فصلنامه اعتیاد پژوهی
پیاپی 69 (پاییز 1402)

The current research aimed to discover the effective patterns of substance use in Iran and provide appropriate solutions based on previous research studies.

This research was descriptive (systematic review) and analytical (qualitative and of meta-synthesis type). A systematic search of domestically published articles was conducted in the Scientific Information Database (SID), the Magiran database, etc., aiming to determine valid, reliable, and relevant documents in the period of 2002 to 2021, and 89 articles were extracted, which in the next step, 58 relevant articles were selected based on the methodological rules of meta-synthesis. The quality of the results (validity) was evaluated through consultation with several experts and reliability evaluation using the Kappa index.

Descriptive results showed that the mean age of starting substance use in Iran is during adolescence and youth. Also, the first experience of getting to know substances was through relatives and friends, and factors such as ethnic subculture, social norms, contextual-demographic factors, individual-psychological factors, social failure, high-risk behavior, differential association, socialization, leisure style, social control, social label, socioeconomic anomie, policy-making weakness, and structural-functional disorders affected substance use. In general terms, the aforementioned meta-synthesis was conducted in the form of 6 constructive themes and 19 basic themes with related statistical primary codes.

The prevalence of substance use and its transformation into a norm and lifestyle has complexity under causal conditions, and its solutions should also be based on comprehensive and comprehensive policy-making across various fields, such as family, society, economy, culture, and deep social education related to the mentioned issue.

The present study aimed to investigate the lived experiences of young substance users in Farahzad, Tehran.

The research method was qualitative interpretive phenomenology. The research population included young substance users from Farahzad, Tehran. Thirty-five people (20 males and 15 females) were selected based on purposeful sampling using the data saturation technique in 2022. Data collection was performed by semi-structured in-depth interview method, and data analysis was performed using Strauss and Corbin method.

The results showed that the triangle of family, individual, and community together with the mediation of familial, social, individual, economic, cultural, and psychological factors along with unsatisfied and prone personalities with behavioral problems were effective in the emergence and formation of the lived experiences of addictive life of the studied sample.

Based on the lived experiences, the studied individuals with an individuality-centered viewpoint sought to value their actions among their peers, and in order to compensate for losses and deprivations, increase the quality of friendship, complete leisure time, and forget failures and problems, they continued the substance use behavior to the extent that it caused the creation of addictive lived experiences and getting locked in the vortex of the fall and decline of substance use. Comprehensive interventions, including economic, family, social, and psychological support, are suggested to this group of young people.

The present research aimed to predict resiliency based on childhood trauma, psychological distress, and difficulty in emotion regulation in individuals with substance use.

The present research was descriptive-correlational. The statistical population consisted of all individuals with substance use under treatment in addiction treatment clinics and private and public maintenance camps in the city of Tabriz in 2022. Among them, 384 people were selected according to the inclusion criteria using the convenience sampling method. The tools used in this research included the childhood trauma questionnaire, the psychological distress scale, the resilience questionnaire, and the emotion regulation difficulty scale.

The results showed that childhood trauma, psychological distress, and difficulty in emotional regulation were significantly and negatively correlated with resiliency. The regression results also indicated that childhood trauma, psychological distress, and difficulty in emotional regulation simultaneously explained 34% of the variance of resilience.

The results of the current research emphasize the roles of childhood trauma, psychological distress, and emotional regulation difficulty in the level of resiliency in substance users. These variables can be regarded as causal and preserving factors in substance use.

The present research aimed to investigate the effective factors on the tendency of street-working children to substance retail sales in the western provinces of the country (Ilam and Kermanshah).

The method of this research was qualitative and of thematic analysis type. The statistical population of the present research consisted of scientific and executive experts and specialists from Faraja, the judiciary and welfare, experts in the field of social harm and drugs, and street-working children and their families. Among them, 30 people were selected using the purposeful sampling method. In-depth and semi-structured interviews were used to collect data. The data were analyzed in three stages of open, axial, and selective coding.

The results showed that the effective factors included two main dimensions of direct and contextual factors and 4 components of psychological, family, social, and economic factors. The re-examination of the findings from two focus groups consisting of some active participants led to the identification of 4 process patterns, including the poor immigrant family, the family with a work culture, the family with irresponsible parents, and the beggar family.

