Addiction and Health最新文献

Background: Despite considerable advances in comprehending the neurobiology of drug addiction, available treatment options remain limited in terms of effectiveness and are often accompanied by adverse side effects that contribute to relapse. Notably, oxytocin administration has demonstrated potential in influencing neurobehavioral changes related to drug abuse. Furthermore, the effect of zinc on male fertility has been established. This study aimed to assess the impact of combining oxytocin with zinc sulfate on reproductive parameters in men addicted to opioids who are undergoing methadone maintenance therapy.

Methods: This research followed a double-masked randomized controlled clinical trial design and involved 40 men with opioid dependence receiving methadone treatment. Patients were randomly assigned to one of two groups: a control group receiving a saline nasal spray and a zinc sulfate placebo, and an intervention group receiving 40 international units of oxytocin nasal spray in combination with 220 mg zinc sulfate capsules, daily. Baseline evaluations of testosterone, oxytocin, sperm characteristics, and zinc levels were conducted three days after a 5-10 mg reduction in methadone dosage. Subsequently, a two-week treatment regimen was administered, followed by post-intervention assessments.

Findings: The age of participants was comparable in the control and intervention groups. Zinc levels in the control and treatment groups showed no significant difference before the intervention, while a significant increase was seen after the intervention in the treatment group (P=0.023). A significant increase was reported in testosterone levels (P=0.002) and the active motility of sperm (P=0.015) in the treatment group after the intervention. The intervention led to a significant reduction in the total abnormality of sperm (P<0.001). Prescription of nasal oxytocin spray with zinc supplementation can be an effective remedy in improving reproductive indices in opiate-addicted men and could be considered in addiction management guidelines. The present study is one of the first studies evaluating the effects of combined oxytocin and zinc supplementation on improving the reproductive indices in opiate-addicted men.

Conclusion: According to the results, the combination of oxytocin and zinc supplementation had a positive and significant effect on sperm parameters in opioid-dependent men undergoing methadone treatment.

Background: Laser auricular acupuncture is a form of therapy that is non-invasive, aseptic, and painless, thus advantageous over the traditional form of acupuncture for tobacco cessation. The objective of the study is to evaluate and compare nicotine dependence, urinary cotinine level, physical effects, and quit rate among tobacco chewers before and one month after laser therapy and behavioral counseling, and to evaluate and compare extrinsic stains one month post-intervention.

Methods: The present study was a randomized controlled trial, with laser therapy and behavioral counseling as the test and control interventions, respectively. The laser was focused on both ears once a week for four weeks. Counseling sessions were held once a week for four weeks. Nicotine dependence, urinary cotinine level, physical effects, as measured using the Visual Analog Scale, and quit rate were recorded before and after the intervention.

Findings: The results showed significant reductions in nicotine dependence in both laser and counseling groups post-intervention (P<0.001). Urinary cotinine levels increased significantly in the counseling group post-intervention (P=0.010). Inter-group comparison revealed significant differences in pre- and post-intervention cotinine levels (P<0.05). Adjusted analysis confirmed significant post-intervention differences between the groups (P=0.048).

Conclusion: This study demonstrates that combining laser auricular acupuncture therapy with behavioral counseling yields superior outcomes for smokeless tobacco cessation compared to behavioral counseling alone. The combined approach results in greater reductions in nicotine dependence, lower urinary cotinine levels, slightly higher quit rates, and significant improvements in various physical effects associated with tobacco use.

Background: The present research aimed to identify the maternal, fetal, and neonatal complications experienced by opioid-dependent mothers (ODMs) within the geographical context of Kerman, Iran.

Methods: This study meticulously compared the outcomes of 326 ODMs and an equal number of non-ODMs in Iran, using the data obtained from the Iranian Maternal And Neonatal (IMAN) network, a national health information system in Iran. The selection process involved a census approach, and the participants were carefully matched based on age, gestational age, and nationality. To determine the statistical relationship between opioid dependence during pregnancy and the occurrence of pregnancy and neonatal complications, the chi-square test was employed for analysis.

Findings: Women with ODMs exhibited significantly higher rates of placental abruption (P=0.01) and chorioamnionitis (P=0.04) compared to non-ODMs. Neonates born to ODMs had increased risks of adverse outcomes, including neonatal death (P=0.05), respiratory distress syndrome (RDS) related mortality (P=0.01), intrauterine growth restriction (IUGR) (P=0.001), neonatal intensive care unit admission (P<0.001), hypoglycemia (P=0.006), neurological complications (P=0.004), low birth weight (LBW) (P<0.001), and meconium-stained amniotic fluid (P=0.001). No significant differences were found in congenital anomalies, Apgar scores, or intrauterine fetal death.

