Iran
An Eastern Mediterranean country that manufactures opioid medicines domestically for a large addiction treatment system, which separates the capacity to produce opioids from the will to use them for pain.
9 domains reviewed · 8 high-confidence · 1 dated estimate · 9 material gaps
WHO region: Eastern Mediterranean. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 3 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 14
- Newest source 2026
Lessons from Iran
- Iran shows a sanctioned regional economy can manufacture opioid medicines at scale for addiction treatment. Supply capacity is not the binding constraint on pain relief; the pain system has to be built to use it.99,98
- A national strategy, a ministry focal point and an accredited subspecialty still left Iran in the region's lower development cluster. Policy and credentials outpaced services.49
- Without a public budget line, care fell to private insurance, direct payment and NGOs. A discrete public line is worth securing early.49
- Where patients self-manage cancer pain with opium and home remedies, asking about these practices is a practical entry point for safer pain control.458
Palliative care
Is morphine available in Iran?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
Opium tincture is produced domestically and approved alongside methadone for opioid agonist treatment. The evidence concerns addiction treatment, not cancer pain.98,99
What is consumption of opioid analgesics for pain, and is oral morphine consistently available for cancer patients?
Help answer it:Search PubMedHow does Iran regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
Iran has a national palliative care strategy and a designated Ministry of Health officer for palliative care.49
Which regulation governs opioid prescribing and dispensing for pain, and when did it last change?
Help answer it:Search PubMedWho can prescribe morphine in Iran?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
Providers interviewed in Iran reported that opioids reach patients with incurable disease at hospitals or through the national Food and Drug Administration only after a doctor's prescription. Cancer patients go monthly to the Food and Drug Administration to collect drugs prescribed by a specialist. Based on stakeholder interviews; no legal text was read.326
Which physician categories (specialists, general practitioners, family physicians) may legally write opioid prescriptions, and may nurses do so?
Help answer it:Search PubMedHow does palliative care reach patients in Iran?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
The regional survey places Iran in the lower development cluster with Morocco, Iraq, Egypt and Pakistan, while naming it among countries with an early increase in specialised services.49
How many specialised services exist, and where? NGO and cancer institute services were named in the brief but not documented.
Help answer it:Search PubMedWho pays for palliative care in Iran?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Palliative care is paid through private insurance and direct payments to health centres or NGOs, not a national budget line.49
What do the public insurance organisations cover for palliative care drugs and visits?
Help answer it:Search PubMedHow are palliative care clinicians trained in Iran?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 15 specialistsMODELED ESTIMATE · 2020
Palliative medicine specialists, expert estimate, Iran, 202049
Last checked 2026-09-24.
The same survey estimates four in Pakistan and about fifty in Saudi Arabia.
Cite this figure:
Palliative medicine is an officially recognised subspecialty. Nursing schools teach palliative content within oncology, home care and pain topics.49
Which body awards the subspecialty, and how many hold it today?
Help answer it:Search PubMedHow does Iran prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Iran runs a large methadone maintenance program, and opioid agonist therapy is also available in prisons, though 32.5% of eligible people in prison had no uptake. Methadone-related poisoning and deaths are rising concerns. Opioid analgesic consumption remained low through 2018, with tramadol making up most use and strong opioids only 13.2%.644,645,646
Is naloxone available in the community, and what rules govern prescribing strong opioids for cancer pain?
Help answer it:Search PubMedHow do children get palliative care in Iran?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Pediatric palliative care centers in Iran remain underdeveloped; the Mofid Children's Hospital clinic, opened in 2021, offers 24-hour in-person and telephone services. Pediatricians describe difficulty telling children and families the truth about disease and conflicts between physicians and parents.647,648
How many children receive specialist palliative care in Iran, and which child-appropriate opioid formulations are available?
Help answer it:Search PubMedHospice care in Iran
How the hospice model works here, who can use it, who pays and who it reaches. Covered 3 of 4.
What does hospice care look like in Iran?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
As of 2022, Iran had no hospice centers and no integrated, formal hospice program. A few centers, mainly in large cities, provide sporadic palliative care at home or in hospital that includes end-of-life care, and researchers have proposed a national hospice model.325
Has the proposed hospice model been piloted regionally, and by whom (Ministry of Health, universities or charities)?
Help answer it:Search PubMedWho can get hospice care in Iran?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
No hospice admission rules exist; the proposed national model lists admission criteria and a standard referral time as items still to define (PMID 35418901). What criteria do existing home palliative services use?
Help answer it:Search PubMedWho pays for hospice care in Iran?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
A 2022 policy model for Iranian hospice care, written while no hospice centers existed, proposed mixed funding: government funding, insurance service packages with set prices, private investment and charity support. The authors judged private and donor funding the more important source. This is a proposal, and one co-author works for the MACSA charity.325
Has any Iranian insurer since added hospice or end-of-life services to its benefit package?
Help answer it:Search PubMedHow many people reach hospice in Iran?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
Critically ill and end-of-life patients in Iran are generally hospitalized in ICUs, since no hospice centers exist. The palliative services that do exist are concentrated in large cities.325
How many patients receive home-based end-of-life care each year, and what share are non-cancer or rural patients?
