فهرست مطالب

High Risk Behaviors & Addiction - Volume:1 Issue: 1, Mar 2012

International Journal of High Risk Behaviors and Addiction
Volume:1 Issue: 1, Mar 2012

  • تاریخ انتشار: 1391/03/20
  • تعداد عناوین: 10
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  • Nour-Mohammad Bakhshani Page 6
  • Kobra Lashkaripour, Elham Torbati Page 7
    Methamphetamine use and dependency is a serious public health problem with implications across multiple areas from societal impact to burden on psychiatric and medical resources (1). Different areas such as East and Southeast Asia, Australia, Middle West and Western areas of United States and some regions of Great Britain are suffering from Methamphetamine use and related problems (2). An estimated 8% of admissions to substance abuse treatment programs are associated to stimulants with Methamphetamine misuse (1). The comparison of demographic characteristics and variety of substances in Methadone maintenance clinic of Baharan Psychiatry Hospital in Zahrdan, Iran in 2009-2011, has reported an increasing proceeding of methamphetamine use from 6% to about 20% (3). The Administrator of Health and Social anti-drug campaign declared that the substance related psychotic symptoms are noticeable among Methamphetamine users, it has also been reported that 50% of patients of psychiatric wards consist of Methamphetamine users psychosis patients, which would bring a number of harmful demerits to this the wards (4). Methamphetamine is a potent form of amphetamine, administrated through different routes such as: inhalation, smoking, intravenous injection and orally (2, 5). The primary effect of Methamphetamines is at the point of the catecholamine release (specially Dopamine), from the presynaptic cells, these effects are stronger among ventral tegmental Dopaminergic neurons connected to the cerebral cortex and limbic system, the activation of this reward pathway may probably lead to amphetamine dependency (5). Craving is the principal cause of drug abuse; Ekhtiari et al. reported that Methamphetamine is a common stimulant substance in Iran, which produce high level of cravings (6). Short term effects of methamphetamine such as initial rush, increased level of energy, appetite and general sense of well-being, would last 6-8 hours. Methamphetamine increases the sex desires and enhances the sexual experience, which is directly related to high risk behaviors including multiple sexual partnership, pregnancy, infectious diseases such as hepatitis and syphilis (7). Restlessness, insomnia, hyperthermia and probably seizures are the side effects of Methamphetamine (2). Addiction, mood disturbance, paranoia, agitation, psychosis, cognitive impairments, poisoning and death are the long-term effects of Methamphetamine (2, 8, 9). In the past few years, the rate of drug poisoning has been increased among the youngsters (10). Methamphetamine abstinence after a long term consumption leads to withdrawal syndrome such as; dysphoric mood, weakness and lethargy, anxiety, nightmare, insomnia, sweating, tension headache and abdominal cramps (6, 11). The withdrawal syndrome will be peaked within 2-4 days and will eliminate after a week and depression associated with suicidal ideation and attempts are the most important symptoms of abstinence (5). The efficiency of pharmacological intervention for treatment of Methamphetamine related disorders is not clear yet (2, 12). Different drugs such as sertraline, bupropion, mirtazapine, Modafinil, Dextroamphetamine, Ondansetron, Risperidone, Aripiprazole, Baclofen, Gabapentin and Nalterxon as a treatment of methamphetamine-related disorders were examined, it has been reported that Aripiperazol is the most common drug used (1, 12).Maintenance therapy for Methamphetamine dependency has been suggested, due to increased rate of methamphetamine dependency, low effectiveness of methamphetamine related drug therapy and the good effects of methadone and buprenorphine maintenance therapy in treatment of opioid dependency. Preliminary studies have shown that Dexamphetamine maintenance therapy increases patients’ retention in treatment program and decrease methamphetamine consumption (2).Consistent with low effectiveness of pharmacological interventions and risky behaviors which increase the risk of Human immunodeficiency virus (HIV) and hepatitis transmission among Methamphetamine abusers, it is expected that further investigations related to Methamphetamine dependency and appropriate treatment approaches for more effective treatment would increase the retention of patients by providing therapeutic protocols, however we should consider that Psychotherapy despite the high relapse rate, is still the main treatment. Further surveys with the use of combination models, will provide beneficial and useful treatments to patients with methamphetamine addiction.
