فهرست مطالب

Addiction & Health
Volume:4 Issue: 3, Summer-Autumn 2012

  • تاریخ انتشار: 1391/11/23
  • تعداد عناوین: 11
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  • Hassan Ziaaddini, Mansooreh Nasirian, Nouzar Nakhaee Page 79
    Background
    Since the number of drug users is increasing, applying a method of detoxification with fewer side effects during withdrawal from opioids and greater reliability seems to be necessary. In addition, without maintenance treatment, there will be limited success of treatment. This study aimed to compare success rates of detoxification with sublingual buprenorphine and clonidine and to evaluate addiction relapse in patients using naltrexone in a six-month follow-up.
    Methods
    This double-blind trial was carried out on opioid dependent patients in a psychiatric hospital in Kerman (Iran) during 2007-09. The subjects were randomly selected from individuals who had referred for detoxification. They were allocated to two groups to receive either clonidine (n = 21) or buprenorphine (n = 14). The success rates of the two methods were assessed at the end of the course and patients were discharged while prescribed with 25 mg daily use of naltrexone. They were followed up for six months and the continuous use of naltrexone and relapse of substance abuse were evaluated.
    Findings
    A total number of 35 patients entered the study. Success of detoxification with naltrexone was confirmed in all cases. One person (8.4%) in the clonidine group and no patient in the buprenorphine group had a Clinical Opiate Withdrawal Scale (COWS) score of more than 12 (P > 0.05). The mean levels of objective signs and subjective symptoms of withdrawal and the desire for drug abuse had significant reductions during detoxification period in both groups (P < 0.001). However, the difference in these variables between the two groups was not statistically significant (P > 0.05). Naltrexone was used for an average of one month in 43% and 64% of subjects in the clonidine and buprenorphine groups, respectively. In addition, 62% of patients in the clonidine group and 92.8% of subjects in the buprenorphine group received maintenance treatment. Nevertheless, the mean number of days staying in treatment was not significantly difference between the two groups (P > 0.05).
    Conclusion
    Buprenorphine is as effective as clonidine in controlling withdrawal symptoms. A greater percentage of patients detoxified by buprenorphine received maintenance treatment, but there was not a significant difference in relapse rates between the two methods.
    Keywords: Buprenorphine, Clonidine, Naltrexone, Opioid detoxification, Addiction relapse
  • Shahrzad Mazhari Page 87
    Background
    Although problematic Internet use (PIU) is a growing problem among adolescents, few studies have examined its prevalence among university students in Iran. This study was designed to investigate the prevalence of PIU and its potential risk factors among students at Kerman University of Medical Sciences, Kerman, Iran.
    Methods
    In a cross-sectional study, data was collected from 976 university students. PIU was assessed by the 18-item Problematic Internet Use Questionnaire. In addition, information on demographics and Internet usage pattern was also collected.
    Findings
    A total of 920 students completed the survey (response rate = 94.8%). Of them, 98% were Internet users. Overall, 21% of the students were identified as problematic Internet users. Logistic regression analysis showed that spending more time online, having a history of psychiatric disorders, and using the Internet for chatting and playing games were risk factors for PIU.
    Conclusion
    PIU is a common problem among university students. These results suggest the need for preventive and interventional strategies for this vulnerable group.
    Keywords: Problematic Internet use, University students, Iran
  • Afshin Mansourian, Mohammad Askarzadeh, Mohammad Shabani, Kouros Divsalar Page 95
    Background
    Duration of spinal anesthesia depends on the type of anesthetic agent, dosage and additive materials such as epinephrine, ephedrine and opioid. We compared the duration of spinal anesthesia with lidocaine 5% with or without epinephrine in addict and non-addict patients undergoing inferior limb fracture surgery.
    Methods
    This single blinded randomized clinical trial was performed on 201 males (height ranged 150-180 cm) who referred to the Shahid Bahonar Hospital of Kerman for the inferior limb fracture. Their physical class was matched to the American association standard class 1 and 2, and they were appropriate candidates for the spinal anesthesia. The addict or non-addict groups were each divided into two subgroups. 75 mg of 5% lidocaine was prescribed for one subgroup, and the other subgroup received 75 mg of 5% lidocaine plus 0.2 mg epinephrine. The level of primary anesthesia was elevated to T6. Duration of returning to the 4 primary sensory levels was measured since baseline.
