International Journal of High Risk Behaviors and Addiction
Year:2016 | Volume:5 | Issue:4|Papers Count:20

Background: Street children are at risk of various high risk behaviors, but few studies have been performed in this field in Iran and worldwide.Objectives: This study aimed to assess the prevalence of high risk behaviors and its predictors among street children to design interventions and future research agenda regarding these children in Iran, especially in southeast region.Patients and Methods: This cross-sectional study was conducted in southeast Iran in 2015. Based on postal map, the city was divided into 5 districts and 216 male street children were selected using snowball sampling. An unstructured questionnaire was provided by integrating 8 previously used questionnaires in different studies with approved validity and reliability and filled through interview and observation. Data was analyzed in Stata.12 software using bivariate and multiple logistic regression by Hosmer-Leme show method.Results: The mean age of subjects was 12.53.2 years. The lowest mean age of initial use and usually firstly used substance was for cigarette smoking. The prevalence of high risk behaviors was 47.7% (95% CI: 44% - 51%). In final multiple logistic regression model, separation of parents (OR: 3.8 [95% CI: 1.86 - 16.2]), peddling activity type (OR: 2.73 [95% CI: 1.28 - 9.5]) and lower fathers’ educational level (OR: 3.83 [95% CI: 1.86 - 15.4]) significantly increased the prevalence of high-risk behaviors among street children.Conclusions: The prevalence of high-risk behaviors among street children in southeast Iran is almost high. In this regard, street vendors and children who their parents are illiterate or have been separated are more at risk. Generally, principal organizing these children and family education could decline their problems. However, these actions need intersect oral collaboration in society.

Background: Military service is one of the stressful life periods for young men in Iran, and because of these multiple stressors, soldiers’ drug abuse status can be exacerbated during this period. Identifying the predictors of worsening drug abuse can help us to control addiction in young soldiers.Objectives: To examine the military service predictors resulting in worsening drug abuse status.Patients and Methods: A cross-sectional study with 3140 young soldiers was conducted in summer and autumn of 2010 and; the participants completed three questionnaires, namely the Texas Christian University Drug Screen (TCUDS) II, The Addiction Severity Index and a questionnaire designed by the researchers. We analyzed the data using ordinal logistic regression. The dependent variable was changing the drug abuse status, scored from 1 to 4 according to the state of deterioration of soldiers’ drug abuse.Results: The study included 3, 140 soldiers with ameanage of 22.1 year. The predominant level of educationamongthe soldiers was a diploma (72.6%), and 87.7% of the soldiers were single. In the model, the four predictors that affected drug abuse status deterioration were as follows: level of satisfaction with service location (odds ratio [OR] =0.83, P=0.040), relationship with commander (OR= 0.79, P=0.001), relationships with other soldiers (OR=0.71, P=0.031), and the time of additional service (OR=1.15, P=0.002).Conclusions: To prevent worsening drug abuse status among soldiers, it is necessary to decrease the time of additional service, increase the quality of the commander’s relationship with soldiers, and elicit soldiers’ help to assist decision makers in controlling the deterioration of soldiers’ drug abuse during military service.

Background: Rheumatic diseases are chronic diseases, which may be associated with severe and debilitating pain.Objectives: The purpose of this study was to examine the prevalence of tobacco and opioid use among rheumatic patients.Patients and Methods: In this cross-sectional study, 1042 patients referred to a major rheumatology clinic of Kerman city, in south east of Iran, were interviewed. Patients were divided into seven groups of disease, including rheumatoid arthritis (330 persons) osteoarthritis (313 persons), systemic lupus erythematosus (149 persons), back pain (146 persons), spondyloarthropathies (62 persons), Behcet’s disease (25 persons), and scleroderma (17 persons). The questionnaire consisted of demographic variables, disease-related variables (e.g. duration of disease), the severity of pain on the VAS scale and use of opioids and tobacco based on self-reporting.Results: The mean age of the patients was 49.3  15.0 years and mean disease duration in the whole sample was 7.1  5.1 years. Opium consumption was reported by 104 persons (9.9%), codeine, by 185 persons (17.7%), cigarette smoking by 49 persons (4.7%) and water pipe smoking by 34 persons (3.3%).Conclusions: In this study, codeine consumption is the most frequently used substance. The consumption of opiumis not much different from the general population. Also, the rate of cigarette and water pipe smoking was less than that in the general population. The prevalence of opium use and tobacco smoking was higher in men than in women. There was no significant relationship between type of rheumatic diseases, disease-related variables, and substance use.

Background: Research evidence suggests that the quality of life (QoL) of substance abusers is seriously low.Objectives: The aim of this study was to assess domains of QoL in narcotic anonymous (NA) members.Patients and Methods: In this cross-sectional study, 386 NAmembers were randomly selected from the city of Yazd, Yazd province, Iran, in 2012. The World Health Organization Quality of Life -Brief Questionnaire was used to assess domain scores of QoL. Data were analyzed using analysis of variance (ANOVA) and LSD test with SPSS software version 17.Results: The results showed that there was a significant difference between age, marital status, drug type used and length of abstinence with domains of QoL (P=0.001).Conclusions: The findings of the current study show that consistent participation in NA self-help groups can significantly lead to an increase in QoL. Further research is recommended to find out causal relationships between participation in NA and QoL in Iran.