  • Mohsen Kianpoor, Nour-Mohammad Bakhshani Page 9
    Epidemiological studies and clinical findings have shown an association between trauma and dissociation; dissociative experiences are also more prevalent among select populations such as substance dependent individuals and criminal offenders. In the present non-systematic review, we explored the association between trauma, dissociation, and high-risk behavior. We aimed to find if the presence of dissociative symptoms could lead us to better understand and recognize those who are prone to high-risk behaviors, among individuals exposed to psychological trauma.The present overview indicated a substantial relationship between dissociation and high-risk behaviors. We concluded that designing and establishing appropriate studies regarding the relationship between trauma, dissociation, and high-risk behavior would enable health professionals to have a better understanding and recognition of people prone to high-risk behaviors, as well as implement more effective strategies to prevent high-risk behaviors among at-risk populations.
  • Zahra Heidari, Hamidreza Mahmoudzadeh-Sagheb, Farhad Kohan Page 14
    Background
    Opiate abuse is a matter of serious concern in adolescent men. The primary drugs used in the treatment of opiate addiction are methadone and buprenorphine.
    Objectives
    This study was undertaken to determine the quantitative and qualitative changes in rat testes after methadone and buprenorphine administration.
    Materials And Methods
    In this experimental study, 15 male Wistar rats, each weighing 250 ± 15 g, were selected and randomly divided into 3 groups (n = 5). The first group received an intraperitoneal dose of 0.5 mg/kg/day methadone and the second group received an intraperitoneal dose of 30 mg/kg/day buprenorphine for 15 days each. The third group (control) received normal saline injections. After the last injection dose, the rats were sacrificed and their testes were removed, weighed, and fixed in modified Lillie’s solution, and embedded in 3.5% agar, after which 1-mm slices perpendicular to the long axis of the testes were prepared using a tissue slicer. Then, on the basis of Cavaleri’s principle, the testis volume was calculated by point-counting method. For histological analysis, systematic random samples of each testis were selected, processed, and stained by hematoxylin and eosin (H&E) and periodic acid schiff (PAS) methods. The results obtained for the 3 groups were compared using nonparametric Kruskal–Wallis test. P < 0.05 was considered as the level of significance.
    Results
    Stereological analysis of rat testes showed no significant effect of methadone and buprenorphine administration on the testis volume (P > 0.05). However, microscopic studies of rat tissues in the methadone-administered group showed atrophic seminiferous tubules, reduction of sperm stem cells, destruction of Sertoli cells, irregularities in the basement membrane of seminiferous tubules, cellular degeneration of spermatogonia and primary spermatocytes, and significantly fewer spermatozoids than in the control group. Furthermore, in the methadone-administered group, the germinal cells of seminiferous tubules were damaged and extensively detached from the basement membrane and the vessels of the interstitial tissue were congested. Microscopic studies of the buprenorphine-administered group showed no significant changes in the basement membrane, seminiferous tubules, Sertoli cells, interstitial tissue, and sperms.
    Conclusions
    Buprenorphine is more suitable for treating opiate addiction in males since it does not affect normal testicular structure and function.
  • Mansour Karajibani, Farzaneh Montazerifar, Mansour Shakiba Page 18
    Background
    Drug addiction is a lifestyle disease. An assessment of the nutritional state of addicts is often done in parallel to their medical treatment.
