ali reza noroozi

One of the most common psychological problems among people who use drugs (PWUD) is cognitive impairments (CIs). Several studies show that the prevalence of cognitive impairments in PWUD is higher than in the general population.

The aim of the current study was to investigate the prevalence of CI and its related factors among people who inject drugs (PWID) in Iran.

A cross-sectional study was designed among PWID in 2023. About 410 PWID were recruited using snowball and convenience sampling in four provinces in Iran. Demographic and clinical data, as well as the status of cognitive impairments, were collected using bio-behavioral and Montreal Cognitive Assessment questionnaires, respectively. We examined the relationship between all independent variables and CIs status using bivariate logistic regression.

The prevalence of CI among participants was 28% (95% confidence interval (CI): 22% - 32%). Behaviors associated with an increased risk of CIs included the length of injecting drug use [adjusted odds ratios (aOR) = 2.7, P = 0.01], methamphetamine use (aOR = 2.8, P < 0.05), and alcohol use (aOR = 2.8, P < 0.05).

Methamphetamine and alcohol use were identified as the main predictors of cognitive impairments among PWID. It also seems necessary to consider new interventions in harm reduction programs to address cognitive impairments.

In addition to biology, the theory of "evolution" created a huge revolution in various fields such as worldview and ethics. Darwin did not seek theological and philosophical conclusions of evolution, but his view became the basis for an atheistic interpretation of creation, which was based on the random formation of the order of the world. At the same time, theists and supporters of the "intelligent design" theory, with different modeling, show the astonishing insignificance of the possibility of random evolution and even its impossibility. The central issue of this article is to investigate the possibility of random formation of information in the DNA of organisms in the modern evolutionary synthesis. The current research is focused on the problems of the random creation of genetic information with the method of systematic and descriptive analysis and with the analytical statement of the stages of the evolution theory, and by critically examining the latest readings of evolution in the Western world, while rereading the "logical" and "psychological" certainty, it presents an innovative explanation of "cumulative reasoning" through which the logical certainty of the existence of a supreme origin and "intelligent design" beyond the wonderful order of the universe is proven. In fact, this essay examines the theological and philosophical elements of evolution.

Background :

Estimating the number of people using illicit drugs and alcohol is necessary for informing health policy and programming. However, it is often challenging to reliably estimate the size of these marginalized populations through direct methods. In this study, we estimated the population size of these groups using the indirect Network Scale-Up (NSU) method in Iran from 2015 to 2016.

Methods :

Using a self-administered questionnaire, we asked 15 124 individuals (54% men) about the number of people they know who used different types of drugs at least once in the past 12 months. Prevalence estimates were reported per 100 000 population. The uncertainty level (UL) was calculated using the bootstrap method.

Results :

The average age of the respondents was 33 years old, and 35.1% of them were unmarried. The most common drugs and their prevalence were as follows: opium (2534 [95% UL: 2467-2598]), hashish (849 [95% UL: 811-886]), stimulants (methamphetamine, ecstasy pills, cocaine, and Ritalin) (842 [95% UL: 802-879]), heroin/crack (578 [95% UL: 550-607]), and drug injection (459 [95% UL: 438-484]). Additionally, we estimated the prevalence of alcohol use as 2797 (95% UL: 2731-2861). On average, substance use was 5.23 times more prevalent among men than women. Opium use was more prevalent among individuals aged >50 years old. Moreover, alcohol use was more prevalent among participants between 18 and 30 years old (5164 per 100 000 population).

Conclusion :

Although opium continues to be the most prevalent illicit drug in Iran, the patterns of illicit drug use are heterogeneous among different age groups, genders, and provinces. Age-gender specific and culturally appropriate interventions are warranted to meet the needs of people in different subgroups.