    Findings
    A significant increase in the duration of anesthesia level in both addict and non-addict patients receiving lidocaine plus epinephrine was observed compared to the subgroups receiving lidocaine alone (P < 0.01). Duration of decrease in sensory level in addict subgroups receiving lidocaine or lidocaine plus epinephrine was lower compared to non-addict patients (P < 0.0001). In addict subgroup receiving lidocaine alone, a significant decrease was observed in the time needed for decrease in sensory level (P < 0.01).
    Conclusion
    According to the results of this study, regardless of the anesthetic agent being used, duration of spinal anesthesia was shorter in addict patients compared to non-addict ones. Addition of epinephrine to lidocaine 5% increased the duration of spinal anesthesia in both addict and non-addict patients.
    Keywords: Spinal anesthesia, Addict, Lidocaine, Epinephrine
  • Yasamin Abedini, Bibi Eshrat Zamani, Ali Kheradmand, Ghodratollah Rajabizadeh Page 102
    Background
    Addiction to computer (video) games in adolescents and its relationship with educational progress has recently attracted the attention of rearing and education experts as well as organizations and institutes involved in physical and mental health. The current research attempted to propose a structural model of the relationships between parenting styles, mothers’ occupation status, and addiction to computer games, self-control, and educational progress of secondary school students.
    Methods
    Using multistage cluster random sampling, 500 female and male secondary school students in Kerman (Iran) were selected and studied. The research tools included self-control, parenting styles, and addiction to computer games questionnaires and a self-made questionnaire containing demographic details. The data was analyzed using exploratory factor analysis, Cronbach’s alpha coefficient and route analysis (in LISREL).
    Findings
    We found self-control to have a linking role in the relationship between four parenting styles and educational progress. Mothers’ occupation status was directly and significantly correlated with addiction to computer games. Although four parenting styles directly and significantly affected addiction to computer games, the findings did not support the linking role of addiction to computer games in the relationship between four parenting styles and educational progress.
    Conclusion
    In agreement with previous studies, the current research reflected the impact of four parenting styles on self-control, addiction to computer games, and educational progress of students. Among the parenting styles, authoritative style can affect the severity of addiction to computer games through self-control development. It can thus indirectly influence the educational progress of students. Parents are recommended to use authoritative parenting style to help both self-management and psychological health of their children. The employed mothers are also recommended to have more supervision and control on the degree and type of computer games selected by their children.
    Keywords: Self control, Parenting styles, Addiction to video games, Mother's occupation, Academic achievements
  • Mahin Eslami Shahrbabaki, Ali Akbar Haghdoost, Azadeh Mashaiekhi, Navid Khalili, Zahra Amini Ranjbar, Alireza Ghayomi Page 111
    Background
    Methadone is currently the most frequently used substance in the treatment of short-term and particularly long-term opiate dependence. Patient's beliefs about the adverse effects of methadone on function of organs, especially liver, have widely affected the use of this substance. This study aimed to determine the effects of methadone on liver enzyme levels in patients on methadone maintenance treatment.
    Methods
    In a retrospective study, a total of 94 patients undergoing methadone maintenance therapy were recruited from Shahid Beheshti Hospital (Kerman, Iran). Liver enzyme levels in all patients were tested every six months from the onset of treatment until 24 months. The relations between test results and age, gender, and methadone dose were then evaluated. Data was analyzed using logistic regression with random data plan.
    Findings
    At the 24th month, alanine aminotransferase (ALT) levels in 4 patients (4.3%) and aspartate aminotransferase (AST) levels in 3 patients (3.2%) were above normal. Among 46 patients (50%) who had normal alkaline phosphatase (ALP) levels after 24 months, 26 subjects were younger than 40 and 20 subjects were over 40 years of age. The mean age of subjects with abnormal ALP levels and the mean methadone dose were 39.9 years and 19.55 cc, respectively.
    Conclusion
    The results of this study indicated the significant effect of methadone on ALP levels. These effects can account for cholestatic pattern liver injury (obstruction). Further prospective studies including greater samples of patients with heart and liver complications and encompassing other drugs are required to confirm our findings.
