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Mehmandoost S, Sharifi H, Shokoohi M, Khezri M, Mirzazadeh A, Shahesmaeili A, Gahlekhani N, Kamali K, Haghdoost AA, Karamouzian M. Sexualized Substance Use among Female Sex Workers in Iran: Findings from a Nationwide Survey. Subst Use Misuse 2022; 58:298-305. [PMID: 36576274 PMCID: PMC10881188 DOI: 10.1080/10826084.2022.2161824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Female sex workers (FSWs) are at higher risk of HIV due to high-risk sexual and drug use related behaviors. This study characterized sexualized substance use among FSWs in Iran. Methods: In 2015, 1,337 FSWs were recruited from centers for vulnerable women and through outreach efforts in 13 major cities in Iran. Data were collected via face-to-face interviews from consenting FSWs on a range of socio-demographic and behavioral characteristics. The primary outcome of interest was sexualized substance use, defined as reporting alcohol or drug use before or during sex in the past month. Bivariable and multivariable modified Poisson regression models were used to assess the correlates of sexualized substance use. Adjusted prevalence ratio (aPR) and 95% confidence interval (CI) were reported. Results: The prevalence of sexualized substance use was 31.3% (95% CI: 28.7, 34.0). Inconsistent condom use during sex with clients in the past month (aPR = 1.31; 95% CI: 1.01, 1.71), regular (i.e., at least weekly in the past month) alcohol use (aPR = 2.87; 95% CI: 2.17, 3.80), regular opioid use (aPR = 2.09; 95% CI: 1.45, 3.02), regular stimulant use (aPR = 2.68; 95% CI: 2.12, 3.39), and self-reported HIV negative status (aPR= 1.88; 95% CI: 1.14, 3.10) were significantly and positively associated with sexualized substance use. Conclusions: Sexualized substance use was associated with riskier sexual behavior and self-reported HIV sero-negativity. Harm reduction messaging to FSWs needs to go beyond focusing on sexual health promotion and further highlight the risks associated with sexualized substance use.
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Affiliation(s)
- Soheil Mehmandoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nima Gahlekhani
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kianoush Kamali
- Midlife Health Office, Department of Population Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Centre On Drug Policy Evaluation, St. Michael's Hospital, Toronto, Canada
- Brown School of Public Health, Brown University, Providence, Rhode Island, USA
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2
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Ahmadi J, Bazrafshan A, Sahraian A, Jalali S, Fakhermanesh M, Hooshyari Z. Anxiety treatment of methamphetamine-dependent patients with buprenorphine: A randomized, double-blind, clinical trial. Tzu Chi Med J 2022; 35:89-94. [PMID: 36866345 PMCID: PMC9972937 DOI: 10.4103/tcmj.tcmj_297_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/30/2021] [Accepted: 01/24/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives In this double-blind, randomized clinical trial, the effectiveness of buprenorphine (BUPRE) in the reduction of anxiety symptoms among the methamphetamine (MA) dependents was evaluated. Materials and Methods The 60 MA-dependent patients were randomly assigned to three groups (0.1 mg, 1 mg, and 8 mg of BUPRE), The Hamilton Anxiety Rating Scale was administrated to assess the anxiety symptoms daily at baseline and second to the 5th day after intervention. The inclusion criteria were the MA dependence, age of over 18 years, and absence of any chronic physical illnesses; exclusion criteria were the presence of other drug dependence in combination with MA. The mixed-design analysis of variance was performed for data analysis. Results A significant main effect of time (F = 51.456, P < 0.001) and group (F = 4.572, P = 0.014) and group-by-time interaction (F = 8.475, P < 0.001) were detected. Conclusions This finding supports the efficacy of BUPRE to decrease anxiety. High doses of the drug (1 and 8 mg) were more effective than 0.1 mg. Here was not a significant difference between anxiety score when patients received 1 mg of BUPRE instead of 8 mg.
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Affiliation(s)
- Jamshid Ahmadi
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Bazrafshan
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Sahraian
- Research Center of Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Jalali
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maedeh Fakhermanesh
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Tehran University of Medical Science, Tehran, Iran,Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Zahra Hooshyari, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran. E-mail:
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Protection of the PC12 Cells by Nesfatin-1 Against Methamphetamine-Induced Neurotoxicity. Int J Pept Res Ther 2022. [DOI: 10.1007/s10989-022-10417-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Giang LM, Trang NT, Diep NB, Thuy DTD, Thuy DT, Hoe HD, Van HTH, Truc TT, Nguyen HH, Lai NL, Linh PTD, Vi VTT, Reback CJ, Leibowitz A, Li L, Lin C, Li M, Do Van Dung, Shoptaw S. An adaptive design to screen, treat, and retain people with opioid use disorders who use methamphetamine in methadone clinics (STAR-OM): study protocol of a clinical trial. Trials 2022; 23:342. [PMID: 35461300 PMCID: PMC9034071 DOI: 10.1186/s13063-022-06278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam. METHOD Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions. PARTICIPANTS We will recruit 600 participants in 20 methadone clinics. ELIGIBILITY CRITERIA (1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone. OUTCOMES Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity. DISCUSSION This study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness. TRIAL REGISTRATION ClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.
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Affiliation(s)
- Le Minh Giang
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Thu Trang
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam.
| | - Nguyen Bich Diep
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Dao Thi Dieu Thuy
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Dinh Thanh Thuy
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Han Dinh Hoe
- Centre for Training and Research on Substance use and HIV, Hanoi Medical University, Hanoi, Vietnam
| | | | - Thai Thanh Truc
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoa H Nguyen
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Ly Lai
- South Vietnam HIV and Addiction Technology Transfer Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Pham Thi Dan Linh
- South Vietnam HIV and Addiction Technology Transfer Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Vu Thi Tuong Vi
- South Vietnam HIV and Addiction Technology Transfer Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Cathy J Reback
- Friends Research Institute, Friends Community Center, Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, Los Angeles, USA
| | - Arleen Leibowitz
- Department of Public Policy, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, USA
| | - Li Li
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, USA
| | - Chunqing Lin
- Department of Psychiatry and Biobehavioral Sciences, Jane & Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, USA
| | - Michael Li
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles, Los Angeles, USA
| | - Do Van Dung
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Steve Shoptaw
- Center for Behavioral and Addiction Medicine, Department of Family Medicine, University of California, Los Angeles, Los Angeles, USA
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Fayaz Feyzi Y, Vahed N, Sadeghamal Nikraftar N, Arezoomandan R. Synergistic effect of combined transcranial direct current stimulation and Matrix Model on the reduction of methamphetamine craving and improvement of cognitive functioning: a randomized sham-controlled study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:311-320. [PMID: 35404725 DOI: 10.1080/00952990.2021.2015771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Addiction is associated with decreased activity of the prefrontal networks, especially dorsolateral prefrontal cortex (DLPFC). OBJECTIVE This study examined the effectiveness of transcranial direct current stimulation (tDCS) over DLPFC in combination with Matrix Model psychotherapy in the alleviation of craving and cognitive improvement of participants with methamphetamine use disorder. METHODS In a randomized and sham-controlled trial, 60 male participants were assigned to Matrix psychotherapy only, sham tDCS plus Matrix, or active tDCS plus Matrix. Sixteen sessions of 20-min anodal (2 mA over F3 for targeting the left DLPFC) or sham tDCS along were administered in the outpatient setting. Pre- and post-intervention craving, executive functioning, and working memory were assessed using the Obsessive-Compulsive Drug Use Scale, Wisconsin Card Sorting Test, and Wechsler Memory Scale, respectively. One month following the interventions relapse was investigated by urine drug screen or interview. RESULTS In comparison with sham tDCS (n = 12) and Matrix psychotherapy only group (n = 13), the active tDCS group (n = 15) showed more reduction in craving (p<.05, η2 = .21). Auditory and visual memory (Wechsler) and true answers and false answers (WCST) significantly improved in the active tDCS group (η2 = .18, η2 = 12, η2 = 03, η2 = .02, respectively) but not in the other groups. Relapse rates did not significantly differ between groups (p = .17). A significant correlation was found between craving reduction and cognitive functioning in the active tDCS group. CONCLUSION The combination of Matrix Model psychotherapy and tDCS may an effective therapy for cognitive improvement and craving in participants with methamphetamine use disorder. CLINICAL TRIALS REGISTRY This study was registered at the Iranian Registry of Clinical Trials (IRCT20161026030510N3).
