Original Article(s)
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.
Short Communication(s)
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.
Case Report(s)
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.
Letter(s) to Editor
Reza Afshari; Abbas Zavar; Mahbobeh Alidoust; Razieh Pourandi
Volume 7, 1-2 , Winter 2015, Pages 96-98
Original Article(s)
Hassan Ziaaddini; Toktam Roohbakhsh; Nouzar Nakhaee; Alireza Ghaffari-Nejad
Volume 7, 1-2 , Winter 2015, Pages 14-23
Abstract
Background: Persistent methamphetamine (METH) psychosis is a psychotic state beyond 1-month after abstinence, for which there is no effective treatment. This study aimed to evaluate the effectiveness of electroconvulsive therapy (ECT) in persistent METH psychosis patients hospitalized at Shahid Beheshti ...
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Background: Persistent methamphetamine (METH) psychosis is a psychotic state beyond 1-month after abstinence, for which there is no effective treatment. This study aimed to evaluate the effectiveness of electroconvulsive therapy (ECT) in persistent METH psychosis patients hospitalized at Shahid Beheshti Hospital, Kerman, Iran, from 6 September 2012 until 6 September 2013, who were not remitted after treatment with olanzapine. Methods: This research was a pilot study on hospitalized patients. After 4 weeks of treatment with olanzapine, 10 out of 71 studied patients did not show complete remission of psychotic symptoms despite their response to the treatment. The mentioned 10 patients were divided into 2 groups by random digit numbers. 5 patients had continued olanzapine and other 5 received 6 sessions of bilateral ECT every other day in addition to olanzapine. Findings: Remission rate of patients in the initial 4 weeks was 78.7%. Reduction in total brief psychiatric rating scale (BPRS) scale at the end of 1-week compared with the next week demonstrated improvement in the symptoms until the end of the study. There was no significant difference in BPRS scores between weeks 4 and 6 in the two groups. Conclusion: This research demonstrated that few sessions of ECT in persistent METH psychosis will not lead to remission in all patients.
Short Communication(s)
Nagesh Bhat; Swapnil Oza; Jaddu Jyothirmai Reddy; Ruchi Mitra; Rahul Patel; Sopan Singh
Volume 7, 1-2 , Winter 2015, Pages 87-91
Abstract
Background: The aim of this study was to evaluate the effect of anti-smoking legislation in public places and public support for smoking ban. Methods: A cross-sectional survey was conducted in public places such as market, bus/railway station, workplaces and hospitals in Udaipur, India. Informed consent ...
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Background: The aim of this study was to evaluate the effect of anti-smoking legislation in public places and public support for smoking ban. Methods: A cross-sectional survey was conducted in public places such as market, bus/railway station, workplaces and hospitals in Udaipur, India. Informed consent was obtained. The questionnaire comprised of details about their agreement with the current anti-smoking legislation and their views on the support for smoking ban in public places. Findings: The study was conducted among 314 individuals of whom 255 (81.2%) supported the general ban on smoking in public places. Non-smokers (54.4%) agreed more than smokers that the introduction of legislation would create healthier environment (P < 0.001), second hand smoke is serious threat to health (P < 0.001), more implementation needed for current antismoking legislation (P < 0.001). Smokers (45.5%) agreed more than non-smokers that everyone has the right to smoke in public places (P < 0.001). Conclusion: Local support for a ban on smoking in public places in Udaipur is high. But there is a lack of enforcing mechanism in support of the legislation and hence complete smoking ban along with strong enforcement may provide better results.
Original Article(s)
Noushin Parvaresh; Abdol Reza Sabahi; Shahrzad Mazhari; Hoda Gilani
Volume 7, 1-2 , Winter 2015, Pages 24-29
Abstract
Background: Methadone is a synthetic opioid and receptor agonist morphine; thus, its consumption has the effects and side effects of opioid. Methadone maintenance treatment (MMT) is used as an alternative treatment for people who are suffering from substance abuse and do not have the ability to withdraw. ...
