Addiction and Health最新文献

Background: This study aimed to examine the toxico-clinical and sociodemographic characteristics of patients who have experienced poisoning from common illicit drugs, such as opioids and stimulants.

Methods: This retrospective chart review study was conducted on cases of opioid and stimulant poisoning who were admitted to the referral poisoning emergency center in the central part of Iran, Isfahan, from January 2019 to January 2020. The toxico-clinical and sociodemographic characteristics of patients were evaluated.

Findings: Data obtained from 496 patients were analyzed. Poisoning with opioids and stimulants accounted for 67.13% and 7.86% of cases, respectively. Most of the patients in both the opioid and stimulant groups were male. The most common route of poisoning was ingestion (82%) for opioids and inhalation (43.6%) for stimulants. Suicide (40.2%) was common in patients with opioid poisoning, whereas abuse (28.2%) was more commonly observed in stimulant poisoning. There were no significant differences regarding marital status, occupation, education, criminal convictions, history of somatic diseases, and psychiatric diseases between patients with opioid and stimulant poisoning. The mortality rate in opioid poisoning was 0.9%, whereas no deaths were reported in patients with stimulant poisoning. Binary regression analysis showed that age, coma/stupor, abnormal respiratory manifestations, previous cardiovascular disease, incomplete response to naloxone, and endotracheal intubation were predictive factors for worse outcomes (complications/death) in opioid poisoning.

Conclusion: Opioid poisoning was more common than stimulant poisoning. Except for the type and route of exposure, there were no significant differences between patients poisoned with opioid or stimulant drugs. This highlights the necessity for targeted interventions based on specific clinical characteristics to improve patient outcomes.

Background: Drug addiction is one of the social and health problems worldwide. Children are the most vulnerable social stratum in the problem of addiction. The study aimed to design a questionnaire for children's addiction tendencies and study the psychometric characteristics of Iranian children.

Methods: It was a cross-sectional study that was conducted in 2023 among 400 students of Shiraz city (Iran), selected using multi-stage sampling (stratified cluster simple random). Inclusion criteria were students, residents of Shiraz city, studying in the first or second year of high school, and exclusion criteria were non-cooperation and unwillingness to participate in the study. Validity was determined through face, content, and construct validity, with exploratory factor analysis (EFA), and reliability was assessed using Cronbach's alpha and the intraclass correlation coefficient (ICC). Moreover, SPSS 26 was applied for further analysis.

Findings: The average age of the participants was 15.39±1.94. The face and content validity of the scale was quantitatively and qualitatively assessed and confirmed, and the construct validity was demonstrated through EFA. The scale consists of 30 items with four factors that explain 40% of the total extracted variance. Cronbach's alpha and the ICC of the factors indicated strong to excellent reliability of the scale.

Conclusion: The results showed that the current questionnaire has good validity and reliability; thus, it can be applied with confidence to study the addiction tendency and screening of Iranian children aged 12 to 18 years.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is a common liver disorder associated with metabolic abnormalities. This study aimed to evaluate the effectiveness of N-acetylcysteine (NAC) in improving liver function and metabolic profile in patients with MASLD.

Methods: In this randomized controlled trial (RCT), 69 patients with MASLD were randomly assigned to either the NAC group (600 mg, administered three times daily, n=34) or the placebo group (n=35) for eight weeks. The severity of hepatic steatosis, liver enzymes, and metabolic profile were measured at baseline and the final trial. Data were analyzed using SPSS.

Findings: Following eight weeks of NAC administration in patients with MASLD, no significant changes were observed compared to the placebo in hepatic steatosis grade (P=0.215), serum aspartate aminotransferase (AST) (P=0.21), alanine transaminase (ALT) (P=0.28), malondialdehyde (MDA) (P=0.79), total antioxidant capacity (TAC) (P=0.56), triglycerides (P=0.15), total cholesterol (P=0.28), low-density lipoprotein cholesterol (P=0.32), and high-density lipoprotein cholesterol (P=0.16). However, NAC administration resulted in significant reductions in fasting blood glucose (FBG) (P=0.01), fasting insulin levels (P<0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (P<0.001), and C-reactive protein (CRP) (P<0.001), along with a significant increase in total glutathione levels (P=0.003), compared to the placebo group.

Conclusion: NAC administration in patients with MASLD does not significantly impact hepatic steatosis, liver enzymes, or lipid profiles; however, it improves oxidative, glycemic, and inflammatory markers. Therefore, NAC may be a beneficial adjunct therapy for managing metabolic parameters and reducing inflammation and oxidative stress in MASLD patients.

Trial registration: The trial was registered with the Iranian Registry of Clinical Trials (IRCT20201220049772N1) on February 20, 2021.

Background: Congress 60 is an NGO that offers services to drug abusers, but its underlying theory has not been explored in previous studies. The purpose of this study is to examine the changes in the physical dimensions of the people treated in Congress 60.

Methods: Grounded theory methodology was used to arrive at the underlying theory of Congress 60. The data were collected from 2021 to 2023 through interviews with 21 individuals, participant observation, and a review of available texts from Congress 60. Data were analyzed in MAXQDA 2020 following the constant comparison method recommended by Corbin and Strauss in 2014.

Findings: The core concept included "Addiction-related transformations in body structures". Addiction-related transformations in body structures include addictive body structures (addiction and chronic substitution, and nervous system and external substances) and healthy body structure (opium tincture medicine, opium tincture dosage measurement, and taper-up-off of opium tincture in over time or Dezhakam Step Time).