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Affiliation(s)
- Yasha Fayaz Feyzi
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Neda Vahed
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | | | - Reza Arezoomandan
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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The Relationship between Serum Brain-Derived Neurotrophic Level and Neurocognitive Functions in Chronic Methamphetamine Users. Neurosci Lett 2022; 772:136478. [DOI: 10.1016/j.neulet.2022.136478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
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The Effect of Add-on Buprenorphine to Matrix Program in Reduction of Craving and Relapse Among People With Methamphetamine Use Disorder: A Randomized Controlled Trial. J Clin Psychopharmacol 2021; 41:45-48. [PMID: 33347022 DOI: 10.1097/jcp.0000000000001320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Methamphetamine addiction is a global issue. Buprenorphine might have beneficial roles in reducing craving to methamphetamine use via altering neurotransmission signaling and dopaminergic system-related reward mechanisms. PROCEDURES This clinical trial was performed in 2019 to 2020 in Khorshid Hospital, Isfahan, Iran. The study was conducted on patients with methamphetamine use disorder. The intervention group received sublingual buprenorphine for 8 weeks, and the other group also received placebo tablets. Patients were followed up and visited every month for the next 4 months. Both groups were treated simultaneously by matrix program for 2 months and observed for the next 4 months. Patients filled out the Cocaine Craving Questionnaire-Brief (CCQ-Brief) every week during intervention time (first 2 months) and every month during follow up visits (4 months). The Depression Anxiety Stress Scale (DASS-21) was also filled out before and after interventions for all of the patients. Data were analyzed using SPSS software using χ2, independent t test and repeated-measure analysis of variance tests. RESULTS Our data indicated significantly lower CCQ-Brief scores in the intervention group compared with the placebo group (P < 0.05). It was also indicated that changes in CCQ-Brief scores were also significant among both groups (P < 0.001). We also showed that the anxiety, depression, and stress scores reduced significantly after interventions (P < 0.001). These scores were also significantly lower in the intervention group compared with placebo group (P < 0.05). CONCLUSIONS Buprenorphine may be effective and may have positive potential roles in reducing methamphetamine craving. This drug is also helpful in reducing the anxiety, depression, and stress of patients with methamphetamine use disorders.
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Bakhshinezhad H, Darharaj M, Feyzi YF, Babaei S, Ahadi R, Jamei B, Pourhamzeh M, Daneshi A, Arezoomandan R. The Relationship Between Brain Metabolites Alterations and Neuropsychological Deficits in Patients with Methamphetamine Use Disorder: A Proton Magnetic Resonance Spectroscopy Study. Arch Clin Neuropsychol 2021; 37:160-172. [PMID: 33993207 DOI: 10.1093/arclin/acab033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Chronic use of methamphetamine induces neuropsychological deficits and neurochemical changes in frontostriatal regions. This study aimed to examine the relationship between brain metabolites alterations in frontostriatal regions and neuropsychological deficits in patients with methamphetamine use disorder. METHOD A total of 30 methamphetamine users and 20 control participants were selected and a battery of standardized executive function, attention, and memory tasks, including the Wisconsin Card Sorting Test, Stroop Test, and Wechsler Memory Scale, was administered to them. Proton-Magnetic resonance spectroscopy (H-MRS) of N-Acetylaspartate/Creatine (NAA/Cr), Choline/Creatine (Cho/Cr), and glutamate + glutamine/creatine (Glx/Cr) in dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and basal ganglia (BG) were also undertaken. RESULTS Current findings indicated that there were significant differences between two groups in metabolite ratios including NAA/Cr, Cho/Cr, and Glx/Cr in three areas, except for Glx/Cr in BG. Moreover, compared to healthy controls, methamphetamine users showed poorer performance in all neuropsychological tests. Finally, a significant relationship was found between regional metabolites alterations, particularly in the ACC, and neuropsychological deficits in methamphetamine users. CONCLUSIONS In addition to neurochemical changes and neuropsychological deficits in patients with methamphetamine use disorder, current results highlighted the relationship between these changes in DLPFC, ACC, and BG with cognitive deficits in methamphetamine users.
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Affiliation(s)
- Hamideh Bakhshinezhad
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Darharaj
- Student Research Committee, Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Yasha Fayaz Feyzi
- Student Research Committee, Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Shirzad Babaei
- Student Research Committee, Psychology Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ahadi
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Behnammaddin Jamei
- Neuroscience Research Center (NRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Pourhamzeh
- Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolhadi Daneshi
- Haft-e-Tir Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Arezoomandan
- Addiction Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Abedi Gheshlaghi L, Sharifi H, Darabi M, Chegeni M, Khalili M, Noroozi A, Rajaei L, Ardalan G, Tohidinik HR. Prevalence of amphetamine-type stimulants use in Iran: a systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1879289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Leili Abedi Gheshlaghi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Darabi
- Research Center for Environmental Determinant of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Chegeni
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Leila Rajaei
- Adolescent and Youth Heath Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Gelayol Ardalan
- Adolescent and Youth Heath Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, Koh EBY, Gupta AK, Kudva KG. The state of psychiatric research in the Asia Pacific region. Asia Pac Psychiatry 2021; 13:e12432. [PMID: 33145988 DOI: 10.1111/appy.12432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Affiliation(s)
- Glen Cedric Roche
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Paul Fung
- Paramatta Mission, Parramatta, New South Wales, Australia.,Health Education and Training Institute Higher Education, North Paramatta, New South Wales, Australia
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Isa Multazam Noor
- Department of Psychiatry, Dr. Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, Singapore
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Asadi M, Rashedi V, Khademoreza N, Seddigh R, Keshavarz-Akhlaghi AA, Ahmadkhaniha H, Rezvaniardestani SM, Lotfi A, Shalbafan M. Medication Adherence and Drug Attitude Amongst Male Patients with the Methamphetamine-Induced Psychotic Disorder After Discharge: A Three Months Follow Up Study. J Psychoactive Drugs 2021; 54:18-24. [PMID: 33594958 DOI: 10.1080/02791072.2021.1883778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Medication adherence and attitudes toward psychiatric medication affect treatment outcome. The objective of this study was to evaluate the effect and interaction of psychotic symptoms, sociodemographic factors, and attitudes concerning medication use with a three-month follow-up among methamphetamine-induced psychotic male patients. In this prospective, descriptive study, 42 male patients diagnosed with a methamphetamine-induced psychotic disorder were selected on the last day of their admission period in Iran Psychiatry Hospital, Tehran, Iran. Each patient was evaluated using the Persian version of the Drug Attitude Inventory (DAI-10), Medication Possession Ratio (MPR), Positive and Negative Syndrome Scale (PANSS), as well as a sociodemographic questionnaire immediately, one month and three months after discharge. There was a significant difference in MPR between the first and third months. Moreover, the frequency of patients with a positive attitude toward their medications increased over time. Indeed, all participants stated a positive attitude at the last follow-up based on the DAI-10 cutoff. Based on our findings, medication adherence of male patients with methamphetamine-induced psychotic disorder should be an essential aspect of treatment after discharge from psychiatry inpatient wards, more specifically, through the first months.
