RecoveryAnswers.org September Highlighted Article: More than just a Mutual-Help Organization in Iran
Congress 60, a nongovernmental organization (NGO) in Iran was created in response to the increasing needs of individuals with substance use disorders (SUD) and works to reduce substance use and to support recovery in several ways. In this paper, White summarizes the history, governance, philosophy and recovery support mechanisms of Congress 60. There may be between 1-4 million Iranians that meet Diagnostic and Statistical Manual of Mental Disorders Fourth edition (DSM-IV) criteria for substance dependence with the majority of those suffering with addition to opium due to the proximity to Afghanistan, (the world’s leading source of opiates), a young population, urbanization and financial distress and unemployment due to economic sanctions. The average individual with SUD in Iran is 25 years old, male, married, with limited education but who is employed, and who is supported by their family. Following the 1979 Iranian Revolution, the government closed detoxification and treatment centers, banned poppy cultivation (the plant that opium comes from), and introduced harsh anti-drug fines, incarceration, or even death. However, the period since 1990 has seen increased public health rather than legal response, in association with recognition of addiction and injection drug use as well as concerns about AIDS and HIV among injection drug users. This recognition was characterized by an increase in use of pharmacotherapy, expanded detoxification and treatment resources, and prison clinics. Additionally, there has been a growth in NGO involvement including the 12-step mutual-help group, Narcotics Anonymous (NA). In fact, 26% of all NA meetings worldwide take place in Iran, the availability of which is second only to the United States.
Congress 60 was created by Mr. Hossein Dezhakam as a community where individuals could find support as they move towards recovery. The first session was in 1998 and included 8 individuals; there are now more than 20,000 members within the 38 branches and the foundation is based on the principal of an individual in recovery helping other individuals who are still using drugs to stop. Congress 60 is primarily funded by donations and all positions are voluntary. Congress 60 involves fellow users (called travelers) and family members and friends (called companions), and includes both physical activity and other activities to create a recovery community. Each meeting features a speaker and small group discussions are held three times a week after work. Like Alcoholics Anonymous and NA, Congress 60 uses two books to educate members about the challenges of addiction and encourages a “renovation of the individual’s beliefs and views of himself, family, society and the universe”. Congress 60 views the journey to recovery as a three-step journey with the first step involving opium tincture until recovery is continued. Opium tincture is used as an 11-month long pharmacotherapy treatment. The second step is a drug/medication free journey where an individual focuses on physical, mental, emotional rejuvenation and self growth. The third step is an ongoing spiritual process of understanding the “order and mystery” of the universe, however, the third step is not necessary for SUD recovery. All steps are used to reconstruct personal identity, relationships and daily lifestyle.
Similarly to Alcoholics Anonymous (AA) and other mutual-help organizations (MHOs), Congress 60 is a place where individuals with SUD can receive support and education about recovery. However, unlike AA and other MHOs, Congress 60 involves medication and physical activity, therefore, creating a more comprehensive and multimodal recovery community. Individuals have the opportunity to support one another and are able to invest in both their future and the futures of those around them by rebuilding their social connections and by building healthier relationships and a healthier environment. Congress 60 has successfully created a recovery community that integrates many individuals with SUD and offers a broad spectrum of services that can create a more comprehensive recovery environment and culture. Through additional research on Congress 60, other MHOs may be able to help expand their recovery communities to better serve their populations. Congress 60’s combination of abstinence-based and medication assisted therapy may inform opioid treatment in the United States where these treatments are often exclusive; combining both approaches at different stages may help assist long-term recovery, but awaits further study