    Objectives
    The aim of the present study was to investigate the nutritional status of drug addicts.Patients and
    Methods
    This study was conducted among 54 drug addicts (47 men and 7 women) who sought detoxification treatment at the Central Drug Addiction Treatment Hospital in center of drug dependency treatment (Baharan Hospital) in Zahedan, Iran. Age, body weight, and height were measured. Body mass index (BMI) was calculated by dividing body weight (kg) by the square of the height (m²). The percentile of the BMI indicator dictated the nutritional status in the subjects. The amount of food consumed was determined according to the number of servings consumed in the different food groups and was compared to the recommended allowances given by the Food Guide Pyramid.
    Results
    The mean age, body weight, height, and BMI were 34.4 ± 9.7 years, 63.1 ± 10.1 kg, 171.1 ± 11.6 cm, and 21.8 ± 4.4 kg/m², respectively. According to the percentile status of the BMIs, the results showed that 35.2%, 20.4%, 37%, and 7.4% of subjects were wasting, at risk of wasting, normal, or overweight, respectively. When their intake was compared to the Food Guide Pyramid, 72.2% of the subjects showed a deficiency in the bread and cereal group, 67.2% in vegetables, 57.4% in fruits, 40.7% in milk and dairy products, and 24.1% in the meat group.
    Conclusions
    The present study revealed different degrees of malnutrition among drug addicts with multiple deficiencies in both macro- and micronutrients.
  • Zahra Nikmanesh, Mahdeie Adrom, Nour-Mohammad Bakhshani Page 22
    Background
    Drug abuse causes various societal problems, including decline in public health, increase in mortality, social and domestic traumas, loss of educational and occupational opportunities, increase in involvement with the judicial system, and development of drug abuse cycles. The tendency to use drugs is directly related to the attitudes of the individuals regarding the legality and the scale of social acceptance of drug use, the harm resulting from drug use, or the pleasant consequences of using drugs.
    Objectives
    The aim of the present study is to predict the psychological inclination to drug use in youths by studying their personality traits.Patients and
    Methods
    The research sample included students of the Medical Science University, Zahedan, Iran, with an average age of 19–24 years. Participants were selected by probability proportional cluster random sampling. The instruments were the Addiction Potential Scale (APS (and the Minnesota Multiphasic Personality Inventory (MMPI). The hypotheses were tested using the Pearson correlation method and regression analysis.
    Results
    Addiction potential was positively related to personality characteristics. We found that those with the highest addiction potential (47%) exhibited the following 3 traits: characteristics of schizophrenia, psychological exhaustion, and depression.
    Conclusions
    There were no significant differences in the addiction potential among the students with respect to grade, field of study, age, or gender.
  • Bahram Ali Ghanbari Hashem Abadi, Morad Rasouli Azad, Omid Saed Page 27
    Background
    Diagnosis of nicotine dependence is a common psychiatric disorder. Use of tobacco products, particularly cigarette smoking, is the most widespread form of nicotine use.
    Objectives
    To determine the prevalence of cigarette, water-pipe, and oral tobacco use among students at Ferdowsi University in Iran and to evaluate the associations between socio-demographic characteristics and nicotine use.Patients and
    Methods
    A cross-sectional survey of 1565 students was conducted in December 2009 at Ferdowsi University of Mashhad in Iran. The survey included questions from the substance use section of the Youth Risk Behavior Survey questionnaire. Three manners of prevalent nicotine use were evaluated: cigarette, water-pipe and oral tobacco use. Data were analyzed using χ2 tests and logistic regression analysis.
    Results
    For cigarette use, 17.6% of respondents reported using cigarettes at least once, 3.7% reported using cigarettes occasionally, and 3.9% reported using cigarettes on a regular basis. For water-pipe use, the corresponding percentages were 30.5%, 6.4%, and 4.3%, respectively. Men were more likely than women to report using nicotine at least once (odds ratio 5.46; 95% confidence interval, 3.9–7.60) or regularly (odds ratio 11.267; 95% confidence interval, 6.64 – 19.11). The odds of having used nicotine at least once were higher in students with poor academic performance, very good family income, and a history of cigarette smoking by family members.