Help answer it:Search PubMedWhat fills the gap in Iran
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
Most home-based care for advanced cancer is carried by women in the family. Female caregivers in Isfahan described depression, anxiety, mental exhaustion and death anxiety, and asked for counseling and preparation for mourning.456
Subnational evidence- Volunteers and compassionate communities
Stakeholders described volunteers as "the missing link in the health system" in a palliative care landscape that relies on charitable support. They called for legal frameworks, standard training and organizational models to make volunteer roles sustainable.457
National evidence- Substitute and informal pain relief
Iranian cancer patients described managing their own pain with opium (Taryak) and tobacco, herbal and home remedies, massage, heat and cold, and spiritual practices. Small qualitative sample of 14 patients.458
Subnational evidence- Charity, religious giving and mutual aid
Home care nurses in northwest Iran named insurance coverage and charity support as financial needs of patients receiving cancer care at home.459
Subnational evidence
Sources cited here
- 98Nikoo M, Kianpoor K, Nikoo N, Javidanbardan S, Kazemi A, Choi F, et al.
Opium tincture versus methadone for opioid agonist treatment: a randomized controlled trial. Addiction 2023;118(2):284-294. DOI 10.1111/add.16030. Abstract read. Four-clinic trial in Iran comparing domestically produced oral opium tincture with methadone for opioid use disorder.
- 99Noroozi A, Kebriaeezadeh A, Mirrahimi B, Armoon B, Ahounbar E, Narenjiha H, et al.
Opium tincture-assisted treatment for opioid use disorder: a systematic review. Journal of Substance Abuse Treatment 2021;129:108519. DOI 10.1016/j.jsat.2021.108519. Abstract read. Opium tincture is approved in Iran for treating opioid use disorder.
- 49Sanchez-Cardenas MA, Pourghazian N, Garralda E, et al.
Palliative care in the Eastern Mediterranean: comparative analysis using specific indicators. BMC Palliative Care 2022;21:168. DOI 10.1186/s12904-022-01047-7. Expert survey of 12 EMR countries, including Iran, Jordan, Egypt, Morocco and Pakistan. Iran and Jordan are among the countries reported to have a national palliative care strategy, a designated Ministry of Health officer for palliative care and palliative care recognised as a subspecialty; recognition years are not given. Full text read.
- 326Hojjat-Assari S, Rassouli M, Kaveh V, et al.
Explaining health care providers' perceptions about the integration of palliative care with primary health care; a qualitative study. BMC Prim Care 2022;23(1):226. Qualitative study in Iran (21 interviews, one focus group, 2016-2020) describing how cancer patients obtain prescribed opioids through hospitals or the national Food and Drug Administration; stakeholder perceptions. Full text read.
- 644Kalantar A, Rezaei M, Jafarzadeh Kohneloo A, et al.
A nationwide study on consumption of opioid analgesics in Iran from 2000 to 2018. Int J Clin Pharm 2023;45(2):397-405. National wholesale data on opioid analgesic consumption over 19 years. Abstract read.
- 645Rostam-Abadi Y, Gholami J, Noroozi A, et al.
Public health risks associated with methadone in Iran: A systematic review and meta-analysis. Int J Drug Policy 2022;100:103529. Systematic review of 65 studies on non-prescribed methadone use, poisoning and deaths. Abstract read.
- 646Rafiee M, Mehmandoost S, Sadidi N, et al.
Unmet needs for opioid agonist therapy in Iranian prisons: a cross-sectional study. Int J Prison Health 2026:1-13. National bio-behavioral survey of 5785 people in 33 prisons, 2994 eligible for OAT. Abstract read.
- 647Babaie M, Rassouli M, Farahani AS.
Transforming pediatric palliative care through technology: Insights from Iran's experience and existing challenges. Asia Pac J Oncol Nurs 2025;12:100753. Editorial on pediatric palliative care and telenursing in Iran; two authors sit on the journal's editorial board and it presents no new data. Full text read.
- 457Ashrafizadeh H, Eshaghian-Dorcheh A, Beiranvand S, et al.
The Role of Volunteers in Providing Palliative Care Services in Iran: A Qualitative Study. J Soc Work End Life Palliat Care 2026:1-23. Interviews with 12 stakeholders in volunteer-based palliative care, including volunteers and family caregivers, describing volunteers as filling gaps in a charity-reliant system; small stakeholder sample. Abstract read.
- 648Zahedi F, Kadivar M, Khanali Mojen L, et al.
The ethical challenges of palliative care from the perspectives of pediatricians: A qualitative study in Iran. Front Pediatr 2022;10:928476. Interviews with 15 pediatricians in Tehran hospitals in 2019. Abstract read.
- 325Beiranvand S, Rassouli M, Hazrati M, et al.
Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer. Front Psychol 2022;13:807621. Mixed-methods health policy study (comparative review plus Delphi) stating that Iran has no hospice centers and no formal hospice program, and proposing a national model; country level. Full text read.
- 458Orujlu S, Hassankhani H, Rahmani A, et al.
Pain Self-management Strategies in Patients With Cancer: A Qualitative Study. Holist Nurs Pract 2023;37(2):90-97. Interviews with 14 Iranian cancer patients (Tabriz-based team) describing self-managed pain relief including opium (Taryak), tobacco, herbal and home remedies, massage and spiritual practices; small sample. Abstract read.
- 456Monemian S, Sharbafchi MR, Taleghani F
Psychological challenges of female caregivers in providing home-based palliative care for patients with advanced cancer: A descriptive-exploratory study. J Educ Health Promot 2024;13:30. Qualitative interviews in Isfahan with 20 female family caregivers and 18 providers on the psychological load of home-based care; one city. Abstract read.
- 459Hassankhani H, Dehghannezhad J, Rahmani A, et al.
Caring Needs of Cancer Patients from the Perspective of Home Care Nurses: A Qualitative Study. Asian Pac J Cancer Prev 2022;23(1):71-77. Interviews with 15 home care nurses in northwest Iran identifying financial support needs, including insurance and charity support, for home cancer care; one region. Abstract read.