مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال هجدهم شماره 3 (پیاپی 73، تابستان 1389)

Methadone maintenance therapy is a well-known approach to the treatment of drug use disorders and harm reduction. But the main challenge is retention rate in MMT Through simple random sampling, 155 addicts aged between 18-60 years who referred to drug addiction center of university and underwent MMT were followed for at least one year and up to two and half years. Of the total, 3.9% female, 62% married, 37.4% workers and 27.1% were jobless. 80% had education level of less than diploma, 43.2% abused marijuana, 54.2% abused alcohol and 49.7% were living in rented houses. 60% referred to this center because of economical problems, 15.5% because of legal issues and 67.7% because of family pressure. 31.6% were opium and opium resin addicts, 60% were heroin addicts, 8.4% were crack addicts and 21.9% were IV abusers. 76.8% had at least one high risk behavior. Average dose of methadone was 86.5+35 mg/day. Mean survival time was 80 weeks. Relapse rate was 3.3% in the first month, 13.9% in three months, 23.2% in six months, 31.7% in first year and 41. 7% was a total relapse rate. Survival rate had a direct significant statistical relationship with the age, type of drug and method of use. According to the results of the present study that indicate a survival rate of 68.2% in a year and 58.3% after a year and also considering the results of other studies, we can conclude that MMP could be an effective method in the treatment of opiate drug disorders.

With industrialization of human societies, pollutants like lead have entered in the life cycle, causing harmful effects on body organs. No sufficient studies have been done on the effects of pollutants on behavior. The aim of this study was to investigate possible effects of lead on some measurable behaviors of an animal model. Forty eight male adult mice were divided into 4 groups of 12 each. Lead acetate was added at concentrations of 0, 5, 50, or 500 ppm to the drinking water of the animals for 4 weeks (28 days). On day 29, animals were placed on an Elevated Plus maze (EPM) for 5 min and the time in sec spent was measured on closed arms, open arms and the end 1/3rd of the open arms. Increased time on open arms, particularly the end 1/3rd was considered to reflect an enhanced risk-accepting behavior. In this study, it was shown that lead exposure caused an increased number of entrance (P=0.006) and time spent (P=0.034) by mice on open arms of the EPM. There was a positive correlation between the concentration of lead acetate and those two effects. The present study demonstrated that lead poisoning may decrease normal anxiety in mice and increase risky behavior in this species. Clinical studies on human subjects with risky behavior are strongly suggested in order to find a possible relation between chronic exposures to lead as well as plasma concentration of lead with the extent of this kind of behavior.

Addiction and drug abuse in one of the most important health, social and political problems in the world, especially in developing countries. Nowadays this problem has higher prevalence in young people, and so students of the universities are at risk. The aim of this study was to identify drug abuse prevalence and risk factors in students of Shaheed Sadoughi Medical University, Iran, Yazd This was a descriptive cross sectional study and 534 students were selected through random sampling from different medical sciences colleges. The data was collected by self-designed questionnaire and interview, and then analyzed using SPSS software and chi-square test. Data showed the prevalence of drug abuse in students to be 21.5%, frequency of drug abuse was as follows: Hookah 15.9%, cigarette 24.13%, opium 2.8%. The major risk factors were amusement 47.4% and unemployment 42.98%. It was higher in single males who lived in university dormitories. According to the study results, it is recommended that families and university managers facilitate student's entertainment, marriage and occupation. The high prevalence of smoking hookah which is usually accompanied by use of other drugs should be considered in educational programs.

Improper lifestyle is one of the factors affecting the incidence of chronic diseases. According to the World Health Organization statistics, smoking causes four million deaths annually. Studies show that in 1993, 28.6% men and 3.6% of women older than 15 years in the country were smokers. The most practical stage behavior change model is Transtheoretical model. Therefore, this study used this model. This cross-sectional study was done on 200 smokers or ex- smokers of Khorramabad who had high school diploma or higher educational levels. Cluster sampling was conducted in two stages. Data was collected by a questionnaire whose validity and reliability had been approved. Data was analyzed by using SPSS statistical software 11.5 and descriptive statistics. P level <0.05 was considered as significant. Mean age was 42.5±7.85 years. Regarding stages of change, 39.5% were in pre-contemplation stage, 25.5% in contemplation stage, 12% in preparation stage, 5.5% in action stage and 17.5% were in maintenance stage. Variables that had a significant relationship with stages of change included; years of smoking (p=0.001), complications of smoking (0.000), and age (p=0.04). There was no significant relationship between marital status, education, family and income, and stages of change. In this study, majority of the population under study were in the early stages. It is therefore necessary to provide educational programs and develop strategies for the same. Due to the significant relationship between age and years of smoking and exposure to advanced stages of change, people should be made aware of the problems of smoking earlier so that they can decide as soon as possible about smoking cessation.

