Concurrent Amphetamine and Methamphetamine Use Among Clients of Opioid Maintenance Treatment Programs in Golestan, Iran

Concurrent use of stimulants during opioid maintenance treatments (OMTs) negatively impacts the treatment outcomes. The aim of this study is to evaluate the prevalence and correlation of amphetamine and methamphetamine use among OMT clients in Golestan province-Northeast of Iran. In a cross-sectional study, 750 OMT clients were recruited through a two-stage cluster sampling. Face-to-face interviews were conducted to complete the study questionnaire. Urine samples were also taken to perform rapid drug testing for morphine, amphetamine, methamphetamine, tramadol, cannabis, and benzodiazepines. Survey analysis command in STATA was used to estimate the prevalence of drug use among the target population. In this study, 8.1% (95% CI: 3.6 to 12.6) of the participants had positive urine sample for amphetamine or methamphetamine. Also, 41.8% (95% CI: 34.4 to 49.1) of the clients had positive samples for morphine. The urine positivity rate of morphine was significantly higher among those who had positive urine sample for amphetamines (68.3%; 95% CI: 51.7 to 84.9 versus 39.4% 95% CI: 31.3 to 47.6). In multivariate analysis, lifetime alcohol consumption (adjusted OR: 2.8, 95% CI 1.5 to 5.5) and history of imprisonment (adjusted OR: 2.2, 95% CI: 1.0 to 4.6) were associated with positive urine sample for amphetamines. Simultaneous use of amphetamines among clients of OMTs was considerable. It is recommended to regularly test all OMT clients for concurrent use of stimulants. This is particularly important for clients with past history of alcohol consumption or imprisonment.