The purpose of this study was to compare mindfulness-based relapse prevention (MBRP) group therapy and treatment as usual (TAU) in terms of their effectiveness on positive and negative perfectionism in men with opioid use disorder (OUD). The method of this study, due to its purpose, is an applied research and its method, in terms of the way of data collection, is an experiment with a pre-test-post-test. The population included men with opioid use disorder who were referred to Iranian National Center for Addiction Studies in Tehran in 2018. 36 patients were selected as the sample and randomly assigned to two groups: one group received a combination of MBRP group therapy and TAU and the other was treated with TAU only. Participants completed the Positive and Negative Perfectionism Scale (PANPS) at pretest, posttest, and follow-up. Data were statistically analyzed using a mixed-design ANOVA model. SPSS software (version 22) was used for data analysis. The results showed that none of the intergroup, intragroup, and interactive sources of variation in positive perfectionism were statistically significant. For negative perfectionism, the differences between the study phase groups were significant. The Bonferroni method was applied to examine the difference scores in the test phases and showed that the mean score decreased significantly in the posttest and follow-up phases compared with the pretest. According to these results, MBRP was effective in reducing negative perfectionism, but we cannot find any differences in the effectiveness of the therapies. These results indicate that MBRP can be considered an effective therapeutic approach for reducing negative perfectionism in individuals with OUD.

Shame and self-criticism are two variables that refer to negative self-assessment. Such negative self-assessments cause unpleasant emotions, which are among the known factors involved in drug abuse and relapse.

This study aimed to compare mindfulness-based relapse prevention (MBRP) group therapy and treatment as usual (TAU) in terms of their effect on shame and self-criticism in individuals with opioid use disorder (OUD).

The current quasi-experimental study with a pretest-posttest and follow-up design was conducted on 36 patients who met the diagnostic and statistical manual of mental disorders (DSM-5) criteria for OUD. The participants were randomly assigned to two groups. One group received a combination of MBRP group therapy and TAU, and the other group was treated only by TAU. The participants filled out the Other as Shamer Scale and the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale in the pretest, posttest, and follow-up stages. The data were statistically analyzed using a mixed-design analysis of variance.

Our results indicated that the mean score of shame significantly decreased in the follow-up compared to pretest and posttest. Moreover, the combination of MBRP group therapy and TAU was significantly more effective than TAU alone. The posttest and follow-up mean scores of the participants who received a combination of MBRP group therapy and TAU were significantly lower than those treated only with TAU.

The study results showed that MBRP could be considered an effective therapeutic approach for reducing shame and self-criticism in individuals with OUD.

The purpose of this study was to investigate the causal effects of automatic negative thought on craving mediating by cognitive emotional regulation. This study had a descriptive and correlational design. The study population consisted of methadone maintained clients of the Iranian National Center for Addiction Studies, Tehran City (n=78) and Mehr-Aein clinic in Rey city (n=42) who referred to treatment centers during February to April 2019. Data were collected through convenient sampling using craving questionnaires including Francken’s Obsessive-compulsive Drug Use Scale and Visual Analog Scale. Other study questionnaires were Cognitive Emotional Regulation Questionnaire and Automatic Negative Thought Scale. For data analysis, we used multivariate linear regression using the structural equation modeling and path analysis using STATA software. Findings revealed that there are significant correlations between automatic negative thoughts, cognitive emotional regulation and craving (P<0.001). Also, the results of hierarchical regression analysis indicate that cognitive emotional regulation can mediate the relationship between automatic negative thoughts and craving (P< 0.001). According to the results of this study, it can be concluded that clients who have higher levels of automatic negative thoughts and higher negative strategies of cognitive emotional regulation, experience a higher level of craving. Thus, identifying the level of negative thoughts and cognitive emotion regulation strategies of methadone-treated clients can predict the severity of craving and their leave or retention of the treatment.

A brief neuroscience-informed psychoeducation program (Neuroscience-Informed Psychoeducation for Recovery [NIPER]) was developed to promote awareness (metacognition) in the main cognitive domains affected by drug and alcohol use to increase willingness to invest time and effort in the brain and cognition recovery process. The primary aim of this pilot study was to determine the feasibility and acceptability of the NIPER program and its potential effectiveness in increasing metacognition, psychological wellbeing, and willingness for the brain and cognition recovery programs among patients with Substance Use Disorders (SUDs).

A total of 56 patients with SUDs were recruited from four outpatient treatment centers in Tehran City, Iran. They participated in four 90-min weekly sessions delivered adjunct to their routine treatment. The program’s effectiveness was measured in terms of metacognition and psychological wellbeing at baseline and the end of the program. The rate of adherence and participation and willingness to continue with brain and cognition recovery programs were measured as feasibility outcomes.