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Background: Methadone is a synthetic opioid and receptor agonist morphine; thus, its consumption has the effects and side effects of opioid. Methadone maintenance treatment (MMT) is used as an alternative treatment for people who are suffering from substance abuse and do not have the ability to withdraw. Despite its benefits, this drug also has side effects. The purpose of this study was to investigate the effects of methadone treatment on sexual function, sleep, and weight after 6 months. Methods: The study subjects consisted of 200 patients who had referred to the Methadone Clinic of Shahid Beheshti Training Hospital, Kerman, Iran, during a 6-month period and were treated using MMT. Data collection tools consisted of the demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Arizona Sexual Experience Scale (ASEX). The questionnaires were completed by the participants before and 6 months after the treatment. Findings: The results of this study showed that methadone consumption has significant effects on sexual dysfunction, sleep disorders, and weight gain. Conclusion: The consideration of the side effects of MMT can result in consumers’ commitment to the treatment.
Original Article(s)
Seyed Mehdi Hosseinifard; Narjes Kaviani
Volume 7, 1-2 , Winter 2015, Pages 30-36
Abstract
Background: Today, the society’s need to find the roots of a few thousand-year old substance abuse and the drugs addiction crisis has increased to the extent that it has become a problem within our country. The problem of substance dependence is not only about drug abuse, but it is actually the interrelationship ...
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Background: Today, the society’s need to find the roots of a few thousand-year old substance abuse and the drugs addiction crisis has increased to the extent that it has become a problem within our country. The problem of substance dependence is not only about drug abuse, but it is actually the interrelationship of the person and the dependency on drugs. This study aimed to compare early maladaptive schemas, attachment styles, and coping styles in men dependent on opiates and stimulants in Kerman, Iran. Methods: This was a comparative descriptive study. The study population consisted of men dependent on opiates and stimulants who referred to addiction treatment clinics in Kerman. Therefore, 150 patients (75 opium addicted men and 75 men dependent on drugs) were selected. The participants completed the Young schema questionnaire-short form (YSQ-SF), adult attachment scale (AAS), and Young coping styles questionnaire (YCSQ). The research data were analyzed using independent t-test and SPSS software. Findings: Mean age of patients using opium was 27.9 ± 3.35 years and mean age of patients using stimulant drugs was 25.6 ± 3.41 years (18-60 years old). The results showed that there was no difference between the early maladaptive schemas and coping styles in men dependent on opium and stimulants. However, there was a significant difference between attachment styles in men dependent on opium and stimulants. The mean score of avoidant and ambivalent styles in men dependent on stimulants was higher. Conclusion: Knowledge on the distinctions of early maladaptive schemas, attachment styles, and coping styles in substance abuse patients helps the therapists to conduct more effective treatment strategies tailored to the type of substance used in order to provide behavior modification.
Original Article(s)
Mahin Eslami-Shahrbabaki; Alireza Fekrat; Shahrzad Mazhari
Volume 7, 1-2 , Winter 2015, Pages 37-46
Abstract
Background: The abuse of narcotic drugs and psychotropic substances such as amphetamines and ecstasy has had a growing trend. Tachycardia, increased blood pressure, hallucinations, panic attacks, and psychosis are the negative effects of methamphetamine abuse. The present study aimed to assess psychiatric ...
