Nooshin Parvaresh; Arman Masoudi; Shiva Majidi; Shahrzad Mazhari
Volume 4, 1-2 , Summer 2012, , Pages 1-8
Abstract
Background: Methadone Maintenance Treatment is a useful method for opioid dependents, which results in harm reduction and increased quality of life in opioid dependents. The prevalence of psychiatric disorders in addicts is higher than in the general population which can interfere with the course and ...
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Background: Methadone Maintenance Treatment is a useful method for opioid dependents, which results in harm reduction and increased quality of life in opioid dependents. The prevalence of psychiatric disorders in addicts is higher than in the general population which can interfere with the course and treatment of substance dependents and decrease the efficacy of treatment. Methods: This descriptive, cross-sectional study was aimed to determine the correlation between psychiatric disorders and methadone dosage. It was performed on 154 patients of Kerman Shahid Beheshti Hospital’s Methadone Clinic during a six month period from Dec 2010 to Jul 2011. The study population was chosen by convenience sampling. The searching tools were Socio-Demographic Questionnaire, psychiatric structured interview based on DSM-IV-TR, Beck Depression Inventory, Young Mania Rating Scales, and Anxiety and Depression Rating Scales. Findings: Significant correlations were observed between increased methadone dosage and antisocial personality disorder. In addition, significant positive correlations were observed between increased methadone dosage and Hamilton anxiety scores, Hamilton depression scores and Young Mania scores. Conclusion: High methadone dosage may be a marker of coexisting psychiatric disorders in patients on methadone maintenance treatment which indicates the necessity of devoting further attention to this group. Psychiatric services should be open and accessible to the patients, especially those who seek treatment voluntarily. Early diagnosis and treatment of patients with coexisting psychiatric disorders may increase the efficacy of methadone maintenance treatment. Keywords: Methadone maintenance treatment, Psychiatric disorders, Substance dependents
Hassan Ziaaddini; Batoul Ebrahim Nejad; Nouzar Nakhaee
Volume 5, 1-2 , Winter 2013, , Pages 1-6
Abstract
Background: A significant number of opioid-dependent patients in Iran are now being treated by methadone maintenance therapy (MMT). One of the social complications of substance dependency is family disorganization and a decrease in marital satisfaction. This study aimed to determine the effect of group ...
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Background: A significant number of opioid-dependent patients in Iran are now being treated by methadone maintenance therapy (MMT). One of the social complications of substance dependency is family disorganization and a decrease in marital satisfaction. This study aimed to determine the effect of group therapy based on the transtheoretical model of change on family functioning of the patients under MMT. Methods: In this open clinical trial, 48 married people who were between the ages of 19 and 40, and under methadone maintenance therapy had been assigned to two random groups of test and control. In the intervention group, group therapy was held based on the transtheoretical model of behavior change, for 29 sessions (two times a week). To assess the overall health and pathology of the family, the two questionnaires Family Assessment Device (FAD) and Marital Conflict Questionnaire (MCQ), both with approved reliability and validity, were used. Findings: A total of 24 patients in the control group and 23 patients in the intervention group (one person withdrew from the study in the early meetings) were evaluated. The mean ± SD of age of the control and intervention groups, respectively, were 33.9 ± 4.8 and 32.8 ± 4.3 (P = 0.40). Before the intervention began the average score of FAD and MCQ questionnaires between the two groups was comparable. After the intervention was over the score of each of the two questionnaires, with the adjustment of the baseline score, was lower in the treatment group than the control group, the difference was marginally significant (P < 0.10). Conclusion: The family functioning of the MMT treated patients showed improvement. Therefore, with the use of stage-of-change and group therapy, steps can be taken for improving family functioning of these patients. Due to the relatively long duration and frequency of treatment sessions the feasibility of this intervention needs further research. Keywords: Behavior change, Marital satisfaction, Drug dependence, Transtheoretical model
Najmeh Rahimi; Mohamad Hossain Gozashti; Hamid Najafipour; Mostafa Shokoohi; Hamid Marefati
Volume 6, 1-2 , Winter 2014, , Pages 1-6
Abstract
Background: Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors, the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients. Methods: This study ...
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Background: Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors, the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients. Methods: This study enrolled 374 diabetic subjects from diabetes care centers in Kerman, Iran including opium user group (n = 179) and a non opium user group (n = 195). The data were collected through a questionnaire completed by interviewing, physical examination and laboratory assessment. Findings: Opium did not show any statistically significant effect on blood glucose, glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL) and diastolic blood pressure. However, systolic blood pressure and prevalence of high systolic blood pressure were significantly higher in opium user group (P < 0.050). In addition, lower serum high-density lipoprotein (HDL) and frequency of lower HDL was significantly higher in opium user group (P < 0.001). Conclusion: According to this study, opium does not seem to have beneficial effects on diabetes control or cardiovascular risk factors. Therefore, it would not be advisable to consume opium as an anti-diabetes or cardioprotective agent.