Considering high prevalence of addiction, the age range of drug abuse and availability of new synthetic drugs, evaluation of knowledge of adolescents about drugs would be a priority in research.

In this descriptive cross-sectional study, 517 rural high school students were asked to complete a questionnaire and through SPSS soft ware version 13, collected data was analyzed by chi-square and analysis of variance tests.

7.1% of rural families with at least one boy in high school had an addict family member. 70.2% of high school students had had a contact with an addict and 42.5% knew an adolescent addict. Also, 17.5% had been offered drugs and 37.9% of high school students claimed that there was at least one addict in their family or relations.

Considering the frequency of addiction in families and rate of invitation to drug abuse in students, there is a high risk of increment of addiction in high schools and therefore real and urgent need to do an intervention.

University is a position of formal training and learning and students in order to successful in this position should have effective learning. Motivation is key to effective learning. Additional to academic motivation can have the role of prevention in high-risk health behaviors. We examined students motivation in Yazd and communication with academic motivation in high-risk health behavior study. This was a cross-sectional study and the sample size was 720. Analysis of the data, collection tool and standard questionnaire construction was achieved. In this study, 32.4 percent of students enjoyed modest motivation condition. 23.3 percent were smokers and 5.6 percent seemed to have used illicit drugs, 40.6 percent of the students exercised regularly. The findings of this research proved that there is a significant correlation between smoking status, alcohol consumption, physical involvement, high risk sexual behavior, watching movies, non-moral condition of the safety belt and academic motivation (P<0.05) There was a significant correlation between the amount of study hours and academic motivation (P<0.05). In order to promote academic motivation in students, both students and teachers should become more acquainted with workshop models and also, students leisure time activities should be analyzed and they should be attracted towards scientific and community organizations.

Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

Child abuse includes; abuse of the body, mental and sexual abuse or misbehavior against children that leads to damage to the child's heath and comfort. Therefore, the present study was done in order to determine the prevalence of child abuse in opiate addicts referring to addiction withdrawal centers. The cross sectional study included 300 participations (150 addicts and 150 non-addicts) The addicted group comprised of opiate addicts referring to addiction withdrawal centers of Yazd. The non addicted group was selected randomly from healthy people. Data collection was performed via a standard questionnaire. Data assessment was done via statistical analysis (K S) Collected data in the addicted group showed the following results; about 56 percent were child tormentors, 1- 45.3% males, 10.7% females, 2-18.7% uneducated, 3-46% with divorce history in their family and 4-38% child body abuse. The most prevalent type of the body abuse was slapping (24%), mostly because of bad training (26%). Collected data in the no addicted group showed the following results; 42% were child tormentors (26% male and 15.3% female) 23.4% with family divorce history, 30.4% were child body abuse and the most prevalent type of body abuse was slapping (22.79%), mostly because of bad training (33.3%) A direct relationship was observed between child abuse and persons addicted to opiates. Factors playing an important role include; illiteracy, divorce history in the family and history of child abuse in childhood period. Therefore, compilation of rules supporting children, establishment of support and parent education centers can be effective to reduce child persecution.

Because of the progressive nature of addiction in all aspects of life, it influences the health of society individuals and has bad effects on psychological, physical, social, emotional, spiritual and cognitive health. In order to investigate mental health and the quality of life of addicts referring to addiction centers in Golestan province, this research was done. A total of 322 patients were selected from the addiction census centers of the province during 2009 and studied in a descriptive cross-sectional analysis. The data included a questionnaire about demographic characteristics and two questionnaires contained the mental health (MHC) and the quality of life (SF17) variables. Of the total, 52 percent reported their mental health to be somewhat favorable and 17 percent reported favorable. On the other hand, 53 percent reported somewhat favorable quality of life and 8 percent had a desirable quality of life. There was significant relationship between mental health and quality of life. Mental health was significantly related to sex and type of material consumption, while quality of life was significantly related to job and type of material consumed. Many addicts can’t give up addiction and repeatedly refer to centers. But care team members can identify common characteristics, personality traits and support systems for promoting mental health and the quality of addict’s life which facilitate prevention, treatment and rehabilitation.