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Background: The abuse of narcotic drugs and psychotropic substances such as amphetamines and ecstasy has had a growing trend. Tachycardia, increased blood pressure, hallucinations, panic attacks, and psychosis are the negative effects of methamphetamine abuse. The present study aimed to assess psychiatric disorders associated with methamphetamine-induced psychotic disorder. Methods: This cross-sectional study was performed from October 2013 to March 2014 on 165 patients hospitalized at Shahid Beheshti Hospital in Kerman, Iran, and diagnosed with psychosis induced by methamphetamine abuse within the previous 6 months. Study subjects were selected via census method. Based on the exclusion criteria and due to the lack of cooperation of some patients, 121 patients were enrolled in the study. Research data were gathered using clinical interviews, the Yale-Brown obsessive compulsive scale (Y-BOCS), Hamilton anxiety scale (HAM-A) and Hamilton rating scale for depression (HRSD), Young mania rating scale (YMRS), substance dependence severity scale (SDSS), positive and negative syndrome scale (PANSS), and clinical global impression (CGI) scale. The data analysis was performed using SPSS software, descriptive statistics, and ANOVA. Findings: Among the 121 patients of the sample group, 4 patients (3.3%) had anxiety, 58 patients (47.9%) depression, 30 patients (24.8%) obsessive-compulsive disorder (OCD), 20 patients (16.5%) bipolar mood disorder (BMD), 8 patients (6.6%) persistent psychotic symptoms, 85 patients (70.2%) personality disorder, and 36 patients (29.8%) had no personality disorders. The highest prevalence was related to borderline personality disorder (35.5%). However, 45 patients (37.2%) had no impairment associated with methamphetamine-induced psychosis. Conclusion: It seems that there is comorbidity between psychiatric disorders, including mood disorders, especially depressive disorder, childhood history of attention deficit hyperactivity disorder (ADHD), bipolar disorder, and personality disorders such as borderline personality disorder, and antisocial personality disorders, and methamphetamine abuse.
Original Article(s)
Gholamreza Asadikaram; Somayeh Igder; Zahra Jamali; Nader Shahrokhi; Hamid Najafipour; Mostafa Shokoohi; Abdollah Jafarzadeh; Mohammad Kazemi-Arababadi
Volume 7, 1-2 , Winter 2015, Pages 47-53
Abstract
Background: The risk of infectious, autoimmune and immunodeficiency diseases and cancers rise in opioid addicts due to changes in innate and acquired immune responses. Three types of opioid receptors (К،δ،μ) are expressed on the surface of lymphocytes and mononuclear phagocytes. The present study ...
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Background: The risk of infectious, autoimmune and immunodeficiency diseases and cancers rise in opioid addicts due to changes in innate and acquired immune responses. Three types of opioid receptors (К،δ،μ) are expressed on the surface of lymphocytes and mononuclear phagocytes. The present study was designed to examine the effects of different concentrations of opium on the secretion of some cytokines produced by lymphocyte cells. Methods: Jurkat cells were exposed to different concentrations of opium for periods of 6, 24 and 72 h in cell culture medium. The amount of interleukin-6 (IL-6), interferon-γ (IFN-γ) and transforming growth factor-b (TGF-β) were then measured using enzyme-linked immunosorbent assay (ELISA) method. Findings: The results showed that opium increases the secretion of IL-6 in different concentration of opium in 6 h. The amount of IFN-γ decreased in 6 h and increased in 24 h significantly compared with control. On the other hand, opium had an inhibitory effect on the TGF-β secretion in 6, 24 and 72 h. Conclusion: Overall, the study showed that opium stimulates pro-inflammatory and suppressed anti-inflammatory cytokine secretion in Jurkat cells. This may account for the negative effect of opium on the immune system leading to chronic inflammation and a base for many disorders in opium addicts.
Original Article(s)
Mohammad Hossein Gozashti; Farzaneh Yazdi; Pouria Salajegheh; Mohammad Moein Dehesh; Kouros Divsalar
Volume 7, 1-2 , Winter 2015, Pages 54-59
Abstract
Background: Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance. Methods: This comparative study including 53 addicts in case groups who used opium just ...
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Background: Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance. Methods: This comparative study including 53 addicts in case groups who used opium just in the form of smoking and 55 non-addicts in a control group, took part in the study, after proving not to be opium users. After taking blood samples, their fasting blood glucose (FBG), fasting blood insulin and lipid profiles were evaluated. Furthermore, insulin resistance index was analyzed via the homeostatic model assessment of insulin resistance (HOMA-IR) formula with the cut-off points of 7.2 and 7.1. Findings: Age and gender were not significantly different between the groups. There was no significant difference regarding the prevalence of insulin resistance between the two groups, according to the cut-off points of 7.1 and 7.2 (P = 0.196 and P = 0.248, respectively). Mean insulin resistance index was not significantly different between the two groups (P = 0.325). In the case group, fasting blood insulin was considerably lower (P = 0.025) and fasting blood sugar (FBS) was significantly higher (P = 0.016) than the control group. Conclusion: According to the level of insulin and FBS in addicts, it does not seem that opium has a significant effect on reducing the blood glucose and insulin resistance.
