Addiction & Health
Volume:5 Issue: 3, Summer-Autumn 2013

There are numerous studies and documents regarding the prevalence of smoking in Iran. Thus, to provide suitable information for decision-making and policy-making in this regard, the prevalence of smoking in Iran was evaluated using the meta-analysis of the results of the existing researches. Data were collected by searching the keywords cigarette, smoking, tobacco, and nicotine in English databases, searching their Persian equivalents in Persian Databases, and in non-electronic resources. After studying the titles and texts of collected articles, the repeated and irrelevant cases were excluded. Cases which had the inclusion criteria of this meta-analysis were entered into the Stata software. According to heterogeneity results, random effect model was used to estimate the prevalence of smoking. In initial studies and non-communicable surveillance system, 274992 Iranian adults were studied regarding daily smoking. Among initial studies, smoking prevalence varied from 12.3% to 38.5% in men, and from 0.6% to 9.8% in women. Based on the meta-analysis of initial studies and risk factors of non-communicable disease surveillance system, smoking prevalence was estimated 21.7% and 19.8% in men and 3.6% and 0.94% in women, respectively. Moreover, smoking prevalence in all subjects was estimated 13.9% according to the meta-analysis of the initial study. The findings of this meta-analysis revealed that a significant part of the general population over 15 years of age, and one fifth of Iranian male adults smoke. Thus, concerning causal relationship confirmed between smoking and most diseases, if suitable guidelines are not employed the diseases related to this factor will increase in Iran.

The prevalence of substance use among bodybuilding athletes has been poorly studied in Iran. This study was conducted to examine the prevalence of drug use, especially anabolic steroids, among bodybuilding athletes. This cross-sectional study was conducted in the first half of 2013 among body building athletes referring to gyms located in Kerman, Iran. Five gyms were selected randomly and 380 athletes were invited to complete a self-administered anonymous questionnaire, consecutively. The questionnaire included two parts; baseline characteristics and substance related questions. The prevalence of anabolic steroids was estimated based on three methods; self-report, projective question, and crosswise model. We enrolled 298 male athletes in the final analysis. Mean ± SD age of subjects was 25.9 ± 8.4. The most frequent recent (past 30 days) drug use was waterpipe smoking (45%). The second most frequently used drug was alcohol (26.5%, recent use). Based on self-reports, the prevalence of lifetime anabolic steroid use was calculated to be 24.5%. The corresponding figure based on crosswise method was obtained to be 56.8%. Participants believed that a median of 40% of athletes had used anabolic steroids in their lifetime. The prevalence of anabolic steroid was higher in single and less educated individuals (P < 0.05). The main reason for using anabolic steroids was to increase muscle size. The prevalence of drug use, especially tobacco, alcohol, and anabolic steroids, was high among bodybuilding athletes. We could not rely on self-reports to examine anabolic steroid use.

Cardiovascular disease (CVD) is the main cause of mortality in the world and is normally argued as the third cause of all mortalities. Opium and alcohol every day consumption can cause people to have many health problems. The present study aimed to assess the effect of ethanol and opium consumption on lipid profiles and atherosclerosis in aorta. Twenty four male golden Syrian hamsters were randomly divided into four treatment groups (n = 6): Control, addicted (40 mg/kg), alcohol (6.0 g/kg) and combination of opium and alcohol. All of the hamsters were scarified and their livers were removed immediately and fixed in formalin solution 10%. The plasma levels of the lipid profiles were measured enzymatically. Aorta sections were examined by a pathologist. The amount of the total cholesterol significantly increased in ethanol (P < 0.05) and combination (P < 0.05) groups, while it had a non-significant decrease in opium group. Serum triglyceride significantly increased in ethanol (P < 0.05) and combination (P < 0.001) groups, as well as this parameter increased in opium group but it was not significant. Low density lipoprotein cholesterol (LDL-C) markedly increased in the combination group (P < 0.05). No significant difference was observed in serum LDL-C among other treatment groups. Levels of high density lipoprotein cholesterol had a significant rise only in ethanol group. Change in aorta histology was not significant. The results showed that consumption of opium plus alcohol has harmful effects on lipid profile; however, it had no effect on aorta histology that was maybe due to the short period of the treatment.