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Affiliation(s)
- Marzieh Asadi
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Nooshin Khademoreza
- Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Ruohollah Seddigh
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | - Amir-Abbas Keshavarz-Akhlaghi
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Ahmadkhaniha
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ali Lotfi
- School of Applied Biosciences and Chemistry, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Tajbakhsh A, Alimardani M, Asghari M, Abedini S, Saghafi Khadem S, Nesaei Bajestani A, Alipoor F, Alidoust M, Savardashtaki A, Hashemian P, Pasdar A. Association of PICK1 and BDNF variations with increased risk of methamphetamine dependence among Iranian population: a case-control study. BMC Med Genomics 2021; 14:27. [PMID: 33499851 PMCID: PMC7836203 DOI: 10.1186/s12920-021-00873-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Genetic factors play an important role in susceptibility to methamphetamine dependency. In this line, protein that interact with C-kinase-1 (PICK1) and brain-derived neurotrophic factor (BDNF) genes are linked to methamphetamine dependence (substance use disorder). Thus, in a case-control study, we investigated the association between polymorphisms of PICK1 and BDNF genes and methamphetamine dependence in an Iranian population. METHODS Total of 235 cases and 204 controls were recruited in a period between 2015 to 2018. The PICK1-rs713729, -rs2076369 and BDNF-rs6265 genotypes were determined via ARMS-PCR assay. Statistical analysis was performed, using SPSS 20.0, PHASE 2.1.1 program as well as SNP Analyzer 2.0. RESULTS In the present study, two polymorphisms including PICK1-rs713729 (OR 1.38 (CI 1.08-1.52; P-value 0.004) in multiplicative and dominant models, and PICK1-rs2076369 (OR 1.31 (CI 1.10-1.56; P-value 0.002) in multiplicative, dominant and co-dominant models were associated with the risk of methamphetamine abuse. Moreover, haplotype analysis showed a significant association of haplotype AG (OR 2.50 (CI 1.50-4.16; P-value 0.0002) in dominant, recessive and co-dominant models, and haplotype TT (OR 0.67 (CI 0.50-0.91; P-value 0.009) in dominant and co-dominant models with the risk of methamphetamine abuse. None of the polymorphisms in this study had a high level of linkage disequilibrium. CONCLUSION Our findings indicate that the PICK1 gene polymorphism might affect the risk of methamphetamine dependency in our population.
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Affiliation(s)
- Amir Tajbakhsh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Alimardani
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahla Asghari
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheila Abedini
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sohrab Saghafi Khadem
- Ibn-E-Sina and Dr Hejazi Psychiatry Hospital, University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Nesaei Bajestani
- Department of Medical Genetics, Ayatollah Madani Hospital, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Forough Alipoor
- Islamic Azad University Torbat-e Jam Branch, Torbat-e-Jam, Iran
| | - Maryam Alidoust
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Savardashtaki
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Hashemian
- Medical Genetics Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Pasdar
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetics Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Division of Applied Medicine, Faculty of Medicine, University of Aberdeen, Foresterhill, Aberdeen, UK
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13
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Paknahad S, Akhgari M, Ghadipasha M. An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011-2018. Forensic Sci Med Pathol 2020; 17:208-215. [PMID: 33237521 DOI: 10.1007/s12024-020-00339-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
Methamphetamine is one of the most commonly abused illicit drugs in Iran. Despite this fact, there has been relatively little research on methamphetamine-associated deaths in Iran. The present study aimed to investigate the cause of death in methamphetamine positive cases based on forensic toxicology findings In this data base descriptive study, individuals with methamphetamine-associated deaths that were referred to the Legal Medicine Organization, Tehran, Iran (2011-2018) were assessed. Deaths including those from natural causes, toxicity, accident and suicides with positive forensic toxicology analyses for methamphetamine and its metabolite amphetamine in postmortem samples were investigated. All cases were examined to determine trends in methamphetamine-associated deaths, and in the manner and causes of deaths. During the eight year study there were 1389 methamphetamine-associated deaths. The mean age was 37.47±10.87 years, with a male/female ratio of 12.36:10. The methamphetamine-associated death rate increased significantly during the study period (2.05 vs. 21.93 per 106 Tehran province populations). The most common cause of death was cardiac arrest due to stimulant abuse with supportive histologic findings of acute myocardial infarction, myocardial fiber hypertrophy, aortic dissection and perivascular fibrosis (25%). Opioids (methadone, tramadol and morphine), tricyclic antidepressants and benzodiazepines were frequently present in postmortem samples of study cases. Methamphetamine-associated deaths significantly contribute to illicit drug-associated deaths in Tehran and represent a substantial clinical and public health problem.
