Addressing Opioid Use Disorder in the Middle East and North Africa (MENA) Regions

The opioid crisis has devastated communities across the United States, prompting extensive litigation against pharmaceutical companies for their role in fueling addiction. Aggressive pharmaceutical marketing has led to the development of key lawsuits against Purdue Pharmaceuticals, the Sackler family, Johnson & Johnson, and Teva Pharmaceuticals, as well as a landmark $26 billion global settlement involving major distributors. U.S. courts have played a crucial role in corporate accountability, mandating record financial settlements alongside behavioral and policy reforms. By contrast, the opioid crisis in MENA, which stemmed largely from illicit drug trafficking often linked to geopolitical instability, has been more often met with strict criminal penalties rather than structured legal redress.

While many countries prioritize enforcement, Iran and Turkey have implemented harm reduction strategies, such as medication-assisted treatment and controlled opium production, which offer valuable models for balancing regulation with public health needs. This article contends that MENA’s response could be strengthened by incorporating judicial oversight akin to the civil litigation framework employed in the U.S. By allowing courts to address opioid-related harms through civil mechanisms while working alongside policy-level actors to combat trafficking and stigma, both regions can build more effective, sustainable frameworks to manage opioid use and its detrimental societal impacts.