فهرست مطالب

Addiction & Health
Volume:13 Issue: 3, Summer 2021

  • تاریخ انتشار: 1400/08/16
  • تعداد عناوین: 8
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  • Maryam Eslami Jahromi, Sareh Keshvardoost, Roghayeh Ershad Sarabi *, Kambiz Bahaadinbeigy Pages 138-147
    Background

    The purpose of this study was to investigate the information needs of addicts from the perspective of addicts. By identifying the experiences of the individuals involved in addiction and assessing the information they need, targeted educational interventions can be provided to meet their needs.

    Methods

    Semi-structured interviews were conducted with 13 addicts in two addiction outpatient clinics. Data were analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman.

    Findings

    The information needs of the interviewees included recognizing types of addictive substances and the degree of dependence on them, awareness of the physical and psychological symptoms of addiction to various addictive substances, awareness of various pharmacological and non-pharmacological treatments, physical and psychological symptoms of quitting addiction, awareness of the length of treatment, knowledge about the dose and degree of dependence on drugs, recognizing the causes of failure in quitting addiction, awareness of governmental and non-governmental services, and awareness of the psychological measures and care services necessary after quitting addiction.

    Conclusion

    The results of the study showed that the knowledge and awareness of addicted individuals in various fields of addiction is low and it is necessary to provide education based on the information needs of these individuals. This requires the cooperation and efforts of policy makers, the Ministry of Education, welfare managers, and specialists in camps and addiction treatment centers. Specialists in addiction treatment clinics can use the information needs of addicts determined in this study to enrich the education of addicts.

    Keywords: Information needs, Addiction, qualitative research, awareness, Substance-related disorders
  • Rizwana Quraishi *, Siddharth Sarkar, Raka Jain Pages 148-155
    Background

    Assessment of biochemical parameters can help in the comprehensive management of patients with substance use disorders (SUDs). The aim of this study was to analyse the biochemical parameters of patients with alcohol and opioid dependence at an addiction treatment facility.

    Methods

    This retrospective study analysed the investigation reports of male patients (aged 18 to 70 years) who visited outpatient department (OPD) with primary diagnosis as opioid dependence syndrome (ODS) or alcohol dependence syndrome (ADS). The data included liver function tests (LFTs), kidney function tests (KFTs), and electrolyte tests conducted in the laboratory in a span of one year.

    Findings

    The study included 713 ADS, 654 ODS, and 227 controls. The ADS group showed significant elevations in mean values of bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and gamma-glutamyl transferase (GGT) as compared to other groups. A significant decrease in albumin levels in ADS group and raised potassium levels in ODS group was observed. De Ritis ratio above threshold (AST/ALT > 2.0) alone and along with raised GGT levels was observed among 11.3% and 9.7% of patients with ADS, respectively (P < 0.001). Electrolyte abnormalities were present in about 20% of patients with ADS and ODS as compared to 8.4% among controls (P < 0.001).

    Conclusion

    LFT and electrolyte abnormalities are frequently observed in patients with alcohol and opioid dependence. De Ritis ratio along with raised GGT levels significantly denotes ADS group. These results merit attention in the course of clinical care of alcohol and opioid-dependent patients.

    Keywords: Opioid, Electrolytes, Kidney, Liver
  • Amir Hossein Nekouei, Sina Kakooei, Hamid Najafipour, Shahla Kakoei * Pages 156-161
    Background

    Promoting oral health is a complicated issue among drug abusers and opium is the most frequent drug abused in Iran. This study aims to find the oral health determinants of opium users in Kerman, Iran.

    Methods

    This cross-sectional study was a part of the second phase of Kerman coronary artery disease risk factors study (KERCADRS, 2014-2018). In this survey, the data of 1140 opium users were analyzed. The information about using a toothbrush, dental floss, number of dental visits at last year, age of first use of opium, duration, and opium consumption frequency was recorded. The total number of decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) was recorded by an oral examination. Poisson and logistic regressions analyses were used for assessing the relationship among variables.