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Affiliation(s)
- Somayeh Paknahad
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Masoud Ghadipasha
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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14
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Paknahad S, Akhgari M, Ghadipasha M. An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011-2018. Forensic Sci Med Pathol 2020. [DOI: https://doi.org/10.1007/s12024-020-00339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Aryan N, Banafshe HR, Farnia V, Shakeri J, Alikhani M, Rahimi H, Sehat M, Mamsharifi P, Ghaderi A, Omidi A. The therapeutic effects of methylphenidate and matrix-methylphenidate on addiction severity, craving, relapse and mental health in the methamphetamine use disorder. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:72. [PMID: 32977820 PMCID: PMC7519552 DOI: 10.1186/s13011-020-00317-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/18/2020] [Indexed: 11/17/2022]
Abstract
Background Little evidence has examined the therapeutic effects of methylphenidate (MPH) and Matrix Model treatment on addiction severity, craving, relapse and mental health in people who use methamphetamine (PWUM). This study was conducted to determine the effects of MPH, Matrix Model treatment, and Matrix-MPH on addiction severity, craving, relapse and mental health in PWUM. Methods This clinical trial was conducted among 100 patients with METH users. Participants were randomly divided into four groups who received: 1) 22 sessions of 45-min, twice a week for Matrix Model treatment (n = 25); 2) MPH 10 mg/day in the first month, 7.5 mg/day in the second month and 5 mg/day in the third month (n = 25); 3) Matrix Model treatment combined with MPH (n = 25); 4) control group (n = 25) for 12 weeks. Addiction severity, craving, relapse and mental status were evaluated at baseline and end-of-trial. Results Matrix Model treatment combined with MPH significantly reduced MA craving (P < 0.001) and addiction severity (P < 0.001). In addition, Matrix Model treatment combined with MPH resulted in a significant increase of mental health (P = 0.001), compared with Matrix Model treatment, MPH, and control group. Also, negative METH urine test significantly increased in the Matrix Model treatment combined with MPH group compared with the other groups (P < 0.001). Conclusions In conclusion, Matrix Model treatment combined with MPH for 12 weeks had beneficial effects on addiction severity, craving, relapse, and mental health in PWUM, compared with Matrix Model treatment, MPH, and control group. Trial registration This study was retrospectively registered in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT20171105037245N1). Registration date: 9 December 2017.
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Affiliation(s)
- Nazanin Aryan
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Banafshe
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalal Shakeri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibollah Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojtaba Sehat
- Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Peyman Mamsharifi
- Department of Psychology, Allameh Tabataba'i University, Tehran, Iran
| | - Amir Ghaderi
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Clinical Research development unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdollah Omidi
- Department of clinical psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran.
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16
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Sarani EM, Ahmadi J, Oji B, Mahi-Birjand M, Bagheri N, Bazrafshan A, Manshadi MD, Yaghoubi S, Dezhkam A, Khatami M, Abdollahpour-Alitappeh M. Investigating the sequential patterns of methamphetamine use initiation in Iran. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:52. [PMID: 32727512 PMCID: PMC7392828 DOI: 10.1186/s13011-020-00297-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 07/22/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Methamphetamine (MA) remains one of the most commonly used amphetamine-type stimulants, accounting for the second most widely-used substance after marijuana. Due to increased use of MA, a wide variety of research has focused on the patterns of MA use initiation among adolescents. Nevertheless, there are few data available for people who use MA. The present study set out to assess the sequential patterns of substance use initiation in patients with MA use disorders in Iran. MATERIALS AND METHODS This cross-sectional study described substance initiation patterns for 302 patients who used MA admitted to hospitals and psychiatric centers of Shiraz University of Medical Sciences. The study was conducted between April 2015 and June 2016. After obtaining informed consents, participants were interviewed by trained interviewers using face-to-face, semi-structured interviews. The collecting data were analyzed using the chi square tests and one-way analysis of variance (ANOVA) tests to compare the relationship between qualitative and quantitative variables, respectively. RESULTS Out of 302 participants enrolled in the study, 16 (5.3%) and 286 (94.7%) were female and male, respectively. The mean age of participants in the study was 37.29 years. The mean age of onset of MA use was found to be 15.9 years. 46.1% of the patients started MA use before 15 years. 77.2% of the patients who used MA had family members with a history of substance use. 93.71% of the patients who used MA started substance use with tobacco, alcohol, or opium, as the most frequent substances. Tobacco, as the first substance or starting substance, exhibited the most widely-used substance (69.53% of the cases). Tobacco-alcohol-cannabis-opium-heroin-MA sequencing was significantly related to the early onset of the substance use. Early-onset substance use was significantly higher in those with lower income, primary education, and family history of substance use. No significant relationship was found between employment status with the age of onset of substance use, and different substance use with marital status. CONCLUSION Tobacco, alcohol and opium can be considered as the main sequencing substances for initiation to MA use. Standardized measures to decrease and control access to main starting and sequencing substances, including tobacco, alcohol, and opium, can greatly help decrease the early onset of the MA use, develop suitable prevention, and establish early intervention strategies.
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Affiliation(s)
- Ebrahim Moghimi Sarani
- Research Center for Psychiatry and Behavior Science, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Jamshid Ahmadi
- Substance Abuse Research Center, Dual Diagnosis Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahare Oji
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahareh Mahi-Birjand
- Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Department of Clinical Pharmacy, Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Nader Bagheri
- Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Amir Bazrafshan
- Substance Abuse Research Center, Dual Diagnosis Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sajad Yaghoubi
- Department of Clinical Microbiology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Asiyeh Dezhkam
- Department of Midwifery, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mehrdad Khatami
- NanoBioelectrochemistry Research Center, Bam University of Medical Sciences, Bam, Iran
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17
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Mohebbi E, Haghdoost AA, Noroozi A, Molavi Vardanjani H, Hajebi A, Nikbakht R, Mehrabi M, Jabbarinejad Kermani A, Salemianpour M, Baneshi MR. Awareness and Attitude Towards Opioid and Stimulant Use and Lifetime Prevalence of the Drugs: A Study in 5 Large Cities of Iran. Int J Health Policy Manag 2019; 8:222-232. [PMID: 31050967 PMCID: PMC6499902 DOI: 10.15171/ijhpm.2018.128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 12/15/2018] [Indexed: 01/01/2023] Open
Abstract
Background: Providing population-based data on awareness, attitude and practice of drug and stimulant use has policy implications. A national study was conducted among Iranian general population to explore life time prevalence, awareness and attitudes toward opioids and stimulant use.
Methods: We recruited subjects from 5 provinces with heterogenic pattern of drug use. Participants were selected using stratified multistage cluster sampling. Data were collected using a validated self-administered questionnaire. Logistic regression model was applied to identify the variables that are associated with drug and stimulant use.
Results: In total 2065 respondents including 1155 men (33.96 ± 10.40 years old) and 910 women (35.45 ± 12.21 years old) were recruited. Two-third of respondents had good awareness about adverse effects of opioid use. Corresponding figure in terms of stimulants was 81.4%. Almost 95% of participants reported a negative attitude towards either opioid or stimulant use. The lifetime prevalence of opioid use and stimulant use were 12.9% (men: 21.5%, women: 4.0%) and 7.3% (men: 9.6%, women: 4.9%), respectively. Gender (adjusted odds ratio [AOR]M/W=6.92; 95% CI: 2.92, 16.42), education (AORundergraduate/diploma or less =0.49; 95% CI: 0.26, 0.90), and marital status (AORothers/single=2.13; 95% CI: 1.36, 3.33) were significantly related with opioid use. With respect to stimulant use, age was negatively associated with the outcome (AOR60+/20-29 years = 0.08: 95% CI; 0.01, 0.98) and men were 2 times more likely than women to use stimulants (ORM/W=2.15: 95% CI: 0.83, 5.56). In addition, marital status (AOROthers/singles = 3.45; 95% CI: 1.09, 10.93), and awareness (AORWeak and moderate/good =0.40; 95% CI: 0.25, 0.61) were independently correlated with stimulants use.
