neda vahed

Objectives:

 Cannabis is the most commonly used illicit substance in the world.  Craving is one of the most important treatment challenges in people with cannabis use disorder. The study aims to evaluate the relationship between brain activity and craving among people with cannabis use disorder.

Methods :

This is a descriptive-analytical study. Participants were 20 patients with cannabis use disorder, who were selected by a convenience sampling method. Resting-state quantitative electroencephalography (QEEG) data were recorded in resting state with eyes closed and eyes open, and their craving was measured by the marijuana craving questionnaire-short form. The data were analyzed in MATLAB software, version 22.

Results :

In open eyes conditions, a significant negative correlation was observed between craving and relative power in the theta band, particularly in the frontal and temporal regions (P<0.05). Additionally, in both open and closed eye conditions, a significant positive correlation was identified between craving and relative power in the beta and gamma bands, specifically in the frontal, occipital, and central regions (P<0.05). 

Conclusion :

There is a significant relationship between craving and changes in the activity of different brain regions in people with cannabis use disorder. It is necessary to pay attention to the neurobiological aspects of addiction to cannabis during the treatment process.

One of the methods of addiction treatment and reduce its related high risk behaviors is maintenance treatment with agonist drugs. It is necessary to determine the economic evaluation related to this method due to the concern about the cost of services. Accordingly, this study aimed to conduct a cost-effectiveness analysis of maintenance treatment centers in Tehran.

This cost-effectiveness study was a longitudinal study before and after receiving treatment with agonist drugs in private centers. In this study, the reduction of high risk behaviors was regarded as the effectiveness index. Totally, 300 people referred to the maintenance treatment centers in Tehran between 2017 and 2018 were selected using cluster sampling method. The data was analyzed using descriptive statistics and sensitivity analysis.

A six months survey showed that of all the high-risk behaviors with the possibility of contracting HIV/AIDS; It has decreased from 160 (before going to the maintenance treatment centers) to 42. Also, the Incremental Cost-Effectiveness Ratio showed that the intervention is cost effective.

This study showed that maintenance treatment centers have higher effectiveness than their costs in reducing high risk behaviors.

Addiction has caused numerous socio-psychological problems around the world as well as in the process of substance abuse treatment. To improve psychological problems and cravings, it should be focused on detoxification, drug withdrawal, and psychotherapy. The study aimed to investigate the effectiveness of multifaceted Islamic therapy and cognitive-behavioral therapy (CBT) on the craving, cognitive emotion regulation strategies, and psychological well-being in male opioid-dependent patients.

This was a quasi-experimental interventional study in Tehran, Iran, in 2018. 60 male opioid-dependent patients were selected. They were randomly assigned to three groups of the MIT (n = 20), CBT (n = 20), and controls (n = 20). The experimental groups received 10 sessions of MIT and CBT. Tools were the Craving Beliefs Questionnaire (CBQ), Cognitive Emotion Regulation Questionnaire (CERQ), and the Psychological Well-being Questionnaire. Data were analyzed using multivariate analysis of covariance (MANCOVA).

A significant difference was observed between the mean scores of the experimental groups and the control group in the variables of craving, cognitive emotion regulation, and psychological well-being (P < 0.05), but there was no significant difference between the two experimental groups.

The MIT and CBT impacted the craving, cognitive emotion regulation, and psychological well-being in opioid-dependent patients. However, there were no significant differences between the two approaches

Drug use disorder and dependency is one of the most challenging problems in the world. One of the most common therapy for opioid use disorder is agonist maintenance therapy especially methadone maintenance treatment and buprenorphine maintenance treatment. The study aimed to investigate the challenges of providing agonist therapy from the perspective of stakeholders.

The present study is a qualitative study with a content analysis method that has used exploratory and semi-structured interviews and purposeful sampling. Interviews were conducted individually to collect data from the view of stakeholders; including some of the physicians as service providers and a group of patients as service recipients. Sampling reached saturation with 21 people. The data were analyzed based on the Graneheim and Lundman model.

