Addiction & Health
Volume:9 Issue: 1, Winter 2017

Evaluation of sexual disorders among persons receiving methadone replacement therapy is of great importance, because these problems may lead to non-compliance and relapse. This study aimed to estimate the effect of methadone maintenance therapy (MMT) on sexual function among addicted Iranian men using met-analysis.
Investigating the available data banks, relevant studies were identified. After exclusion of duplicates, irrelevant papers and low quality articles, eligible papers were entered into the meta-analysis. Prevalence and standardized mean difference of sexual function scores were illustrated by forest plots based on sexual desire, orgasm and erectile function.
Findings: During the primary search, 5341 evidences were identified. After application of the inclusion/exclusion criteria and quality assessment, nine papers were detected eligible for final meta-analysis. Total prevalence [95% confidence intervals (CI)] of sexual disorders and erectile dysfunction among Iranian men under methadone therapy were estimated as 66.3% (27.1-105.5) and 77.5% (61.9-93.1), respectively. The standardized mean differences (95% CI) of Sexual desire, orgasm and erection before and after methadone therapy were estimated as 0.16 (-0.68, 0.99), -0.01 (-0.75, 0.74) and 0.11 (-0.41, 0.64), respectively.
This meta-analysis showed that methadone therapy did not significantly influence the sexual desire, erectile function and orgasm among opium dependent men.

cancer invasion and lymphatic metastasis. Smoking has been reported to increase the metalloproteinase level, but the role of opium consumption in metalloproteinase level has not yet been examined. The current research intended to examine the impacts of opium consumption on the serum levels of metalloproteinase.
This case-control research was conducted in Kerman (in the southeast of Iran), after getting medical approve by the ethics committee. Case group of 33 non-smokers with no active inflammatory diseases who had the experience of inhaled opium and its derivatives were compared with a control group of 40 non-smokers with no active inflammatory disease and no experience of inhaled opium and its derivatives. Student’s t-test, mean, and chi-square test were employed to determine the correlation between the variables.
Findings: No statistically meaningful variation was detected in plasma metalloproteinase concentration between the case and control groups (P = 0.160). Also, there was no significant relation between the plasma metalloproteinase concentration and urinary morphine in case groups (P = 0.410), but a statistically significant correlation was found between gender and metalloproteinase in both the case and control groups (P = 0.003).

Regarding the limited studies about effects of addiction on coagulation factors as a risk factor for increasing coagulation, and its relation to coronary artery disease, we decided to investigate the effect of opium on inflammatory and coagulation factors in a controlled setting.
This case-control study was performed using two groups of smoking males addicted to opium (27 cases) and not addicted to opium (27 cases). After collecting demographic data, venous blood samples were gathered and sent to laboratory for measuring homocysteine, fibrinogen, prothrombin time (PT), partial thromboplastin time (PTT), International Normalized Ratio (INR), and C-reactive protein (CRP) quantity. In order to analyze the data, we used independent t-test plus Mann-Whitney test with significance level of P Findings: The average age in this study was 32.2 ± 6.2 in case group and 33.3 ± 6.2 in control group. Comparing case and control groups regarding age and education showed no significant difference (P = 0.598 and P = 0.848, respectively). Mean daily smoking in case group was 7.9 ± 5.4 and 8.1 ± 5.0 in control group. Mean smoking duration in case group and control group was 10.1 ± 6.5 and 9.0 ± 7.2 years, respectively. There was no significant difference between two groups regarding smoking duration (P = 0.567). Comparison of inflammatory and coagulation factors showed no significant difference except for CRP and fibrinogen for which P = 0.661 and P = 0.889, respectively. Consumption-based comparison of inflammatory and coagulation factors showed no significant difference except for PT in oral and inhaled consumptions which showed a significant difference (P = 0.035).
Results of this study suggest that opium addiction can be an influential factor in blood parameters and can lead to inflammatory and coagulation processes complications.

The aim of this research was to determine the effectiveness of resilience training upon ego-control and hardiness of the addicted persons.
This was a semi-experimental study with pretest and posttest control groups which was conducted in Sari, Iran, during 2014-2015. Thirty persons were selected among 240 illicit drug users who underwent screening. Resilience training was performed in ten sessions for the experimental group. The Kobasa hardiness questionnaire and self-restraint scale (SRS) were used for data collection and multivariate covariance test was performed for data analysis.
Findings: According to the data, ego-control and hardiness of participants were improved significantly by resilience training (P Resilience training is effective upon the rate of ego–control and self-restraint and hardiness. This method can be used in addiction treatment clinics and residential centers.

There are different street substance user's communities (SSUCs). Typology of SSUCs in Tehran, Iran was approached in this qualitative study.
Using content analysis and saturation principles, 22 street-outreach workers were recruited and interviewed. Data were analyzed using open, axial, and selective coding.
Findings: Three types of SSUCs were identified. SSUCs were different in geographic location, the community hierarchy, roles of residents and its function during a 24-hour period. Type 1: surrounded naturally by trees, mountains etc. or located in places like canals that make them not simply reachable, a nonresident smuggler (or a small group of smugglers) has the most power in its hierarchy, works 24 hours with at least two shifts, structured with special roles (nonresident smuggler, the Balancer, sex-worker, seller, armed guard, resident substance users and nonresident costumers). Type 2: mostly located in the city gardens, several nonresident smugglers with limited power, works 16 hours or less in a day, semi-structured with roles of nonresident drug dealer, sex-worker, resident substance users and nonresident costumers. Type 3: houses that their landlords are the resident drug dealers and let the costumers to use drug in the house. The substance users have to leave the house after using drug. The house is open less than 24 hours a day.
Strategies for delivering harm reduction services in different types of SSUCs should be modified according to characteristics of these communities.

We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs).
Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis.
Findings: The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participant's education and marital status (P Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.

This research sought to determine how well the causes of addiction, addiction harms, and prevention of addiction have been noticed in high school textbooks.
We used descriptive method to select the main related components of the addiction concept and content analysis method for analyzing the content of textbooks. The study population comprised 61 secondary school curriculum textbooks and study sample consisted of 14 secondary school textbooks selected by purposeful sampling method. The tools for collecting data were “content analysis inventory” which its validity was confirmed by educational and social sciences experts and its reliability has been found to be 91%. About 67 components were prepared for content analysis and were divided to 3 categories of causes, harms, and prevention of addiction. The analysis units in this study comprised phrases, topics, examples, course topics, words, poems, images, questions, tables, and exercises.
Findings: Results of the study showed that the components of the addiction concept have presented with 212 remarks in the textbooks. Also, the degree of attention given to any of the 3 main components of the addiction concept were presented as follows: causes with 52 (24.52%) remarks, harm with 89 (41.98%) remarks, and prevention with 71 (33.49%) remarks.
In high school textbooks, little attention has been paid to the concept of addiction and mostly its biological dimension were addressed while social, personal, familial, and religious dimensions of addiction have been neglected.

Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia.
Case Report: Herein, we report a 35-year-old man with a 13-year history of abusing opioids who had undergone detoxification for four times during this period. He underwent detoxification for using 200 mg loperamide daily with anticholinergic agents, clonidine, non-steroidal analgesics, and diazepam. No evidence of arrhythmia was seen in the patient.
Tolerating high doses of loperamide could be dangerous and increases the risk of fatal cardiac arrhythmias.