    Keywords: Methadone, Substance abuse, Liver, Alanine aminotransferase, Aspartate aminotransferase, Alkaline phosphatase
  • Mahmood Karimi Mobarake, Ali Nemati, Ali Kheradmand, Ghodratollah Rajabyzadeh Page 117
    Background
    Osteonecrosis is common after taking Temgesic and Norgesic. This study intended to suggest the preferable surgical treatment in osteonecrosis patients who use these drugs.
    Methods
    Twenty tree patients with hip osteonecrosis who were hospitalized in the Kerman hospitals after using Temgesic and Norgesic were followed for about 14 months from 2008 to 2010 (from a minimum of 2 months to a maximum of 2 years). 65% of patients underwent total hip arthroplasty (THA) and core decompression was performed for 35% of them. Patients were compared based on functional scoring of hip before and after surgery.
    Findings
    Duration of drug use was 38 months on average and injection frequency of drug was averagely 3 months. The average functional scoring of hip was 9.1 before operation while it was 16 after surgery (P < 0.001). Recovery rate of patients in THA was very good and in core decompression was good.
    Conclusion
    In treatment of osteonecrosis after taking Temgesic and Norgesic, the THA surgery in comparison with core decompression showed better results and caused significant clinical improvement.
    Keywords: Total hip arthroplasty, Core decompression, Avascular necrosis, Temgesic, Norgesic
  • Vaibhav Gharat, Sunil Nayak, Rajkumar Bansal Page 122
    Background
    The relationship between becoming a smoker and having smoker parents, siblings, and relatives is still uncovered in India. The influences of a smoking role model in a family on smoking habits of individuals are yet to be revealed. This study aimed to understand the relationship of smoking abuse of a person with smoking of their family members.
    Methods
    This community-based cross-sectional study was conducted in the slums of 20 urban health centers (UHCs) of Surat city (India). A pretested semi-structured questionnaire was used to collect data. The data was analyzed using Epi-Info software.
    Findings
    Among 281 smoker participants, 168 (59.8%), 55 (19.6%), 95 (33.8%), and 50 (17.8%) had smoking fathers, grandparents, siblings, and other relatives, respectively. While 131 participants (44.6%) had correct information about the law of banned smoking, 249 participants (88.6%) were in favor of this law. The association of smoking abuse in fathers with smoking abuse in siblings came out to be odds ratio (OR) = 3.75 (95% CI: 2.11-6.63) and grandparents to be odds ratio 16.43 (95% CI: 4.98-54.17), respectively. The association between education and following the law of banned smoking was statistically significant OR = 2.98 (95% CI: 1.43-6.00).
    Conclusion
    Substance abuse in parents, siblings, and other relatives is likely to influence the behavior of the person towards it. Persons living in the same vicinity may also greatly influence the behavior of an individual.
    Keywords: Smoking, Smoker, India
  • Mehdi Dehestani, Morteza Tarkhan, Maryam Abbasi, Zahra Sadat Aghili Page 127
    Background
    Addiction as a biopsychosocial problem has been dramatically increased in our country. Adverse consequences of the addiction in women have been shown to be more than men, which in turn can affect family members’ health and wellbeing. The current study examined the efficacy of stress coping skills training in addicted women referring to an outpatient centre of addiction prevention located in Welfare Organization of Gorgan, Iran.
    Methods
    30 women with low levels of social adjustment measured by Social Adjustment Scale were randomly assigned to coping skills training with detoxification treatments (experimental) or detoxification alone groups. Both groups (N = 15) completed pre-post assessments of Bell’s adjustment Inventory. Experimental group received coping skills training program in ten sessions, each session last 90 minutes.
    Findings
    Social adjustment was considerably improved more in addicted women who followed coping skills training program with detoxification treatment in comparison with the women who was undergone only detoxification treatment.
    Conclusion
    Skills training program can help addicted women to better cope with their adjustment problem and these skills should be integrated into detoxification programs for this population.
    Keywords: Addiction, Detoxification, Stress, Coping skills training, Social adjustment
  • Hasan Khoshakhlagh, Salar Faramarzi Page 133
    Background
    This study aimed to evaluate the relationship between emotional intelligence and mental disorders, with internet addiction in university students.
