Estimating the prevalence of opiates use by unlinked anonymous urine drug testing: a pilot study in Iran.

In order to estimate the prevalence of opiate use and to cross-validate the current program of urine testing as the sole screening and detection method for finding opiate abusers in Iran, urine samples of 1120 men with a mean (+/- SD) age of 46.6 (+/- 16.5) years referring to a large clinical lab for diagnostic and screening purposes in Kerman (the center of the biggest province in Iran) were assayed by anonymous, unlinked testing for opioid metabolites during 2004. The specimens were analyzed by an immunoassay screening test and a thin-layer chromatography (TLC) confirmation test. The initial screening test was positive in 28.8% (95% CI: 26.1-31.5) of cases (322 individuals), half of whom were confirmed by TLC. As a whole, 14.4% (95% CI: 12.4-16.6) of urine samples were positive for opioid metabolites. Although individuals referring to clinical labs do not exactly represent the general population, according to relatively high figures achieved in this study we suggest revising the urine test as the sole screening and detection method for finding Iranians who use opiates for non-medical reasons. Research is needed to further pursue these findings.