The Crescent and the Needle: The Remarkable Rise of NA in Iran


Narcotics Anonymous has thrived in Iran since 1990, second in membership and groups only to the United States. The Fix takes a look inside the phenomenon.

As of 2012 there were61,800 Narcotics Anonymous meetings worldwide. 27,650 in the USA and 15,955 in the rest of the world, except for Iran. There are 18,195 weekly NA meetings in Iran where Narcotics Anonymous was voted the top NGO by the government. How did such a paradoxical reality come to pass? 

Shattering Expectations

Rebecca had experience being in tough situations at 3 AM in the morning. In the thick of her heroin addiction, she had been in jeopardy countless times. As the Assistant Executive Director of the Narcotics Anonymous World Services Office, she had traveled all over the world. She had led workshops for emerging NA fellowships in many Third World countries. Still, nothing had prepared her for standing in line at customs at the Tehran Imam Khomeini International Airport in 2006.

Standing next to NA Board Member Tom M. from Hawaii, Rebecca leaned on her old friend for reassurance. As a six-foot-tall blond woman with a poorly-tied impromptu veil, she knew she stood out; an American in the wrong place at the wrong time. Although Tom reassured her that everything would be all right, Rebecca kept thinking of the tabloid reports about Iran in the American media. She came of age during the Iranian hostage crisis. Night after night, the images of bound and blindfolded hostages on Ted Koppel’s Nightline had been downright terrifying.

After passing through customs, Rebecca and Tom were greeted by Siamak, the office manager of NA World Services Iran, and several other enthusiastic Iranian NA members. She was surprised they had stayed up so late. Rebecca felt her fears evaporating as she was met with smiles and respectful embraces. They got their luggage and headed into the city. “Tehran is huge,” Tom wrote in his Iran Diaries, “The city at 3:00 AM was still bustling.” 

After a quick bite to eat, they wondered if they could take a rest. Siamak let them know that wouldn’t be possible until later because there was so much to do and see. There were people to meet and things to accomplish. Most importantly, the fellowship had set up a Narcotics Anonymous meeting where they would share their stories through translators.

With so many NA members wanting to attend, the fellowship had rented out a local sports arena. When Rebecca and Tom heard this, they looked at each other, a bit confounded. Rebecca thought, “I mean, a sports arena? How many people will be there?” 

When they arrived at the Arena in mid-afternoon on a workday, the car had to navigate through a maze of parked vehicles to reach the back entrance. Ushered down the kind of hallway where one usually only sees professional athletes, rock stars and security guards, Tom could hear the roar getting louder and louder. In the Iran Diaries, he described the experience of entering the arena:

“…the members all started clapping and then chanting as they clapped. You know why they are clapping and you know exactly who you represent. I thought holy shit, this is off the charts. Rebecca says to me, ‘What did we ever do to deserve this experience?’ I said we shot a lot of dope, that’s all, and beyond that we have just showed up like any other member.”

Over 24,000 Iranians in recovery greeted the NA World Services representatives in celebration. But it wasn’t Tom and Rebecca they were cheering; it was NA itself. Coming from the United States, they represented the birthplace of Narcotics Anonymous, a program that had saved so many lives and become such a force for good in Iran. 

All of Rebecca’s fears of going to a fundamentalist country as an American citizen evaporated as the tradition of Persian hospitality, the passionate belief of the Iranian NA members and a truly universal celebration of recovery became the zeitgeist of the moment. Tears came to her eyes as she looked up to see banners hanging in the arena with the traditional recovery proverb written in English specifically for them, “Just For Today.” 

Tom described the power of the moment when he wrote, “There were several rows of women in the back of the room. Becky shared as a woman with 27 years clean. You can imagine the impact that had. When we spoke and said how long we were clean they all chanted out something in Farsi that I later found out meant, ‘and may nothing ever take it from you.’”

May nothing ever take it from you because recovery from the depth of addiction is a blessing and a miracle all over the world. It doesn’t matter the name of the country or the tenor of the politics. But the looming question is how did this happen? How did Narcotics Anonymous become so successful in Iran?

The Quality Of Narcotics Anonymous In Iran

Founded in the United States in 1953, Narcotics Anonymous officially describes itself as a « nonprofit fellowship or society of men and women for whom drugs had become a major problem.” Since the rocky beginnings of this 12 Step program in California when police harassment was common, the fellowship has spread and today can be found in over 130 countries across the world. After the United States, the country with both the most weekly meetings and the largest population in the fellowship is the Islamic Republic of Iran. 