A total of 51 participants completed the study. Compared to the baseline assessments, patients reported more problems in dimensions of attention, memory, inhibitory control, decision making, motor/speech, interoception, insight, and a higher level of psychological wellbeing (t=4.66; P<0.001). In terms of feasibility outcomes, the adherence and participation rates were found above 85%. Most participants expressed their high willingness to continue the brain and cognition recovery programs (86.2%) and would introduce NIPER to their peers (98%).

Considering the pilot results in terms of feasibility and preliminary effectiveness of NIPER in the clinical context of addiction treatment, we think that NIPER is a potentially beneficial intervention to be offered to people with SUD. It would increase their awareness and engage them in the brain and cognition recovery process. However, the clinical efficacy of the intervention should be tested in future randomized clinical trials.

scholars and jurists, mainly by challenging between facts and credentials. They have disputed the jurisprudents' rational argumentations as put forward in their works.   By induction in this regard, we achieve three important views: general prohibition of the use of rational rules in jurisprudential inference, non-prohibition of quoting rational rules in jurisprudential citation, permissibility of citing to rational rules, and promising in detail among the rules of reason.   Adopting a basis for this issue depends on the analysis of two minor and major debates; the minor discussion is that whether the Osuli and jurisprudential propositions are factual or credential.  Assuming on its credential nature, it is argued that if the major issue regarding the citation of rational principles in credential discussion is true or not.   In this paper, with the aim of focusing on the position of rational rules in jurisprudential inference, the authors support the rationalist principles and by analyzing the principles and arguments in both minor and major debates have focused on the problem of facts and credentials confusion to prove this assumption that in order to deduce the rules of jurisprudence, based on the real support that religious laws and credentials  have, we can use the rules of real and rational sciences, and in this regard, we will express a new detailed theory and standard to cite the rules of reason in deriving religious rules.

The most common drug, illegally used in Iran is opium. The treatment of people with substance use disorder is one of the most important strategies in reducing its burden. The aim of this study was to investigate the effect of different increasing and decreasing opium treatment coverage on the patterns of abstinence, transition to heroin dependence and mortality, over 30 years.

This study was a dynamic compartmental modeling conducted in three stages: 1) presenting a conceptual model of opium dependence treatment in Iran, 2) estimating model’s parameters value, and 3) modeling of opium dependence treatment and examining the outcomes for different treatment coverage scenarios. The input parameters of the model were extracted from the literature, and secondary data analysis, which were finalized in expert panels.

The number of opium dependence will increase from 1180550 to 1522063 [28.93% (95% CI: 28.6 to 29.2)] over 30 years. With a 25% decrease in coverage compared to the status quo, the number of deaths will increase by 459 cases [3.28% (95% CI: 0.91 to 5.7)] in the first year, and this trend will continue to be 2989 cases [15.63% (95% CI: 13.4 to 17.9)] in the 30th year. A 25% increase in treatment coverage causes a cumulative decrease of heroin dependence by 14451 cases [10.1% (95% CI: 9.5 to 10.8)] in the first decade.

The modeling showed that the treatment coverage level reduction has a greater impact than the coverage level increase in the country and any amount of reduction in the coverage level, even to a small extent, may have a large negative impact in the long run.

divorce is one of the major concerns of today's societies,which has raised increasing concerns due to its.full destructive effects,especially in adolescents.Most of these effects are due to a change in their beliefs that can be effective in coping with divorce stress.Considering that quality of attachment plays a key role in the use of,stress coping strategies,the purpose of this study was to test the mediator effect of quality of attachment among the girl-adolescent students’s beliefs about parental divorce and stress coping strategies.The sample consisted of242high school girl students inTehran who were selected by available sampling method.Participants responded to the Children’s Beliefs About Parental Divorce Scale(CBAPS),The Inventory of Parent and Peer Attachment(IPPA),Coping Inventory for Stressful Situations(CISS).In this study, the statistical method of structural equation modeling(SEM)was used to test the mediator effect.The results showed that the relationship between students' beliefs about parental divorce and quality of attachment and stress coping strategies were negative and significant.Also,in this model,the relationship between quality of attachment and stress coping strategies was also negative and significant.the results showed that after the correction,the model’s fitness parameters reached to an optimal level.Overall results showed:that,on the one hand,self blaming and mother blaming in adolescents' beliefs about divorce have the most impact on the phenomenon of divorce and,on the other hand,the quality of attachment to the parent plays a more important role than attachment to peers in creating more suitable conditions later.It also plays a role of divorce andthe avoidance coping strategy,is the most common type of coping.in adolescents affected by divorce.

