Guiding principles of drug demand reduction: an international response

A comparative study of characteristics and risky behaviors among the Iranian opium and opium dross addicts

BACKGROUND

Iran ranks first per capita in the use of opiates, but we have little information about possible differences regarding the 2 most commonly used illicit drugs, namely opium and its dross (residue).

DESIGN

This is a cross-sectional study.

SETTING

A cross-sectional study about drug abuse and drug dependence in Iran was conducted from April 2006 to August 2008 in the prisons of 28 Iranian provinces, in the treatment centers, and in the streets.

PARTICIPANTS

To pursue the objectives of this research, participants included 2979 opiate addicts including opium users (n = 2636) and dross users (n = 343), who were not significantly different by gender (P = 0.269) or age (P = 0.452).

MEASUREMENTS

An anonymous questionnaire was completed through an interview that gathered sociodemographic characteristics and information about some high-risk behaviors.

RESULT

: By the end of the study, we concluded that dross addicts, in comparison with opium addicts, were mostly immigrants from rural areas to urban areas (P = 0.031 χ test, 95% confidence interval [CI]), mostly uneducated, illiterate, or semiliterate (P = 0.04 χ test, 95% CI), had illegal occupations (P = 0.048 χ test, 95% CI), were cigarette smokers (P < 0.000 χ test, 95% CI), and had experienced drug injections (P = 0.032 χ test, 95% CI) and drug overdose (P = 0.007 χ test, 95% CI). They also had a history of hospital admission within the preceding year because of drug overdose (P < 0.000) and a record of being arrested and jailed in the past year (P = 0.028 χ test, 95% CI).

CONCLUSION

These results indicated the need for more intensive and effective care for the opioid addicts in Iran.

Impacts of federal ephedrine and pseudoephedrine regulations on methamphetamine-related hospital admissions

AIMS

To determine whether the federal regulation of ephedrine and pseudoephedrine, precursors used in illicit methamphetamine production, reduced methamphetamine-related acute care hospital admissions.

DESIGN

ARIMA-intervention time-series analysis.

SETTING

California (1983-2000), Arizona and Nevada (1991-2000), USA.

MEASUREMENTS

Monthly counts of methamphetamine-related acute care hospital admissions.

INTERVENTIONS

Bulk powder ephedrine and pseudoephedrine: regulated November 1989. Products containing ephedrine as the single active medicinal ingredient: regulated August 1995. Products containing pseudoephedrine: regulated October 1997. Large-scale producers used ephedrine and pseudoephedrine in these forms. Ephedrine combined with other active medicinal ingredients (e.g. various cold medicines), used mainly by small-scale producers: regulated October 1996.

FINDINGS

In California, the bulk powder regulation stopped a 7-year rise in admissions (1983-89) and reduced them by 35% (P < 0.01). The single ingredient ephedrine regulation stopped a 4-year rise (1992-95) in California, Arizona and Nevada, with 48% (P < 0.01), 71% (P < 0.01) and 52% (P < 0.01) reductions, respectively. The pseudoephedrine products regulation stopped a 2-year rise (1996-97) in California, Arizona and Nevada, with 38% (P < 0.01), 41% (P < 0.05) and 61% (P < 0.01) reductions, respectively. Admissions rose at the end of the study period but were still well below peak 1990s levels. The regulation of ephedrine combined with other active medicinal ingredients had no significant impact in any of the three states.

CONCLUSIONS

Regulations targeting precursors used by large-scale producers reduced admissions substantially during the study period. However, the regulation of precursors used primarily by small-scale producers had little, if any, effect.