Withdrawal syndrome may influence patient''s motivation for participation in addiction treatment programs. Management of the symptoms can improve the success rate of addiction treatment programs. In the present study, we have evaluated the efficiency of an herbal product as adjunct therapy for alleviation of withdrawal syndrome in opium abuse. In the present clinical trial, 81 patients were assigned into case and control groups. The control group was treated with methadone and placebo for 4 weeks. The case group was treated with methadone and powdered dried leaves of Rosmarinus officinalis for the same interval. Occurrence of withdrawal syndrome was compared between groups on days 3, 7, and 14 after beginning of the treatment, and the possible signs and symptoms of withdrawal syndrome were checked. The clinical opioid withdrawal scale (COWS) was used for evaluation of withdrawal syndrome in the patients. Patients in the case group experienced less severe withdrawal syndrome compared to those in the control group; chiefly bone pain, perspiration, and insomnia. The present study showed that rosemary can be used as an optional extra drug for treatment of withdrawal syndrome during treatment programs for opium addiction and possibly addiction to other opioids.

Ischemic stroke is a major cause of mortality and morbidity worldwide. Various studies on the etiology of this disease are in progress. Some studies have suggested that opium abuse may is associated with increased risk of ischemic stroke. The present study aimed to analyze the frequency of opium addiction and to compare cerebrovascular ultrasound patients’ changes to non-addicts. This cross-sectional study was performed on 97 patients with ischemic stroke. The diagnosis was confirmed by imaging and paraclinical studies. All the patients underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. A questionnaire containing demographic data, opium use information [based on the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria], and vascular ultrasound findings were completed for each patient and the results were analyzed using descriptive statistics and chi-square test. In this study 38 patients (39.18%) were addicted to opium and the remaining were non-addicts. Among the addicted patients, 31 patients were male and 7 patients were female, while 26 and 33 patients of non-addicts were male and female, respectively (P < 0.01). Among the risk factors for stroke, smoking was higher in the addicts than non-addicts (P = 0.04). Frequency of vascular stenosis and stenosis location did not show a statistical significant difference between the addicted and non-addicted patients. More than one-third of the patients with stroke were addicted to opium which was higher than general population; although the pattern of stenosis in these patients was similar to the non-addicts.

Considering the need for a better understanding of smoking among the student population and its impact on their mental health and their success, this study was conducted in Kerman Medical Sciences University. This cross-sectional study on 772 students, chosen by random sampling, was conducted in 2007. Subjects were assessed with 28-questionquestionnaires that included demographic questions, questions about smoking, fagerstrom nicotine dependence test, and a general health questionnaire (GHQ). The prevalence of smoking was 15. 8%. Records of failing in high school and conditional failures of a university semester in smokers were significantly higher than non-smokers. The average scores of the mental health questionnaires showed a significant difference between smokers and non-smokers (P < 0.001). Based on the results, 2.35% of smokers and 9.5% of non-smokers had mental illnesses. Since cigarette dependence in teens and youth is significantly high and failures in education and mental health disorders are more common among them, it is necessary that the authorities pay more attention to the social skill training and timely diagnosis of mental disorders.

Child abuse is one of the vulnerabilities that threaten child''s physical and mental health in childhood and is associated with serious short-term and long-term complications. The present study aimed to review the association of parental addiction with types of child abuse in high-school students of Kerman, Iran. In this cross-sectional study, 360 students were recruited and studied through cluster sampling method. Abuse and the related factors were assessed using a standard self-report 48-item questionnaire. Average child abuse among the study subjects was 27.6%. Physical behavior, negligence, and emotional abuse were seen in 9.7%, 23.6%, and 17.9% of the subjects, respectively. Parental addiction had a significant association (P = 0.001) with incidence of all the child abuse domains. Special consideration to families of addicted parents and early identification of child abuse cases may prevent the adverse side effects.