Conclusion: The theory of "Addiction-related transformations in body structures" derived from this study explains the process of entering and leaving addiction from the perspective of Congress 60. A person using drugs enters Congress 60 with addicted body structures. In Congress 60, using the right dose of opium tincture medicine and the Dezhakam Step Time (DST) method, the person's body structures return to normal. The findings of this study offer a novel perspective on addiction, suggesting potential avenues for further research through the exploration of various hypotheses.

Background: The risk of periodontal disease is considered to be high among tobacco users compared to those not consuming tobacco in any form. A rise in salivary enzyme levels reflects the destruction of healthy tissues, making it a potential clinical biomarker. Thus, the aim was to assess periodontal health and examine salivary enzyme levels and their correlation with tobacco use.

Methods: Unstimulated saliva was collected using a standard protocol from 128 individuals who visited the outpatient department (OPD) of a dental hospital, divided into four groups. Clinical assessment was done using the gingival index (1963) (GI) and the community periodontal index (1982) (CPI).

Findings: There was a strong correlation between tobacco use and salivary enzyme levels. Tobacco chewers had the most elevated salivary enzyme levels, followed by smokers and passive smokers. Significant periodontal deterioration presenting as an increase in probing depth and clinical loss of attachment (LOA) was seen among the chewers (3.22±0.87 and 2.16±1.27, respectively) and smokers (3.16±0.80 and 1.63±1.38, respectively), which was more than passive smokers (2.75±0.80 and 0.84±0.30, respectively) and was considered significant between all the groups (P=0.001).

Conclusion: Tobacco use in either form affects the severity of periodontal diseases and the levels of salivary enzymes. Thus, salivary enzymes are regarded as reliable biochemical indicators of periodontal tissue damage and can be used as motivators to quit tobacco usage. Additionally, passive smoking was found to have a negative impact on periodontal health and can be considered a risk factor.

Background: Buprenorphine therapy has emerged as a primary therapy method for both opioid addiction and chronic pain; however, the «one size fits all» approach to buprenorphine administration is no longer tenable. This review analyzes the pharmacology of both dosing approaches and their clinical outcomes, safety profiles, and societal implications, providing valuable insights for healthcare professionals.

Methods: Multiple databases were used in conjunction with a set of inclusion and exclusion criteria to source articles to assess the consensus of best methods for treating opioid use disorder (OUD). This comprehensive review discusses two distinct dosing strategies, microdosing and macrodosing, through a detailed literature search to assess the differences and similarities of each strategy.

Findings: Microdosing entails administering minimal buprenorphine doses, with promise in pain alleviation and addiction management while mitigating the risks of dependence and side effects typically associated with traditional opioids. In contrast, macrodosing employs higher buprenorphine doses, which is well-established for OUD and chronic pain management but raises concerns concerning misuse and overdose.

Conclusion: Tailoring buprenorphine therapy to patients' individual needs is essential in the face of contemporary healthcare challenges related to pain management and opioid addiction.

Background: Addiction is one of the most common psychiatric disorders and is closely related to depression and anxiety disorders. The presence of these disorders makes the process of addiction treatment difficult. Binaural beats are the representation and perception of a stimulus that does not exist in the outside world but is the brain's mental perception error of a virtual third sound, that is, the slight frequency difference between the two sounds.

Methods: The present study was conducted to assess the effectiveness of brain synchronization using binaural beats in the theta band on depression and anxiety in opioid-dependent patients in Tabriz city. The method of conducting quasi-experimental research with two test and control groups is pretest-posttest. The statistical population was all opioid-dependent people referring to outpatient clinics in Tabriz city. The research sample included 30 opioid-dependent people who completed the informed consent form and Beck's depression and anxiety questionnaire. The subjects were randomly assigned to two experimental and control groups and received eight sessions of 7.5 Hz binaural beats, 20 minutes each, by headphones. The questionnaires above were administered again after the completion of the treatment sessions.

Findings: This study analyzed the obtained data by ANCOVA using SPSS20 software. The reasult showed binaural beat in Tetha band (7.5 Hz) have a significant effect on depression and anxiety (P=0.000).

Conclusion: According to the results, the binaural beats in the theta band reduce anxiety and depression in opioid-dependent patients.

Background: Substance use disorders (SUDs) pose substantial challenges to society, creating widespread negative effects. Given their frequent and direct contact with patients, nurses hold a vital position in managing and addressing these disorders. This systematic review aimed to examine nurses' understanding of substance use and their perceptions of individuals affected by these conditions.

Methods: This systematic review involved a comprehensive search of online databases such as PubMed, Web of Science, and Scopus, utilizing relevant keywords up to July 9, 2021. Only studies published in English and aligned with the review's objectives were considered. The quality of the included studies was evaluated using the AXIS tool.

Findings: A total of 3273 nurses participated across 12 studies. The results indicated that nurses' knowledge about substance use was moderate, and their attitudes toward substance users were generally positive. Knowledge-related factors included variables such as age, gender, and work experience. Similarly, age, gender, ethnicity, education level, job position, work experience, participation in workshops on substance use, interest in patient care, hours spent on substance use courses during education, and continuing education hours related to substance use were identified as potential factors influencing attitudes.

Conclusion: Therefore, holding workshops and improving guidelines for patient care with SUDs can enhance nurses' knowledge and attitudes and, ultimately, the quality of nursing care.