Rebecca described her impression in an interview with The Fix, “What we talk about as principles in 12 Step fellowships, the Iranians in NA live and embrace in a way that impacted my own recovery for the better. The lengths they will go to help an addict in need was inspiring; a lesson in true recovery.” 

The NA World Service office in Chatsworth has become accustomed to excluding Iran from worldwide reports; the Iranian phenomenon skews the figures. Statistics From the 2008 NAWS Report include the following: 

1. Iran accounted for 126,000 copies of 447,000 Basic Text sales worldwide (the Basic Text is to NA what the Big Book is to AA)

2. The Iran office distributed one million key tags, including 200,000 multi-year key tags: 9% more than the United States

3. Iran distributed 1.7 million NA information pamphlets; this number was greater than the rest of the world combined

Since the Islamic revolution in 1980 that overthrew the corrupt regime of the Shah, Iran often has found itself at odds with the Western world in general and the United States in particular. But the story of Narcotics Anonymous in Iran has nothing to do with politics or international conflicts or religious fundamentalism. The surprising success of NA in Iran is based on a remarkable commitment to recovery by the fellowship and an ardent focus on continuing to reach out to the newcomer. 

NA World Services was not aware of the true success of Narcotics Anonymous in Iran until 2003 when Iranian members started reaching out for guidance. Chatsworth knew that NA in Iran existed, but, according to Rebecca, their impression was that it was a struggling movement. The movement did have a bumpy start in October 1990 when Mohsen T. returned to Iran from the United States and tried to start a NA meeting in an Iranian rehab center.

At the time, Mohsen had only one year clean. He had joined NA while living in Los Angeles and was so taken with the program that he hoped to bring it back to his home country. Unfortunately, the Iranian rehab tried to co-opt that first NA meeting and attach their name to it. Not wanting to violate the traditions, Mohsen had to abandon the project. 

Later, according to an anonymous source for The Fix from the NA WS office in Iran, Mohsen started meeting in private homes with three other Iranians who had experience in 12 Step programs in the United States and Canada. These men bumped into each other by happenstance, an example what people in recovery call a God Shot.

Since they were all newcomers, according to a NA member from Iran, “It was another 4 years before NA really took hold in Iran. Once members accumulated some time and worked the steps, they began translating NA literature into Farsi and the fellowship took off.” 

When the NA World Service office was contacted in 2003, the initial reaction was nothing less than utter surprise. The movement had grown so big and so fast that the office staff in Chatsworth thought surely something had gone wrong. Had the government become directly involved? Had NA in Iran become co-opted by a religious movement?

In order to find out what was really happening, Rebecca described the next steps taken: “In 2004, someone from the region we trusted went to check it out and discovered that NA in Iran was not only like NA as we knew NA, but it was even better. Better in the enthusiasm, better in carrying the message to the addict who still suffers, better in terms of a commitment to their own recovery and helping others find the same path. In May of 2005, a branch office of NA World Services was opened in Iran.” 

When asked why Narcotics Anonymous proved to be so successful, a member of the NA WS Iran office told The Fix:

a) The early and continuing efforts to translate NA literature into Farsi and distribute it to NA members

b) A powerful service structure with dedicated trusted servants

c) The traditions of Persian culture that worked so well in conjunction with the 12 Steps and 12 Traditions of NA.

A Short History Of Opium From Persia To Iran

Beyond the obvious passion for being of service in recovery by the Iranian NA members, another clear reason for the success of NA in Iran is the devastating extent of the drug problem in that country. The history of opiates in Iran is long and dates back before even the establishment of the Persian Empire. Yet, the problem has never been as bad as it is today. 

As detailed in a Radio Free Europe report,  

“Opium and heroin in Iran is widely available, and the country has the highest per capita number of opiate addicts in the world at a rate of 2.8% of Iranians over age 15. The Iranian Government estimates the number of addicts at 2 million…. Opium costs far less in Iran than in the West and is even cheaper than beer. In Zahedan, an Iranian town near the Pakistani border, 3 grams of opium can be purchased for 10,000 Iranian rials, equivalent to $1 USD… Opium and heroin are popular because alcohol is haram (forbidden in Islam), and more tightly controlled by the Iranian government. According to official Iranian government reports, within Tehran the daily consumption of opium is 4 metric tons.”

Beyond being one of the world’s oldest societies, Iran also has one of the oldest histories of opiate abuse. Although opium first appeared in Persian culture in 3300 BC thanks to Sumerian traders, the drug did not take hold until Alexander the Great reintroduced it in 330 BC. Later, in the 1600s, Persians began eating and drinking opium mixtures on a regular basis for recreational use. From that point until the 20th century, opium was an accepted part of the culture.

