Drug control policymaking in Iran, despite benefiting from numerous upstream documents and legal frameworks, has failed to curb emerging consumption trends due to the dominance of reductionist approaches and an over-reliance on supply suppression. Evidence indicates that the rising number of consumers, the lowering age of initiation, the shift toward synthetic drugs, changing distribution methods through social platforms, and rapid access to substances necessitate a profound overhaul of existing policies and laws. One fundamental issue is the severity of penalties and the inadequacy of criminal enforcement guarantees, which has led to the emergence of informal judicial policies aimed at mitigating harshness and has consequently weakened deterrence. At the social level, escalating demand is intertwined with disruptions in economic, cultural, and political subsystems—including diminished social capital, the erosion of healthy lifestyle norms, a lack of legitimate opportunities for employment and recreation, and the absence of social defense mechanisms for youth. Furthermore, a uniform nationwide prescription for prevention, poor coverage of preventative programs, a shortage of specialized human personnel, and a failure to transfer organized knowledge to practitioners have undermined intervention efficacy. Proposed strategies emphasize adopting a structural and interdisciplinary approach, shifting from punishment-centrism toward decriminalization and dejudicialization in the domain of consumption, strengthening harm reduction and treatment policies, standardizing therapeutic services, localizing prevention programs in alignment with regional cultural characteristics, developing public participation, and purposefully leveraging cyberspace and innovative dissemination methods.