 There is an increasing trend in treatment demand for opioid dependence among adolescents in Iran. However, evidence regarding effective treatment in this population is very limited.

 This study aimed to compare the efficacy of clonidine and buprenorphine for inpatient medically-assisted withdrawal of adolescents with opioid dependence aged 12 and 16 years.

 The study is an open-label, randomized controlled trial with convenience sampling. In total, 36 adolescents took part in this study who were randomly assigned to buprenorphine or clonidine groups. The Clinical Opiate Withdrawal Scale was used to monitor the withdrawal severity on days one, two, three, seven, and 14.

 The findings showed both treatments were effective. However, withdrawal symptoms in the buprenorphine group showed a greater reduction in the first seven days of withdrawal treatment. There was no significant difference in the length of hospitalization between the two groups. Patients with a longer duration of opioid use showed higher levels of withdrawal symptoms in the buprenorphine group on days one and three.

 Buprenorphine treatment was found to be more effective than clonidine in controlling opioid withdrawal during the initial days of treatment. However, it lost its superiority towards the end of the follow-up. It seems that clonidine could be a good alternative to buprenorphine in the medically-assisted withdrawal of adolescents with opioid dependence.

Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran.  

We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis.

We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month

Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.

Iran has been faced with an emerging epidemic of methamphetamine (MA) use during recent years. No effective pharmacotherapy has been identified for MA treatment; and psychological interventions are the only available effective treatment. The aim of this study is to investigate the efficacy and safety of extended-release methylphenidate (ER-MTP) for the treatment of methamphetamine dependence.

Sixty-two people with methamphetamine dependence, according to DSM-IV-TR, were randomly assigned to either fixed-dose extended-release methylphenidate (ER-MTP) (60 mg per day) or placebo for 12 weeks. All participants received twice-weekly cognitive behavioral treatment for stimulant dependence. Recent drug use and craving level were measured using weekly rapid urine test and craving visual analogue scale, respectively. The severity of addiction was measured using the Addiction Severity Index at baseline and study completion. Assessment of MA withdrawal was conducted using Amphetamine Withdrawal Questionnaire and Amphetamine Selective Severity Assessment at baseline, day 3, week 1, week 4 and week 12. Depression and high-risk behaviors assessed with the Beck Depression Inventory and the high-risk behavior questionnaire at baseline, weeks 4 and 12 of the study.  SPSS software version 22 was used for data analysis and p<0.05 was considered significant.

Percent of weekly MA negative urine tests was not significantly different between groups during the course of the study (p=0.766). Two groups showed similar retention rates. Changes in MA craving, withdrawal, addiction severity, depression and high-risk behaviors were not significantly different between groups. No serious adverse event was observed.

Our finding did not show the superiority of fixed-schedule ER-MTP over placebo when added to an intensive biweekly outpatient psychosocial treatment. Further studies using individually tailored flexible-dose regimes might provide new insights regarding the safety and efficacy of psychostimulant maintenance treatment for MA dependence.

Substance use is a growing problem in many countries especially among teenagers. We aimed to estimate the prevalence and complications of substance use in teenagers referring to a tertiary hospital following intoxication.

In a cross-sectional study between 2012 and 2013 in Loghman Hakim Hospital, Tehran, Iran, sixteen substances were checked in teenagers referring due to poisoning. They divided into two groups of young (13 to <16 yr; group 1) and old-teenagers (16 to 19 yr; group 2). History of lifetime substance use and drug use within the week prior to admission were recorded.

Mean (range) age of young teenagers was 14.5±0.6 [13, 15] and 17.7±1.1 [16, 19] in old-teenagers with female predominance. Of 264 teenagers, four in group 1 and 27 in group 2 were admitted due to drug overdose. Six and 69 patients in groups 1 and 2 claimed that they had used some kind of substance in the week prior to admission. Twenty (37%) and 106 (50.5%) patients in the young and old-teenager groups were defined as drug users and rates of unreported substance use were 27.8% (15 cases) and 23.8% (50 cases) respectively. Ninety-six substance users (36.4%) had referred due to poisonings other than recreational intoxication (P<.001). Screening toxicological lab data showed significant opioid and sedative exposure in old-teenagers.