Conclusion: While the attitude of Iranian adults toward opioid and stimulant use was negative, their awareness was not that adequate to prevent the drug use. Men and those with lower socio-economic status (SES) should be the focus of health promotion programs regarding opioid use. However, regarding stimulants use, promotion programs should target younger age groups and those with higher SES status.
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Affiliation(s)
- Elham Mohebbi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Noroozi
- School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Ahmad Hajebi
- Research Center for Addiction & Risky Behavior (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Nikbakht
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Mehrabi
- Department of Sociology, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran.,Department of Mental, Social Health and Drug Use, Ministry of Health, Tehran, Iran
| | - Akram Jabbarinejad Kermani
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahshid Salemianpour
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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18
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The Effect of Matrix Model on Depression, Anxiety, and Quality of Life in Methamphetamine Users and Their Caregivers. ADDICTIVE DISORDERS & THEIR TREATMENT 2018. [DOI: 10.1097/adt.0000000000000136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Hajebi A, Amini H, Kashani L, Sharifi V. Twelve-month course and outcome of methamphetamine-induced psychosis compared with first episode primary psychotic disorders. Early Interv Psychiatry 2018; 12:928-934. [PMID: 27991722 DOI: 10.1111/eip.12404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND To assess the clinical course and outcome of patients with methamphetamine-induced psychosis in comparison with patients with primary psychotic disorders. METHODS This prospective study was conducted on patients with methamphetamine-induced psychosis, and 2 groups of primary psychotic disorders: affective psychosis and non-affective psychosis admitted to 2 psychiatric hospitals in Tehran, Iran, with a first episode of a psychotic illness. A total of 165 subjects (55 in each group) were selected using convenience sampling. They were assessed at the time of admission, discharge and 6 and 12 months after discharge using the Positive and Negative Syndrome Scale, the Young Mania Rating Scale and the Global Assessment of Functioning Scale. The frequency of readmissions and suicide attempts were also assessed. RESULTS Significant differences were found in the trend of changes of symptoms and functioning among the 3 groups. At all-time points, the severity of negative psychotic symptoms and dysfunction in the non-affective psychosis group were greater than those in affective or methamphetamine-induced psychosis groups, with latter 2 having similar profiles. However, the course of positive symptoms in methamphetamine-induced psychosis was more similar to non-affective psychosis. Number of suicide attempts and readmissions were non-significantly higher in methamphetamine-induced psychosis than in the other groups. CONCLUSION Methamphetamine-induced psychosis does not have a satisfactory course and in some cases symptoms may remain even after many months of follow-up. Rate of certain outcomes such as re-hospitalization is also considerably high. It is a challenge for the health-care system that requires evidence-based interventions.
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Affiliation(s)
- Ahmad Hajebi
- Research Center for Addiction & Risky Behavior (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Homayoun Amini
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Kashani
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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20
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Comparison of Continuous Performance Test Results of Former Morphine and Methamphetamine Users During the Early Abstinence Phase. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.57233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Bananej A, Völkl-Kernstock S, Lesch O, Walter H, Skala K. No evidence of subgroups found in amphetamine consumers in Iran. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2018; 32:69-74. [PMID: 29516360 PMCID: PMC5993840 DOI: 10.1007/s40211-018-0259-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 02/08/2018] [Indexed: 11/04/2022]
Abstract
Amphetamine type substances are the second most commonly consumed illicit drug type and their use is an important contributor to the global burden of disease. This investigation set out to determine whether, similar to alcohol or nicotine addiction, subgroups of consumers can also be found in amphetamine addicts. 204 consumers of methamphetamine only (n = 50) or both methamphetamine and heroin (n = 154) have been investigated in Mashhad, Iran by means of "Lesch Alcoholism Typology". No significant differences in consumption pattern or age of onset have been found between the different types. Many subjects, however, reported symptoms of anxiety (n=78) or depression (n = 129) prior to drug use. These findings highlight the need for high quality epidemiological studies further addressing this issue.
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Affiliation(s)
- Atireza Bananej
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Otto Lesch
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Henriette Walter
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Katrin Skala
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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22
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Rostami M, Karamouzian M, Khosravi A, Rezaeian S. Gender and geographical inequalities in fatal drug overdose in Iran: A province-level study in 2006 and 2011. Spat Spatiotemporal Epidemiol 2018; 25:19-24. [DOI: 10.1016/j.sste.2018.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 12/07/2017] [Accepted: 01/08/2018] [Indexed: 02/07/2023]
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23
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Shokoohi M, Karamouzian M, Sharifi H, Rahimi-Movaghar A, Carrico AW, Hosseini Hooshyar S, Mirzazadeh A. Crystal methamphetamine use and its correlates in women engaged in sex work in a developing country setting. Drug Alcohol Depend 2018; 185:260-265. [PMID: 29477085 DOI: 10.1016/j.drugalcdep.2017.12.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/22/2017] [Accepted: 12/09/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Worldwide, crystal methamphetamine (CM) use and associated high-risk sexual behaviors are a concern, but they are less studied among female sex workers (FSW) in developing countries. This study aimed to characterize the prevalence and individual, interpersonal, and structural correlates of self-reported past-month CM use among FSW in Iran. METHODS FSW aged ≥ 18 years who reported penetrative sex with more than one client in the last year were recruited (analytic sample: 1295). Data were collected in one-on-one interviews using a standardized behavioral questionnaire. Poisson regression model was used to assess the correlated of past-month self-reported CM use by crude and adjusted prevalence ratio (APR) and 95% confidence intervals (CI). RESULTS Non-injecting and injecting CM use was reported by 15.0% (95% CI: 8.7, 24.7) and 0.9% (95% CI: 0.4, 2.1) of participants. CM use was positively associated with concurrent use of opioids (APR from 2.08 to 3.84, P-value < 0.01), higher number of sexual partners (APR: 2.05, P-value: 0.018), housing instability (APR: 3.54, P-value: 0.001), and history of forced sex (APR: 1.47, P-value: 0.050). CONCLUSIONS A considerable number of FSWs use CM along with opioids, have a higher number of sexual partners, forced sex, and housing instability. Both prevention strategies as well as strategies to reduce harm associated with CM need to be added to current programs that predominantly focus on opioid dependency and male drug injectors.
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Affiliation(s)
- Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1151 Richmond St., London, ON, Canada.
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada.
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, 1120 NW 14th St., Miami, FL, USA.
| | - Samira Hosseini Hooshyar
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Department of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California San Francisco, 550 16th St., San Francisco, CA, USA.
