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Drug users need more choices at addiction treatment facilities

BMJ 2013; 346 doi: (Published 22 March 2013) Cite this as: BMJ 2013;346:f1520
  1. Arash Alaei,
  2. Kamiar Alaei, University at Albany, Albany, New York, USA
  1. Correspondence to: A Alaei aalaei{at}

The brothers Arash and Kamiar Alaei—internationally celebrated doctors who advanced treatment for drug users in Iran but were imprisoned, to the vociferous protest of the international medical community (BMJ 2009;338:b109, doi:10.1136/bmj.b109)—set out their experiences and hopes for harm reduction

The patient first arrived at our clinic in 2001, complaining of a persistent cough and feverish chills. His cheeks were sunken, and his weathered clothes hung loosely from his frail body. He nervously wiped away beads of sweat that formed on his pale forehead, and his yellowed eyes looked warily past us while we spoke.

The patient did not admit it then—and we, as a policy, did not ask—but he was one of the one or two million drug addicts in Iran at that time,1 out of a population of about 67 million in the late 1990s.2 We had opened our first clinic of this kind in the Iranian city of Kermanshah. It served the needs of three overlapping target groups: those infected with HIV; individuals with other sexually transmitted infections; and injecting drug users.

We invited the patient to come into …

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