It seems young adolescents hide their drug abuse more than old teenagers. Using illicit drugs screening tests may help us to provide hidden rate of abuse in teenagers.

Estimating the population who use drugs is essential for planning, monitoring, and evaluation of substance use prevention and treatment. This study aims to estimate the population who misuse tramadol in urban population in Iran.

We used the wisdom of the experts (WOTE) and network scale-up (NSU) methods to calculate the population of tramadol misusers in 10 provincial capitals of Iran, in 2016. The WOTE was conducted among pharmacists in drugstores and the personnel of traditional medicinal herbs stores. They guessed the best estimation of tramadol misusers population in their cities. The NSU method was conducted among the general population and participants were questioned about ever and daily, non-medical use of tramadol during last 12 months in their network. The median of the methods was used to calculate the proportion of the adult population (15-49 years old).

The population size of tramadol misusers in studied cities was 83300 [95% uncertainty limits (UL): 47960-256220]. This corresponded to 6.6 per 1000 (95% UL: 3.88-20.30) of the 15-49-year-old population. The projected number of tramadol misusers for all 31 provincial capitals was 118290 (95% UL: 68100-363130840) and 212440 (95% UL: 122310-653410) for all urban areas. NSU also estimated the number of people who misuse tramadol on daily basis. These numbers were 52000 (95% UL: 19940-176570) for studied cities, 73840 (95% UL: 28320-250740) for all 31 provincial capital cities, and 132610 (95% UL: 50860-450310) for all urban areas in Iran.

This study presents information on high prevalence of tramadol misuse in urban population. We need national control measures and demand reduction programs to control tramadol misuse.

Parallel with the rapid growth of smartphone users among the youth, its problematic use has received attention due to adverse outcomes. The psychometric properties of smartphone addiction inventory (SPAI) have been studied among Italian and Taiwanese university students. The aim of this study was to investigate the psychometric properties of the SPAI among Iranian university students. We recruited 402 undergraduate university students in the study from February to March 2017. The SPAI and young’s Internet addiction test (IAT) were completed for them. The AMOS statistical software (version 21) was used to test the five-factor model proposed in the original SPAI. The results of the goodness-of-fit index showed an ambiguous solution. For more appropriate trimming of the SPAI factorial structure, an exploratory-confirmatory cross-validation strategy was followed. The SPAI showed excellent internal consistency (Cronbach’s α = 0.92). Cronbach’s α values of the five subscales varied from 0.53 to 0.84. The results supported a five-factor solution consisting of sleep interference, craving, daily life inference, compulsivity, and time spent (chi-square = 1105.445; P < 0.000; CFI = 0.902; TLI = 0.91; RMSEA = 0.09), which showed good convergent validity with the IAT scores. Moreover, the SPAI showed high factor correlations. Given the increasing trend of smartphone users in the country, the Persian version of the SAPI could be a useful tool for further investigation of smartphone problematic use among Iranian university students.

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.

  Drug addiction treatment (DAT) is a dynamic market influenced by customers’ requests and regulating policies. With about 6000 active clinics nationwide, there is insufficient data regarding the trend of DAT market in Iran. However, these treatment centers advertise their services in daily newspapers providing an indirect manner for their market analysis. The current study was the second phase of the authors’ longitudinal study on evaluating DAT network in Tehran. The current study was designed to provide an outline of treatment services, along with communicative and economic aspects of these centers through tracking their advertisements in newspapers. A trend study was conducted in two time points, May 2009 and November 2012, and reviewed all relevant advertisements in the daily newspapers in a one-month period, in Tehran. After content analysis of the advertisements, the data collection was finalized with telephone-structured interviews. In 2009, sixty-six clinics advertised for their services, using 383 codes to introduce their centers (43%) and treatment menus (57%). Three years later, in 2012, ninety-nine clinics advertised their services a 33% increase. They used 923 codes (140% growth) to introduce their centers (64%) and advertise treatment menus (36%). Regarding their treatment menus, there was a wide range of treatment choices, including common and broad categories of care center (i.e., outpatient and inpatient), and treatment modalities (detoxification to maintenance with methadone, buprenorphine, and naltrexone). Based on the results, methadone maintenance therapy (MMT) remains as the most popular treatment in Tehran offered by 85% of the centers. On average, it costs 1,185,270 Rials (US$37.03) per month, a 16% increase in three years. In 2009, there was no code regarding methamphetamine in the ads, but in 2012, about 43% of centers included the related code in their ads, reflecting the market response to rapidly growing methamphetamine addiction in Iran. Longitudinal trend analysis of DAT market using newspaper advertisements, as an indirect, but rapid and feasible method, provides a dynamic picture of drug treatment network. It showed that opioid maintenance therapy still continues its services in the market, and treatment services likewise grow in response to methamphetamine crisis in Iran.