Armita Shahesmaeili ; Ali Akbar Haghdoost ; Hamid Soori
Volume 7, 1-2 , Winter 2015, , Pages 1-13
Abstract
Background: Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis ...
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Background: Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models. Methods: From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET software’s for the analysis of data. Findings: The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score. Conclusion: Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks.
Pougnet Richard; Heno Gilles; Zarrin Alavi; Lienau Christine; Le Bretonnic Maryline; Garlantézec Ronan; Pougnet Laurence; Perriot Jean; Dewitte Jean-Dominique
Volume 8, Issue 1 , Winter 2016, , Pages 1-8
Abstract
Background: The purpose of this study was to detect chronic obstructive pulmonary disease (COPD) among smokers seeking treatment for the first time in a smoking cessation clinic and to assess the predictors of positive screening. Methods: This study was based on a multicenter survey with questionnaires ...
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Background: The purpose of this study was to detect chronic obstructive pulmonary disease (COPD) among smokers seeking treatment for the first time in a smoking cessation clinic and to assess the predictors of positive screening. Methods: This study was based on a multicenter survey with questionnaires (Richmond, Fagerstrom, clinical signs) and spirometry miniaturized. Data were analyzed with SAS® by Pearson chi-square test, the test of analysis of variance, Spearman correlation coefficient, and multivariate logistic regression step down. Findings: 1918 patients were assessed for eligibility and only 1737 were included. The report forced expiratory volume in 1 second (FEV1/FEV6) was < 0.8 for 33.2% of smokers and < 0.7 for 7.5% of them. People with likely COPD had more dyspnea (P < 0.010) and chronic bronchitis (CB) (P < 0.010). In multivariate analysis, CB, duration of smoking history since longer than 30 years, and dyspnea significantly increased the risk of being detected as COPD. The odds ratios of the above factors were 2.9, 4.1, and 4.5, respectively. Conclusion: 7.5% of smokers were likely COPD. Patient’s risk factors, such as the presence of CB, smoking addiction for longer than 30 years, or dyspnea, were predictive of a positive screening for COPD.
Masoudeh Babakhanian; Ali Akbar Haghdoost; Mahdi Afshari; Fatemeh Taghizadeh; Mahmood Moosazadeh
Volume 9, Issue 1 , Spring 2017, , Pages 1-10
Abstract
Background: Evaluation of sexual disorders among persons receiving methadone replacement therapy is of great importance, because these problems may lead to non-compliance and relapse. This study aimed to estimate the effect of methadone maintenance therapy (MMT) on sexual function among addicted Iranian ...
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Background: Evaluation of sexual disorders among persons receiving methadone replacement therapy is of great importance, because these problems may lead to non-compliance and relapse. This study aimed to estimate the effect of methadone maintenance therapy (MMT) on sexual function among addicted Iranian men using met-analysis.Methods: Investigating the available data banks, relevant studies were identified. After exclusion of duplicates, irrelevant papers and low quality articles, eligible papers were entered into the meta-analysis. Prevalence and standardized mean difference of sexual function scores were illustrated by forest plots based on sexual desire, orgasm and erectile function.Findings: During the primary search, 5341 evidences were identified. After application of the inclusion/exclusion criteria and quality assessment, nine papers were detected eligible for final meta-analysis. Total prevalence [95% confidence intervals (CI)] of sexual disorders and erectile dysfunction among Iranian men under methadone therapy were estimated as 66.3% (27.1-105.5) and 77.5% (61.9-93.1), respectively. The standardized mean differences (95% CI) of Sexual desire, orgasm and erection before and after methadone therapy were estimated as 0.16 (-0.68, 0.99), -0.01 (-0.75, 0.74) and 0.11 (-0.41, 0.64), respectively.Conclusion: This meta-analysis showed that methadone therapy did not significantly influence the sexual desire, erectile function and orgasm among opium dependent men.
Mohammad Khodayarifard; Gholamreza Sohrabpour
Volume 10, Issue 1 , Winter 2018, , Pages 1-10
Abstract
Background: This paper investigated the effectiveness of narrative therapy in groups on psychological well-being and distress among Iranian women with addicted husbands.Methods: The research was an experimental study with pretest-posttest control group design along with follow-ups of one month and three ...
