Research Article
Drug Use and its correlated factors among University students in Tehran
Sahar Delavari1, Sogol Olamazadeh1, Shahab Baheshmat1, Jaleh Gholami1, Behrang Shadloo1, Masoumeh Amin-Esmaeili2, Afarin Rahimi-Movaghar1
Iranian National Center for Addiction Studies, Tehran University of Medical Sciences,1
2 Johns Hopkins University
https://doi.org/10.21203/rs.3.rs-2383060/v1
Abstract
Objective: This study aimed to investigate the prevalence of lifetime, last year, and last month use of illicit drugs (opioids, cannabis, stimulants, and hallucinogens) and associated factors among the first to fourth-year students at the Tehran University of Medical Sciences in Iran. Method: The sampling method was multi-stage cluster sampling. Anonymous, self-administered questionnaires used in the previous similar surveys were distributed to 1050 students. We provided prevalence of lifetime, last 12 months, last month, and daily use for the main classes of drugs. We evaluated correlated factors of any drug use in the past 12 months using the bivariate and multivariate logistic regression model. Results: Overall, 945 students participated in this study. A total of 6.6% reported any illicit drug use in the past 12 months (11.2% among male students vs. 3.1% among female students, P > 0.05). Cannabis was the most used drug in the past year by both male and female students, reported by 4.9% of the participants, followed by methylphenidate (2.9%). Daily use of any illicit drug was reported only by 0.7% of male students and no female students. There was an association between illicit drug use in the past 12 months with smoking cigarettes and using alcohol in the past 12 months and drug use among friends or family members. Conclusions: In general, the prevalence of drug use among the students at Tehran University of Medical Sciences has increased compared to similar previous studies, which call for preventive measures. Medical students, substance use, epidemiology, young population, high-risk behavior.
Fatemeh Khakpai Islamic Azad University
Yasaman Issazadeh Tehran University of Medical Sciences
Niloofar Rezaei Tehran University of Medical Sciences
Mohammad Reza Zarrindast ( zarinmr@ams.ac.ir )
Departement of pharmacology, Tehran,Iran
Abstract
The involvement of the opioidergic system on anxiolytic and anti-nociceptive responses induced by cholestasis was investigated in cholestatic and addicted mice. Elevated plus-maze and tail-flick devices were used to assess anxiety and pain levels, respectively. The data indicated that induction of cholestasis and injection of opioid drugs including morphine and tramadol enhanced %OAT and %OAE but naloxone reduced %OAT and %OAE in the sham-operated and bile duct ligated (BDL) mice. Induction of cholestasis and addiction to morphine and tramadol prolonged tail-flick latency which was reversed by naloxone. Co-administration of morphine and tramadol enhanced anxiolytic and analgesic effects in the sham-operated and BDL mice. It seems (i) cholestasis and addiction affect anxiety and pain behaviors, (ii) µ-opioid receptors play a key role in anxiolytic and analgesic effects induced by cholestasis, (iii) co-treatment with morphine and tramadol augmented the effectiveness of them for induction of anxiolytic and analgesic effects both in cholestatic and addicted mice.
Keywords: Cholestasis, Morphine, Tramadol, Anxiety, pain, Mice
ORIGINAL ARTICLE
Mohammad‑Hossein Mohammadi‑Mahdiabadi‑Hasani 1 • Mohaddeseh Ebrahimi‑Ghiri 2 • Mohammad‑Reza Zarrindast 4,5,6,7 • Fatemeh Khakpai 3
Abstract
Depression and anxiety are psychiatric diseases that commonly occur together, and the patient burden and complexity increase when both are present. Comorbid anxiety and depression are often more resistant to common drug treatments such as antidepressants. Combination therapy is a suggested approach in treating these patients, where a decline of doses could reduce undesirable outcomes and still achieve optimal effects. We, therefore, conducted a preclinical study to assess the effect of two-drug combinations of citalopram, bupropion, and scopolamine on anxiety- and antidepressive-like behaviors in male NMRI mice and aimed to determine the nature of the interaction between components. Anxiety- or antidepressive-like activity of mice was assessed by the hole-board or forced swim test (FST), respectively. Our results revealed that citalopram (0.01-0.25 mg/kg; i.p.), bupropion (1-9 mg/kg; i.p.), or scopolamine (0.01-0.1 mg/kg; i.p.) diminished immobility time in the FST, suggesting an antidepressive-like effect. Citalopram decreased dead-dip counts in the hole-board, indicating an anxiogenic-like activity. All two-drug combinations, at inactive doses, exerted an antidepressive-like behavior. Only bupropion/scopolamine combination increased head-dip counts compared to the bupropion/saline group. Isobolographic analysis revealed an antidepressive synergy effect between citalopram plus bupropion, and an antidepressive additive impact between scopolamine plus citalopram or bupropion. It should be noted that the higher dose of each drug alone declined locomotor activity, while two-drug combinations did not affect this parameter. These results suggest a stronger antidepressive effect for citalopram/bupropion combination than other two-drug combinations.
Keywords: Anxiety; Bupropion; Citalopram; Depression; Scopolamine.
