Table 3 Summary of factors affecting agenda-setting of policies related to the treatment of substance use disorder

Agenda-setting

Problem stream

Indicators:

Increase in drug detection and arrested people involved in drug crimes during the years after the Iranian revolution

The rapid growth of the pattern of AIDS transmission among PWID

Increase in high-risk sexual behavior among people who use drugs

Decrease in the average age of first drug use

Increase in the number of injecting and non-injecting people who use drugs

Increase in prevalence of drug use in women

Lack of effectiveness of compulsive treatment methods and criminological perspective

Increase in the number of deaths due to drug use

Increase in the social harms and crimes related to drug use

Focusing events:

AIDS epidemic among PWID in the prison of Kermanshah

Announcement of general anti-narcotics policies by the Supreme Leader of Iran

Feedbacks:

Criticism to the health system due to the inability and unwillingness of the health system to treat substance use disorder

Increase in people's demands and dissatisfaction of people with the government's performance in the field of substance use disorder

Policy stream

Criminological perspective to drug use and the war on drugs

Patient-centered perspective to people who use drugs and harm reduction

Political stream

Announcement of general anti-narcotics policies of Iran

Understanding the need for treatment, rehabilitation, harm reduction, and social support for drug dependent individuals by officials and policymakers

Opportunity window

People involved in the health system of Iran (especially the State Welfare Organization and physicians)

Scientific and academic groups

Responsible international organizations