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Background: This paper investigated the effectiveness of narrative therapy in groups on psychological well-being and distress among Iranian women with addicted husbands.Methods: The research was an experimental study with pretest-posttest control group design along with follow-ups of one month and three months. The statistical population consisted of all the women with addicted husbands who referred to welfare and social service houses of district 10 in Tehran, Iran. Participants were forty-four persons who had mental health score lower than the mean of statistical society. They were selected using the voluntary sampling method, and were also randomly assigned to two groups, experimental and control. After the early loss, each group included twenty persons and was evaluated by Mental Health Inventory (MHI-28). The experimental group received 10 sessions of the group counseling. Data were analyzed with repeated measure ANOVA and Bonferroni post-hoc test.Findings: The results showed that psychological well-being of women who received the sessions of group counseling "narrative therapy" was improved significantly rather than those who did not received that (P < 0.001), and psychological distress of them was reduced significantly in comparison to the women who did not participated in the sessions (P < 0.001).Conclusion: Based on these findings, it seems that narrative therapy in groups is effective in the promotion of psychological well-being of women with addicted husbands, and also could be effective in reducing their psychological distress. Therefore, it can be concluded that narrative therapy group interventions improve mental health of women with addicted husbands.
Chin-Siang Ang; Kye-Mei Teo; Yong-Le Ong; Siau-Li Siak
Volume 11, Issue 1 , Spring 2019, , Pages 1-10
Abstract
Background: The exponential growth of smartphones has afforded many users with ubiquitous access to socialization as seen in the various mobile apps used to communicate and connect with others. The present study employed mixed-method approaches to analyse the impact of phubbing on social connectedness ...
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Background: The exponential growth of smartphones has afforded many users with ubiquitous access to socialization as seen in the various mobile apps used to communicate and connect with others. The present study employed mixed-method approaches to analyse the impact of phubbing on social connectedness among adolescents in Malaysia. Methods:A total of 568 adolescents were participated in quantitative surveys, and of these participating adolescents, 6 were further invited to join focus group interviews. Findings: Quantitative findings supported the mediating role of communication disturbance in the relationships between phone obsession and familial connectedness, school connectedness, and self-connectedness, but not for friendship connectedness. Qualitative findings further elucidated the detrimental effect of phone obsession on their sense of belonging from the perspectives of adolescents. Conclusion: This study reaffirms that phubbing behaviour is predictive of social disconnectedness. Therefore, preventive and treatment interventions should be developed to avoid and control a potential risk of social disconnectedness epidemics attribute to phubbing.
Mohammad Azami; Motahareh Pilevarzadeh; Neda Sharifi
Volume 12, Issue 1 , Winter 2020, , Pages 1-10
Abstract
Background: The low level of drug adherence in addicts who are quitting is one of the biggest challenges inthe treatment and management of this disease. Therefore, this study aimed to evaluate the effect ofinformation therapy on adherence to treatment among the patients in addiction treatment centers.Methods: ...
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Background: The low level of drug adherence in addicts who are quitting is one of the biggest challenges inthe treatment and management of this disease. Therefore, this study aimed to evaluate the effect ofinformation therapy on adherence to treatment among the patients in addiction treatment centers.Methods: The present quasi-experimental study was performed on 60 patients referred to addictiontreatment centers in Jiroft City, Iran. The control and experimental groups were selected using simplerandom sampling method. The 8-item Morisky Medication Adherence Scale was used for data collection. Thelevel of adherence to treatment was assessed before and after the intervention, which consisted of 6 one-hourtraining sessions per week.Findings: The adherence to medication was low in both experimental and control groups before thenotification. However, the chi-square value obtained by comparing the frequencies of the experimental andcontrol groups in three variables of adherence level (high, moderate, and low) was 9.84 which wasstatistically significant (P = 0.007). Therefore, there was a significant difference between the experimentaland control groups after information therapy. In fact, the information in the experimental group had asignificant and positive effect.Conclusion: Because of the low level of adherence to treatment, it is recommended to use informationtherapy to give information on timely and correct use of drugs as well as its importance in the treatment ofaddiction; so that the level of adherence would improve.
Mehran Zarghami; Maryam Rezapour
Volume 9, Issue 1 , Spring 2017, , Pages 59-63
Abstract
Background: Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia.Case Report: Herein, we report a 35-year-old man with a 13-year history of ...
