فهرست مطالب

  • Volume:13 Issue: 1, Winter 2021
  • تاریخ انتشار: 1400/02/06
  • تعداد عناوین: 8
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  • Mehdi Ahmadinejad, Hakimeh Karimi Aliabadi, Mahlagha Dehghan, Parvin Mangolian, Shahrad Tajoddini * Pages 1-8
    Background

    Opium addiction is associated with multiple physical, psychological, and social problems. Theaim of this study was to compare the risk of morbidity and mortality in opium-addicted and non-addictedtrauma patients admitted to the intensive care units (ICUs) of trauma center of Kerman Province, Iran.

    Methods

    In this cohort study, a total of 200 addict and non-addicted patients who were admitted due totrauma in ICUs of Shahid Bahonar Hospital in Kerman during 9 months of 2018 were included. Patients werecompared in terms of mortality, incidence of pressure ulcers, incidence of organ failure, duration of mechanicalventilation, and duration of hospitalization. Data were analysed using Fisher's exact test and independentt-test at P < 0.05.

    Findings

    Out of 197 examined patients, 161 (81.7%) individuals were men and 36 (18.3%) were women.Moreover, 98 (49.7%) patients had a history of opium abuse, while 99 (50.2%) patients had no history of opiumaddiction. The addicted and non-addicted groups had no significant differences in terms of age(P = 0.650) and gender (P = 0.580). In addicted patients, mortality, duration of mechanical ventilation(P = 0.027), the incidence of pressure ulcer, and organ failure were significantly higher (P < 0.001), but meanICU stay and hospitalization time was the same in both groups.

    Conclusion

    The results of this study indicated higher mortality and morbidity in opium-addicted patientsadmitted to ICU than non-addicted ones. This suggests that various systems of the body are affected by opiumand, in certain circumstances such as severe diseases, this will cause problems for patients. Therefore, expertsshould pay attention to complications and side effects of addiction in the management of critical patients witha history of opium abuse.

    Keywords: mortality, Morbidity, Intensive care units, Opioid-related disorders
  • Kesha Baptiste Roberts *, Niya Werts, Kimberly Coleman, Mian Hossain Pages 9-17
    Background

    Religious beliefs can assist with the success of treatment in persons with substance abuseproblems by providing social support, confidence, and hope.

    Methods

    As such, a secondary analysis using 2013 National Survey on Drug Use and Health (NSDUH), of20219 participants with self-identified illicit substance use problems was conducted. Survey was weightedbivariate and multivariate regression analysis was used to adjust for potential confounders.

    Findings

    Approximately, 15.0% of the study sample were between ages of 18-25 years and 71.5% wereNon-Hispanic Black, 11.3% were Non-Hispanic White, and 12.1% were Hispanic. About 10.3% had less than ahigh school education, 28.0% graduated high school, 30.0% had some college education, and 32.0% werecollege graduates. Only 1.3% reported receiving substance abuse treatment in the past 12 months and5.4% perceived a need for substance abuse treatment in the last 12 months. 65.0% reported that religiousbeliefs were an important part of their life and 62.5% reported that their religious beliefs influenced theirdecision making. After adjustment for sociodemographic factors, both the importance of religious beliefs andthe influence of religious beliefs on decision making were associated with increased odds of having treatment[odds ratio (OR) = 1.56, 95% confidence interval (CI): 1.14-2.14 and OR = 1.51, 95% CI: 1.11-2.05, respectively].However, there was no association between the importance of religious beliefs or the influence of religiousbeliefs on decision making and perceived need for substance abuse treatment.

    Conclusion

    These findings suggest that religious beliefs may be an important determinant in receiving treatmentamong substance abusers and also have implications for exploration of faith-based and faith-placed interventions

    Keywords: Religious, Substance-related disorders, treatment
  • Maryam Akhgari *, Fariba Sardari Iravani, Masoud Ghadipasha Pages 18-28
    Background

    Poly drug use is a public health threat causing morbidity and mortality all over the world.Combined use of licit and illicit drugs is among the possible causes of death. In this retrospective analyticalstudy, we evaluated forensic toxicology analysis results from 2011 to 2016 in Tehran province, Iran.

    Methods

    All deaths related to poly drug use and referred to the Legal Medicine Organization, Tehran duringthe 6-year study period were evaluated. Postmortem samples were analyzed to detect alcohols, andprescription and illicit drugs using headspace gas chromatography (HSGC), high performance liquidchromatography (HPLC), and gas chromatography/mass spectrometry (GC/MS) in a forensic toxicologylaboratory. Manner of death, demographic characteristics, and different drug categories in postmortemsamples were analyzed.

    Findings

    A total of 1388 poly drug use-associated deaths were investigated during the 6-year study period.Overall, victims were mostly young men of 20-40 years of age (56.8%). The male to female ratio was 7:16.Methadone (n = 660; 47.6%) and amphetamine type stimulants (ATS) (n = 657; 47.3%) were in the highestcategory for poly drug use-associated deaths. Moreover, in some cases, opium (n = 458; 32.9%), tramadol(n = 389; 28.0%), and tricyclic antidepressants (n = 151; 10.9%) had been used with other drugs.

    Conclusion

    The present study provides information about poly drug use-associated deaths in Tehran andhighlights the major role of substance abuse in death.

    Keywords: Substance-related disorders, Forensic toxicology, Amphetamine, Methadone, public health
  • Parkar Sujal *, Patel Anand, Sharma Abhishek Pages 29-35
    Background

    The purpose of this research was to compare Heaviness of Smoking Index (HSI), high earlysmoking, and heavy smoking with the Fagerstrom Test for Nicotine Dependence (FTND) and further toevaluate the sensitivity of HSI, high early smoking, and heavy smoking among existing smokers.