Conclusion: Pregnant women with opioid dependence exhibit a heightened susceptibility to antepartum and postpartum complications compared to their non-opioid-dependent counterparts. The sequelae of these complications may be modulated by the caliber of antenatal care received. This research emphasizes the critical importance of consistent clinical management and robust support systems for this population throughout the gestational period and the puerperium.

Background: Schizophrenia is a debilitating psychiatric disorder in which non-adherence to medication leads to symptom relapse, rehospitalization, reduced quality of life, and increased treatment costs; therefore, an appropriate tool is needed to assess the attitudes of patients with schizophrenia towards medication.

Methods: Three hundred patients with schizophrenia enrolled at the specialized neuropsychiatric clinic at Shafa Hospital in Rasht 2023 participated in this cross-sectional study. The patients filled out the Drug Attitude Inventory-30 (DAI-30) and a demographic questionnaire. Qualitative and quantitative methods were used to evaluate content validity. Face validity was assessed using qualitative content validity, and the content validity ratio (CVR) and content validity index (CVI) were computed for quantitative content validity. Kolmogorov-Smirnov test was used to assess the normal distribution of the questionnaire scores. Reliability was assessed using test-retest procedures and Cronbach's alpha. Data were analyzed using SPSS version 26, and confirmatory factor analysis (CFA) and model fit were performed using Smart PLS version 8.8. A P value<0.05 was considered statistically significant.

Findings: In this study, 211 participants (70.33%) were male and the mean±standard deviation (SD) of age was 40.32±10.87 years. All items of the Persian version of DAI-30 showed a CVR greater than 0.62 and CVI greater than 0.80, confirming their content validity. Construct validity showed sufficient internal correlations for conducting exploratory factor analysis (EFA). Cronbach's alpha for reliability was 0.983. The test-retest correlation coefficient was high (r=0.936, P<0.001).

Conclusion: The findings of this study recommend that the Persian version of the DAI-30 is a relevant and reliable measure for evaluating drug attitudes in patients with schizophrenia.

Background: HIV partner notification is known as one of the methods to increase HIV testing. Evaluating the barriers, facilitators, and recommendations to improve it can lead to the increased uptake of HIV testing, as well as achieving the 95-95-95 UNAIDS targets. Therefore, the present study aimed to evaluate the approaches, barriers, and facilitators of HIV partner notification from different aspects.

Methods: The barriers and facilitators of HIV partner notification were evaluated. Also, some recommendations were presented to improve the HIV partner notification program in Iran.

Findings: Based on the results, HIV stigma and discrimination were identified as the most important barriers, and the main facilitator was the support from the spouse or sexual/injection partner and family. Also, the results showed that the HIV partner notification program in Iran was in line with the international guidelines introduced by the World Health Organization. However, it had weaknesses and challenges in various aspects such as the content, the method of implementation, monitoring, and evaluation.

Conclusion: Overall, this study has shown a critical need to strengthen the HIV partner notification program in Iran. HIV partner notification program can be strengthened by considering the introduced facilitators, from different aspects including content, implementation, monitoring, and evaluation. These measures will ultimately increase HIV testing and thus achieve UNAIDS targets.

Background: Disturbance in the sense of taste can destroy appetite and change eating habits, causing a significant decrease in the quality of life. The use of opium causes a disturbance in the sense of taste. Opium is a narcotic drug that can cause temporary or permanent damage to the taste system, making it a source of concern in dentistry. This research was conducted to determine the effects of opium consumption on the sensation of the four main tastes.

Methods: This study was conducted in a single-masked and descriptive-analytical manner. The study population included 107 opium addicts and 113 smokers who were in the same age group. None of the studied subjects had any systemic disease or consumed herbal or chemical drugs. The four substances, citric acid, sodium chloride, sucrose, and caffeine, were used to evaluate sourness, saltiness, sweetness, and bitterness, respectively. Finally, the obtained data were analyzed using SPSS version 26 and the Mann-Whitney U test. P values<0.05 were considered statistically significant.

Findings: Opium use did not have a significant effect on the perception of sweetness (P=0.437), saltiness (P=0.536), or sourness (P=0.8), but a significant effect was seen concerning the perception of bitterness (P=0.0000002).

Conclusion: It seems that opium addicts do not have significant problems in perceiving the taste of sweetness, sourness, and saltiness, but impairment was observed in the perception of bitterness.

Background: Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity and survival. The BDNF gene Val66Met polymorphism is hypothesized to be linked with alcohol dependence syndrome (ADS). We studied the relationship between the BDNF Val66Met polymorphism and the clinical features of ADS, including severity, craving, and perceived stress among alcohol-dependent patients.

Methods: In this cross-sectional study on treatment-seeking north Indian male ADS patients aged 18 to 60 years, alcohol dependence severity (Severity of Alcohol Dependence Questionnaire, SADQ), craving (obsessive compulsive drinking scale), and perceived stress (perceived stress scale-4) were measured. The genetic analysis for calculating the BDNF Val66Met allele frequency was carried out using TaqMan assays. Statistical analysis was done using SPSS Version 26.