    Conclusions
    The prevalence of nicotine use among Ferdowsi University students is lower than the prevalence in the general population of Iran and the prevalence in other countries.
  • Esa Jafari, Mohsen Ahmadi, Ali Mohammadzadeh, Mahmood Najafi Page 34
    Background
    Drug addiction is a complex disorder that incorporates multiple factors including those related to genetics, beliefs, unconscious processes, gender, and temperament as well as developmental, social, economic, and political factors. The present study investigates these factors.
    Objectives
    The aim of this study is to determine the effectiveness of lifestyle training in relapse prevention and resiliency enhancement in people with substance dependency. Patients and
    Methods
    In a semi-experimental study, 26 subjects with a diagnosis of opiate use disorders in the Jameiate Aftab Center of Tehran who had successfully detoxified, were divided into two groups, an experimental group (12 subjects) and a control group (14 subjects). The participants were selected according to available sampling methods. The experimental group underwent 12 sessions of coping skills training while the control group did not receive any treatment. All subjects in the study were assessed by the Conner-Davidson Resiliency Scale (CD-RIS) and a test for morphine before treatment, after treatment, and at a 4-month follow-up stage. Data were analyzed using descriptive methods as well as t-test and ANCOVA analyses.
    Results
    The χ2 test showed that the experimental and control groupssignificantly differed in relapse rates (χ2 = 6.30, df = 1, P < 0.001). In addition, the covariance analysis showed a significant difference between the two groups in resiliency enhancement at post-test (F = 33.76, P < 0.001) and follow-up (F = 37.67, P < 0.001).
    Conclusion
    The results indicate that lifestyle training is effective in resiliency enhancement and relapse prevention for people with substance dependency.
  • Mahvash Raghibi Page 39
    Background
    Iranian communities have experienced substantial changes in recent years. Free time and pleasure-seeking have been transformed, increasing the risk of unhealthy and dangerous behaviors, leading to increases in well-known diseases.
    Objectives
    This study was performed to examine high-risk behavior among students of Zahedan Universities.Patients and
    Methods
    The current study adopted a descriptive survey method. Given the focus on Zahedan universities, the present sample was drawn from the male and female students of the universities of Sistan and Baluchestan, Islamic Azad University, Quran sciences, and Payamm-e-Noor (distance learning). Of those, 361 subjects were selected for participation using stratified random sampling. Data collection consisted of a questionnaire investigating risk behaviors. The content validity of the questionnaire was confirmed by university researchers and lecturers. The Cronbach’s alpha coefficient was α = 0.93, indicating strong reliability. Two methods, descriptive statistics and inferential (deductive) statistics, were used to describe and analyze the data. The indices were based on percentage estimations using single-variable and multi-variable chi-square tests. The present research investigates the epidemic of disorderly behaviors including deliberate violence, unintentional loses and damage, inappropriate diet, lack of physical activities, lack of knowledge concerning dangerous diseases, suicidal thoughts, absence from the dormitory, stealing, smoking (cigarettes or hookah), and alcohol or drug abuse.
    Results
    The research indicates that 45.2% of students sometimes, mostly, or always have an improper diet, 56.5% have no physical activity, 62.3% have experienced unelaboratingdamages and losses, 59.3% of them are not aware of dangerous diseases and the symptoms of infection, and 46.9% have suicidal thoughts. In addition, 15.8% of subjects have been absent without permission from the dormitory or their home, 12.2% have behaved violently on purpose, 15.3% often smoke (cigarette or hookah), 6.9% have committed theft, and 6.4% of the participants are alcohol or drug abusers.
    Conclusions
    These results indicate that the epidemic of risk behavior varies in subjects according to factors including gender, the university where one studies, parents’ occupation and their income, and the number of family members.
  • Masoomeh Shirzaii, Mahmood Sarani Page 44