فهرست مطالب

Addiction & Health - Volume:9 Issue: 2, Spring 2017
  • Volume:9 Issue: 2, Spring 2017
  • تاریخ انتشار: 1396/03/18
  • تعداد عناوین: 8
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  • Shahin Fakhrzadegan, Hossein Gholami-Doon, Bagher Shamloo, Solmaz Shokouhi-Moqhaddam Pages 64-71
    Background
    Prisoners are a vulnerable group within societies, and also threaten society due to their dangerous behavior. The objective of the present study was to evaluate the relationship between prisoners’ personality disorders and their crime and substance use.
    Methods
    This was a descriptive-correlational study. The statistical population consisted of all prisoners of Kerman, Iran. Through stratified random sampling, 228 prisoners (114 women and 114 men) were selected as the study subjects. Data were collected through clinical interviews by a psychiatrist [structured interviews based on the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV)], a social worker, and a physician and using a demographic characteristics questionnaire and the Millon Clinical Multiaxial Inventory-2th Edition (MCMI-II) (the 175-item Persian version). Data were analyzed using frequency, percentage, and Fisher's z-distribution in SPSS software.
    Findings: The results showed that 87.3% of women and 83.3% of men had a personality disorder at the time of committing the crime. Moreover, 46.5% of the target population had developed substance dependence at the time of committing the crime. The highest percentage of substance abuse in both women and men was related to opium, especially in the age group of 18-28 years. The highest rates of mental disorders were related to major depressive disorder (MDD), dependent personality disorder (DPD), borderline personality disorder (BPD), and antisocial personality disorder (ASPD), respectively. In these personality disorders, opium, methamphetamine, heroin, and alcohol, respectively, had the highest rates of use. The results of Fisher's z-distribution illustrated a significant relationship between personality disorders and type of crime committed and substance used. The total rate of substance abuse was lower in sexual offenses and fraud, but was the highest in theft and drug trafficking.
    Conclusion
    The presence of personality disorders in the target population is indicative of the need for judicial officials’ attention to this effective factor in crime and the use of mental health services and treatment instead of the penalty of deprivation of liberty.
    Keywords: Personality disorder, Crime, Drugs, Prisoners
  • Mina Danaei, Akram Jabbarinejad-Kermani, Elham Mohebbi, Mohsen Momeni Pages 72-80
    Background
    Waterpipe smoking is a growing public health threat worldwide. The aim of this study was to assess waterpipe smoking prevalence and its associated factors among Iranian adults.
    Methods
    This cross-sectional study was conducted in Kerman, Iran, recruiting 1090 adult participants using multistage sampling in 2016. A self-reported researcher-designed questionnaire was used. The socio-demographic characteristics and waterpipe smoking behaviors such as pattern, duration, and the most common place of waterpipe use, the type of tobacco, and the concurrent use of alcohol and substances were assessed. Data analyses were performed using chi-square, independent t-test, and multiple logistic regression.
    Findings: The prevalence of ever, current and daily waterpipe smoking were 43.8%, 28.8%, and 7.2%, respectively. Men initiated to use waterpipe in more early ages than women (P
    Conclusion
    The present study revealed that men, high level of education, younger age and unemployment were associated with waterpipe smoking. Therefore, we need to design and implement more effective interventions, especially for vulnerable target groups.
    Keywords: Waterpipe smoking, Prevalence, Risk factors, Behavior
  • Sirus Pourkhajoei, Mohsen Barouni, Alireza Noroozi, Ahmad Hajebi, Saeed Amini, Mohammad Karamouzian, Hamid Sharifi Pages 81-87
    Background
    Acquired immune deficiency syndrome (AIDS) is one of the greatest social health problems in many communities in the twenty-first century. Methadone maintenance treatment (MMT) could decrease HIV infection among injection drug users (IDU). The main aim of this paper was to determine the cost-effectiveness of the governmental MMT program to prevent human immunodeficiency virus (HIV) infection among IDU.
    Methods
    This analytical study was performed through a before-after assessment during a one-year period. Using census sampling, 251 IDU referred to the public MMT program of Kerman, Iran, were selected. The expenditures of MMT centers were calculated in the view of government (public sector). The cost-effectiveness was calculated using TreeAge software.
    Findings: MMT centers averted 86 new cases of HIV infection. The total cost of centers was US$471 per client in the year. The share of IDU from current expenditures was 35% and from capital expenditures was 32%. Also, methadone per capita for each person who injected drug was US$514. Per capita expenditure of HIV drug treatment was estimated US$8535 per year. Incremental cost effectiveness ratio (ICER) was US$2856 per year, which means governmental MMT program is cost-effective according to the World Health Organization (WHO) criteria.
    Conclusion
    MMT centers are cost-effective in preventing HIV infection and the access to this program should be facilitated for IDU.
    Keywords: Cost-benefit analysis, Methadone, Maintenance, Therapeutics, HIV
  • Ghodratolah Rajabizadeh, Fatemeh Yazdanpanah, Mohammad Arash Ramezani Pages 88-95
    Background
    The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT).