During the time of the Shah, opium was illegal in name only and tolerated by the corrupt regime. PBS Frontline explained how the Shah tried to placate his Western benefactors by making a weak stand against drug use in Persian culture: “As part of Iran’s drug-control efforts, a law was passed in 1968 permitting opium addicts above the age of fifty to register with the government; in 1975 the number of these was about 170,000, though estimates of additional unregistered addicts range from 200,000 to one million.”

After the revolution, the response by the leaders of the new Islamic republic was to take a hardline against both drugs and drug users. The days of tolerance for opium smokers and heroin abusers in Iran were over. Like America’s “Just Say No” efforts during the War on Drugs, this uncompromising approach only managed to fill up the prisons with addicts in need of recovery. Being caught in the grip of the Golden Crescent of Afghanistan and Pakistan where the poppy fields bloom, the present day Iranian government tries to stop the importation of the drug. But it is a losing battle. 

As detailed in Intellibriefs by Conrad Legendy, “Total annual opium intercepts by the Iranian authorities are larger than in any other country, but the government admits that they can only intercept a tiny proportion of the thousands of tons that are trafficked through Iran every year.” 

Given the amount of drugs entering the country and the religious prohibition on alcohol, is the opium and heroin problem in Iran really all that shocking?

The Iranian government has evolved in their approach toward drug addiction in the country, shifting from a punishment perspective to a harm-reduction model. Today, in order to reduce the spread of blood-borne viruses like HIV and hepatitis C, Iranians can obtain needles without a prescription in any pharmacy. (Although this was the policy during the Shah’s regime as well, it has not changed.) With the jails overflowing, the government does not know what else to do.

An Iranian NA member told The Fix that such a policy does not result in the promotion of true recovery. He described garbage pails containing used needles next to toilets in public bathrooms in the big cities in Iran. This is how extensive the drug problem has become in a society where alcohol is replaced by heroin and the tradition of opium use continues to resonate—indeed opium use is still more common in Iran than the extensive heroin use precisely because it is more traditionally accepted.

Narcotics Anonymous And The Iranian Government

The initial response from the Iranian government to Narcotics Anonymous was cautious and open. Proactive efforts by the first NA members to do positive public relations work with the government showed that they meant no harm and posed no threat. In a 2000 NA Way magazine, Frouhar T. made one of the first reports about the fellowship in Iran and its relationship with local authorities:

“It is wonderful to inform you that last week we celebrated the fifth anniversary of our first NA meeting in Iran. It was a moving experience when, at the end of the gathering, a recovering family of four (a father and his two sons in NA, the mother in Naranon) blew out the candles on our fifth anniversary cake. This was a clear message of recovery and hope.

We had high-ranking guests from interested government agencies, including someone from the Iranian House of Representatives. For the first time, we were able to invite legislators and decision makers from the Iranian government to see how our program works, and we were able to do this without jeopardizing our members or compromising our traditions. It is a miracle to achieve such acceptance and respect in a country that only six years ago was still whipping and sometimes executing addicts.” 

Although the report sounded truly positive, it also made the staff of NA World Services nervous. After all, despite the claim that no traditions had been broken, it sounded questionable that government officials would attend such a gathering. In addition, the description of the officials as “high-ranking guests” could either have been a question of English being the writer’s second language or it could imply a potential violation of the 10th Tradition of NA that clearly states: “Narcotics Anonymous has no opinion on outside issues; hence the NA name ought never be drawn into public controversy.” 

Later, such fears were proved wrong when NA Iran reached out to the NA World Services office in Chatsworth for help in 2003. The Islamic Republic of Iran had voted Narcotics Anonymous the top NGO (non-governmental organization) in the country and wanted to give the fellowship an award. NA WS informed the government that, while the award could be accepted on behalf of Narcotics Anonymous, the fellowship’s policy was not to accept any external offers of financial support. This surprised the Republic. If the fellowship wasn’t after money, what did they want?

Rebecca of NA WS gave a succinct answer in her interview with The Fix: « [The members of NA] just wanted to be allowed to exist. »

Why Is The Tenor Of NA Recovery In Iran So Remarkable?

When trying to understand the logic behind the success of NA in Iran, Tom M. from Hawaii told The Fix, “Another reason is the age ‘maturity’ of the membership; most members are in their mid 30’s to 60’s; most are university educated and have careers and families. This is unlike the growth in the US and most of the rest of the NA world where we have had mostly young addicts with no education; off the streets and out of the jails. I think they in someway had the same demographics as the early AA fellowship.”

