Opioid use among women on a stable methadone dose

Copyright © 2017, Iranian Journal of Psychiatry and Behavioral Sciences. Background: Opioid use on a stable methadone dose is a health concern in Iran, the most populous Persian Gulf country. However, the underlying reasons associated with opioid use have not been studied. Objectives: The study aimed to explore the reasons associated with opioid use among a group of Persian methadone-maintained women. The other aim was to explore effective interventions to stop this problem. Methods: The current qualitative study was conducted between June 2008 and December 2009. The study sites included ten large methadone treatment clinics in Tehran. The study employed semi-structured interviews with 50 women. Six roundtable meetings were conducted with nine key informants. NVivo 10 was used to thematically analyze the data. Results: Women were on a stable methadone dose of 45 - 115 mg for at least six months. Opioid availability, an opioid-dependent lifestyle, peer pressure and self-treatment were the reasons of opioid use. The provision of cognitive-behavioral therapy, life skills, observational learning, and mental health services were the suggested interventions to stop opioid use. Conclusions: Opioid use on a stable methadone dose had been facilitated by some factors which should be considered in methadone treatment. The suggested interventions should be considered in increasing methadone treatment outcomes

Research paper: Characteristics of an online HIV education program for iranian female methadone patients: The first study

Objectives: Female methadone patients need specific education on HIV. However, few studies have been conducted on the essential characteristics of designing an online HIV education program for this population. Therefore, the current qualitative study aimed at addressing this research gap. Methods: Semi-structured interviews were conducted with 34 female patients and 19 methadone treatment providers in 11 methadone treatment centres in Tehran, Mashhad and Sari, Iran. Both focus group discussions and individual interviews were conducted and a narrative analysis approach was implemented. The NVivo 9 software was used for data analysis. Results: The qualitative analyses of the data revealed three major themes and six minor themes as follows: a. information for focused action (knowing the epidemic response) using the effective visual presentation and audio presentation; b. interventions for impact evaluation (covering the needed services) by short-term documentary movies and animations; and c. program delivery for understanding (covering the population in need of services) using problem-solving and taking quizzes. Discussion: Audio and visual components, as well as the role of documentary movies and animations, should be considered in HIV education. The active role of women in learning using problem-solving and taking quizzes was highlighted. The findings of this study can be used in designing women-specific HIV education programs in Iran. Randomized controlled trials are suggested to evaluate the effectiveness of such programs. © 2020 University of Social Welfare and Rehabilitation Sciences

Methamphetamine dependence, psychologicalwell-being, criminality and high risk sexual behaviors in female-only methadone services in tehran and karaj, iran

©2018, Iranian Journal of Psychiatry and Behavioral Sciences. Background: Methamphetamine (MA) abuse is a health concern among drug abuse patients in Iran. Objectives: This study aimed at determining the prevalence of MA dependence among a group of female methadone users and investigating the current psychological well-being, high risk sexual and criminality behaviors, and the status of receiving MA treatment. Methods: This study was a cross-sectional survey conducted in Iran. The study was conducted at 5 central female-only methadone services in Tehran and Karaj, during years 2011 to 2013. A questionnaire was devised to collect baseline data. The general health questionnaire-28 and the Opiate Treatment Index were used to assess psychological well-being, and criminality and high-risk sexual behaviors. Results: Overall, 245 females were registered at these sites. Of them, 201 females (82%) were dependent on MA while on treatment. Duration of MAdependence was 6 years. However, only 14.3% of the participants reported lifetimeMAtreatment. Noparticipant was on MA treatment. Participants reported high rates of MA-related depression (76.4%), anxiety (68.4%), social dysfunction (41.2%), and somatic symptoms (38.2%), respectively. Untreated MA dependence in methadone treatment was associated with engagement in high-risk sexual behaviors (43.8%) and criminality (28.7%). Only 10% of the participants reported receiving a lifetime matrix model. All of them reported that the Matrix model was long and it was not easily available in methadone services. Conclusions: The study showed that the high prevalence for MA dependence and its adverse health impacts while receiving MA treatment remained the same. Effective psychosocial treatments should be delivered forMAdependenceamong female methadone users

Gender differences among patients with Hepatitis C virus undergoing rehabilitation through methadone maintenance treatment

Objectives: Hepatitis C Virus (HCV) is a health problem among patients undergoing rehabilitation through methadone maintenance treatment in Iran, the most populous Persian Gulf country. The study aimed to examine gender differences among a group of methadone maintenance treatment patients with HCV problem. Methods: Overall 150 patients (n=75 men, n=75 women) were enrolled from nine methadone clinics in Tehran. The study was conducted between July 2013 and June 2014. Participants of the two genders were compared in baseline characteristics, perceived stress, social support, coping strategies and mental health. Results: Men were more likely to report being currently on parole than women (χ(1)=9.23). Age of first illicit drug use was significantly higher among men than women (t(121)=2.43). Men were more likely to report drug injection in the last 12 months compared with women (χ(1)=4.62). Men were more likely to report criminal charges (t(121)=2.21) and being in correctional facilities (χ(1)=5.32) compared with women. Women reported higher levels of emotion-focused coping than men. Despite women reporting more social support [4.20(0.79)], they also reported higher levels of emotion-focused coping [2.66(0.55)] than men. Women were more likely to have a current mental health disorder (χ(1)=8.15) than men. Discussion: The study results demonstrated some gender differences in baseline characteristics and psychological problems. Such differences may have important impacts on methadone treatment outcomes. Further studies are suggested

Therapeutic community program for opioid-dependent treatment seekers

© 2017, Iranian Journal of Psychiatry and Behavioral Sciences. Background: Therapeutic community program (TCP) is available for opioid users in Iran (Persia), the most populous Persian Gulf country. TCP can reduce opioid use and some associated harms. However, there are few studies about TCP in Iran. Objectives: The current qualitative study aimed to explore the self-perceived positive and negative aspects of TCP among a group of Persian opioid users in Tehran. Methods: The studywasconducted at a large men-onlyTCcenter betweenDecember2010andJuly 2011. Overall, 50opioid users were interviewed in eight roundtable meetings. Nine key informants were individually interviewed. NVivo 10 was used to thematically analyze the data. Results: The mean age of the participantswas 38 (SD = 9) years. Participants were dependent on opioids. The thematic data analyses indicated that peer support, group meetings, and the lack of medications were the most frequently self-perceived positive aspects of TCP. Untreated withdrawal symptoms, long duration of residence, anxiety, and depression were the most frequently reported negative aspects of TCP. Conclusions: The identified positive treatment aspects should be considered to improve the TCP quality. The identified negative treatment aspects should be managed in the provision of TCP