فهرست مطالب

Addiction & Health - Volume:7 Issue: 1, Winter-Spring 2015

Addiction & Health
Volume:7 Issue: 1, Winter-Spring 2015

  • تاریخ انتشار: 1393/12/04
  • تعداد عناوین: 10
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  • Gholamreza Asadikaram*, Somayeh Igder, Zahra Jamali, Nader Shahrokhi, Hamid Najafipour, Mostafa Shokoohi, Abdollah Jafarzadeh, Mohammad Kazemi, Arababadi Page 1
    Background
    The risk of infectious, autoimmune and immunodeficiency diseases and cancers rise in opioid addicts due to changes in innate and acquired immune responses. Three types of opioid receptors (К،δ،μ) are expressed on the surface of lymphocytes and mononuclear phagocytes. The present study was designed to examine the effects of different concentrations of opium on the secretion of some cytokines produced by lymphocyte cells.
    Methods
    Jurkat cells were exposed to different concentrations of opium for periods of 6, 24 and 72 h in cell culture medium. The amount of interleukin-6 (IL-6), interferon-γ (IFN-γ) and transforming growth factor-b (TGF-β) were then measured using enzyme-linked immunosorbent assay (ELISA) method.
    Findings
    The results showed that opium increases the secretion of IL-6 in different concentration of opium in 6 h. The amount of IFN-γ decreased in 6 h and increased in 24 h significantly compared with control. On the other hand, opium had an inhibitory effect on the TGF-β secretion in 6, 24 and 72 h.
    Conclusion
    Overall, the study showed that opium stimulates pro-inflammatory and suppressed anti-inflammatory cytokine secretion in Jurkat cells. This may account for the negative effect of opium on the immune system leading to chronic inflammation and a base for many disorders in opium addicts.
    Keywords: Opium, Jurkat Cell, Interferon, γ Interleukin 6, transforming Growth Factor Beta
  • Hamid Reza Morteza, Bagi, Mohsen Amjadi, Reyhaneh Mirzaii, Sousefidi* Page 2
    Background
    Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen plus a low dose of morphine with a full dose of morphine in renal colic.
    Methods
    In present randomized clinical trial, 100 patients with confirmed renal colic were recruited from the emergency ward of Imam Reza Teaching Hospital affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, during a one-year period. These patients randomly received either intravenous acetaminophen (Apotel, 1 g) plus a low dose of morphine (n = 50), or a high dose of morphine (5 mg) (n = 50). Visual analogue scale was used for reporting pain during 35 minutes. Side effects and rescue analgesic demand were recorded after 30 minutes.
    Findings
    The two groups were matched for the patients'' age and gender. Intra-group analysis showed significant gradual decreases in pain intensity after 35 minutes for both groups. Inter-group analysis, however, did not show a significant difference between the two groups in this regard. There was no significant difference between the two groups in terms of side effects. The rate of rescue analgesic demand was 36% in the first and 40% in the second group (P = 0.68).
    Conclusion
    According to the results study, Apotel plus a low dose of morphine is at least as effective and safe as a full dose of morphine in patients with renal colic.
    Keywords: Renal colic, Intravenous acetaminophen, Morphineý
  • Armita Shahesmaeili Ý, Ali Akbar Haghdoost Ý, Hamid Soori Ý* Page 3
    Background
    Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models.
    Methods
    From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET softwares for the analysis of data.
    Results
    The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score.
    Conclusion
    Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks.
    Keywords: Social network analysis, Injecting drug users, Human immunodeficiency virus transmission ýrisk, Network location, Iran
  • Nagesh Bhat, Swapnil Oza*, Jaddu Jyothirmai Reddy, Ruchi Mitra, Rahul Patel, Sopan Singh Page 5
    Background
    The aim of this study was to evaluate the effect of anti-smoking legislation in public places and public support for smoking ban.
    Methods
    A cross-sectional survey was conducted in public places such as market, bus/railway station, workplaces and hospitals in Udaipur city. Informed consent was obtained. The questionnaire comprised of details about their agreement with the current anti-smoking legislation and their views on the support for smoking ban in public places.
    Results
    The study was conducted among 314 individuals of whom 255 (81.2%) supported the general ban on smoking in public places. Non-smokers (54.4%) agreed more than smokers that the introduction of legislation would create healthier environment (P < 0.001), second hand smoke is serious threat to health (P < 0.001), more implementation needed for current antismoking legislation (P < 0.001). Smokers (45.5%) agreed more than non-smokers that everyone has the right to smoke in public places (P < 0.001).
    Conclusion
    Local support for a ban on smoking in public places in Udaipur is high. But there is a lack of enforcing mechanism in support of the legislation and hence complete smoking ban along with strong enforcement may provide better results.
    Keywords: Antismoking Legislation, Smoking Ban, Public Health
  • Mahin Eslami, Shahrbabaki, Delaram Barfeh, Parvin Eslami, Shahrbabaki* Page 6
    Background
    Breastfeeding is one of the best ways to promote, develop, and secure the health of infants. Child abuse is one of the most common and most important problems in the world, and one of the factors that increase its incidence is substance dependency of the parents. Breastfeeding beyond the normal age range can be harmful to the health of the mother and baby, and may represent a pathological parent-child relationship. Case Report: A little girl, who was breastfed until the age of 8 years by her heroin-dependent mother, was hospitalized in a child and adolescent psychiatric ward due to heroin dependency. During the investigations, it was found that not only had the girl been breastfed until this age, but she had also not been enrolled into a school. In other words, due to the mother’s heroin dependency, her infant was also dependent on the drug.