Indeed, such maturity of the Iranian NA fellowship in the initial years helped to establish the guiding principles that ensured their future success. Such an establishment is reflective of the work done by Bill Wilson and Dr. Bob in the early years of Alcoholics Anonymous. Still, given the American perception of the Iranian government and the religious extremism associated with Islamic fundamentalism, it remains hard to accept the facts: Narcotics Anonymous is not only accepted in Iran, but it continues to be lauded year after year.

How can this be? Especially in the face of so many challenges. 

With the huge size (200 to 300) of the average meeting, it’s a real challenge for the Iranian fellowship to find weekly meeting places in so many cities that can hold so many members. It’s a challenge for any non-governmental organization in Iran to renew a license. Yet, NA in Iran continues to successfully navigate each of these hurdles and more. 

How do you maintain the intimacy and safety needed for newcomers in such large meetings? How do you work the steps with newcomers when there are so many more people in early recovery than members with experience as sponsors? It is not surprising that a major focus of the fellowship is the creation of solid foundations for newcomers.

Rebecca illuminates the staggering challenges, “There are people in the fellowship that have 150 sponsees. Sponsors tend to have sponsee gatherings and meetings just with their sponsees. Still, I can’t imagine how it is possible for one person to listen to 150 5th step inventories.”

She then went on to explain how the Iranian fellowship so effectively deals with its greatest challenge, that of avoiding conflict with the politics of Islamic fundamentalism: “NA in Iran has done an amazing job of demonstrating that they are not a religious program. They are not in conflict with any of the precepts of Islam. They do a remarkable job of keeping politics out of NA and focusing on their primary purpose to carry the NA message of recovery to the addict who is still suffering. Even though they have grown faster than anyplace in the world, they continue to make an unprecedented effort to carry that message.”

The fellowship in Iran has shown a remarkable dedication to the principles that exist at the heart of the Narcotics Anonymous program. In the Iran Diaries, as the representatives from NA World Services visited city after city and held workshop after workshop, the consistency of the recovery in Iran took their breath away. Tom particularly was surprised when they were invited to a party to celebrate the completion of the 12 Steps by NA members:

“Basically what they do is the first time a member has worked all 12 steps they have a party, their sponsors line up and the sponsees line up in rows in front of them. Of course, everyone is sitting on the floor. The sponsees have something written and each one is called upon to read their 12th step. At first, I thought this was really strange, but as I watched, I realized what a brilliant little ceremony this is. What would be more worth celebrating than completing the 12 steps for the first time? I know scores of members in the states who have been clean for years and have never done all 12 steps. Here, working the NA program means working the 12 steps, no if’s and’s or but’s about it.”

By keeping the emphasis on the 12 Steps, Narcotics Anonymous in Iran revitalizes the lifeblood of the program and fosters proactive long-term recovery. In a country with the highest per capita number of heroin and opium addicts in the world, the desperate nature of the situation is obvious. Without Narcotics Anonymous, what would happen to these addicts in Iran? Would they be thrown into prison? What would there loved ones do? 

When it comes to an addiction as extreme as heroin, there are no easy answers. The horror experienced by the families and friends of addicts as they watch their loved ones caught in the vise of addiction is unspeakable. Such horror transcends borders and boundaries. It has nothing to do with politics or international relations or stories in newspapers. It is a daily reality experienced around the world, and the success of NA in Iran shows the tremendous importance of recovery and how 12 Step programs truly provide a universal resource to addicts and alcoholics all over the world. 

During his trip to Iran, Tom did not expect to keep running into NA members outside of meetings. Yet, wherever they went, they seemed to bump into person after person who wanted to express their gratitude for the NA program. One such member told a story that presented an iconic image that captures the essence of why the success of Narcotic Anonymous in Iran is so important:

“…before he found NA he tried everything to stop using. He had walked all the way to Mashhad (a holy site) four different times in hopes of a healing from his addiction, it would take him 10 days by foot. It is supposed to be common for Muslims to do things like this, it is their belief that they would receive a miracle… at the mosque in Mashhad, he (recently) saw a young man tied to the tomb with ropes and two large men guarding him so he wouldn’t run away. When asked why he was tied to the tomb, they told him his parents had him brought there in hope that a miracle would happen and he would be free from his drug addiction. The NA member talked to him and ended up bringing him to an NA meeting. As of this date he has 7 days clean.”

The young man’s family had grown so hopeless that they had tied their son to a column at a holy site, desperately seeking a miracle. The tragedy of addiction drives people to such extremes, praying for a divine intervention in order to save a loved one. If Narcotics Anonymous had not taken hold in Iran, would that young man still be tied to that column today? 

John Lavitt is a regular contributor to The Fix. He last wrote about The Anonymous People.