Drug Injection to Sites other than Arm: A Study of Iranian Heroin Injectors.

For almost all injecting drug users (IDUs), the first site of injection is the arm. Years after injection, IDUs may shift to using other sites for intravenous (IV) access. Although injection to sites other than the arm is associated with higher risks, literature is limited regarding this behavior. We aimed to determine the prevalence and associated factors of using IV access points other than the arm among a national sample of IDUs in Iran. Data came from the National Drug Dependence Survey, 2007, which had enrolled 863 IDUs with at least one daily injection. Data on socio-demographics, pattern of drug use, and injection-related behaviors were entered into a logistic regression to determine predictors of injection to sites other than the arm. From all participants, 54.8% reported current injection sites in areas other than the arm. The other injection sites were the femoral venous sinus (17.0%), followed by the groin (14.5%) and neck (11.5%). Logistic regression revealed that living alone [odds ratio (OR) = 1.789, 95% confidence interval (CI) = 1.218-2.629], being Sunni (OR = 3.475, 95% CI = 1.775-6.801), having higher family income (OR = 1.002, 95% CI = 1.001-1.003), higher age at first drug use (OR = 1.039, 95% CI = 1.009-1.069), longer injection duration (OR = 1.071, 95% CI = 1.041-1.102), and more injection frequency (OR = 1.255, 95% CI = 1.072-1.471) were associated with higher likelihood of using injection sites other than the arm. Using sites other than the arm for IV injection is linked to socio-demographics, drug use data, and injection-related characteristics that can be used by policy makers. This information can be used for harm reduction planning

Impact of Spouse's Opiate Dependence on the Partner's

Objective: We aimed to evaluate the influence of drug dependency on sexual function of wives of opium addicts. Materials and methods: In a cross-sectional study, 150 wives of opiate dependent men were assessed for the impact of drug addiction. Sociodemographic factors like age, educational level, job, marital duration and having child were evaluated. Sexual function was measured using relationship and sexuality scale (RSS). Results: Approximately 73% of the participitants were sexually active with having at least one intercourse in the last 2 weeks, and approximately half of the participitants had unsatisfied intercourse. About ninety percent reported negative effect of the addiction on their sexual life. After the spouse addiction, sexual desire, ability to reach orgasm and frequency of sexual intercourse were decreased in 73%, 64% and 67.3%, respectively. Conclusion: The wives of opiate addicts believe that their sexual function has been impaired by the addiction of their husbands

Needle and syringe sharing among Iranian drug injectors

Abstract Objective The role of needle and syringe sharing behavior of injection drug users (IDUs) in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8%) reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs.</p

Risk factors of suicidal ideation and attempt in women with drug user spouses

Background: Despite ample evidence of the presence of mental and psychological disorders observed in the family members of drug users, few studies have attempted to focus on suicidal behavior in women whose spouses are drug users. Methods: This cross-sectional study focused on 131 women who had a drug user spouse. They had all been married for >2 years, with no mental or psychological disorders and no history of drug use prior to marriage. Drug use history after marriage, the extent and nature of physical and non-physical wife abuse, and any history of suicidal ideation and attempt in the past year were collected, in addition to data about anxiety and depression. Results: Our study showed that women who identified with a history of suicidal ideation and attempt were younger, had a shorter marital duration, had a more extensive history of drug use, were more likely to be abused by their spouse, and had higher anxiety and depression scores than their counterparts. Suicidal ideation predictors included a personal history of drug use [odds ratio (OR) = 9.217, 95% confidence interval (CI) = 1.727–49.180, p = 0.009] and anxiety and depression (OR = 1.080, 95% CI = 1.022–1.141, p = 0.004), whereas suicidal attempt predictors included a personal history of drug use (OR = 7.236, 95% CI = 1.671–31.326, p = 0.010), exposure to physical abuse by spouse (OR = 4.005, 95% CI = 1.393–11.523, p = 0.008), and anxiety and depression (OR = 1.092, 95% CI = 1.015–1.175, p = 0.018). Conclusion: The findings of this study showed that a personal history of drug use, an elevated anxiety score, and depression and exposure to physical abuse by their spouse may act as predictors of suicidal ideation or attempt in women with a drug user spouse. These findings may serve to benefit and support healthcare systems, associated with ongoing efforts to develop preventive programs for suicidal behavior in this population

Factors influencing engagement and utilization of opium tincture-assisted treatment for opioid use disorder: A qualitative study in Tehran, Iran

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-, individual-, familial- and community-level barriers impede its availability and acceptability