Extra/pre-marital sexual behaviors (EPSB) are considered as an important problem, especially among the young generation.

This study was conducted to estimate the prevalence and determinants of EPSB among university students in Kerman, Iran.

This cross-sectional study was conducted on 2157 students in 2016. This study used different data collection methods such as direct and network scale-up (NSU). A self-administrated questionnaire was completed by the participants for direct data survey. Then NSU data were gathered through the interview by a trained same-sex interviewer.

Total of 1035 male and 695 female students (n = 1730) were studied with the mean age of 20.5 years (range 18 - 29). In the direct method, 14.9% of the students had sex with non-student partners (SNSP) (3.4% females and 22.6% males). Corresponding percentages in the NSU method were 2.5% and 7.9%. Comparing direct method results of two groups, it was determined that males’ last year SNSP (22.6 %,) was more prevalent but in females, last year sex with student partner (SSP) (4.7%) was more prevalent. Comparisons revealed that in the direct method, 41.7% of the students watched pornography (16.6% females and 58.8% males). There was a significant association between watching pornography and gender (OR male to female = 7.2), as well as between SSP and SNSP without any payment regarding the gender (OR male to female = 5.3 and 7.7).

Our findings showed that extra/pre-marital sexual relationships are relatively common among university students, especially males. We found lower percentages in the indirect NSU method, which is mainly because of nature of such behaviors that are invisible in society and we could not provide estimationfor visibility

There are limited data supporting the effectiveness of buprenorphine treatment for opioid use disorder among adolescents. The aim of this study was to investigate the outcomes of using buprenorphine for inpatient medically assisted withdrawal of vulnerable adolescents with opioid use disorder. Twelve consecutive vulnerable adolescents due to working or living in streets were admitted to the Child and Adolescent Psychiatric Ward of Ali Ibn-e-Abi Talib Hospital for treatment of opioid use disorder using buprenorphine-assisted withdrawal. The clinical chart abstraction of patients’ files was made to provide the baseline situation of the patients, as well as treatment progress at discharge and one and three months post-discharge. All the complaints of pain and other withdrawal signs and symptoms decreased dramatically within the first four days of treatment. At one-month follow-up, all study participants were still in the foster care and the urine tests for morphine and methamphetamine were negative. At the three-month follow-up, the older sister of the only one 15-year-old adolescent took the responsibility of his guardianship. The urine tests of all study participants were negative in month 3. Medically managed opioid withdrawal must be considered only as a part of a comprehensive psychosocial program providing a stable living environment, adolescent welfare, and custody services. The treatment program also proved its safety and effectiveness for the management of pain and other opioid withdrawal signs and symptoms among adolescents

Providing population-based data on awareness, attitude and practice of drug and stimulant use has policy implications. A national study was conducted among Iranian general population to explore life time prevalence, awareness and attitudes toward opioids and stimulant use. We recruited subjects from 5 provinces with heterogenic pattern of drug use. Participants were selected using stratified multistage cluster sampling. Data were collected using a validated self-administered questionnaire. Logistic regression model was applied to identify the variables that are associated with drug and stimulant use. In total 2065 respondents including 1155 men (33.96 ± 10.40 years old) and 910 women (35.45 ± 12.21 years old) were recruited. Two-third of respondents had good awareness about adverse effects of opioid use. Corresponding figure in terms of stimulants was 81.4%. Almost 95% of participants reported a negative attitude towards either opioid or stimulant use. The lifetime prevalence of opioid use and stimulant use were 12.9% (men: 21.5%, women: 4.0%) and 7.3% (men: 9.6%, women: 4.9%), respectively. Gender (adjusted odds ratio [AOR]M/W = 6.92; 95% CI: 2.92, 16.42), education (AORundergraduate/diploma or less = 0.49; 95% CI: 0.26, 0.90), and marital status (AORothers/single = 2.13; 95% CI: 1.36, 3.33) were significantly related with opioid use. With respect to stimulant use, age was negatively associated with the outcome (AOR60+/20-29 years = 0.08: 95% CI; 0.01, 0.98) and men were 2 times more likely than women to use stimulants (ORM/W=2.15: 95% CI: 0.83, 5.56). In addition, marital status (AOROthers/singles = 3.45; 95% CI: 1.09, 10.93), and awareness (AORWeak and moderate/good = 0.40; 95% CI: 0.25, 0.61) were independently correlated with stimulants use. While the attitude of Iranian adults toward opioid and stimulant use was negative, their awareness was not that adequate to prevent the drug use. Men and those with lower socio-economic status (SES) should be the focus of health promotion programs regarding opioid use. However, regarding stimulants use, promotion programs should target younger age groups and those with higher SES status.