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Background: Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia.Case Report: Herein, we report a 35-year-old man with a 13-year history of abusing opioids who had undergone detoxification for four times during this period. He underwent detoxification for using 200 mg loperamide daily with anticholinergic agents, clonidine, non-steroidal analgesics, and diazepam. No evidence of arrhythmia was seen in the patient.Conclusion: Tolerating high doses of loperamide could be dangerous and increases the risk of fatal cardiac arrhythmias.
Ali Hosseininasab; Aliasghar Vahidi; Fatemeh Bagheri-Charouk
Volume 8, Issue 1 , Winter 2016, , Pages 61-66
Abstract
Background: Methadone is a synthetic opioid that has been used to relieve severe pain in addiction withdrawal. Unfortunately, due to non-standard supply and storage, the incidence of poisoning and deaths caused by this drug is increasing daily. The purpose of this study was to determine the underlying ...
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Background: Methadone is a synthetic opioid that has been used to relieve severe pain in addiction withdrawal. Unfortunately, due to non-standard supply and storage, the incidence of poisoning and deaths caused by this drug is increasing daily. The purpose of this study was to determine the underlying causes of methadone poisoning in children admitted to Kerman Afzalipour Hospital, Kerman University of Medical Sciences, Iran, during 2012. Methods: This cross-sectional study was performed on 105 children diagnosed with methadone poisoning and admitted to the pediatric emergency ward at Kerman Afzalipour Hospital. The required information was recorded through interviews with parents, patient examination, and if necessary telephone calls with the parents. The data were analyzed using SPSS software. Findings: Mean age of children was 3.9 ± 2.4 years and 59.0% of them were boys. Most parents had a high school diploma or a lower level of education. In all cases, a family member or relative, or at least one person in a party they attended was an addict. In most cases, methadone was fed to the child by mistake instead of water or other drugs. Parental substance abuse, employment status, and family income were significantly associated with methadone poisoning. Conclusion: Training of methadone storage in individuals who need to use this drug can help to prevent accidental ingestion and poisoning of children.
Shahin Fakhrzadegan; Hossein Gholami-Doon; Bagher Shamloo; Solmaz Shokouhi-Moqhaddam
Volume 9, Issue 2 , Summer 2017, , Pages 64-71
Abstract
Background: Prisoners are a vulnerable group within societies, and also threaten society due to their dangerous behavior. The objective of the present study was to evaluate the relationship between prisoners’ personality disorders and their crime and substance use.Methods: This was a descriptive-correlational ...
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Background: Prisoners are a vulnerable group within societies, and also threaten society due to their dangerous behavior. The objective of the present study was to evaluate the relationship between prisoners’ personality disorders and their crime and substance use.Methods: This was a descriptive-correlational study. The statistical population consisted of all prisoners of Kerman, Iran. Through stratified random sampling, 228 prisoners (114 women and 114 men) were selected as the study subjects. Data were collected through clinical interviews by a psychiatrist [structured interviews based on the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV)], a social worker, and a physician and using a demographic characteristics questionnaire and the Millon Clinical Multiaxial Inventory-2th Edition (MCMI-II) (the 175-item Persian version). Data were analyzed using frequency, percentage, and Fisher's z-distribution in SPSS software.Findings: The results showed that 87.3% of women and 83.3% of men had a personality disorder at the time of committing the crime. Moreover, 46.5% of the target population had developed substance dependence at the time of committing the crime. The highest percentage of substance abuse in both women and men was related to opium, especially in the age group of 18-28 years. The highest rates of mental disorders were related to major depressive disorder (MDD), dependent personality disorder (DPD), borderline personality disorder (BPD), and antisocial personality disorder (ASPD), respectively. In these personality disorders, opium, methamphetamine, heroin, and alcohol, respectively, had the highest rates of use. The results of Fisher's z-distribution illustrated a significant relationship between personality disorders and type of crime committed and substance used. The total rate of substance abuse was lower in sexual offenses and fraud, but was the highest in theft and drug trafficking.Conclusion: The presence of personality disorders in the target population is indicative of the need for judicial officials’ attention to this effective factor in crime and the use of mental health services and treatment instead of the penalty of deprivation of liberty.
Shima Torkzadeh-Mahani; Saeed Esmaeili-Mahani; Sima Nasri; Fatemeh Darvishzadeh; Reyhaneh Naderi
Volume 11, Issue 2 , Summer 2019, , Pages 66-72
Abstract
Background: Chronic usage of morphine elicits the production of inflammatory factors by glial cells andinduces neuroinflammation. Ginger (Zingiber Officinale Roscoe) is a medicinal herb that has antiinflammatory properties. It has been reported that ginger shows anti-addictive effects against chronic ...