Findings: The participants' mean age (SD) (n=80) was 37±8.52 years. Half of the participants had tobacco dependence, too. Almost half of the participants showed alcohol dependence with mild severity. The mean OCDS and PSS-4 scores were 26.08±9.34 and 9.08±2.4, respectively. The allelic frequency of the Val and Met alleles were 73.1% and 26.9%, respectively. Among the Met allele carriers, the OCDS (P=0.02) and PSS-4 scores (P=0.03) were significantly higher than observed in the Val group patients.

Conclusion: The study concludes that BDNF gene Val66Met polymorphism could impact clinical variables such as craving and perceived stress in alcohol-dependent subjects. It merits the use of genetic analysis in determining the course of clinical maintenance of alcohol-dependent patients.

Research, a systematic inquiry, is the bridge that connects existing knowledge to the research question in an objective and testable manner, ultimately solving problems. Just as the foundation is crucial to a building's construction, the research problem is the initial and the most vital step in scientific research. Therefore, problem identification is a task of utmost importance and challenge for researchers prior to the design and execution of research. In this paper, we delve into the concept of the research problem, a term distinct from the research topic and question, its potential sources, and the common approaches for its identification. A difficulty or deficiency that needs to be overcome, a desirable condition that needs improvement, a gap in existing knowledge or a conflicting issue, a theory that requires meaningful understanding, a neglected area of knowledge, and an idea that requires validation or confirmation or application are all examples of the research problem. Known problems, existing literature, or serendipitous ideas may serve as potential sources of a research problem. Research problems are often constructed from the literature by structuring intertextual coherence or problematization strategies. Overall, the most common way of defining research problems is gap-spotting.

Background: Previous studies have shown that implementation intentions are moderately effective in reducing smoking among smokers, but the factors determining its effectiveness are unclear. CREB1 (rs2253206) and BDNF (rs6265) polymorphisms have been proposed as the genes involved in addictive behaviors; therefore, we investigated their association with smokers' responses to implementation intentions psychotherapy.

Methods: This clinical trial was conducted on smoking male students at Tehran University and Shahid Beheshti University. The research sample was 78 smoking students who smoked at least seven cigarettes weekly. All of the participants received an implementation intentions intervention session. Their smoking rates were measured before and after the intervention, and all of them were genotyped for CREB1 (rs2253206) and BDNF (rs6265) using PCR-RFLP. The prospective-retrospective memory questionnaire (PRMQ) was used to evaluate the prospective memory (PM). Analysis of covariance (ANCOVA) and simple linear regression were used to analyze the data using SPSS version 26 at a significance level of 0.05.

Findings: The results showed that implementation intentions affect smoking reduction (t=4.44, P=0.001). Data analysis showed no relationship between these two SNPs and treatment response. Also, no association was observed between these SNPs and PM. However, regression analysis showed that PM could predict the response to treatment (R²=0.10, F=12.15, P=0.001).

Conclusion: Implementation intentions can be suitable for reducing smoking. Studying the effect of genetic factors on psychotherapy in larger samples could be an effective way to individualize psychological treatments in reducing smoking, including implementation intentions.

Background: Smokeless tobacco (SLT) use constitutes a considerable public health concern, especially in India, where there are more than 300 million users. This study seeks to assess the influence of graphic health warning labels (GHWLs) on smokeless tobacco (SLT) packaging on encouraging cessation among users.

Methods: A cross-sectional study was conducted at the Faculty of Dental Sciences, BHU, Varanasi outpatient department, from December 2023 to April 2024. The study involved 387 participants, selected via simple random sampling, who were current smokeless tobacco users. Data was collected through structured interviews using a validated questionnaire. Statistical analysis was performed using SPSS version 21.0, with a significance level set at P<0.05.

Findings: Awareness of GHWLs was high, with 91.7% of participants recognizing the labels. Among these, 66% considered quitting or reducing smokeless tobacco use due to the labels. Increased health awareness and serious consideration to quit were reported by 50.1% of participants, while 28.9% reported no impact. Awareness of tobacco cessation clinics was moderate at 48.1%, and 66.1% expressed willingness to seek help, primarily due to health concerns. Positive correlations were found between education level and awareness (r=0.387) and education and attitude towards quitting (r=0.227). Younger participants and those with shorter durations of smokeless tobacco use exhibited higher health awareness and a greater likelihood of considering cessation.

Conclusion: GHWLs are a potent tool in tobacco control, significantly influencing smokeless tobacco users' intentions to quit. A multifaceted approach involving GHWLs and comprehensive support systems can substantially reduce smokeless tobacco use and its associated health risks.