Sir,
In Asia, Illicit opium and cannabis are produced mainly in Afghanistan, which makes major social and health problems for some countries, particularly Iran as the neighborhood.[1] In Iran, opium and hashish have been used for near 300 years,[2] but other drugs such as heroin, buprenorphine, cocaine, tramadol, and ecstasy are new drugs of abuse in this country.[3–6] Abuses of the new drugs in Iran are now a major health problem, particularly for the youth and young adults.[3,4]
In Iran, drugs which have been named by substance abusers may have a similar western name, but with different chemical entity. For example, crack is one of the popular names among the substance abuser in Iran, but is totally different with the western crack. In the other parts of the world, the main ingredient of Crack is cocaine, but in Iran it is heroin which may also contain morphine, codeine, caffeine, noscapine, papaverine, dextromethorphan, and acetyl codeine or corticosteroids with different amounts that make it even more harmful than pure heroin or any other drugs.[7]
“Crystal meth,” is the smokable form of methamphetamine hydrochloride. Crystal meth is more likely to cause dependence than other forms of methamphetamine. Crystal meth is a cheap and easily available drug in the western countries, which is a common abused drug among youths in these countries.[8]
Nowadays, crystal is one of the most common abused drugs in Iran.[4,9] It is one of the newest drugs between the Iranian addicts that are spreading widely among youngsters. In eastern part of Iran, there is no difference between crack and crystal in term of ingredient, because both of them are heroin and urinary test for the substance abusers have been positive for morphine but negative for amphetamine and the other common abused substances.[9]
The important point in this view for the physicians is to know that the slang word of drug abusers “Crystal” in the eastern of Iran is a misunderstanding of the crystal- meth and it is in fact heroin.
Iranian Crystal is made in the illegal laboratory, with no standardization. Unfortunately, lack of awareness about the toxicity of this substance have caused health problem among adults or youngsters who used it freely with no fear. Even some Iranian addicts believe that the crystal is the crystal-meth (amphetamine base) because of similarity in name.
What is behind this non-awareness and all these misunderstanding? High concentrate of heroin in Iranian crack and crystal may lead to acute intoxication and dependency with lots of physical and mental health effects of the addict, as well as social and economical problems. In this letter, we have tried to bring attention to all health professionals, particularly emergency physicians and clinical toxicologist, on the confused slang name of crack and crystal in Iran. Although it has been reported to the local health authorities, general awareness on the misunderstanding and toxicity of these substances are recommended.
Footnotes
Source of Support: Nil
Conflict of Interest: None declared
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