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Prevalence and Reasons for Psychoactive Drugs Use Among University Students of Medical Sciences in Yazd, Iran. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.9384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Alammehrjerdi Z, Ezard N, Dolan K. Methamphetamine dependence in methadone treatment services in Iran: the first literature review of a new health concern. Asian J Psychiatr 2018; 31:49-55. [PMID: 29414387 DOI: 10.1016/j.ajp.2018.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/12/2017] [Accepted: 01/06/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Methamphetamine dependence is a serious health problem among Iranian methadone patients. AIM The current study is the first research that reviewed the prevalence of methamphetamine dependence and the associated harms among Iranian methadone patients. The other aims were to review the history of receiving methamphetamine treatment among methadone patients and the evaluated psychosocial treatments for methamphetamine dependence and/or associated harms. METHODS Searching included both peer-reviewed literature and grey literature in English and Persian. Reference lists of the relevant papers and reports were searched manually for more information. The time period between 1 January 2005 and 28 October 2017 was set for searching. FINDINGS Available evidence indicated that methamphetamine dependence increased from 3.9% among the two genders in 2007 to 60.3% among men in 2014 and 89.5% among women in 2015-2016. The prevalence of methamphetamine dependence was higher among female methadone patients than their male counterparts. Methamphetamine dependence was associated with multiple health problems in the social and health contexts of the two genders especially women. However, receiving methamphetamine treatment was negligible. The review indicated that cognitive-behavioural therapy improved psychological well-being. The Matrix Model led to abstinence from methamphetamine and improved psychological well-being. Motivational interviewing increased attendance in treatment. Family therapy improved the quality of life and social support. However, more similar studies were needed. CONCLUSION Despite a serious increase in methamphetamine dependence, there were a few evaluated psychosocial treatments. There is an immediate need to evaluate efficacious psychosocial treatments especially for women. Methamphetamine treatment should be provided in methadone treatment services.
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Affiliation(s)
- Zahra Alammehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Akhgari M, Amini-Shirazi N, Iravani FS. Forensic Toxicology Perspectives of Methadone-associated Deaths in Tehran, Iran, a 7-year Overview. Basic Clin Pharmacol Toxicol 2017; 122:436-441. [PMID: 29076627 DOI: 10.1111/bcpt.12930] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/20/2017] [Indexed: 02/02/2023]
Abstract
Methadone has a long history of pain relief and successful substitute for maintenance treatment in heroin and narcotic addiction. The aim of the study was to assess the trends of methadone-associated deaths in Tehran, Iran, in 2009-2015, from a forensic toxicology point of view. All methadone-associated deaths during this 7-year study period were evaluated according to demographic parameters and forensic toxicology analysis results. Results showed that 1274 cases of methadone-associated deaths were investigated during the study period. The incidence rate of methadone-associated deaths had risen 7.7 times in 2015 in comparison with 2009 (p < 0.05). The majority of cases were men (90.35%), aged from 20 to 40 years. About 80% of cases had shown positive results for other drugs and poisons in combination with methadone. Methamphetamine and tramadol were the most drugs detected in post-mortem samples. Death rates among methadone users in Tehran, Iran, increased year by year during 2009-2015. These findings raise the attention to the concomitant use of drugs with the need for changes in regulation and regulatory policy to restrict access and use of controlled drugs.
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Affiliation(s)
- Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Akhgari M, Amini-Shirazi N, Iravani FS. Forensic Toxicology Perspectives of Methadone-associated Deaths in Tehran, Iran, a 7-year Overview. Basic Clin Pharmacol Toxicol 2017. [DOI: https://doi.org/10.1111/bcpt.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maryam Akhgari
- Legal Medicine Research Center; Legal Medicine Organization; Tehran Iran
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Methamphetamine Use and Emergency Department Utilization: 20 Years Later. JOURNAL OF ADDICTION 2017; 2017:4050932. [PMID: 28913001 PMCID: PMC5585625 DOI: 10.1155/2017/4050932] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/19/2017] [Indexed: 11/20/2022]
Abstract
Background Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed. Methods Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED. Results 638 MAP-positive patients, 3,013 toxicology screens, and 20,203 ED visits represented an increase in prevalence compared to 1996: 461 MAP-positive patients, 3,102 screens, and 32,156 visits. MAP patients were older compared to the past. Mode of arrival was most frequently by ambulance but at a lower proportion than 1996, as was the proportion of MAP patients with positive cocaine toxicology screens and ethanol coingestion. Admission rate was lower compared to the past, as was discharge to jail. The proportion of MAP patients presenting with blunt trauma was lower compared to the past and higher for chest pain. Conclusion A significant increase in the prevalence of MAP-positive patients was found. Differences in presenting complaints and resource utilization may reflect the shifting demographics of MAP users, as highlighted by an older patient population relative to the past.
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Bagheri N, Mirzaee M, Jahani Y, Karamouzian M, Sharifi H. Correlates of methamphetamine use among young Iranians: Findings of a population-based survey in 2013. Am J Addict 2017; 26:731-737. [DOI: 10.1111/ajad.12604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/04/2017] [Accepted: 07/23/2017] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nahid Bagheri
- Modeling in Health Research Center; Institute for Futures Studies in Health; Kerman University of Medical Sciences; Kerman Iran
- Department of Biostatistics and Epidemiology; School of Public Health; Kerman University of Medical Sciences; Kerman Iran
| | - Moghaddameh Mirzaee
- Modeling in Health Research Center; Institute for Futures Studies in Health; Kerman University of Medical Sciences; Kerman Iran
- Department of Biostatistics and Epidemiology; School of Public Health; Kerman University of Medical Sciences; Kerman Iran
| | - Yunes Jahani
- Modeling in Health Research Center; Institute for Futures Studies in Health; Kerman University of Medical Sciences; Kerman Iran
- Department of Biostatistics and Epidemiology; School of Public Health; Kerman University of Medical Sciences; Kerman Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health; Kerman University of Medical Sciences; Kerman Iran
- School of Population and Public Health, Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health; Kerman University of Medical Sciences; Kerman Iran
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Kheirabad AK, Farshidfar G, Nasrollaheian S, Gouklani H. Prevalence and Characteristics of Precore Mutation in Iran and Its Correlation with Genotypes of Hepatitis B. Electron Physician 2017; 9:4114-4123. [PMID: 28607644 PMCID: PMC5459281 DOI: 10.19082/4114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 11/03/2016] [Indexed: 01/05/2023] Open
Abstract
Introduction Mutation of the HBV precore gene prevents the production of HBeAg, which is an important target for immune responses. Distribution of this mutation varies along with frequency of HBV genotypes in accordance with geographic and ethnic variations. The general objective of this study was to evaluate the prevalence and characteristics of precore mutation in Iran and its correlation with genotypes of hepatitis B. Methods In this cross-sectional study, viral DNA of 182 Iranian hepatitis B surface antigen positive patients who were admitted to Bandar Abbas Blood Transfusion Organization in 2012 and 2013 was retrieved from their serum samples. HBeAg, anti-HBe, and anti-HBc IgM diagnostic tests were performed using ELISA kits. Precore and Pre-S regions were amplified using specific primers and PCR thereafter to determine the genotypes; precore mutation, PCR, and restriction fragment length polymorphism (RFLP) methods also were applied. SPSS version 12 was used for data analysis by Mann–Whitney U test, Fisher’s exact probability test, and t-test. Results A total of 62 patients (34.1%) had precore mutation (A1896G), and genotype D was the predominant genotype in these patients, which was followed by an unknown genotype that was suspected for genotype B. Interestingly, the relationships between precore mutation and HBeAg (p=0.037) and genotype D (p=0.005) were significant; however, no correlation was observed between this mutation and acute or chronic hepatitis and sex of patients. Conclusion This study found high prevalence of precore mutations in southern Iran, which was significantly associated with HBeAg and genotype D.