Millions of children are left to survive on the streets around the world. Investigations on drug use disorders among street children reveal that they not only abuse all types of drugs higher than their peers who live at home or in shelters, but also they abuse more harmful drugs such as injection drugs or methamphetamines. This guideline provides a comprehensive approach to the treatment and management of substance use disorders among children of 3 to 18 years of age for the staff of substance use disorder clinics. It highlights examples of how to perceive and approach the management and issues of substance abuse among street children at an early stage of development through various medical, psycho-social, and other interventions. It also defines the characteristics of the street children with a focus on prevention. These provisions consist of addressing the applicability matters in this area and necessity of a decision model in our country.

Literature documents the high prevalence of trauma and posttraumatic stress disorder (OTSD) in individuals with substance use disorders, which complicate the clinical profile of patients and present challenges for treatment providers. Although several evidence-based integrated therapies are developed for comorbid PTSD/SUD (substance use disorder), there is a considerable gap addressing this co-occurrence and none of such practices are studied yet on such patients. Through A-B-A single subject design.
The current study aimed to explore the effectiveness of seeking safety (SS), an integrative evidence-based therapy for PTSD/SUD, to reduce PTSD and SUD symptoms in a 32-year-old female with both disorders.
Patients and Measures of PTSD checklist (PTSD Checklist_Civilian; PCL-C), Addiction Severity Index (ASI), Brief Symptom Inventory (BSI), and Coping Inventory for Stressful Situations (CISS-21) were completed by the participant at baseline, intervention, and 2-month follow-up.
Results were analyzed through visual analysis and computing 3 effect size indices including standardized mean difference (SMD), mean baseline reduction (MBLR), and percent of non-overlapping data (PND).
Clinically significant reductions in PTSD symptoms, psychological distress, and ASI scores, as well as improvement in coping skills were observed at intervention phase and maintained at 2-month follow-up, which indicated that the participant benefited from SS.

This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence.
Study Design: A cross-sectional study.
Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university.
The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male.
Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.

Many studies have recognized the importance of sexual and injection risk behaviors in HIV transmission among people who inject drugs (PWID). We aimed to examine effect of alcohol use on sexual and injection risky behavior using coarsened exact matching (CEM) approach among PWID in Tehran, Iran.
Study design: A cross-sectional study.
This study was conducted from Mar to Aug 2016 in Tehran, Iran. PWID were recruited by a convenience and snowball sampling from five of Drop-in Centers (DICs) in Tehran. We assessed three outcomes of interest, all treated as binary variables, including distributive and receptive sharing and inconsistent condom use with any type of sexual partner. We applied coarsened exact matching (CEM) to estimate the independent effect of alcohol use on injection and sexual risk behaviours. All data analysis was performed using Stata v.11.
Overall, 550 PWID (all male) were enrolled. The prevalence of receptive sharing, distributive sharing, and inconsistent condom use was 32%, 15% and 55%, respectively. In the matched samples, last month drinkers were more likely to report receptive sharing (OR=2.12 95% CI: 1.31, 3.81; P=0.022), as compared to abstainer participants. Distributive sharing in last 30 d, was also significantly higher among last month drinkers group (OR=2.72 95% CI 1.72, 4.21; P=0.011), compared last month abstainers group. Finally, there was a statistically significant relationship between alcohol use and inconsistent condom use (OR=4.21 95% CI: 2.71, 7.52; P=0.013).
The findings emphasize importance of addressing alcohol use in risk reduction interventions for Iranian PWID with alcohol use.