فهرست مطالب
Addiction & Health
Volume:10 Issue: 2, Spring 2018
- تاریخ انتشار: 1397/03/05
- تعداد عناوین: 8
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Pages 67-75BackgroundThe articles and research reports presented in the scientific journals are selected without a proper critical appraisal in many cases. This is a major problem, as it leads to the opinions of the experts being neglected in many of these scientific journals. A descriptive study was done in fall and winter of 2016.MethodsJournals were identified searching the electronic databases, including PubMed, Medline, Scopus, Google Scholar, and national Persian databases of SID and Magiran. All the articles on addiction published in the time span of 2010-2015 in 8 psychiatry, psychology, and addiction journals were included in this study. The journals included Journal of Behavioral Sciences, Iranian Journal of Psychiatry and Clinical Psychology, Journal of Fundamentals of Mental Health, and Journal of Research on Addiction in Persian, and Health and Addiction Journal, International Journal of Psychiatry and Behavioral Sciences, Journal of Research in Behavioral Sciences, and International Journal of Psychological Studies in English. These journals were evaluated according to their research design and methodology, scientific writing style, and the validity of the references. For all of the 264 articles, the research design and references were thoroughly evaluated.FindingsThe most frequent problems were seen in the introduction section, the sampling method of study, the exclusive criteria, analysis, and the limitations of the study.ConclusionMajor deficiencies in the articles on addiction in Iranian journals were seen. It can be prevented by including important items in the checklists published by some of the journals for reviewers.Keywords: Addiction, Iran, Journal, Evaluation
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Pages 76-85BackgroundSubstance abuse and consequently the use of methadone in Iran are reported at high levels. Drugs alter sexual function by affecting the organs of the body. The aim of this study was to evaluate sexual functioning and serum testosterone levels in opiate addicts, individuals receiving methadone maintenance treatment (MMT), and healthy men living in the city of Rafsanjan, Iran, in 2016.MethodsThe statistical population of this descriptive study included: A) opium-smoking men, B) individuals undergoing MMT, and C) those without any history of substance abuse. Using a formula, the sample size consisted of 70 individuals who were randomly selected from the statistical population. The study samples also completed the International Index of Erectile Function (IIEF). Moreover, the serum testosterone levels were measured using the laboratory-based Enzyme Linked Immunosorbent Assay (ELISA) diagnostic kits. The data were analyzed by SPSS software using Mann-Whitney U and Kruskal-Wallis tests with a significant level of < 0.050.FindingsThe serum testosterone levels in healthy individuals were higher than those in other two groups (P = 0.001). In addition, the sexual functioning indicators of men receiving MMT and opiate-smoking ones (P = 0.001) were lower than those of healthy individuals except for overall sexual satisfaction (P = 0.069).ConclusionMethadone and opium reduce different aspects of sexual functioning. It seems that this change was through having impacts on serum testosterone levels; however, psychological, social, and economic dimensions are suggested to be considered in this domain.Keywords: Testosterone, Sexual functioning, Methadone, Opium
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Pages 86-94BackgroundChronic opioid use is a major public health problem with significant morbidity. The aim of this study was to investigate factors associated with sustained remission among a sample of Iranian chronic opioid users in Shiraz, Iran.MethodsThis was a cross-sectional study to evaluate sustained remission among chronic opiate users aged 20-60 years. Participants included two groups: 365 people who have been in sustained remission for the past year, and 187 persons who did not achieve remission for the past one year. Then, demographic and factors related to drug use pattern and previous treatments were compared between two groups. Pearson chi-square test was used for univariate analysis and backward stepwise logistic regression was used to estimate adjusted odds ratios (AORs).FindingsOur findings showed that sustained remission was associated with Narcotic Anonymous (NA) participation [AOR = 3.28, 95% confidence interval (CI): 2.19-4.89, P < 0.001], male gender (AOR = 2.53, 95% CI: 1.45-4.43, P = 0.001), younger age of onset (AOR = 1.63, 95% CI: 1.03–2.58, P = 0.037), higher total years of opioid use (AOR = 2.13, 95% CI: 1.42–3.19, P < 0.001), no history of imprisonment (AOR = 2.11, 95% CI: 1.16-3.85, P = 0.015), and family support (AOR = 2.58, 95% CI: 1.33-5.01, P = 0.005).ConclusionParticipation in self-help groups can be a suitable alternative in predicting sustained remission among chronic opiate users. Chronic opioid users should be encouraged by the physicians who are involved in the treatment of drug addiction to participate in NA programs.Keywords: Drug addiction, Opioids, Substance use disorders, Remission
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Pages 95-101BackgroundThe prevalence of opium addiction among Iranians is considerable. Since endogenous opioid systems may be altered as a consequence of addiction, it is very important to determine the plasma and cerebrospinal fluid (CSF) levels of morphine in Iranian patients addicted to opiates who will undergo surgery.MethodsWe obtained CSF and plasma samples from 50 volunteers with an established opioid addiction pattern. Samples were analyzed using high-performance liquid chromatography (HPLC). Additionally, frequency of nausea and vomiting, baseline heart rate (BHR), and systolic blood pressure (SBP) were recorded within the surgery and postoperatively during a 10-min interval.Findings84% of participants were men with a median age of 39.08 years. Mean score of body mass index (BMI) was 23.30 and most of the participants (46%) used opium in its traditional inhaled form. A higher concentration of morphine in blood was found in comparison with CSF (P < 0.001) in relation to the way of use. However, no statistically significant differences were found in relation to the type of addictive substance. No other association was found between the levels of morphine and the clinical characteristics of the patients. Moreover, results revealed no difference between hemodynamic-related data with blood and CSF level in opium-dependent patients.ConclusionQuantification of plasma and CSF morphine, both immediately before initiation of surgery and subsequently on recovery room, showed that although clinical efficacy of systemic morphine was poor in addicted patients, it had no effect on patients’ hemodynamic variable and following complications after surgery.Keywords: Morphine, Cerebrospinal fluid, Opium addiction, Postoperative pain
