Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran)

Background:

There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake.

Objectives:

The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan.

Patients and Methods:

Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software.

Results:

Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P < 0.0001). There was a significant difference regarding the grade of KAP in patients based on gender, marital status, and education level after education (P < 0.0001).

Conclusions:

This study showed that nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style.

Evaluation of serum adiponectin concentrations among drug abusers on methadone maintenance treatment

BACKGROUND

Adiponectin, an adipocyte-derived protein, modulates a number of metabolic processes. Methadone maintenance treatment (MMT) changes the level of hormones produced by adipose tissue in addicts. However, current data remains contradictory.

OBJECTIVES

The aim of this study was to evaluate the effect of MMT on serum adiponectin levels in drug addicts.

MATERIALS AND METHODS

Twenty-five drug abusers with a mean age of 37.4 ± 8.7 years were referred to the Baharan Hospital, Zahedan, and 22 healthy age-matched control subjects with a mean age of 35 ± 9.5 years were enrolled in the study. Addicts were treated with methadone at (40 to 120 mg/d) for six months. Measurement of anthropometric parameters, serum adiponectin, and biochemical parameter levels, were assessed in the addicts, before and after six months of MMT, but only once in the healthy controls.

RESULTS

The mean basal serum adiponectin level was not significantly lower in the drug abuser group compared to the healthy subjects (P > 0.05). After six months of MMT, the mean serum adiponectin level of the drug addicts was not significantly different from their mean baseline level or that of the healthy subjects (P > 0.05). However, the mean baseline serum adiponectin level was significantly lower in overweight/obese addicts when compared to underweight patients and healthy individuals (P < 0.001). After six months of MMT, the mean level of serum adiponectin increased significantly in the underweight subjects compared to the normal weight and overweight/obese subjects (P < 0.0001) and the control group (P < 0.001). Adiponectin concentration was correlated inversely with body mass index and positively correlated with waist circumference and serum high-density lipoprotein levels.

CONCLUSIONS

This study showed that MMT did not markedly alter the concentration of serum adiponectin in drug abusers. However, in regard to the variations in the serum lipid profiles and anthropometric parameters, the findings indicated that low concentrations of serum adiponectin might play a role in the pathogenesis of obesity and other metabolic abnormalities. Thus, more long-term studies with larger sample sizes are recommended.

Effect of methadone maintenance therapy on anthropometric indices in opioid dependent patients

Background

Opium abuse significantly affects the nutritional status of users and frequently leads to undernourishment. Methadone maintenance therapy has been used as one of the possible ways to prevent of infection diseases such as HIV and hepatitis B and C and improve the quality of life in opioid-dependent patients.

Objectives

The aim of this study was to assess the anthropometric and socio-demographic characteristics of opium addicted persons before and after 8 weeks of methadone maintenance therapy (MMT).

Patients and Methods

A clinical cross-sectional study was carried out on 55 opium users (15 women and 40 men; mean aged 31.6 ± 10 years), dependent on opium and its derivatives at the Addiction Treatment Clinic of the Baharan psychiatric Hospital, Zahedan, Sistan and Baluchistan Province, Iran, in 2011. The patients were examined before and after 8 weeks MMT. Weight and height of participants were taken and the body mass index (BMI) was calculated.

Results

Body weight increased significantly from 61.4 ± 14.4 to 65.3 ± 14.2 kg and BMI from 21.4 ± 4.2 to 23 ± 5.6 (kg/m²) after 8 weeks of methadone maintenance therapy in opium users (P < 0.01). The percentages of underweight, overweight and obese patients were; 27.3%, 18.2% and 3.6%, respectively pre-MMT, and 12.7%, 18.2% and 7.2%, respectively after MMT.

Conclusions

The study shows that methadone Maintenance Therapy led to improvements in nutritional status.

Quality of life in patients on methadone maintenance treatment: a three-month assessment

OBJECTIVE

To examine the 3-month effect of methadone maintenance treatment (MMT) on quality of life (QOL) of substance-dependent outpatients in Iran.

METHODS

The qausi-experimental study performed at the Oral Maintenance Methadone Treatment Clinic of the Baharan Psychiatric Hospital, a university hospital in Zahedan, southeast of Iran, from 2009 to 2010. One hundred patients with substance-dependence disorder were recruited from the outpatient clinic. Quality of life parametres were measured through the World Health Organization Quality of Life scale (WHO QOL-BREF) prior to the treatment, and 1, 2 and 3 months after starting the treatment in order to assess changes in the Quality of Life across the treatment period. Repeated measurement analysis was used for data analysis.

RESULTS

Of the 100 subjects initially recruited, 83 (83%) completed the study period. The total Quality of Life score improved from pre-treatment to the first month into treatment. The improvement was maintained at the 2-month and 3-month points (P < .05). According to the World Health Organization subscales, the treatment was effective in improving physical and social relationship domains over time (P < .05), but there were no significant improvements in psychological and environmental domains.

CONCLUSIONS

Oral methadone maintenance treatment was effective in improving the overall Quality of Life during the first three months of treatment in substance-dependent outpatients.

A randomized effectiveness trial of methadone, TENS and methadone plus TENS in management of opiate withdrawal symptoms

OBJECTIVE

To compare effectiveness of methadone, TENS (Transcutaneous Electrical Nerve Stimulation) and methadone+ TENS in management of opiate withdrawal symptoms.

METHODS

The study was conducted in Zahedan Psychiatric center in 2005. Forty five opiate addicted men meeting DSM-IV criteria for substance dependency disorder participated in the study after informed consent. The subjects were randomly assigned to 3 treatment groups. Patients of first group were given 20-60 mg methadone daily, tapered over a period of 2 weeks. Patients of second group received daily 10-30 mg methadone, tapered similar to first group in combination with TENS treatment. The other 15 patients (third group) experienced low frequency (2 Hz) TENS for two weeks.

RESULTS

There was no statistically significant difference in severity and number of withdrawal symptoms between the 3 groups prior to the start of treatments. But, severity and number of symptoms were significantly higher in TENS group (third group) in third day. In addition, 10 patients of TENS-group left the treatment programme after 5 days. The results showed that methadone only and Methadone plus TENS for the management of opioid detoxification were effective treatments. The comparison of number and severity of withdrawal symptoms in the methadone group and methadone+TENS group by seventh day didn't show significant differences. But, number and severity of withdrawal symptoms in methadone+TENS group were significantly lower than methadone group during tenth and fourteenth days.

CONCLUSION

The results provide support for the use of methadone alone and methadone plus TENS for managing opiate withdrawal, but TENS by itself has no significant effect on withdrawal symptoms. However, TENS in combination with a moderate dose of methadone could reduce severity of withdrawal symptoms effectively.