The research results show that this issue is a multi-dimensional abnormal social phenomenon, and considering its nature, its control requires the interaction and cooperation of various institutions, which should be controlled and managed with necessary coordination and focusing on cultural and social responses.

The present research aimed to determine the effectiveness of cognitive therapy based on the matrix model on post-treatment depression and the risk of relapse in crystal-dependent patients.

The research was semi-experimental with a pretest-posttest design with a control group. The statistical population consisted of all crystal-dependent patients referring to addiction treatment centers in the city of Bojnourd in 2022. Among them, 30 people were selected using the convenience sampling method and were randomly assigned to two experimental (n = 15) and control (n = 15) groups. The participants in both groups completed the depression inventory and relapse risk questionnaire in pretest and posttest. Cognitive therapy based on the matrix model was implemented on the experimental group in 24 90-minute sessions. The data were analyzed by multivariate analysis of covariance.

The results showed a significant difference between the two groups, and the cognitive therapy based on the matrix model reduced depression and the risk of relapse in crystal-dependent patients.

Considering that depression after withdrawal plays a key role in addiction relapse in crystal-dependent patients, it is possible to benefit from cognitive therapy based on the matrix model regarding the effectiveness on depression and ultimately reducing the risk of relapse.

The present study aimed to compare personality traits, mental health, and sensation seeking between adolescents with substance-dependent and normal parents.

The present study method was causal-comparative. The research statistical population included all high school students in the city of Gorgan during the academic year 2021-2022. Among them, 200 people were selected and assigned to two groups of adolescents with substance-dependent (n=100) and adolescents with non-substance-dependent parents (n=100) by purposive sampling method, and responded to the general health questionnaire, the five factor inventory, and the sensation seeking scale. Multivariate analysis of variance (MANOVA) was used to analyze the data.

The results showed that there was a significant difference in the scores of personality traits (components of neuroticism, openness, agreeableness, and conscientiousness), mental health, and sensation seeking between the two groups of adolescents with substance-dependent and normal parents. Adolescents with normal parents scored higher in openness, agreeableness, conscientiousness, mental health, and sensation seeking, and scored lower in the neuroticism subscale than adolescents with substance-dependent parents. There was no significant difference between the two groups in extroversion.

Based on the results, substance-dependent parents face problems and issues that create disturbances in the family structure. With insufficient supervision, incompetence, and inattention to the essential needs of their children, they create the basis for the incidence of personality problems in their adolescent and young children. Also, suffering from problems related to mental health and sensation seeking is particularly an important predictor for adolescents with substance-dependent parents.

The present research aimed to compare the effectiveness of psychotherapy based on narrative therapy and cognitive behavioral therapy on the possibility of relapse in opioid-dependent patients after detoxification.

The research method was semi-experimental with a pretest-posttest and follow-up design with a control group. The research statistical population included all patients of the public addiction treatment and rehabilitation centers in the city of Bojnourd in 2022. Among them, 45 people were selected by the convenience sampling and randomly placed in two experimental and control groups. The relapse risk scale was used to collect data. The experimental groups were subjected to psychotherapy based on narrative therapy and cognitive behavioral therapy for eight 90-minute sessions, one session per week, but the control group did not receive any intervention, and after one month, a follow-up period was performed for each group. The data were analyzed by repeated measures analysis of variance.

The results indicated the effectiveness of both narrative therapy and cognitive behavioral therapy on the possibility of relapse, and both approaches reduced the possibility of relapse in patients. The effectiveness of narrative therapy was greater than cognitive behavioral therapy both in the post-test and in the follow-up period.

The results of this research show that the use of narrative therapy-based psychotherapy is more effective than cognitive behavioral therapy, and it is a more appropriate method in reducing the possibility of relapse in opioid-dependent patients.

The present research aimed to predict the tendency to opioid substance use in adolescents based on psychological distress and health in the family.

The research method was qualitative-correlational. The statistical population included the students of the city of Bojnourd in the academic year 2022-2023. Among them, 310 people were selected according to the inclusion criteria using a two-stage cluster sampling method. The tools used in this research included the addiction potential scale, the psychological distress scale, and the family-of-origin scale. Pearson's correlation test and stepwise regression were used to analyze the data.