    Findings

    The mean age of participants was 52 ± 12 years. 74.4% were men and 24.6% were women. The average DMFT index was 15.7 ± 7.6 and the prevalence of a healthy CPI score was 18.5%. Educational level (P < 0.001), brushing (P < 0.001), flossing (P < 0.001), dental visit (P < 0.001), first age of using opium (P < 0.001), frequency of consumption (P < 0.001), and age (P < 0.001) were associated with DMFT index. Only using floss (P < 0.001), dental visit [odds ratio (OR) = 1.80, P = 0.030], frequency of consumption (OR = 2.92, P < 0.001), and age (P = 0.001) were associated with CPI score.

    Conclusion

    The frequency of opium consumption has the same effect on caries incidence as oral hygiene habits. Moreover, using dental floss has a more significant effect on the periodontal health of participants.

    Keywords: Oral Health, Opium dependence, Oral hygiene, Addictive behavior
  • Hamid Ahmadian Moghadam, Mitra Sadat Sadat Shirazi, Somaiyeh Azmoun, Reza Vafadoost, Solmaz Khalifeh, MohammadReza Zarrindast * Pages 165-175
    Background

    Tramadol induces its unique effects through opioid pathways, but the exact mechanism is not known. The study aims to evaluate changes in the level of mu-opioid receptor (μOR), delta-opioid receptor (δOR), and phosphorylated cyclic adenosine monophosphate (cAMP) response element-binding protein (p-CREB) in the hippocampus (HPC) and amygdala (AL) areas of tramadol-treated rats.

    Methods

    For this purpose, a total of 36 male rats were divided into two main groups for chronic or acute tramadol exposure. The animals were then exposed to 5 mg.kg-1 of tramadol, 10 mg.kg-1 of tramadol, and normal saline. The HPC and AL areas of the animals were dissected upon completion of the period. The levels of p-CREB and μOR were quantified using the western blotting technique. The data were subjected to analysis of variance (ANOVA) followed by Tukey’s post-hoc analysis. The differences with the P-value lower than 0.05 were considered as significant.

    Findings

    In the HPC and AL areas of the brain, the level of μOR was decreased by acute tramadol exposure, while no significant difference was observed by chronic tramadol exposure. Moreover, results showed that the level of p-CREB dose-dependently increased by acute and chronic tramadol exposure.

    Conclusion

    HPC and AL are essential in the control of tramadol abuse. Tramadol abuse affects gene expression and transcription factors such as CREB. With acute drug tramadol treatments, the level of cAMP response element-binding protein (CREB) rapidly increases, while by chronic tramadol treatment, “peak and trough pattern is observing”. The activation of the rewarding mechanism is a precise instance of addictive behavior in tramadol-treated individuals.

    Keywords: Tramadol, Hippocampus, Amygdala, Cyclic adenosine monophosphate response element-binding protein A, Opioid receptor
  • Ali Talaei, Fahimeh Afzaljavan *, Shabnam Niroumand, Raheleh Nejati Pages 176-184
    Background

    Respiratory disorders during sleep are considered a health problem affecting the life quality. There is some evidence indicating the higher prevalence of apnea in substance-dependent patients. However, there is no information on the prevalence of the disease in people under methadone maintenance therapy (MMT). Therefore, the present study was designed to estimate the disease rate in these patients and consider the relationship of the increasing risk of apnea with some psychiatric problems.

    Methods

    Study group included 152 individuals under the MMT program. Baseline data were collected with the interview, and patients were considered using the STOP-BANG questionnaire to evaluate the risk of apnea. Furthermore, Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HDRS) tests were performed for all participants. Data were analyzed using SPSS software.