    Methods

    A cross sectional study was conducted by using FTND questionnaire among 200 existing smokers. Thecut-off point for HSI was kept at 4; high early smokers and heavy smokers were classified as those individualswho smoked within 30 minutes after waking up and individuals who smoked 30 cigarettes or more daily,respectively. Receiver-operating characteristic (ROC) analysis and Cohen's Kappa statistics were evaluated.

    Findings

    A significant agreement was observed between the HSI and the FTND, having Kappa value of 0.70,with good sensitivity of 78.16% and specificity as high as 91.15%. The ROC analysis confirmed that a cut-offscore of 4 for HSI was suitable. Agreement between FTND and high early smoking was observed to be moderate(Kappa = 0.47, P < 0.001), while very low agreement (Kappa = 0.19, P < 0.001) was observed for FTND andheavy smoking.

    Conclusion

    Results show that HSI is an effective tool which can be substituted for the conventional FTND bythe clinicians, psychotherapists, and investigators in health research.

    Keywords: tobacco use disorder, Sensitivity, specificity, Tobacco Smoking, Screening
  • Iman Rad, Arezoo Saberi, Najmeh Sadat Koochakzadeh Nematollahi, Victoria Habibzadeh *, Ehsan Salarkia, Sedigheh Amanollahi, Saeideh Nikpour Pages 36-44
    Background

    There is an increasing concern over acute exposure of amphetamine and its derivative such as3,4-methylenedioxymethamphetamine (MDMA) on male reproductive toxicity. Supplementary vitamins canreduce the oxidative stresses and repair the damages on reproductive organs. This experimental study wasconducted to evaluate the effects of folic acid (FA) on reproductive indices, the antioxidant enzyme activities,and histological changes of testis on adult male rats treated by MDMA.

    Methods

    This experimental study was conducted on adult male Wistar rats. Animals were divided into 4groups: control, MDMA, FA, and MDMA + FA. Animals received a dose of 10 mg/kg of MDMA and 1 mg/kg ofFA for 7 or 14 days. Rats were anesthetized and sperm quality parameters (number, concentration, motility,and morphology), spermatogenesis indices [the mean seminiferous tubule diameter (MSTD), spermiogenesisindex (SI), repopulation index (RI), and tubular differentiation index (TDI)], changes on testicular structure,antioxidant enzyme activities of catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA)beside serum level of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone weremeasured. Data were analyzed, using the one-way analysis of variance (ANOVA) and SPSS software.

    Findings

    MDMA (both 7 and 14 days) caused significant changes in sperm quality (P < 0.001),spermatogenesis indices (P < 0.001), testicular histopathology, and level of LH, FSH, testosterone beside theantioxidant enzyme activities (SOD, CAT, and MDA) (P < 0.001). Supplementation of FA in association withMDMA partially reversed these parameters and made them close to the control group.

    Conclusion

    The results suggested that FA could reduce the adverse effect of MDMA on reproductive ability inadult male rats.

    Keywords: Folic acid, N-Methyl-3, 4-methylenedioxyamphetamine, Spermatozoa, spermatogenesis, Rats
  • Abbas Bakhshipour Rudsari, Alireza Karimpour Vazifehkhorani * Pages 45-51
    Background

    Impulsivity and sensitivity to reward situate at the marrow of pathology of substance usedisorders (SUDs). This study examined the role of impulsivity and sensitivity to reward in dropout of addictiontreatment in heroin addicts.

    Methods

    The participants of this study were 216 heroin addicts. The participants were assigned to three differentgroups including abstinent group (n = 104), relapsed group (n = 45), and dropped out of treatment group(n = 67). The participants completed the semi-structured interview, Carver and White Behavioral InhibitionSystem/Behavioral Activation System (BIS/BAS) questionnaires, and the Delay Discounting Task (DDT).

    Findings

    The delay discounting (DD) and reward-seeking rates were high in relapse and dropout groupscompared to the abstinence group and this difference was significant in P < 0.01 level.

    Conclusion

    People with substance abuse disorders have impulsive behaviors and often prefer immediatereward related to substance use than long-term and greater rewards

    Keywords: Impulsivity behavior, Reward, Heroin addiction, Heroin
  • Ebrahim Balandeh, Abdollah Omidi, Amir Ghaderi * Pages 52-65

    Substance use disorder (SUD) is a prevalent health issue with serious social and personal consequences.SUDs are linked to numerous physical health problems. In the Diagnostic and Statistical Manual of MentalDisorders-5th Edition (DSM-V), the essential characteristic of a SUD is a collection of cognitive, behavioral,and psychological manifestations indicative of the subject’s unbaiting substance use despite experiencingsignificant problems due to continued use. Several alternative interventions have been indicated. Amongthem, mindfulness-based therapies are receiving growing attention. This article reviews evidence for the useof third-wave cognitive-behavioral therapies (CBTs) in addiction treatment. We have reviewed the literaturepublished from 1990 to 2019. Further research is required to better understand the types of mindfulnessbased interventions that work best for specific types of addiction, patients, and situations. Current findingsincreasingly support third-wave CBTs as a promising complementary therapy for the treatment andprevention of addiction

    Keywords: Addiction, Meditation, Mindfulness, Substance-related disorders, Cognitive-behavioral therapy
  • Amin Mahdavi, Maryam Aliramezany * Pages 66-67