Inattention to symptoms of mental disorders and substance abuse in patients with HIV/AIDS and other at-risk groups, may lead to irreversible damages. The purpose of this study was to compare the psychopathological dimensions in substance abusers with and without HIV/AIDS and healthy matched groups. In a cross-sectional and analytical study, selected samples (by available, consecutive, and objective methods) were 43 HIV-positive substance abusers, 49 HIV negative substance abusers under methadone maintenance therapy (MMT) in the counseling clinic of Behavioral Diseases and Addiction Abandonment, and 45 ordinary individuals. All of them were evaluated by matched confounding variables via Symptom Checklist-90-Revised (SCL-90-R). Results indicated a significant difference between these groups in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), and Positive Symptom Total (PST) (P < 0.001). Two by two the comparison of the three groups from psychopathological dimensions revealed that substance abusers with HIV/AIDS persistently suffer more mental problems in all dimensions compared with healthy individuals (P < 0.05). In addition, in comparison with HIV negative substance abusers, they also suffer more mental problems in other dimensions, including somatization, interpersonal sensitivity, depression, anxiety, phobia, and psychoticism (P < 0.05). Yet, the difference in paranoid ideation, hostility, and obsessive-compulsive cases was insignificant. Two by two, the comparison between healthy individuals and substance abusers without HIV/AIDS showed higher levels of depression and psychoticism in substance abusers (P < 0.05), but no difference in other dimensions. Comorbidity of substance abuse and HIV diagnosis intensify mental disorder symptoms. Moreover, lack of prevention and implementation of appropriate psychological and psychiatric interventions after substance abuse and HIV lead to extended establishment of mental disorder symptoms.

Substance abuse is a social, and health problem in Middle Eastern countries such as Iran. One of its most devastating effects is domestic violence against children. This study examined the association between the history of parental substance abuse, and rate of child abuse in Ahvaz, Iran. This was a case-control study. The study population included all parents with high school children in Ahwaz within the academic year 2012-2013. The sample size was 384 people in two groups; with a history of substance abuse (case group) and no history of substance abuse (control group). Multi-stage cluster random sampling method was used through the Cochran formula. The data collection tools included a Childhood Trauma Questionnaire (CTQ) (Bernstein, 1995), a demographic questionnaire, Duncan Socioeconomic Index (DSI), and a researcher-made questionnaire for the history of substance abuse. For data analysis, statistical indicators such as percentage, mean, standard deviation, t-test, and correlation and regression analysis were used. Data analysis showed that there was a significant positive correlation among parents with a history of substance abuse and domestic violence toward children. Mean and standard deviation of the violence level in families with normal parents were 61.34 ± 16.88, and in families with a history of substance abuse were 98.99 ± 32.07. Therefore, the test results showed that there was a significant difference between normal families and families with history of substance abuse and violence toward children (P < 0.001, t = 8.60). Based on the findings, the history of domestic violence and parental substance abuse (physical and emotional abuse, emotional and physical neglect) had a significant positive correlation with their behavior toward their children. After matching the two groups we found that the most common types of violence against children by their parents were, respectively, emotional violence (r = 58%), physical neglect (r = 54%), emotional neglect (r = 46%), and then physical violence (r = 39%).

Addiction has a long history in Iran and it is one of the social problems that create psychological and social conflicts for addicts and their families. Addiction just like other social deviations affects young who are the most valuable assets of a nation. Recognition of socio-economic factors responsible for addiction can help planning and management of programs to fight against addiction. This cross-sectional study was conducted using a questionnaire on 261 spouses of addicts referring to the detoxification centers of Yazd, Iran who were selected randomly. Their perspectives regarding factors thought to be effective in addiction were examined. Statistical tests included chi-square and Kruskal-Wallis tests. Economic problems, divorce, marital problems, lack of familial supervision, unemployment, psychological and physical problems had a statistically significant relationship with the income of the family (P < 0.05), such that with an increase in income of the family these factors played a lesser significant role in addiction. Control of surrounding factors and increase in self-esteem are two important factors that can help effectively control addiction in the young population. After addiction, though environmental and surrounding factors play a role in preventing return to addiction, their role is reduced.