (300) and injecting drugs (280). All types of substances were more common among men than women. The use of opium, shire and injecting drugs was more common in individuals over 30 whereas the use of stimulants and hashish was largest among individuals between 18 and 30 years of age.
  
  
  
  It seems that younger individuals and women are more desired to use new synthetic drugs such as crystal methamphetamine. Extending the preventive programs especially in youth as like as scaling up harm reduction services would be the main priorities in prevention and control of substance use in Iran. Because of poor service coverage and high stigma in women, more targeted programs in this affected population are needed.
authors.affiliation: Supervisor Research and Development Emergency Medical Center, Ministry of Health, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nikfarjam
authors.affiliation: Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Shokoohi
authors.affiliation: Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. Electronic address: a.shahesmaeili@gmail.com.
authors.forename: Armita
authors.initials: A
authors.lastname: Shahesmaeili
authors.affiliation: Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Haghdoost
authors.affiliation: Research Center for Modeling in Health, Institute for Futures Studies in Health, Biostatistics and Epidemiology Department, Health School, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Baneshi
authors.affiliation: Research Center for Modeling in Health, Institute for Futures Studies in Health, Biostatistics and Epidemiology Department, Health School, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Saiedeh
authors.initials: S
authors.lastname: Haji-Maghsoudi
authors.affiliation: Research Center for Modeling in Health, Institute for Futures Studies in Health, Biostatistics and Epidemiology Department, Health School, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Rastegari
authors.affiliation: Iran Helal Institute of Applied-Science & Technology, Tehran, Iran.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Nasehi
authors.affiliation: School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Nadereh
authors.initials: N
authors.lastname: Memaryan
authors.affiliation: Community Medicine Specialist, Ministry of Health, Tehran, Iran.
authors.forename: Termeh
authors.initials: T
authors.lastname: Tarjoman
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Drug use; Iran; Network scale up; Prevalence; Size estimation