    Methods
    The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method.
    Findings: The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model.
    Conclusion
    Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them.
    Keywords: Sexual dysfunction, Methadone, Addiction, Sexual self-concept
  • Sahar Rismantab-Sani, Babak Soltani, Siamak Soltani, Azadeh Memarian Pages 96-102
    Background
    Studies have shown that Iran has a high rate of opiate abuse and the most prevalently used is opium. This study was aimed to evaluate risk factors in patients with acute opium intoxication who referred to Loghman Hakim Hospital, Tehran, Iran, in 2011.
    Methods
    A total number of 383 patients with acute opium overdose, who were referred to the Emergency Department of Loghman Hakim Hospital in Tehran during 2011, were enrolled into this descriptive, cross-sectional study. Clinical data including level of consciousness, vital signs, mode of consumption, medical management, and laboratory results were recorded. Independent t-test was used to analyze the results.
    Findings: Level of consciousness at admission was lower in patients who expired compared to survivors (P = 0.020). Respiratory depression and tachycardia were both more common among patients who expired compared to survivors (P = 0.001). Increase in urea, creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), and serum glutamic pyruvic transaminase (SGPT) was more common among patients who died compared to survivors and the relationships between death due to opium poisoning and increase in these factors were all statistically significant (P ≤ 0.001).
    Conclusion
    The findings of this study clarify the importance of clinical and laboratory findings of patients with opium poisoning in predicting their outcome, although further studies in this context are appreciated.
    Keywords: Opium, Poisoning, Mortality, Iran
  • Rosanna Mozafarinia, Mehrdad Assarian, Ahmad Ziaaddini Pages 103-109
    Background
    The present study aimed to evaluate the prevalence of substance abuse among students of selected schools of Tehran University of Medical Sciences, Iran.
    Methods
    This was a cross-sectional study among students in five schools of Tehran University of Medical Sciences in 2014. Data collection was conducted using a questionnaire which was designed by the researcher. Questionnaires were distributed among participants selected using stratified random sampling. A total of 422 questionnaires were filled and analyzed.
    Findings: In total, 422 students aged 19 to 32 years participated in this study among which 233 were women (55.2%) and 187 were men (44.3%). The highest prevalence belonged to smoking (26.3%), alcohol (19.9%), and hookah (14.9%) use, respectively. The results showed that 311 participants (73.7%) had never smoked a cigarette, 111 (26.3%) had smoked at least once, and 84 students (19.9%) had consumed alcoholic drinks at least once in their lifetime. There was no meaningful difference in smoking and alcohol use in terms of students’ gender. Mother’s educational level (P = 0.006) and financial income (P = 0.049) had significant effect on alcohol consumption.
    Conclusion
    In this study, it was found that gender differences have reduced in cigarette smoking and alcohol consumption as seen in western countries, which should be taken into consideration. The prevalence of alcohol consumption was found to be higher compared to other similar studies conducted in Iran which is noticeable.
    Keywords: Students, Substance abuse, Prevalence, Iran
  • Firoozeh Alavian, Saeedeh Ghiasvand, Hedayat Sahraei, Maryam Rafiei-Rad Pages 110-117
    Background
    The amygdala is one of the nerve centers involved in drug reward. It is suggested that the central nucleus of the amygdala (CeA) is involved in morphine dependency. The CeA gamma-aminobutyric acid-ergic (GABAergic) system is a mediator of morphine rewarding effects. In this research, the effects of stimulation or inhibition of CeA GABA type B (GABAB) receptors on sensitization acquisition to morphine-induced reward was evaluated in Wistar female rats using conditioned place preferential (CPP) method.
    Methods
    Wistar female rats provided by Shahid Beheshti University, Tehran, Iran, were allocated into 17 groups including 7 groups of determining morphine dose-response, 2 groups of sensitivity and control, and 8 groups of different doses of agonists and antagonists in the acquisition stage (n = 7 in each group). Various quantities of morphine (0.5, 1, 2.5, 5, 7.5, 10 mg/kg of animal weight) were used to determine the effective and neutral doses of morphine. After 5 days from the start of the surgery, sensitization was induced. After the end of the sensitization period, CPP was conducted. Baclofen and CGP35348, as an agonist and antagonist of GABAB respectively, with the dose of 1.5, 6 and 12 μg/rat were inserted to the CeA, ten minutes before taking morphine.
    Findings: Administration of baclofen had no significant effect on the acquisition of morphine sensitization. In contrast, injection of CGP35348 reduced the sensitivity to morphine.
    Conclusion
    GABA receptors can be effective in reducing morphine tendency by specific receptors, so these sites can be important therapeutic targets in counteracting the effects of drug abuse.
    Keywords: Morphine, Baclofen, Rats, Amygdala
  • Nader Navabi, Afshin Asadi, Nouzar Nakhaee Pages 118-119