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Affiliation(s)
- Ali Kargar Kheirabad
- Ph.D., Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Farshidfar
- Ph.D., Department of Biochemistry, School of Medicine, Hormozgan University of Medical Sciences, Iran
| | | | - Hamed Gouklani
- Ph.D., Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Evaluation of blood lead level in methamphetamine users in Tehran. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:2. [PMID: 28222753 PMCID: PMC5320762 DOI: 10.1186/s13011-017-0088-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/03/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Given the increasing number of lead poisoning in opioids users and since no study has been conducted so far to review lead poisoning in methamphetamine (crystal) users, this study aimed to investigate blood lead level in methamphetamine addicts. METHODS This study was conducted on 20 patients with methamphetamine poisoning and their blood lead level was measured. The subjects were selected from among patients with a history of continuous use of methamphetamine, without a history of using opiates in the past 6 months confirmed by a negative urine tests, and without a history of heavy metal poisoning. RESULTS Of all, 18 patients were male and the mean age was 32 ± 10 years; 17 patients were abusing the drug via inhalation and three persons via oral administration. The mean blood lead level was 2.3 ± 1.1 μg/dL and poisoning was not observed in any of the cases. Blood lead level was not associated with age, sex, dosage, and route of administration. CONCLUSION Although blood lead level was not at poisoning level in people who only used methamphetamine in Iran, due to the simultaneous use of other substances and because of non-specific symptoms, lead poisoning must be suspected in all cases of substances poisoning.
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Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths. Daru 2017. [DOI: doi 10.1186/s40199-017-0170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Akhgari M, Mobaraki H, Etemadi-Aleagha A. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths. Daru 2017. [DOI: https://doi.org/10.1186/s40199-017-0170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Akhgari M, Mobaraki H, Etemadi-Aleagha A. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths. ACTA ACUST UNITED AC 2017; 25:5. [PMID: 28212679 PMCID: PMC5316196 DOI: 10.1186/s40199-017-0170-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Methamphetamine abuse is a worldwide health concern. Methamphetamine causes health hazards in many vital organs. It can cause damage to cardiac tissue via catecholamines release. Methamphetamine related deaths are becoming one of the most important problems in Iran. The purpose of the present study was to determine cardiac pathology in methamphetamine poisoning-related deaths. METHODS The study included 100 cases of methamphetamine poisoning-related deaths and 100 cases as control group. Toxicology analysis of liver, gastric content, bile, urine, blood and vitreous humor were conducted to detect drugs, poisons and alcohols using thin layer chromatography, gas chromatography/mass spectrometry, and high performance liquid chromatography. Positive toxicology analysis results except for amphetamine and methamphetamine were excluded from the study in order to omit interfering factors. The most striking features of cardiac damage were observed by light microscopy. RESULTS Methamphetamine and amphetamine were detected in either urine or gastric content samples. In all of the cases methamphetamine toxicity was determined to be a direct cause of death by forensic medicine practitioner. Cardiovascular pathology was noted in 68% of studied cases. The most common histopathologic features were myocardial fiber hypertrophy, mild, moderate to severe atherosclerosis and focal degeneration/necrosis. CONCLUSION The results of the present study indicate that cardiotoxicity is one of the major contributing factors in methamphetamine poisoning related deaths. Overall, the current study highlights the fact that cardiotoxic effects of methamphetamine can explain increasing reports of heart failure and consequently death in young abusers. TRIAL REGISTRATION Not applicable. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Old Ghom Road, 500 meters after Beheste Zahra, 1816153141, Tehran, Iran.
| | - Homeira Mobaraki
- Department of Forensic Pathology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Noori R, Daneshmand R, Farhoudian A, Ghaderi S, Aryanfard S, Moradi A. Amphetamine-Type Stimulants in a Group of Adults in Tehran, Iran: A Rapid Situation Assessment in Twenty-Two Districts. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016. [DOI: 10.17795/ijpbs-7704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE OF REVIEW The study reviews publications on the use of methamphetamine and amphetamine in relation to psychotic symptoms, substance-induced psychosis, and primary psychosis published between July 2014 and December 2015. The databases MEDLINE, Embase, and PsycINFO were searched using the terms 'amphetamine psychosis' and 'methamphetamine psychosis' for the time period 1 July 2014 to 31 December 2015. RECENT FINDINGS There were 37 studies published on the subject during this time period. Risk factors for psychotic symptoms, substance-induced psychosis, and primary psychosis included patterns of drug use, but results also pointed to the importance of nondrug-related vulnerability. Cognitive impairment is associated with both amphetamine use and psychosis, and the impairment among those with amphetamine-induced psychosis resembles that of schizophrenia. At the neuronal level, GABAergic mechanisms may offer some understanding about the association between stimulant use and psychosis. Several different types of antipsychotic medication are effective for treating agitation and psychosis, but drugs with high DRD2 blockade should be used with caution. Some novel treatments are described, but are not sufficiently repeated to be recommended. SUMMARY During the past 18 months, studies have been published that cover risk factors, neuronal mechanisms, and treatment. These recent results do not differ from previous understandings, but the role of cognition and GABAergic dysfunction should be further investigated, and knowledge about resilience factors is still scarce. Also, a clearer evidence base for medical treatment of psychosis with concurrent amphetamine use is warranted. VIDEO ABSTRACT.
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Alblooshi H, Hulse GK, El Kashef A, Al Hashmi H, Shawky M, Al Ghaferi H, Al Safar H, Tay GK. The pattern of substance use disorder in the United Arab Emirates in 2015: results of a National Rehabilitation Centre cohort study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:19. [PMID: 27177422 PMCID: PMC4866416 DOI: 10.1186/s13011-016-0062-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 05/03/2016] [Indexed: 11/29/2022]
Abstract
Background Substance use disorder (SUD) is a global problem with no boundaries, which also afflicts individuals from countries of the Arabian Peninsula. Data from this region is limited. In an effort to develop targeted prevention and intervention initiatives in the United Arab Emirates (UAE), it was necessary to identify the nature of substance use by describing the characteristics of those using different substances. Consequently, this study in the UAE was conceived to describe the pattern of SUD in a first-ever cohort that was systematically recruited from the country’s National Rehabilitation Centre (NRC) in Abu Dhabi. Methods Two hundred and fifty male patients were recruited from the NRC. Information on substance use was collected using a questionnaire that was completed at an interview with patients who consented to participate. The questionnaire was based on information that the study was designed to capture. It was reviewed by members of institutional ethics committees and approved prior to use. Two hundred and fifty male subjects from the Emirates Family Registry (EFR) were used as a comparison group. Results In the cohort studied, SUD correlated with smoking and marital status. Poly-substance users formed the majority of the cohort (84.4 %) with various combinations of substances identified across different age groups. Opioid and alcohol were the most common substances used. The use of pharmaceutical opioids, primarily Tramadol (67.2 % of opioid users), was higher among the youngest age group studied (<30 years old), while older opioid users (≥30 years old) commonly used illicit opioids (Heroin). The use of prescribed medication for non-medical use also included Pregabalin (mean of 8.3 capsules ± 0.5 per day), Procyclidin (6.1 tablets + 0.6 per day) and Carisoprodol (4.2 tablets ± 0.4 per day) and was again highest in the age group below 30 years. Conclusion This 2015 study highlights the importance of examining the pattern of poly-substance use in a population in order to develop targeted prevention programs to arrest the prevailing trends. It has drawn attention to the rise in use of prescription medication in the UAE, in particular among younger patients (<30 years), and continuing use of illicit opioid amongst males above 30 years. Specific prevention and intervention strategies, targeting differences between these distinct demographic profiles will capture a large subset of sufferers.