    Findings

    Based on the STOP-BANG score categories, 37.5%, 40.1%, and 22.4% of patients indicated low, intermediate, and high risk of apnea, respectively. Moreover, severe daytime sleepiness, fatigue, depression, and anxiety were observed in 5.3%, 5.5%, 6.0%, and 21.1% of participants, respectively. Sex (P = 0.007) and daytime sleepiness (P = 0.048) were significantly different between low and high-risk groups of apnea after adjustment. Besides, age (P < 0.001) and fatigue (P = 0.007) were factors predicting the STOP-BANG score.

    Conclusion

    These findings revealed the higher prevalence of apnea in MMT patients compared to the general population of Iran and rising of the risk of apnea along with an increase in age and fatigue score. However, attention to the sleep disorders in MMT is a prominent factor that should be considered as a route of therapy.

    Keywords: Respiration disorders, Apnea, Opiate substitution treatment, Substance-related disorders
  • Khishigtogtokh Dashpuntsag, Unurtsetseg Chandaga, Nyamsuren Tserennadmid, Udvaltsesteg Bat-Ochir, Yerkyebulan Mukhtar, Gan Erdene Altankhuyag, Nadmidtseren Gombodorj, Oyunbileg Dulamsuren, Myadagmaa Jaalkhorol * Pages 185-195
    Background

    This study aimed to examine alcohol consumption among Mongolian adolescents and youth, as well as their awareness and attitudes toward alcohol-related consequences.

    Methods

    We analyzed cross-sectional data collected from students in secondary schools, colleges, and universities in Ulaanbaatar, Mongolia, using descriptive analysis methods.

    Findings

    More than half of respondents had tried alcohol in the past, and 15.9% of high school students and 58.8% of university students had consumed alcohol in the last month (P = 0.0001). In total, 70.0% of respondents celebrated holidays with alcohol, 23.4% had economic problems due to alcohol consumption, 7.8% had health problems 1-2 times in the last 30 days, and roughly 36.0% had negative attitudes toward alcohol. Approximately, 15.0% of adolescents and young people had an insufficient understanding of anti-alcohol measures and laws.

    Conclusion

    Our findings suggest that Mongolian adolescents and youth have a high level of alcohol consumption and insufficient awareness and attitude regarding alcohol-related harm.

    Keywords: alcohol drinking, Attitude, Knowledge, awareness, Adolescent
  • Bijaya Nanda Naik, Sanjay Pandey *, Chandramani Singh, Santosh Kumar Nirala, Purusottam Kumar, Manisha Verma Pages 194-204
    Background

    COVID-19 presented an unprecedented situation in which behavioural factors including tobacco use were believed to increase the risk of morbidity and mortality. The objective of the present study was to find the tobacco use pattern among the COVID-19 patients and the perceived risk of developing severe COVID-19 following tobacco use.

    Methods

    This hospital-based, cross-sectional, analytical study was conducted among 300 COVID-19 patients at the All India Institute of Medical Sciences (AIIMS), Patna, India, during November and December 2020 using a semi-structured, pretested questionnaire. Descriptive and univariate analyses were performed using statistical software and the results were presented as proportion and percentage.

    Findings

    About 27% and 16% of the COVID-19 patients were ever and current tobacco users, respectively. Quit attempts were found to have increased during the COVID-19 pandemic. A majority (65%) of current tobacco users had reduced their amount of tobacco use. Nearly 2 in every 3 patients perceived high risk of developing severe COVID-19 following tobacco use. Perceived risk was significantly higher among tobacco non-users, patients who were aware of the ill health effects of tobacco use, and patients who had noticed anti-tobacco messages or had been advised to quit tobacco. Among the current tobacco users, a significantly higher proportion of patients who perceived high risk of developing severe COVID-19 following tobacco use had made quit attempts or had reduced tobacco consumption during the pandemic (76.7% vs. 40%; P = 0.032).

    Conclusion

    A high proportion of COVID-19 patients believed that tobacco use aggravated the COVID-19 condition. Increased quit attempts and reduction in tobacco consumption during this pandemic is a positive sign for tobacco control

    Keywords: Tobacco use cessation, COVID-19, Health risk appraisal, Pandemics
  • Abedin Iranpour * Page 205