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Background: Chronic usage of morphine elicits the production of inflammatory factors by glial cells andinduces neuroinflammation. Ginger (Zingiber Officinale Roscoe) is a medicinal herb that has antiinflammatory properties. It has been reported that ginger shows anti-addictive effects against chronic usageof morphine; however, its influence on morphine-induced neuroinflammation has not yet been clarified.Methods: Morphine (12 mg/kg) was administrated intraperitoneally for 6 consecutive days. To evaluate theeffect of ginger on morphine-induced neuroinflammation, ginger extract (100 mg/kg) was given orally 30minutes before morphine. Glial fibrillary acidic protein (GFAP) and P38 mitogen-activated protein kinase(p38 MAPK) levels were assayed by immunoblotting in the rat nucleus accumbens (NAcc).Findings: The injection of chronic morphine increased the levels of proteins involved in neuroinflammation(p38 MAPK and GFAP) in NAcc. Furthermore, the levels of p38 MAPK and GFAP significantly returned tothe control levels by ginger extract.Conclusion: The results suggest that the ginger extract can reduce morphine-induced neuroinflammation in NAcc.
Maryam Nasirian; Roohollah Zahmatkesh; Mehdi Shafiei
Volume 8, Issue 1 , Winter 2016
Mehran Zarghami; Fatemeh Taghizadeh; Masoadeh Babakhanian; Maedeh Vaghefinejad
Volume 10, Issue 2 , Spring 2018, , Pages 67-75
Abstract
Background: The articles and research reports presented in the scientific journals are selected without a proper critical appraisal in many cases. This is a major problem, as it leads to the opinions of the experts being neglected in many of these scientific journals. A descriptive study was done in ...
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Background: The articles and research reports presented in the scientific journals are selected without a proper critical appraisal in many cases. This is a major problem, as it leads to the opinions of the experts being neglected in many of these scientific journals. A descriptive study was done in fall and winter of 2016.Methods: Journals were identified searching the electronic databases, including PubMed, Medline, Scopus, Google Scholar, and national Persian databases of SID and Magiran. All the articles on addiction published in the time span of 2010-2015 in 8 psychiatry, psychology, and addiction journals were included in this study. The journals included Journal of Behavioral Sciences, Iranian Journal of Psychiatry and Clinical Psychology, Journal of Fundamentals of Mental Health, and Journal of Research on Addiction in Persian, and Health and Addiction Journal, International Journal of Psychiatry and Behavioral Sciences, Journal of Research in Behavioral Sciences, and International Journal of Psychological Studies in English. These journals were evaluated according to their research design and methodology, scientific writing style, and the validity of the references. For all of the 264 articles, the research design and references were thoroughly evaluated.Findings: The most frequent problems were seen in the introduction section, the sampling method of study, the exclusive criteria, analysis, and the limitations of the study.Conclusion: Major deficiencies in the articles on addiction in Iranian journals were seen. It can be prevented by including important items in the checklists published by some of the journals for reviewers.
Hamed Choopan; Seyed Mohammad Kalantarkousheh; Yousef Aazami; Younes Doostian; Ali Farhudian; Omid Massah
Volume 8, Issue 2 , Spring 2016, , Pages 68-75
Abstract
Background: Emotion regulation appears to provide individuals with a doubled ability to avoid drug relapse and assists with the control of temptation to reuse, which is a type of tendency-avoidance conflict. The present study aims to investigate the effect of Gross model-based emotion regulation training ...
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Background: Emotion regulation appears to provide individuals with a doubled ability to avoid drug relapse and assists with the control of temptation to reuse, which is a type of tendency-avoidance conflict. The present study aims to investigate the effect of Gross model-based emotion regulation training on the reduction of craving beliefs in drug-addicted people.Methods: The present study was a quasi-experimental design. This was a pre- and post-test design that consisted of control and experimental groups. The study population comprised all addicted individuals who visited addiction treatment clinics in Marivan, Iran. About 30 drug-addicted individuals by the random selection method were chosen. Participants were randomly assigned to either the experimental or control groups. Results were analyzed by univariate covariance analysis.Findings: Gross model-based emotion regulation training reduced signs and beliefs associated with temptation in drug-addicted people (P < 0.001).Conclusion: Considering the present study’s findings, we recommend that addiction treatment centers teach strategies of emotion regulation to drug-addicted people by establishing workshops with the intent to reduce temptation signs.