    Conclusion
    In the assessment and treatment of parents with substance related disorders, the possibility of child abuse should also be considered. When breastfeeding is continued beyond the normal age range, it is necessary to find the reason. By early detection and timely intervention, negative consequences for the child can be prevented.
    Keywords: Breastfeeding, Child abuse, Heroin dependence
  • Mohammad Hossein Gozashti, Farzaneh Yazdi *, Pouria Salajegheh, Mohammad Moein Dehesh, Kouros Divsalar Page 7
    Background
    Many of lay person believe that opium lowers blood glucose. However some studies show the opposite results. In this study, we tried to evaluate the effect of opium on blood glucose and insulin resistance.
    Methods
    This comparative study including 53 addicts in case groups who used opium just in the form of smoking and 55 non-addicts in a control group, took part in the study, after proving not to be opium users. After taking blood samples, their fasting blood glucose (FBG), fasting blood insulin and lipid profiles were evaluated. Furthermore, insulin resistance index was analyzed via the homeostatic model assessment of insulin resistance (HOMA-IR) formula with the cut-off points of 7.2 and 7.1.
    Findings
    Age and gender were not significantly different between the groups. There was no significant difference regarding the prevalence of insulin resistance between the two groups, according to the cut-off points of 7.1 and 7.2 (P = 0.196 and P = 0.248, respectively). Mean insulin resistance index was not significantly different between the two groups (P = 0.325). In the case group, fasting blood insulin was considerably lower (P = 0.025) and fasting blood sugar (FBS) was significantly higher (P = 0.016) than the control group.
    Conclusion
    According to the level of insulin and FBS in addicts, it does not seem that opium has a significant effect on reducing the blood glucose and insulin resistance.
    Keywords: Opium addiction, Blood sugar, Insulin resistance
  • Reza Afshari, Abbas Zavar*, Mahbobeh Alidoust, Razieh Pourandi Page 8
  • Noushin Parvaresh, Abdol Reza Sabahi*, Shahrzad Mazhari, Hoda Gilani Page 9
    Background
    Methadone is a synthetic opioid and receptor agonist morphine; thus، its consumption has the effects and side effects of opioid. Methadone maintenance treatment (MMT) is used as an alternative treatment for people who are suffering from substance abuse and do not have the ability to withdraw. Despite its benefits، this drug also has side effects. The purpose of this study was to investigate the effects of methadone treatment on sexual function، sleep، and weight after 6 months.
    Methods
    The study subjects consisted of 200 patients who had referred to the Methadone Clinic of Shahid Beheshti Training Hospital، Kerman، Iran، during a 6-month period and were treated using MMT. Data collection tools consisted of the demographic questionnaire، Pittsburgh sleep quality index (PSQI)، and Arizona sexual experience scale (ASEX). The questionnaires were completed by the participants before and 6 months after the treatment.
    Findings
    The results of this study showed that methadone consumption has significant effects on sexual dysfunction، sleep disorders، and weight gain.
    Conclusion
    The consideration of the side effects of MMT can result in consumers’ commitment to the treatment.
    Keywords: Methadone maintenance treatment (MMT), Sleep disorders, Sexual dysfunction
  • Mohsen Adib, Hajbaghery*, Rouhangiz Karimi, Hassan Karbasi, Mostafa Haji, Rezaei, Efat Aminolroayaee Page 10
    Background
    Although some studies have been conducted on violence against women, but all these studies were conducted in the general population and not the wives of addicts. This study was aimed to compare the violence against women with and without an addicted spouse.
    Methods
    This comparative study was conducted on 200 married women in Kashan, Iran. 100 cases were females with addicted spouse and 100 were women with non-addict husbands. Data collected using Haj-Yahia violence questionnaire. Data analysis was performed using SPSS. Descriptive statistics and chi-square, Mann-Whitney U, and Kruskal–Wallis tests, odds ratio (OR) and Kendall''s correlation coefficient were used to analyze the data.
    Findings
    The overall mean score of violence was 69.29 ± 14.84 for the women with addicted husbands and 40.02 ± 9.26 in women with non-addicted spouses (P < 0.001). The mean score of psychological violence was 39.03 ± 7.60 in women with addicted spouses and 21.86 ± 6.11 in those with non-addicted husbands (P < 0.001). Furthermore, the mean score of physical violence was 20.98 ± 6.50 in women with addicted spouses and 12.2 ± 2.55 in those with non-addicted husbands (P < 0.001). Moreover, the mean scores of sexual violence were 4.52 ± 2.21 and 3.28 ± 0.75 in women with and without addicted spouses, respectively (P < 0.001).
    Conclusion
    The overall rate of violence was significantly higher among women with addicted spouse and especially if the spouse abused more than one type of substances. Further investigations are suggested on the effects of opium withdrawal or changes in the substance abused on the rate of violence against women.
    Keywords: Violence, Addiction, Women
  • Shaabanali Alizadeh, Ghafar Ali Mahmoudi*, Hassan Solhi, Bahman Sadeghi, Sedeh, Reza Behzadi, Amir Mohammad Kazemifar Page 11
    Background
    Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine.
    Methods
    A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h.
    Findings
    VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome.
    Conclusion
    The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.
    Keywords: Buprenorphine, Morphine, Post, operative pain, Opioid dependence, Withdrawal syndrome