Opium use has existed in Iran since four centuries ago and it has been estimated that by 1949, 11% of Iranian adults were drug users (Nissaramanesh, Trace, and Roberts, 2005). ∗The journal’s style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor’s note. Address correspondence to Dr. Nouzar Nakhaee, P.O. Box 76195-1447, Kerman, Iran. E-mail: nakhaeen@yahoo.com 513 Subst Use Misuse 2008.43:513-520. Downloaded from informahealthcare.com by University of California San Francisco on 01/29/15. For personal use only. 514 Nakhaee et al. Although opiates use is not a novel issue in Iran, it has had an increasing rate during the recent years (Mokri, 2002), so that in some studies about 21% of university students in Iran had a history of opium use during the last 6 months (Ghanizadeh, 2001). Alcohol consumption is forbidden in Muslim countries, but according to Dixon (1972), public opinion in Muslim countries, including Iran, “does not view the consumption of narcotics as irreligious or morally reprehensible.” (p. 12) It is necessary for the government to have comprehensive information about the frequency, pattern, time, place, and causes of drug use to develop preventive strategies (Jenkins, 2001). In Iran the Drug Control Headquarters (DCHQ) is the main policy-making body who plans and monitors the anti-drug activities and the Ministry of Health is responsible for coordinating and monitoring of the different aspects of treatment and laboratory services, including drug testing. As a whole, a variety of methods are suggested to assess the prevalence of opiate use that have their own advantages and limitations (Kraus et al., 2003; World Health Organization [WHO], 2000). Urine test is a method used in Iran to recognize opiate use. Though the urine test is usually used for suspected populations such as arrested individuals (Makkai, 2001), those involved in car accidents (Marquet et al., 1998), or with specific aims as before job applications (Wu et al., 1999), in Iran it has a wider range of use such as the mandatory test for marriage application (Razzaghi, Rahimi, Hosseini, and Chatterjee, 1999). According to the law legislated in 1980, urine testing for opioids is mandatory before marriage, to obtain license for driving, and after applying for government jobs (Mokri, 2002). The shortcoming of this method is that many of those to be tested are informed in advance about the dating of urine collection and so the false negative results may increase due to adulteration (Mokri, 2002; Wu et al., 1999). Considering the importance and the widespread usage of urine test in evaluation of the prevalence of substance use which has been more emphasized recently (Fendrich, Johnson, Wislar, Hubbell, and Spiehler, 2004), we tried to estimate the prevalence of opiate use through urine testing of men referring to a large clinical laboratory in addition to cross-validating the current program of urine testing for marriage and employment indirectly