Seyed Mojtaba Sohrevardi; Mostafa Pournamdari; Raazieh Salimi; Farhad Sarrafzadeh; Mehdi Ahmadinejad
Volume 12, Issue 2 , Spring 2020, , Pages 69-76
Abstract
Background: Few studies have been conducted regarding the comparison of the efficacy of methadone andtincture of opium (TOP) in controlling agitation induced by withdrawal syndrome. Therefore, the currentrandomized trial study is carried out with the aim to evaluate comparisons on the efficacy of methadone ...
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Background: Few studies have been conducted regarding the comparison of the efficacy of methadone andtincture of opium (TOP) in controlling agitation induced by withdrawal syndrome. Therefore, the currentrandomized trial study is carried out with the aim to evaluate comparisons on the efficacy of methadone andTOP in controlling agitation caused by withdrawal syndrome in opium addicted patients in the intensive careunits (ICUs).Methods: This clinical trial study was conducted on 60 patients admitted to ICU of Shahid Bahonar Hospital,Kerman, Iran. After classification of the patients into two groups, the first and second groups consumedmethadone syrup (5 mg/ml) and TOP (10 mg/ml), respectively. Agitation in these patients was assessedthrough the Richmond Agitation-Sedation Scale (RASS). Vital signs were also assessed. Paired sample t-testand independent t-test were used for data analysis.Findings: In the current study, the administered dose of methadone and TOP was 36.17 ± 26.99 and112.67 ± 102.74 mg, respectively (P < 0.010). Methadone administration led to a significant decrease of thepatients’ vital signs, including systolic blood pressure, heart rate, respiratory rate, and Glasgow Coma Scale(GCS) (P < 0.05). Though TOP administration decreased systolic blood pressure and GCS significantly(P < 0.05), it had no effect on patients’ diastolic blood pressure, body temperature, heart rate, andrespiratory rate (P > 0.05). In total, no significant difference was detected between two groups regardingvital signs (P > 0.05). However, a significant difference was seen between methadone and TOP groups interms of RASS score (P < 0.01). Conclusion: According to the results of the current study, lower dose of methadone, compared to TOP, couldcontrol agitation caused by opium withdrawal symptoms.
Ali Mehdizadeh Zare Anari; Alireza Ghafarinezhad; Hoda Soltani
Volume 5, 1-2 , Winter 2013, , Pages 73-76
Abstract
Background: Fetishism is a type of paraphilia. The focus of sexual arousal in fetishism is oriented towards inanimate objects. Sexual arousal and craving are some of the reasons the youth resort to crystal (glass). Drug abuse may cause disorders in sexual function. Case Report: The patient was a 41 years ...
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Background: Fetishism is a type of paraphilia. The focus of sexual arousal in fetishism is oriented towards inanimate objects. Sexual arousal and craving are some of the reasons the youth resort to crystal (glass). Drug abuse may cause disorders in sexual function. Case Report: The patient was a 41 years old man. He married in age 22 years and experienced frequent intercourses with his wife from which he gained pleasure and it was his preferable method. Her wife left ten years ago. The patient started crystal administration through insufflations since seven months ago. Simultaneous with crystal abuse, wearing women’s underwear was the only medium through which the patient reached sexual orgasm. Discussion: A lot of psychological symptoms related to new substances (for example glass) are new to psychiatrists treating dependency in medical clinics. Fetishism may coexist with addiction as comorbidity. Another point to be mentioned is that, symptoms of fetishism increased and decreased with more and less glass administration, indicating that symptoms of paraphilia emerge as a result of glass use. In addition, prior to glass use, the patient maintained normal sexual tendencies, had experienced sexual intercourse and did not suffer from any type of paraphilia. Keywords: Paraphilia, Methamphetamine, Fetishism
Mohammad Reza Nakhaee; Faezeh Pakravan; Nouzar Nakhaee
Volume 5, 3-4 , Summer 2013, , Pages 77-82
Abstract
Background: The prevalence of substance use among bodybuilding athletes has been poorly studied in Iran. This study was conducted to examine the prevalence of drug use, especially anabolic steroids, among bodybuilding athletes. Methods: This cross-sectional study was conducted in the first half of 2013 ...