The results showed that the dimensions of psychological distress (depression, anxiety, and stress) were positively and significantly related to the tendency to opioid substance use in adolescents, while health in the family was negatively and significantly correlated with the tendency to opioid substance use. The regression results also indicated that depression, health in the family, anxiety, and stress explained 22%, 26%, 27%, and 24% of the variance of the tendency to use opioid substances, respectively. The combined components of these two variables could explain 27% of the variance of the tendency to use opioid substances.

According to the obtained results, psychological distress and health in the family can cause the emergence and continuation of the tendency to opioid substance use in adolescents. As a result, the design of interventions based on improving these characteristics is suggested as a basis for reducing the tendency to use opioid substances in this group of people.

The present research was conducted to evaluate the effectiveness of positivism group training on changing the attitude towards drugs among at-risk male adolescents.

The current study was semi-experimental with a pretest-posttest design with a control group. The statistical population included all at-risk male adolescents living in the outskirts of the city of Kermanshah in 2021, of which 30 people were selected by the convenience sampling method and were randomly divided into two experimental (n= 15) and control (n= 15) groups. Participants in both groups completed the attitude towards drugs questionnaire. Positivism group training was presented to the experimental group in eight 90-minute sessions, with the frequency of one session per week. The data were analyzed by multivariate analysis of covariance.

The results showed that the positivism group training positively affected the components of attitude towards drugs (effects, risks, and substance use) and reduced positive attitude towards drugs among the participants of the experimental group.

According to the results of the present research, positivism training can be used as an effective way to reduce the positive attitude towards drugs in at-risk adolescents. Therefore, it is suggested that positivism training be included in the list of early prevention programs for substance use disorders in schools, universities, and educational centers.

The present research aimed to identify the organizational structure model in the Narcotics Anonymous in the city of Tehran.

This research was qualitative grounded theory. The statistical population consisted of all experts and veteran members of Narcotics Anonymous, of whom 18 people were selected as the research sample using the purposeful sampling method. In-depth and semi-structured interviews were used to collect data. The data were analyzed in three stages of open, axial, and selective coding using MAX.QDA 2020 software.

The results showed that the central category in the organizational structure of Narcotics Anonymous was the acceptance of the purposefulness of the recovery process. The background conditions included the association’s basic principles, organizational characteristics, and causal conditions, including fundamental beliefs, the association’s dualities, and the faith-orientation dominance. The dialectic categories of individual and society within the association, intra-association opportunities, and intra-organizational threats also formed the intervention conditions of this organizational structure. The strategies of Narcotics Anonymous also included organizational strategies and rehabilitation mechanisms. Finally, the category of treatment methods and rehabilitation mechanisms was identified as a consequence of the organizational structure of Narcotics Anonymous.

The results indicate that while the organizational structure of Narcotics Anonymous has achieved remarkable successes in the way of implementation, in the power structure, which is hierarchical and based on vertical rings of power, and in some fundamental beliefs, it has faced substance-dependent individuals’ transformation of identity, which has led to the criticism of some founders of this association in Iran.

The present research aimed to predict high-risk behaviors based on positive youth development and positive psychological capital in adolescents.

This study was descriptive-correlational. The statistical population consisted of adolescents in the city of Tehran in 2020, from which 298 people were selected using the convenience sampling method. The tools used in this research included the questionnaires of Iranian adolescents' risk-taking, positive youth development, hope, resilience, self-efficacy, and optimism. Pearson's correlation and stepwise regression were used to analyze the data.

The results showed that the dimensions of positive youth development and positive psychological capital were significantly associated with high-risk behaviors and attitude towards substance use in adolescents. The results of the regression analysis also indicated that the components of positive youth development and psychological capital explained 45% of the variance of high-risk behaviors.

According to the obtained results, positive youth development and positive psychological capital (hope, resilience, self-efficacy, and optimism) play an important role in predicting high-risk behaviors in adolescents. Positive youth development and positive psychological capital can reduce the occurrence and continuation of the tendency to high-risk behaviors in adolescents. Therefore, the design of interventions based on the improvement of these characteristics is suggested as a basis for reducing high-risk behaviors in this group of people.

The current research aimed to investigate the ways of constructing and representing women's substance addiction in TV series of "Maderaneh".