Data analysis revealed eight important challenges and barriers, including travel and time spent, availability of agonist drugs (used in maintenance therapy) illegally, take-home dose ( home dose of methadone), trust and confidentiality of authorities, the cost of treatment and income and expenditure, policy and cultural issues of the centers, file filing process, and family factors.

The current pattern and the process of treatment with the agonist drugs reasonably have been well received. If the obstacles and problems of this treatment method are not considered, its useful results can face challenges.

 This study aims to assess the implementation of drug-related harm reduction programs in Iranian prisons and suggest solutions for their improvement.

 This study was conducted in three steps. First, library method was used for collecting data from the central library of Iran’s Prisons, Security and Corrective Measures Organization. In the second step, performance indicators were extracted based on the results of first step and two researcher-made checklists were designed. Finally, a field visit and a semi-structured interview with the authorities involved in the treatment and harm reduction services were carried out.

 In most of prisons, drug-related harm reduction programs were underway. Despite a lack of human resources and budget at the beginning, the quality of measures was gradually increased and the attitude of authorities was improved. Methadone Maintenance Treatment and Triangular Clinics were the most common harm reduction programs, in addition to HIV and tuberculosis screening programs in collaboration with medical sciences universities. The program continued despite the change of officials.

 Harm reduction programs are able to reduce infection diseases, self-harm and violent behaviors in prisons of Iran. Cultural programs along with other harm reduction programs, briefings and seeking support from the authorities can greatly help with continuation of the programs in prisons. By eliminating the shortage of manpower and redefining the security areas for ordinary prisoners, it will be possible to make better use of the facilities of universities and research centers.

The aim of the present study was to determine the efficacy of acceptance and commitment therapy (ACT) compared to cognitive-behavioral therapy (CBT) on anger and interpersonal relationships among male students.

In the present study, several universities were selected from the public universities in Tehran province, based on random cluster sampling. Then, 400 students from selected universities were selected randomly and Aggression Questionnaire (AGQ) was administered on them. After collecting information, among the participants who gained scores higher than the average, 30 were selected based on the lottery and randomly (sorting their names in alphabetical order and randomly selecting them) and then were placed randomly in ACT (n = 15) and CBT (n = 15) groups. Also, the Fundamental Interpersonal Relation Orientation- Behavior (FIRO-B) and Aggression Questionnaire (AGQ) was performed on both groups before and after intervention.

The results indicated that at the end of treatment, there was a significant decrease in the degree of anger among the participants and a significant improvement in all subscales of interpersonal relationships. Also, a significant difference was found between the 2 groups of ACT and CBT in terms of anger changes. Considering that the anger changes in the ACT group were higher, it can be concluded that the ACT group had more changes than the CBT group, but there was no significant difference between the 2 groups of ACT and CBT in terms of FIRO-B subscales.

In some cases, such as anger, ACT has a better effect than CBT, and in others, such as interpersonal problems, it is as effective as CBT.

Methadone maintenance treatment (MMT) is a common medication in opioid dependence disorder. This treatment, despite the positive results, has many psychological problems such as difficulty in emotion regulation and distress tolerance. This study aimed to determine the effectiveness of dialectical behavioral therapy (DBT) on emotional regulation strategies and distress tolerance in patients under methadone therapy. This study was a randomized controlled clinical trial with the intervention and control groups. Fifty men referred to the methadone treatment clinic were randomly assigned to two groups. In this study, emotion regulation questionnaire, distress tolerance questionnaire, corrective therapy questionnaire, and unified therapy questionnaire in three stages of pre-test, post-test and follow-up were used. Statistical analysis of the data was performed using SPSS 17 with Leven test, chi-square, t-test and repeated measure ANOVA. The results showed that the scores of the intervention group significantly decreased in the distress tolerance after 4 months of the intervention (P<0.01) and 2 months follow-up compared to the control group (P<0.01). Also, the scores of the intervention group significantly increased in the emotion regulation after 4 months of intervention (P<0.01) and 2 months follow-up (P<0.01) compared to the control group. The simultaneous combination of methadone therapy and dialectical behavior therapy can be useful in reducing the psychological problems of patients with opioid dependence.