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      Compulsory Maintenance Treatment Program Amongst Iranian Injection Drug Users and Its Side Effects

      brief-report

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          Abstract

          Background:

          Psychoactive substance use can cause a broad variety of mental health disorders and social health problems for the drug users, their family and society.

          Objectives:

          The Ministry of Health, Treatment, and Medical Education of Iran has recently proclaimed an estimated number of 2 million drug abusers and 200,000 injecting drug users (IDUs).

          Patients and Methods:

          For data collection, the directory of mental, social health, and Addiction designed a questionnaire in cooperation with Drug Control Headquarters of Iran.

          Results:

          Among 402 IDUs patients, a large amount of them were male, single, and younger than 39 years. Regarding psychotic and somatic symptoms caused by methadone therapy, most of the participants had no problem with methadone maintenance treatment (MMT).

          Conclusions:

          There is a need to train health staff, and the community, concerning preventive measures, treatment, and reducing harm for substance drug users.

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          Housing instability among people who inject drugs: results from the Australian needle and syringe program survey.

          Jenny Iversen, Libby Topp, Eileen Baldry … (2013)
          High rates of substance dependence are consistently documented among homeless people, and are associated with a broad range of negative outcomes among this population. Investigations of homelessness among drug users are less readily available. This study examined the prevalence and correlates of housing instability among clients of needle syringe programs (NSPs) via the Australian NSP Survey, annual cross-sectional seroprevalence studies among NSP attendees. Following self-completion of a brief, anonymous survey and provision of a capillary blood sample by 2,396 NSP clients, multivariate logistic regressions identified the variables independently associated with housing instability. Nineteen percent of ANSPS participants reported current unstable housing, with primary ('sleeping rough'; 5 %), secondary (staying with friends/relatives or in specialist homelessness services; 8 %), and tertiary (residential arrangements involving neither secure lease nor private facilities; 6 %) homelessness all evident. Extensive histories of housing instability were apparent among the sample: 66 % reported at least one period of sleeping rough, while 77 % had shifted between friends/relatives (73 %) and/or resided in crisis accommodation (52 %). Participants with a history of homelessness had cycled in and out of homelessness over an average of 10 years; and one third reported first being homeless before age 15. Compared to their stably housed counterparts, unstably housed participants were younger, more likely to be male, of Indigenous Australian descent, and to report previous incarceration; they also reported higher rates of key risk behaviors including public injecting and receptive sharing of injecting equipment. The high prevalence of both historical and current housing instability among this group, particularly when considered in the light of other research documenting the many adverse outcomes associated with this particular form of disadvantage, highlights the need for increased supply of secure, affordable public housing in locations removed from established drug markets and serviced by health, social, and welfare support agencies.
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            Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

            Hajar Shekarchizadeh, Hamed Ekhtiari, Mohammad Khami … (2012)
            Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT) is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810) in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%), more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education), and employed (>70%). The most commonly reported main drugs of abuse prior to MMT entry were opium (69%) and crystalline heroin (24%). The patients’ lifetime drug experience included opium (92%), crystalline heroin (28%), cannabis (16%), amphetamines (15%), and other drugs (33%). Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.
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              Sublingual Buprenorphine and Methadone Maintenance Treatment: A Three-Year Follow-Up of Quality of Life Assessment

              Salvatore Giacomuzzi, Markus Ertl, Georg Kemmler … (2005)
              This study was conducted to compare long-term outcome effects on the quality of life (QOL) of oral methadone with sublingual buprenorphine maintenance treatment. The QOL status of opioid-dependent patients was assessed using the German version (“Berlin Quality of Life Profile”) of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opiate Withdrawal Scale (OWS). Urine tests were carried out randomly to detect additional consumption. In the first study period, 53 opioid-dependent subjects were enrolled and 25 could be reached after 3 years. The retention rate was 50% for methadone and 45% for buprenorphine (p = 0.786). Baseline values of the total sample (completers and noncompleters) QOL and somatic complaints did not show significant differences between the two treatment groups. QOL characteristics at 6 months of treatment of the buprenorphine completer and noncompleter groups differed significantly regarding job (p = 0.013), family, and total score of physical symptoms (p = 0.002), in which the completer group showed the more favorable values. Concerning physical symptoms at 36 months, logistic regression revealed significantly less stomach cramps (p = 0.037) and fatigue and tiredness (p = 0.034) in buprenorphine compared to the methadone. Moreover, the buprenorphine-maintained group showed significantly less additional consumption of benzodiazepines (p = 0.015) compared with methadone participants. It is concluded that opioid addicts improved their QOL and health status when treated with methadone or buprenorphine. In summary, regarding QOL and health status, the present data indicate that buprenorphine is also a useful long-term alternative for maintenance treatment of opioid-dependent patients.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J High Risk Behav Addict
                Journal ID (iso-abbrev): Int J High Risk Behav Addict
                Journal ID (doi): 10.5812/ijhrba
                Journal ID (publisher-id): Kowsar
                Title: International Journal of High Risk Behaviors & Addiction
                Publisher: Kowsar
                ISSN (Print): 2251-8711
                ISSN (Electronic): 2251-872X
                Publication date (Electronic): 17 September 2014
                Publication date Collection: December 2014
                Volume: 3
                Issue: 4
                Electronic Location Identifier: e21765
                Affiliations
                [1 ]Bureau of Mental, Social Health and Addiction, Ministry of Health, Treatment and Medical Education, Tehran, IR Iran
                [2 ]Substance Abuse and Dependency Research Centre, Social Welfare and Rehabilitation Sciences University, Tehran, IR Iran
                [3 ]Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ]Corresponding author: Mohammad Bagher Saberi-Zafarghandi, 3Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121055106, Fax: +98-2188364380, E-mail: saberiza4@ 123456yahoo.com
                Article
                DOI: 10.5812/ijhrba.21765
                PMC ID: 4331656
                PubMed ID: 25741482
                SO-VID: 260a9790-d3a0-480c-9c1e-013b0caa3855
                Copyright © Copyright © 2014, Zahedan University of Medical Sciences; Published by Kowsar.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                Date received : 04 July 2014
                Date revision received : 27 July 2014
                Date accepted : 20 August 2014
                Categories
                Subject: Brief Report

                Keywords: drug users,methadone,psychotic disorders
                Data availability:
                Keywords: drug users, methadone, psychotic disorders

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