Original Article(s)
Shaabanali Alizadeh; Ghafar Ali Mahmoudi; Hassan Solhi; Bahman Sadeghi-Sedeh; Reza Behzadi; Amir Mohammad Kazemifar
Volume 7, 1-2 , Winter 2015, Pages 60-65
Abstract
Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of ...
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Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. Methods: A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h. Findings: VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. Conclusion: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.
Original Article(s)
Hamid Reza Morteza-Bagi; Mohsen Amjadi; Reyhaneh Mirzaii-Sousefidi
Volume 7, 1-2 , Winter 2015, Pages 66-73
Abstract
Background: Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen ...
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Background: Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen plus a low dose of morphine with a full dose of morphine in renal colic. Methods: In present randomized clinical trial, 100 patients with confirmed renal colic were recruited from the emergency ward of Imam Reza Teaching Hospital affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, during a one-year period. These patients randomly received either intravenous acetaminophen (Apotel, 1 g) plus a low dose of morphine (n = 50), or a high dose of morphine (5 mg) (n = 50). Visual analogue scale was used for reporting pain during 35 minutes. Side effects and rescue analgesic demand were recorded after 30 minutes. Findings: The two groups were matched for the patients' age and gender. Intra-group analysis showed significant gradual decreases in pain intensity after 35 minutes for both groups. Inter-group analysis, however, did not show a significant difference between the two groups in this regard. There was no significant difference between the two groups in terms of side effects. The rate of rescue analgesic demand was 36% in the first and 40% in the second group (P = 0.68). Conclusion: According to the results study, Apotel plus a low dose of morphine is at least as effective and safe as a full dose of morphine in patients with renal colic.
Original Article(s)
Mohsen Adib-Hajbaghery; Rouhangiz Karimi; Hassan Karbasi; Mostafa Haji-Rezaei; Efat Aminolroayaee
Volume 7, 1-2 , Winter 2015, Pages 74-81
Abstract
Background: Although some studies have been conducted on violence against women, but all these studies were conducted in the general population and not the wives of addicts. This study was aimed to compare the violence against women with and without an addicted spouse. Methods: This comparative study ...
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Background: Although some studies have been conducted on violence against women, but all these studies were conducted in the general population and not the wives of addicts. This study was aimed to compare the violence against women with and without an addicted spouse. Methods: This comparative study was conducted on 200 married women in Kashan, Iran. 100 cases were females with addicted spouse and 100 were women with non-addict husbands. Data collected using Haj-Yahia violence questionnaire. Data analysis was performed using SPSS. Descriptive statistics and chi-square, Mann-Whitney U, and Kruskal–Wallis tests, odds ratio (OR) and Kendall's correlation coefficient were used to analyze the data. Findings: The overall mean score of violence was 69.29 ± 14.84 for the women with addicted husbands and 40.02 ± 9.26 in women with non-addicted spouses (P < 0.001). The mean score of psychological violence was 39.03 ± 7.60 in women with addicted spouses and 21.86 ± 6.11 in those with non-addicted husbands (P < 0.001). Furthermore, the mean score of physical violence was 20.98 ± 6.50 in women with addicted spouses and 12.2 ± 2.55 in those with non-addicted husbands (P < 0.001). Moreover, the mean scores of sexual violence were 4.52 ± 2.21 and 3.28 ± 0.75 in women with and without addicted spouses, respectively (P < 0.001). Conclusion: The overall rate of violence was significantly higher among women with addicted spouse and especially if the spouse abused more than one type of substances. Further investigations are suggested on the effects of opium withdrawal or changes in the substance abused on the rate of violence against women.