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Pages 102-111BackgroundTranstheoretical model (TTM) has been recognized as a common theoretical model in researches in terms of addictive behaviors. The aim of this study was to examine the psychometric properties of the Persian brief version of the TTM for hookah tobacco smoking cessation in a sample of Iranian rural adults who were in the preparation stage for hookah cessation.MethodsThis was a validation study on Iranian rural adult hookah smokers by the TTM instrument. First, to translate the questionnaire items from English to Persian, backward-forward procedure was used. Face and content validity of the instrument items were assessed. Confirmatory factor analysis (CFA) was performed to determine the construct validity of the instrument. For this aim, 300 participants completed the instrument. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were calculated to examine the internal consistency and reliability of the subscales of the instrument.FindingsThe content validity index (CVI) and content validity ratio (CVR) of the items were ≥ 0.80 and ≥ 0.60, respectively. Based on CFA, the data fitted the TTM model. root mean square error of approximation (RMSEA), the goodness of fit index (GFI), adjusted GFI, and comparative fit index (CFI) were 0.037, 0.960, 0.910, and 0.950, respectively. At this stage, 6 items were deleted. The ICC and Cronbach's alpha of the subscales ranged between 0.60-0.74 and 0.71-0.86, respectively. The final instrument with 29 items was confirmed.ConclusionThe findings suggest that translating Persian brief version of the TTM instrument was a reliable and valid tool to identify the determinants of hookah smoking cessation among Iranian rural adults.Keywords: Hookah smoking, Transtheoretical model, Scale, Psychometrics, Iran
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Pages 112-122BackgroundIt is not well understood whether the self-reported experience of substance abuse-related problems differs by socioeconomic status.MethodsWe conducted a secondary analysis using the 2013 National Survey on Drug Use and Health (NSDUH) on participants who reported ever using illicit drugs or used illicit drugs in the past year.FindingsAmong those reporting ever using illicit drugs (n = 4701), 71% were Non-Hispanic White, 37% had a family income ≥ $75000, and 3% reported having substance abuse-related problems in the past year. After adjustment for age, race, marital status, and education, individuals in the lowest income group were more likely to report having problems related to their substance abuse compared to individuals in the highest income group [odds ratio (OR) = 1.36, 95% confidence interval (CI): 1.08-1.72] among those who reported ever using illicit drugs. There was no evidence of interaction with race or gender.ConclusionOur findings suggest that poverty may be associated with self-identification of substance abuse-related problems among those who report ever using illicit drugs. Appropriate intervention should be targeted toward the low-income group to address identified substance abuse-related problems.Keywords: Socioeconomic status, Health status disparities, Substance-related disorders
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Pages 123-130BackgroundThe present study was carried out aiming to investigate the effects of opium on some biochemical factors in diabetic and non-diabetic male and female rats.MethodsThis experimental study was carried out on 28 male and 28 female Wistar rats. The animals were divided into diabetic addicted (DA), diabetic non-addicted (DNA), non-diabetic addicted (NDA), and non-diabetic non-addicted (NDNA) groups of male and female. A double dose of opium was intraperitoneally administered to the addicted groups. Peripheral blood samples were collected to measure the creatinine, uric acid, cholesterol, triglycerides (TG), total protein, and albumin levels. Three-way analysis of variance (ANOVA) was used to compare the mean levels of biofactors among the study groups.FindingsCholesterol and total protein were significantly affected by opium and sex, but not diabetes condition, such that there was a decrease of cholesterol and total protein levels in opium-addicted rats compared to non-opium-addicted ones. However, uric acid, TG, albumin, and creatinine were not affected by opium and diabetes conditions.ConclusionOpium significantly decreased cholesterol and total protein levels. It could be deduced that the effects of opium on cholesterol and total protein are not sex-dependent, moreover, opium consumption may not have significant effects on biochemical factors in diabetic conditions.Keywords: Biochemical markers, Cholesterol, Creatinine, Diabetes mellitus, Opium addiction, Total protein
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Pages 131-136BackgroundThere is still no consensus among researchers on the impact of opium dependency on cerebrovascular stenosis. Some studies suggest that opium may be a risk factor for ischemic stroke. This study compared carotid intima-media thickness (CIMT) and cerebrovascular reactivity between opium-dependent and healthy people.MethodsThis case-control study was done among opium addicts at Shafa hospital in Kerman, Iran, in year 2018. People with systemic disease or who took any medicine were excluded from our study. The control group were selected from healthy non-addicted volunteers. The control group was matched in age and sex with the case group. Cerebrovascular reactivity of middle cranial artery and intima-media thickness of carotid artery were measured for all in both groups. The results were analyzed using chi-square, independent samples t, and logistic regression tests.Findings47 opium addicts and 47 healthy people entered this study. 88% of them were men and 12% were women. 68.1% of the case group and 31.9% of the control group were cigarette smokers; this difference was statistically significant. Comparison of cerebrovascular reactivity and CIMT between the two groups was statistically significant (P < 0.001). This relationship remained significant for the CIMT after removing confounding factors (P = 0.018).ConclusionOverall, our findings show that opium dependency affects the carotid intima-media thickness as an indicator of cerebral atherosclerosis.Keywords: Opium, Intima-Media Thickness, Cerebrovascular Diseases, Stroke, Transcranial Doppler Sonography