Neuroscience-Informed Classification of Prevention Interventions in Substance Use Disorders: An RDoC-based Approach
Tara Rezapour a, Parnian Rafei c, Alex Baldacchino d, Patricia J. Conrod e, Geert Dom f, Diana H. Fishbein g h, Atefeh Kazemi a, Vincent Hendriks i j, Nicola Newton k, Nathaniel R. Riggs l, Lindsay M. Squeglia m, Maree Teesson k, Jasmin Vassileva n, Antonio Verdejo-Garcia o, Hamed Ekhtiari b
Abstract
Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.
Risky Sexual Behaviors and Condom Use Barriers in Iranian Women with Substance Use Disorders
Effat Mergati Khoei 1,2,*Zahed Rezaei 3,4, Minoo Mohraz 5, Alireza Bayat , Fatemeh Ghanbarpour 1, Therese Killeen 6, Jeffrey E. Korte
Abstract
Background: Scant information exists on Iranian women's protective behaviors mainly constant condom use. Inconsistent condom use seems prevalent among women with substance use problems. We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian women with substance use disorders (SUDs). Methods: In our cross-sectional study, we recruited 300 women who sought treatments for their SUDs from the active outpatient drug free (ODF) and Methadone Maintenance Therapy (MMT) centers in Tehran, Iran during 2017-2021. We used three batteries including 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 Results: The majority reported at least one lifetime experience of RSBs. Our results show that only 22% of the participants 'always' use condom in their sexual encounters. The lowest and highest subscale scores of the CBS were related to Sexual Experience (SE) (2.47 ± 0.86) and access/availability structure (3.52 ± 0.7), respectively. RSBs had negative significant association with Partner Barrier (PB) subscale scores (OR = 0.4; 95% CI: 0.22 to 0.73) and effect on SE subscale scores (OR= 0.54; 95% CI: 0.31 to 0.94). Conclusion: RSBs was prevalent among our study population. RSBs and condom use barriers are significantly interwoven. The condom use barriers were highly associated with the types of sexual encounters such as group sex or casual sexual relations than specific mean of sexual performance (i.e. anal sex). Gender-specific RSBs, STIs/HIV/AIDS prevention program is recommended for women with SUDs.
Noroozi, Alireza ; Tehran University of Medical Sciences, Iranian National
Center for Addiction Studies
Conigrave, Katherine; Royal Prince Alfred Hospital, Drug Health Service;
University of Sydney, Addiction Medicine, Sydney Medical School
Bastani, Parsa; Brown University, Department of Anthropology
Charkhgard, Nader; Tehran University of Medical Sciences, Department
of Neuroscience and Addiction Studies, School of Advanced Technologies
in Medicine; Tehran University of Medical Sciences, Iranian National
Center for Addiction Studies (INCAS)
Salehi, Mohammad; Tehran University of Medical Sciences, Department
of Neuroscience and Addiction Studies, School of Advanced Technologies
in Medicine; Tehran University of Medical Sciences, Iranian National
Center for Addiction Studies (INCAS),
Narenjiha, Hooman; University of Social Welfare and Rehabilitation
Science, Substance Abuse and Dependence Research Center
Vaziri, Alaleh; Tehran University of Medical Sciences, Iranian National
Center for Addiction Studies (INCAS)
Abstract
Introduction: In response to a high burden of opioid use disorder (OUD), Iran established a network of opioid agonist treatment (OAT) centres beginning in 2002. To increase treatment diversity, particularly for patients who use opium as their drug of choice, opium tincture (OT)-assisted treatment was introduced to the network. This study aimed to explore factors influencing OT-assisted treatment selection for OUD in Tehran, Iran. Methods: We conducted 54 in-depth interviews with patients with OUD (n = 33), family members of patients (n = 9) and drug treatment providers (n = 12). Participants were recruited from 12 drug treatment centres across Tehran, between September and November 2019. All interviews were audio-recorded, transcribed and coded in OpenCode 4.02 software and analysed using thematic analysis. Results: Study participants more commonly reported individual-level factors as facilitators (e.g. to reduce harms associated with illicit opioid use, achieve recovery through a gradual dose reduction regimen combined with Congress 60 recovery program) and structural level factors (e.g. low adoption by OAT system and lack of familiarity of treatment providers) as barriers for utilisation of OT-assisted treatment regimens. OT was perceived to produce lower levels of physiological dependence than methadone, but the requirement for twice supervised dosing was restrictive. Low familial and community acceptance were also seen as barriers to access. Discussion and Conclusions: This research identified a range of perceived benefits for OT-assisted treatment ranging from harm reduction to an intermediate step to achieve recovery. However, several structural-, individuals-, familial- and community-level barriers impede its availability and acceptability.
