Iraq

Iraq is facing a growing public health crisis, especially in relation to substance use. There has been an exponential rise since 2020 in the number of people using drugs and this is happening in the context of political and economic instability and at a time when the healthcare system is severely weakened.

Opioid abuse is common on Iraq’s eastern border, while in the north alcohol consumption is growing. According to UNODC, methamphetamine is now the most dangerous and most prevalent drug in Iraq. The use of amphetamine-type stimulants (ATS) is reported in several regions of the country, with Captagon particularly widespread in Baghdad. In 2022, a total of 2,251 people sought treatment for ATS use.

Médecins du Monde opened a community harm reduction centre for non-injecting users of stimulants in Baghdad in 2024. A local team was recruited and trained and contacts were established with peer workers to offer a range of mental health and psychosocial support services and a drop-in / day centre.

The approach developed in Iraq is different from other harm reduction work done by Médecins du Monde because it concentrates almost exclusively on psychiatric, psychological and social work services. This is in contrast to the interventions more often delivered by MdM which focus on infectious diseases, such as HIV and hepatitis C, and involve the distribution of equipment (syringes and needles) and substitution treatment (methadone and buprenorphine). However, these responses are not suitable in the context of non-injecting stimulant use, so a different approach was developed.

Médecins du Monde conducted an in-depth study of the local context to gain an understanding of the scale of the situation, identify risk factors and evaluate existing community protection measures. Our intervention aligns with the strategy of the Iraqi government’s mental health department.