This research was a qualitative study of Barthes's semiotic type, including hermeneutic, minimal semantic units, symbolic, action, and cultural codes, and the analysis method was based on these codes. The statistical population of this research included the "Madaraneh" series, and the sampling method was purposeful.

The results demonstrated that this series tried to depict women's substance addiction using various types of codes to introduce a form of reasons for women's entrapment as a role model. Some of the most important images presented of women's addiction in this series denote that the family is an important factor in individuals’ tendency to addiction and family problems, including divorce, play a significant role in this issue. Addiction can be seen in both wealthy and poor families, and in this series, it is shown that the substance-dependent character is a patient and has a weak will and motivation. According to the results, the personality of a substance-dependent person is faced with stigma and labels in the family and society, and addiction is a prelude to other social harms.

According to the results, the causes of addiction refer to various individual, familial, and social factors, of which the familial factor has been shown to be the most important reason. Therefore, it is necessary to pay more attention to series with the theme of addiction, and in them, in addition to exploring the reasons for addiction and how to deal with it, its preventive strategies should also be considered.

The current research was conducted to identify the factors shaping the behavior of young people in the tendency to industrial substances in the city of Ardabil.

The current research was applied, descriptive-analytical with a qualitative approach. The statistical population of the research included all young people referring to addiction treatment centers in the city of Ardabil in 2022. Based on the purposeful sampling method and using data saturation technique, 28 people were selected. Data collection was carried out by a semi-structured in-depth interview method, and data analysis was performed by using the directed qualitative content analysis method with sentence-by-sentence analysis technique.

The research results demonstrated that 8 categories and 76 subcategories were identified as factors shaping the behavior of young people in the tendency to industrial substance use, which included emotional behaviors, communication and companionship with peers, planned behavior, attitude, social pressure, family breakup, psychological factors, and economic conditions.

The results of this research indicate the existence of numerous individual, familial, and environmental factors in the formation and direction of the behaviors of young people in the tendency to industrial substance use. Therefore, in order to prevent the formation of underlying behaviors in the tendency of young people to industrial substance use, it is necessary to comprehensively consider various individual, familial, and environmental factors in the design and implementation of programs to prevent the tendency of young people to use industrial substances, and in this regard, proper investment in controlling and directing the behavior of young people according to the identified components and sub-components is suggested.

The current study aimed to investigate the causal model of adolescents' vulnerability to addiction based on sensory processing sensitivity and brain behavioral systems with the mediation of emotional suppression.

The current research was descriptive-correlational of structural equation modeling type. The statistical population of the research included the students of the city of Mashhad in the academic year 2022-2023. Among them, 228 people were selected by the multi-stage cluster sampling method. The tools used in this research included the identifying people at risk of addiction questionnaire, the sensory processing sensitivity questionnaire, the brain behavioral systems questionnaire, and the adjustment inventory. Structural equation modeling was used to analyze the data.

The results indicated that sensory processing sensitivity and the behavioral inhibition system had a positive and significant effect, while behavioral activation system had a negative and significant effect on vulnerability to addiction. In addition, emotional suppression mediated the relationship between sensory processing sensitivity and brain behavioral systems. Overall, the results showed that the model had good fit.

According to the results of the current research, regarding vulnerability to addiction, it is suggested that addiction treatment clinics pay more attention to the antecedents of processing sensitivity and brain systems and their possible negative consequences in order to reduce the level of vulnerability to addiction in adolescents.

The present study aimed to investigate the organizational pathology of addiction treatment centers in responding to the demands of the external environment.

The current research was a case study based on a qualitative approach. The  research population included four groups of individuals referring to addiction treatment centers, managers and heads of addiction treatment centers, assistant social workers at these centers, and experts in the field of addiction. Using the theoretical purposeful sampling method and relying on theoretical data saturation, 37 people were selected; the first three groups working in 11 centers across the country. A semi-structured interview was used to collect research data, and thematic analysis was used to analyze the data.

The research results indicated that addiction treatment centers were facing numerous damages inside the organization (organizational cultural damages, organizational structure damages, human resource management damages, and financial damages) and outside the organization (environmental cultural damages, detrimental  institutional pressures, and lack of institutional support ).

The identified damages can be explained and analyzed from a political point of view. Therefore, in order to create effective accountability, addiction treatment centers need to adopt political strategies, including marketing and negotiating to attract institutional support, and also re-engineering their organizational structure.