Online gaming and internet gaming disorder in Iran: patterns, motivations, and correlates
Hosein Raiemanesh 1,2 • Rabert Farnam 2 • Arshiya Sangchooli 2 • Jamileh Rahimi 3 • Marziyeh Hamzehzadeh • Kamyar Ghani 4,2 • Maral Mardaneh Jobehdar 4,2 • Masoumeh Amin Esmaeili 2 • Behrang Shadloo • Zsolt Demetrovics 5 • Orsolya Kirلly 5 • Afarin Rahimi‑Movaghar2
Abstract
Online gaming may be associated with adverse outcomes in a minority of players. While some suggest that pathological patterns of online gaming are a public health concern in Iran, the evidence on pathological gaming among Iranian online gamers remains scarce. This study aims to investigate the patterns, motivations, and correlates of pathological online gaming in Iran. An online survey in Persian was performed among adult online gamers recruited across Iranian universities and social media. The 10-item Internet Gaming Disorder Test (IGDT-10) was used to screen for Internet Gaming Disorder (IGD). Motivations for gaming were assessed using the Motives for Online Gaming Questionnaire (MOGQ) and correlated psychiatric symptoms were assessed using the Brief Symptom Inventory (BSI). After the estimation of descriptive statistics and bivariate tests, multivariate linear and logistic regressions were used to assess the correlates of the IGDT-10 score and IGD. A total of 791 individuals (75.4% men) responded to the survey. More than 5% played 42 h or more per week. Only 3.7% of respondents met the threshold for IGD. IGD was 9.4 times more common among male than female gamers. The most commonly endorsed criteria were “continuation”, “negative consequences”, and “preoccupation”. Younger age, time spent on gaming, using a PC instead of a smartphone for gaming, “escape” and “fantasy” gaming motivations and psychiatric symptoms were associated with the IGDT-10 score. A small minority of Iranian online gamers may be at risk of pathological gaming and its associated harms, especially younger gamers who play long hours and play with escapist and “fantasy”-related motivations. Further research is needed to elucidate the causes and consequences of gaming-related problems and to evaluate proposed diagnostic criteria and screening instruments.
Association between substance use treatment motivations and retention in treatment
Hamid Tavakoli Ghouchani, Hossein Lashkardoost, Alireza Afshari-Safavi,
Faezeh Kaviyani, Mostafa Akbarzadeh, Zahra Yousefnejad & Hassan Saadati
Abstract
Background: Identifying factors influencing the retention in the treatment of substance users is one of the great issues in the health field. The present study was performed to identify the motivations to start treatment and their relationship with retention in the treatment. Methods and materials: This cross-sectional study carried out on 189 people with substance use disorder undergoing treatment in the first month referred to addiction treatment clinics in 2021. Forty clinics were selected using a simple random sampling method. Required information was collected using a demographic and “motivating factors to quit” questionnaire. Data were analyzed using chi-square, Fisher’s exact and Mann – Whitney U tests through SPSS version 24. Results: This study showed a significant relationship between the place of residence and occupation of the subjects with all the fields of the “motivating factors to quit” questionnaire (p < 0.05). Only “family” item had a significant relationship with retention in the treatment (p < 0.05). Conclusion: Considering the relationship between the family item and retention in the treatment, it seems that informing the patient’s family about the importance of encouraging, supporting and quit plan can be an effective help in increasing retention in the treatment.
RESEARCH REPORT
Antonio Verdejo-Garcia, Tara Rezapour, Emily Giddens, Arash Khojasteh Zonoozi, Parnian Rafei, Jamie Berry, Alfonso Caracuel, Marc L. Copersino, Matt Field, Eric L. Garland, Valentina Lorenzetti, Leandro Malloy-Diniz, Victoria Manning, Ely M. Marceau, David L. Pennington, Justin C. Strickland, Reinout Wiers, Rahia Fairhead, Alexandra Anderson, Morris Bell, Wouter J. Boendermaker, Samantha Brooks, Raimondo Bruno, Salvatore Campanella, Janna Cousijn, W. Miles Cox, Andrew C. Dean, Karen D. Ersche, Ingmar Franken, Brett Froeliger, Pedro Gamito, Thomas E. Gladwin, Priscila D. Goncalves, Katrijn Houben, Joanna Jacobus, Andrew Jones, Anne M. Kaag, Johannes Lindenmeyer, Elly McGrath, Talia Nardo, Jorge Oliveira, Charlotte R. Pennington, Kelsey Perrykkad, Hugh Piercy, Claudia I. Rupp, Mieke H. J. Schulte, Lindsay M. Squeglia, Petra Staiger, Dan J. Stein, Jeff Stein, Maria Stein, William W. Stoops, Mary Sweeney, Katie Witkiewitz, Steven P. Woods, Richard Yi, Min Zhao, Hamed Ekhtiari
Abstract
Aims: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. Design, Setting and Participants: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review. Measurements: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery. Findings: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. Conclusions: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.
Carragher, Natacha ; Billieux, Joël ; Bowden-Jones, Henrietta et al. / Brief overview of the WHO Collaborative Project on the Development of New International Screening and Diagnostic Instruments for Gaming Disorder and Gambling Disorder. In: Addiction. 2022 ; Vol. 117, No. 7. pp. 2119-2121.
In this brief letter, we report a new WHO-led project developing gold standard instruments to detect gaming disorder and gambling disorder following their inclusion in the ‘disorders due to addictive behaviors' section of the eleventh revision of the International Classification of Diseases (ICD-11)