Basma Alansari - Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia
Alireza Noorozi - Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), TUMS, Tehran, Iran
Anne Marie Thow - Menzies Centre for Health Policy, Sydney Medical School, University of Sydney, NSW, Australia
Masoud Mirzaie - Research Center of Prevention and Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Carolyn A. Day - Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia
Katherine M. Conigrave - Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia; Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

Background and Aim : Alcohol is the seventh leading risk factor for death and disability globally [1]. Due to the Islamic prohibition of alcohol consumption, alcohol policy is an under-studied and sensitive topic in Muslim majority countries (MMC). In addition, populations in these countries may face barriers to treatment access due to stigma or legal status of alcohol. Using Iran as a case study, this paper aims to explore how alcohol treatment is planned/ delivered in the complex environment of a MMC. Methods : We searched academic and grey literature, and policy documents, for information on the development and implementation of alcohol treatment policy in Iran, and conducted 6 consultations to verify information obtained. The search was conducted in English, Persian and Arabic. We analysed information based on the Walt & Gilson health policy analysis triangle. This identifies content, context, actors and process as key factors for understanding policy. Results : Iran initiated an alcohol-specific national strategy in 2011-2012 that aims to prevent, reduce and treat alcohol use disorders. This strategy has been designed to be implemented on a multi-sectoral level. Screening and prevention is mainly initiated in primary health care settings and cases are referred accordingly. Alcohol treatment is provided in specialised outpatient and inpatient settings. Due to contextual factors such as stigma, feasibility and affordability, alcohol outpatient units are planned to be integrated into the existing drug addiction treatment facilities. However, the Ministry of Health has faced many obstacles in implementing this pilot project. To date only small numbers of outpatient and inpatient units have formally commenced offering alcohol treatment in the country. Conclusion : Implementing alcohol treatment services is challenging for Iran, primarily due to slow administrative process of official approval of new treatment programs which might be a result of not seeing it as a priority and caution due to existing prohibition for Muslim majority population in the country. MMCs make up a quarter of countries globally, and the findings of this study suggest that WHO and other global agencies could develop targeted support for MMCs. Consequently, they can assist MMCs to develop appropriate services that are feasible for their unique alcohol policy environment

Alcohol policy, prohibition, treatment, Muslim majority countries, alcohol treatment, Iran