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Background: The prevalence of substance use among bodybuilding athletes has been poorly studied in Iran. This study was conducted to examine the prevalence of drug use, especially anabolic steroids, among bodybuilding athletes. Methods: This cross-sectional study was conducted in the first half of 2013 among body building athletes referring to gyms located in Kerman, Iran. Five gyms were selected randomly and 380 athletes were invited to complete a self-administered anonymous questionnaire, consecutively. The questionnaire included two parts; baseline characteristics and substance related questions. The prevalence of anabolic steroids was estimated based on three methods; self-report, projective question, and crosswise model. Findings: We enrolled 298 male athletes in the final analysis. Mean ± SD age of subjects was 25.9 ± 8.4. The most frequent recent (past 30 days) drug use was waterpipe smoking (45%). The second most frequently used drug was alcohol (26.5%, recent use). Based on self-reports, the prevalence of lifetime anabolic steroid use was calculated to be 24.5%. The corresponding figure based on crosswise method was obtained to be 56.8%. Participants believed that a median of 40% of athletes had used anabolic steroids in their lifetime. The prevalence of anabolic steroid was higher in single and less educated individuals (P < 0.05). The main reason for using anabolic steroids was to increase muscle size. Conclusion: The prevalence of drug use, especially tobacco, alcohol, and anabolic steroids, was high among bodybuilding athletes. We could not rely on self-reports to examine anabolic steroid use. Keywords: Substance abuse, Anabolic steroids, Athletes, Iran
Kouros Divsalar; Minoo Mahmoodi; Nouzar Nakhaee
Volume 3, 3-4 , Winter 2011, , Pages 79-84
Abstract
Background: Cost effectiveness, the ratio of relative costs of a program to its desired outcomes, is one of the basic issues in various screening programs performed to detect opium abuse. This study aimed to find the cost-effectiveness of opiates abuse screening through urine analysis. Methods: A total ...
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Background: Cost effectiveness, the ratio of relative costs of a program to its desired outcomes, is one of the basic issues in various screening programs performed to detect opium abuse. This study aimed to find the cost-effectiveness of opiates abuse screening through urine analysis. Methods: A total number of 64698 individuals were selected and divided into to five distinct groups based on the reason for which they were tested. Cost-effectiveness of opiates abuse screening in each group was calculated by dividing the total cost, including personnel and overhead costs, to the number of detected cases. Finally, the results were compared. Findings: The total number of positive cases based on rapid screening assay (RSA) and thin layer chromatography (TLC) was 3460 (5.3%). According to incremental cost-effectiveness analysis, screening program of the group referred by the police was the most cost-effective program with the breakeven point at 2%. Conclusion: According to the obtained results, continuation of drug abuse screening programs is recommended. Keywords: Cost effectiveness, Substance abuse, Urine, Opiates.
Hassan Ziaaddini; Mansooreh Nasirian; Nouzar Nakhaee
Volume 4, 3-4 , Autumn 2012, , Pages 79-86
Abstract
Background: Since the number of drug users is increasing, applying a method of detoxification with fewer side effects during withdrawal from opioids and greater reliability seems to be necessary. In addition, without maintenance treatment, there will be limited success of treatment. This study aimed ...
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Background: Since the number of drug users is increasing, applying a method of detoxification with fewer side effects during withdrawal from opioids and greater reliability seems to be necessary. In addition, without maintenance treatment, there will be limited success of treatment. This study aimed to compare success rates of detoxification with sublingual buprenorphine and clonidine and to evaluate addiction relapse in patients using naltrexone in a six-month follow-up. Methods: This double-blind trial was carried out on opioid dependent patients in a psychiatric hospital in Kerman (Iran) during 2007-09. The subjects were randomly selected from individuals who had referred for detoxification. They were allocated to two groups to receive either clonidine (n = 21) or buprenorphine (n = 14). The success rates of the two methods were assessed at the end of the course and patients were discharged while prescribed with 25 mg daily use of naltrexone. They were followed up for six months and the continuous use of naltrexone and relapse of substance abuse were evaluated. Findings: A total number of 35 patients entered the study. Success of detoxification with naltrexone was confirmed in all cases. One person (8.4%) in the clonidine group and no patient in the buprenorphine group had a Clinical Opiate Withdrawal Scale (COWS) score of more than 12 (P > 0.05). The mean levels of objective signs and subjective symptoms of withdrawal and the desire for drug abuse had significant reductions during detoxification period in both groups (P < 0.001). However, the difference in these variables between the two groups was not statistically significant (P > 0.05). Naltrexone was used for an average of one month in 43% and 64% of subjects in the clonidine and buprenorphine groups, respectively. In addition, 62% of patients in the clonidine group and 92.8% of subjects in the buprenorphine group received maintenance treatment. Nevertheless, the mean number of days staying in treatment was not significantly difference between the two groups (P > 0.05). Conclusion: Buprenorphine is as effective as clonidine in controlling withdrawal symptoms. A greater percentage of patients detoxified by buprenorphine received maintenance treatment, but there was not a significant difference in relapse rates between the two methods.Keywords: Buprenorphine, Clonidine, Naltrexone, Opioid detoxification, Addiction relapse.