Addiction as a social, health problem with its specific complications threatens societies. High risk behaviors such as violence, self mutilation, tattooing, shared injections and unprotected sex behaviors are some of the problems in addicts that need to be treated. One of these treatments is methadone therapy. The purpose of this study was to evaluate effectiveness of methadone in prevention or reduction of high risk behaviors in clients of a MMT center of Shaheed Sadoughi University of medical sciences of Yazd. This study was done on 93 clients of a MMT center.Questionnaire for this study included items from MAP and questions about some other risky behaviors. This questionnaire was completed at onset of treatment and 6 months after. Data was analyzed with SPSS software program 89.2% of participants were married and 10.8% were single. 63.5% of them were in the20-40 years age group. Most commonly abused substances were heroin and opium. Before onset of treatment, 37.6% of participants had history of imprisonment, 35.5% had shared injections, 32.3%had had unprotected sex, 22.6%had tattooing and 5.4%had mutilated their own selves. Only 36.6% didn’t have any high risk behavior. These behaviors were more common in heroin users and in the20-40 years age group. After onset of treatment and during 6 month of MMT, 86% of clients didn’t have any risky behavior. Only 14%of them continued to have unsafe sex behaviors Addiction can cause high risk behaviors. Data in this paper suggests that young age, heroin use, low education level and no or inadequate information about addictive substances and their consequences are effective and important factors that cause high risk behaviors. Treatment of addicts with methadone maintenance therapy plays an important role in reduction of risky behaviors. Development of appropriate and more MMT centers are recommended.

Family is the initial nurture environment of a child that affects future behavior. The types of rewards and punishments in the initial stages of life affect future behavior. The aim of this study was to study the relationship between parent child– rearing practices and high risk behavior on basis of Cloninger's scale in Bandarabbas city. The study was a descriptive correlation study. In this study permissiveness, democratic and authority parent child– rearing practices were measured with Bamerind parent child– rearing practices inventory and Cloninger's high risk behavior scale. The population under study included adolescents aged 11-18 years and their parents. A total of 150 subjects were selected randomly. The results of analysis showed that there was a significant correlation between parent child– rearing practices and subscale avoid of pathology in high risk behavior (P value =0.035). The relation between parent child– rearing practices and authority- logical and subscale innovation in high risk behavior was also significant (P=0.022). The relation between subscale authority- logical parent child– rearing practices and subscale social reward in high risk behavior with P value of 0.037 was significant. There is a significant relationship between parent child– rearing practices and helpful, harmful or destructive behavior and therefore parent's role is very important. Parent's knowledge and family trainings for rearing health are very important.

Today, all kinds of people need vehicles for performing their daily activities. The need for use of these vehicles for transportation frequently leads to a high rate of road accidents and it seems that certain people do not have enough ability to use these vehicles. Dangerous behaviors lead to financial and life risking irreparable damages. The aim of the study was to examine the relationship between psychological characteristics (mental health, aggression, type A characteristic) and driving habits. The researchers chose 110 injured men drivers and asked them to complete the Manchester Driving Behavior, Type A Characteristic, Ahvaz Aggressive and Mental Health questionnaires. The data was analyzed by Pearson's Correlation and Regression Analysis. The findings showed that there is a significant relation between psychological characteristics (mental health, aggression, type A characteristic) and driving habits. The regression analysis also foresees the aggressive and mental health of testers’ dangerous driving behavior. Meanwhile, Type A characteristic is not able to foresee driving behaviors. Risky driving is a phenomenon that leads to many irreparable damages for the society and individual. Present study suggests that in order to reduce dangers and probable damages, procurement of driving license procedures should be prolonged and drivers should be regularly assessed psychologically (personal or public). Risky drivers or the attackers who need education or consultation should attend education-consultation programs.

Substance abuse is a chronic phenomenon that affects mental and physical health and results in a lot of social, domestic and economic trauma. The samples included 80 addicts and 80 healthy individuals. The addicts were selected randomly from private and state remedy and rehabilitation centers of Zahedan city. Healthy individuals were matched with addicts in respect to age and sex and also selected randomly. Then, participants were assessed with The Spiritual Intelligence Self‐Report Inventory-24(SISI) and General Health Questionnaire (GHQ). The data was analyzed with Pearson correlation coefficient and t test for independent groups. There were significant differences in SISI scores and GHQ scores. Addicts scored lower in two scales. There was a significant positive correlation between SISI scores and GHQ scores and subscales of GHQ (P< 0.01) in two groups. Substance abuse affects mental and physical health. Individuals with lesser spiritual intelligence levels are more prone to addiction and maybe with higher levels of spiritual intelligence, we can prevent individuals from addiction.