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Affiliation(s)
- Hiba Alblooshi
- Centre for Forensic Science, University of Western Australia, Crawley, 6009, WA, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Gary K Hulse
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Ahmed El Kashef
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Hanan Al Hashmi
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Mansour Shawky
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Hamad Al Ghaferi
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Habiba Al Safar
- Center for Biotechnology, Khalifa University of Science, Technology and Research, Abu Dhabi, United Arab Emirates.,Faculty of Biomedical Engineering, Khalifa University of Science, Technology and Research, Abu Dhabi, United Arab Emirates
| | - Guan K Tay
- Centre for Forensic Science, University of Western Australia, Crawley, 6009, WA, Australia. .,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, 6009, Australia.
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Alam-mehrjerdi Z, Daneshmand R, Samiei M, Samadi R, Abdollahi M, Dolan K. Women-only drug treatment services and needs in Iran: the first review of current literature. ACTA ACUST UNITED AC 2016; 24:3. [PMID: 26893096 PMCID: PMC4758153 DOI: 10.1186/s40199-016-0141-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/05/2016] [Indexed: 11/15/2022]
Abstract
Background Iran (Persia) has a women-only drug treatment system. However, literature is not documented. The current study aimed to review the development of women-only drug treatment and harm reduction services (WODTHRS) and the factors associated with treatment entry and outcomes in Iran. The review was based on a comprehensive search for all literature focusing on WODTHRS in Iran. Methods Data were collected by conducting systematic searching of scientific English and Persian databases and grey literature. This was done in line with Cochrane Guideline for conducting systematic reviews. Overall, 19,929 studies were found. But, only 19 original studies were included after excluding non-relevant studies. Results The review findings indicate how WODTHRS have been developed in the past 15 years. The review findings underscore the roles of numerous factors in treatment entry such as the side effects of illicit drug use. In addition, cognitive-behavioral interventions, methadone treatment and some factors outside drug treatment such as family support increase positive treatment outcomes among women. In contrast, financial problems as well as other factors such as insufficient medical, psychiatric and social work services hamper treatment entry and positive treatment outcomes. Conclusions The review results highlight that eliminating barriers to treatment entry and positive treatment outcomes should be addressed. Conducting randomized controlled trials is needed to evaluate the effectiveness of WODTHRS. This issue should address the factors influencing service utilization to incorporate the best practice for women. The evaluation of the long-term efficacy of WODTHRS is a critical research gap which should be addressed in future studies.
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Affiliation(s)
- Zahra Alam-mehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine,, University of New South Wales, Sydney, Australia
| | - Reza Daneshmand
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mercedeh Samiei
- Department of Psychiatry, School of Behavior Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Roya Samadi
- Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Abdollahi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine,, University of New South Wales, Sydney, Australia
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Alam-Mehrjerdi Z, Abdollahi M. The Persian methamphetamine use in methadone treatment in Iran: implication for prevention and treatment in an upper-middle income country. ACTA ACUST UNITED AC 2015; 23:51. [PMID: 26578071 PMCID: PMC4650324 DOI: 10.1186/s40199-015-0134-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 11/10/2022]
Abstract
As the most populated Persian Gulf country in West Asia, methamphetamine use in methadone maintenance treatment (MMT) is a new health concern in Iran. Methamphetamine use in MMT can originate in methadone misconceptions or the stimulant effects of methamphetamine use. Several research studies have highlighted the prevalence of methamphetamine use in Iran and conducting further studies on this issue is being developed. Opiate use is treated with MMT. But, there is no effective pharmacological treatment for methamphetamine use and cognitive-behavioral interventions have still remained the best practice. As a psychostimulant drug, methamphetamine use can lead to poor treatment outcomes or even treatment failure among patients in MMT. Therefore, the implementation of methamphetamine education and prevention programs in MMT is required. Prescribing adequate methadone dose and the treatment of comorbidities as well as, doing a series of activities outside treatment is underscored. Methamphetamine use has a chronic nature and methamphetamine treatment is a long-term procedure with a high rate of relapse. Therefore, the implementation of long-term motivational interviewing, teaching necessary skills to prevent relapse and case management is highlighted. A long-term collaboration between treatment teams, patients and their families is suggested to manage methamphetamine use in MMT.
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Affiliation(s)
- Zahra Alam-Mehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Mohammad Abdollahi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Paydar P, Sabzghabaee AM, Paydar H, Eizadi-Mood N, Joumaa A. Outcome of treatment in patients with methamphetamine poisoning in an Iranian tertiary care referral center. J Res Pharm Pract 2015; 4:167-72. [PMID: 26312257 PMCID: PMC4548437 DOI: 10.4103/2279-042x.162365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Methamphetamine is the second most widely abused drug worldwide. We performed a study on the treatment outcome of acute methamphetamine intoxication in a referral tertiary care University hospital in Iran. Methods: In this hospital-based, retrospective study which was carried out from 2012 to 2013, medical records of all patients aged 18 to 65 years who were admitted with a reliable history and clinical diagnosis of acute methamphetamine intoxication were abstracted and analyzed. Patients’ data included gender, age, type and route of poisoning, clinical manifestations, duration of hospitalization, and the treatment outcome. ANOVA, Chi-square, and binary logistic regression statistical tests were used for data analysis. Findings: A total of 129 patients with a mean age of 30.70 ± 0.93 (mean ± standard error), including 111 (86%) males, had been fully evaluated. Most of the patients had intentional poisoning (93.7%). In 42.6% of patients, inhalation was the main route of exposure. Most of the patients had complete improvement without any complication (89.1%). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI] 1.006–1.099), suicide history (OR, 30.33; 95% CI 3.11–295.24), route of poisoning ([ingestion: OR, 0.21; 95% CI 0.05–0.87], [inhalation: OR, 0.19; 95% CI 0.04–0.78]), and pulmonary system manifestations (OR 1.84; 95% CI 1.15–2.93) were predictive in patients outcome (P < 0.05). Conclusion: Methamphetamine poisoning was more common in males with intentional poisoning. Age, past history of suicide, route of poisoning, and pulmonary manifestations on admission could be considered as important predictive factors in patients’ outcome.
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Affiliation(s)
- Parva Paydar
- Pharmacy Students' Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hooman Paydar
- Medical Students' Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Nastaran Eizadi-Mood
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Joumaa
- Pharmacy Students' Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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