Abdoul Reza Sabahi; Zahra Amini-Ranjbar; Ali Sharifi; Ali Kheradmand
Volume 6, 1-2 , Winter 2014, , Pages 81-84
Abstract
Background: Enucleation is a topic discussed in psychiatry which is a self-injury matter. Enucleation is observed as psychotic disorder due to substance abuse. In people with mental disorders who also have substance use leading to hallucinations and delusions, unusual eye evacuation were reported. In ...
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Background: Enucleation is a topic discussed in psychiatry which is a self-injury matter. Enucleation is observed as psychotic disorder due to substance abuse. In people with mental disorders who also have substance use leading to hallucinations and delusions, unusual eye evacuation were reported. In most cases, enucleation was done using sharp tools. Case Report: This report describes a man suffering from psychosis after consuming hashish and has attempted to evacuate his eyes with his finger. Conclusion: Given the increasing prevalence of hashish use by young people, and false beliefs about the use of hashish in order to withdraw other substances, preventive methods and education for young and vulnerable people are suggested.
Tayebeh Baniassadi ; Zeinab Javanmard; Mahmoud Zivari-Rahman; Solmaz Shokouhi-Moqhaddam; Masoumeh Adhami
Volume 7, 1-2 , Winter 2015, , Pages 82-86
Abstract
Background: Smoking is the most common and cheapest addictive substance and has physical, psychological, and social side effects. Personality traits and low self-control have been identified as key factors for substance and tobacco abuse. This study examined the relationship between personality traits ...
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Background: Smoking is the most common and cheapest addictive substance and has physical, psychological, and social side effects. Personality traits and low self-control have been identified as key factors for substance and tobacco abuse. This study examined the relationship between personality traits and self-control, and symptoms of nicotine dependence in male prisoners. Methods: This was a descriptive correlational study. The research sample consisted of 384 male prisoners in Kerman, Iran. The participants were selected using simple random sampling method. The data collection tools consisted of the NEO five factor personality inventory (NEO-FFI), self-control Inventory, and the nicotine dependence symptoms inventory. Findings: The mean age of the prisoners was 35.33 ± 9.28 year. The results showed a significant negative relationship between self-control and nicotine dependence. The most important predictors of prisoners’ self-control were the personality traits of conscientiousness, neuroticism, openness, and temperamental neuroticism, respectively. The most important predictors of nicotine dependence in prisons were personality traits of adaptability, temperamental neuroticism, extroversion, and openness, respectively. Conclusion: Personality traits and self-control have an important role in nicotine dependence; therefore, by training self-control, behaviors such as smoking and consumption of drugs can be reduced.
Mohammad Reza Naqavi; Raheleh Refaiee; Mohammad Reza Baneshi; Nouzar Nakhaee
Volume 6, 3-4 , Summer 2014, , Pages 85-92
Abstract
Background: Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, ...
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Background: Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Methods: Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, Iran, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Findings: Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P < 0.001). Considering the 5 dimensions of the SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). Conclusion: There was a gap between the clients’ expectations and what they actually perceived in the clinics. Thus, more attention should be devoted to the clients` views regarding service quality in addiction treatment clinics.
Mahin Eslami-Shahrbabaki; Delaram Barfeh; Parvin Eslami-Shahrbabaki
Volume 7, 1-2 , Winter 2015, , Pages 92-95
Abstract
Background: Breastfeeding is one of the best ways to promote, develop, and secure the health of infants. Child abuse is one of the most common and most important problems in the world, and one of the factors that increase its incidence is substance dependency of the parents. Breastfeeding beyond the ...
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Background: Breastfeeding is one of the best ways to promote, develop, and secure the health of infants. Child abuse is one of the most common and most important problems in the world, and one of the factors that increase its incidence is substance dependency of the parents. Breastfeeding beyond the normal age range can be harmful to the health of the mother and baby, and may represent a pathological parent-child relationship. Case Report: A little girl, who was breastfed until the age of 8 years by her heroin-dependent mother, was hospitalized in a child and adolescent psychiatric ward due to heroin dependency. During the investigations, it was found that not only had the girl been breastfed until this age, but she had also not been enrolled into a school. In other words, due to the mother’s heroin dependency, her infant was also dependent on the drug. Conclusion: In the assessment and treatment of parents with substance related disorders, the possibility of child abuse should also be considered. When breastfeeding is continued beyond the normal age range, it is necessary to find the reason. By early detection and timely intervention, negative consequences for the child can be prevented.