The Role of Complementary and Herbal Therapies in the Management of Opioid Use Disorder in Iran: A Pharmacoepidemiological and Health Economic Analysis of Trends in Opioid Medications and Natural Products

Background:Chronic opioid misuse, including morphine and related opioids, remains a major public health concern in many countries, including Iran. Long-term opioid use is associated with the development of dependence, tolerance, and significant clinical and social consequences. In recent years, growing awareness of the adverse effects of synthetic pharmacotherapies has increased interest in complementary and herbal medicines as potential adjunctive approaches for managing opioid withdrawal symptoms.Methods:This pharmacoepidemiological and health economic study analyzed trends in opioid use disorder (OUD) medications and natural medicinal products in Iran. Quantitative (unit sales) and monetary data were extracted from annual statistical reports of the Iran Food and Drug Administration (IFDA). In addition, data on natural and traditional medicinal products were obtained from IFDA pharmaceutical market reports. A comprehensive literature review was conducted using PubMed, Google Scholar, SID, and Magiran to identify medicinal plants and herbal products with potential efficacy in opioid withdrawal management and addiction treatment.Results:The OUD medication market in Iran was estimated at approximately ۳ trillion Iranian tomans in ۲۰۲۵, corresponding to about ۵.۹۳ trillion tomans at ۲۰۲۶ prices, with methadone holding the largest market share. In contrast, natural and traditional medicinal products accounted for only about ۷% of the total pharmaceutical market in ۲۰۲۳, with an estimated value of ۱۱.۸ trillion tomans out of a total market size of ۱۶۰–۱۸۰ trillion tomans. Despite this limited share, evidence from the literature suggests that several medicinal plants and herbal formulations may have potential as adjunctive therapies for reducing opioid withdrawal symptoms and craving.Conclusion:Although standard pharmacological treatments remain the cornerstone of opioid use disorder management, they are still associated with important limitations, including adverse effects, persistent craving, relapse risk, and substantial economic burden. Therefore, integrating evidence-based complementary and herbal therapies alongside conventional treatments may provide additional clinical and health system benefits and support a more balanced therapeutic approach.

کلیدواژه ها:

Opioid Use Disorder ، Pharmacoepidemiology ، Herbal Medicine ، Health Economics