    Methods
    The method of study was descriptive-pilot one and correlation. Two hundred internet users (male and female) from Isfahan University and Isfahan University of Technology were randomly selected. For data collection، Carson's emotional intelligence Questionnaire، SCL-90 scale and Internet Addiction Test were used. Data analysis was implemented using multivariate regression statistical method.
    Findings
    The results showed that, anxiety, obsessive-compulsive, aggression, phobia, hypochondria disorders, and emotional intelligence were the most significant predictors of Internet addiction. Moreover, there were significant correlations between these variables and Internet addiction disorder (P < 0. 001). Moreover، the findings showed that there were significant associations between depressive (R = 0. 33), summarization (R = 0. 24), and interpersonal sensitivity (R = 0. 20) disorders. In this study no correlation was found between internet addiction disorder with psychosis and paranoid ideation. Moreover, among mental disorders, there was only a significant difference between the sexes in depression (P < 0. 001); the men showed more depressive tendencies than women.
    Conclusion
    Therefore, the results showed a correlation between emotional intelligence and mental disorders with internet addiction, but these results can help therapists, psychologists and counselors in providing services to help internet addicts
    Keywords: Mental disorders, Internet addiction, Emotional intelligence, Depression, Anxiety
  • Suraj Multani, Jaddu Jyothirmai Reddy, Nagesh Bhat, Ashish Sharma Page 142
    Background
    Tobacco is the most important preventable cause of disease burden and death all over the world. Apart from being the single most important determinant of cancer and cardiovascular diseases, smoking is also a threat to oral health. The Global Youth Tobacco Survey (GYTS) as a part of Global Tobacco Surveillance System (GTSS) was developed to monitor tobacco use, elicit attitudes about tobacco, and obtain information on exposure to tobacco smoke among youth. This study aimed to assess the prevalence, knowledge, attitude, behaviour and interpersonal factors related to the use of tobacco among youth of Udaipur city, Rajasthan, India.
    Methods
    This study was conducted among 1031, 15 to 25 year old youths studying in the different colleges of Udaipur city, Rajasthan, India. The Global Youth Tobacco Survey (GYTS) core questionnaire was used. Simple descriptive statistics were used for the data.
    Findings
    Out of the total 1031 participants (mean age: 19.55 ± 1.35), 632 (61.2%) were male (mean age: 19.66 ± 1.36) and 399 (38.7%) were female (mean age: 19.35 ± 1.35). 493 (47.8%) were current tobacco users, the majority of which were male 411 (39.8%). 122 (11.8%) had a previous history of tobacco use, while 416 (40.3%) reported that they had never used tobacco in any form. The majority of the male participants, 305 (29.5%), were consuming tobacco daily. Majority of current, 152 (30.8%), and ever tobacco users, 122 (41.8%), smoke and chew gutkha at places of entertainment followed by smoking or chewing at school/college premises. The majority of them bought gutkha themselves, 292 (47.4%). Moreover, the majority of current tobacco users, 298 (72.5%) male and 82 (100%) female, wanted to stop smoking /gutkha chewing.
    Conclusion
    The present study indicates that there is a high prevalence of use of tobacco among youth of Udaipur city, Rajasthan, India.
    Keywords: Knowledge, Attitude, Smoking
  • Ali Reza Moradi, Abbas Emdadi, Bahram Soori, Ehsan Mostafavi Page 151
    Background
    Injecting drug users (IDUs) and prisoners are considered to be highly vulnerable to human immunodeficiency virus (HIV) infection in Iran. This study was carried out to determine the prevalence of HIV infection among IDUs released from jail in Bahar (Hamadan, Iran).
    Methods
    In a cross-sectional study, 118 IDUs who were prisoners during 2001-07 were evaluated. Their demographic and personal characteristics were assessed by a questionnaire. In order to determine HIV-positive individuals, blood samples were obtained from the participants and tested by enzyme-linked immunosorbent assay and Western blot technique.
    Findings
    Overall, 20.3% of the subjects had used non-sterile injecting equipment during their imprisonment. The prevalence of HIV infection among the studied population was 4.2%.
    Conclusion
    As the prevalence of HIV among IDUs released from jail is high, it is necessary for prison authorities to take measures against the increase in the prevalence of HIV among this group.
    Keywords: Injection drug users, Acquired immunodeficiency syndrome, Human immunodeficiency virus, Bahar (Iran)