Background: Early detection is known to be the most effective way to promote survival and reduce mortality in cases of oral cancer.Objectives: This study is intended to survey dental practitioners across the city of Mashhad, in northeast Iran, in terms of their self-assessments and performance with regard to the early detection and/or prevention of oral cancers Patients and Methods: This descriptive, cross-sectional study involved 134 general dentists practicing in Mashhad between 2011and 2012. Dentists’ self-assessments, in terms of their knowledge, skill, competence, and performance when it comes to the primary and secondary prevention of oral cancers were assessed using a questionnaire. Statistical analysis was completed using SPSS (11.5).Results: 89.9 % of dentists managed to support their patients in their efforts to stop smoking, though only 39% believed in their own capacity to assist with tobacco use cessation. Dentists reported that 35.4% of their patients aged 40+had undergone screening for oral cancer during their first visit, whereas 11.6% received regular check-up on a periodic basis. Those prone to cancer constituted a larger percentage, at 76.6%. More than half of the participants (59.3%) believed that they had acquired the essential skills for oral cancer screening. This rate was reported to be 77.6% for lymph node palpation. Almost half of all dentists claimed that their knowledge of oral cancer was up to date.Conclusions: There is need for further training with regard to the early detection and prevention of oral cancers.

Background: Amphetamine use is a new critical health concern in the Middle East region. However, few studies have focused on methamphetamine use in this region, including Iran.Patients and Methods: This cross-sectional study was conducted in 2010 to determine the prevalence of stimulant use among the general population of Tehran, the capital of Iran. A total of 6027 participants were recruited from 22 areas of Tehran and asked about their use of opioids and amphetamine.Results: Of all participants, 261 (4.3%) had used methamphetamines (alone or with opiates) and 144 (2.4%) had used opiates only.Over 90% of participants were male and there was no difference between the two drug-using groups in terms of sex. The mean age of methamphetamine users (29 9 years) was significantly lower than opioids users (36  11 years, P<0.001). In addition, the majority of methamphetamine users were single, but the opiate users were not (77% vs.43%, P<0.001). More than half of the participants had a high school diploma or less, which did not differ between the two groups. A previous history of treatment was significantly lower among methamphetamine users than opiate users (61% vs.82%, P<0.001).Conclusions: The findings of the study showed that, compared with the opiate users, methamphetamine users are younger, more likely to be single, and less likely to have received treatment. We recommend that policymakers should not only design preventive programs for improving the level of knowledge about stimulant use, but also prepare treatment plans and facilities for this newly emerged substance.

Background: Despite the mandatory rules and established efficacy of seatbelts and helmets, using them is still unsatisfactory. It seems that there are several factors associated with seatbelt and helmet use in the general public.Objectives: The aim of this study was to assess the factors associated with the use of seatbelts and helmets.Patients and Methods: This questionnaire-based, cross-sectional study was a part of the national survey including 1, 000 respondents in 2008 - 2010. After compilation of the collected data, analysis was carried out using SPSS version 11.5. In all calculations, P< 0.05 was considered statistically significant.Results: The research sampling consisted of 500 men and 500 women ranging in age from 17 to 67 years. Seatbelt use differed according to certain factors, such as location (P<0.009), sex (P<0.001), and smoking (P<0.04). Similarly, the use of helmets also varied according to sex (P<0.001), smoking (P<0.001), and tobacco consumption (P<0.04).Conclusions: Some factors seem to play a very important role in seatbelt and helmet use; these should be taken into consideration by policymakers.

Background: Emotion regulation is a major and important incentive for substance abuse; in fact, substance abusers associate their abuse with the substance’s soothing nature. Emotion regulation can be defined as the process, which enables individuals to regulate experiences and express emotions.Objectives: The goal of the current study was to evaluate the effectiveness of acceptance and commitment therapy (ACT) on emotion regulation in methamphetamine-dependent individuals undergoing rehabilitation.Patients and Methods: This was a quasi-experimental study of pretest-posttest design with a control group (where follow-up was also done). The population under study consisted of Methamphetamine-dependent individuals undergoing rehabilitation (MDUR), who were inpatients and outpatients of Tehran’s medical centers. First, 30 MDUR, who were in the withdrawal stage were selected.Then, based on interest to participate in group therapy and matching, they were assigned to the test and control group. Mindfulness based acceptance and commitment therapy (ACT) in eight sessions (eight weeks) with 1.5-hour duration was done. The tool used for this project was Gratz and Roemer’s difficulties in emotion regulation scale. Repeated measures Analysis of Variance (ANOVA) was used for analyzing the data.Results: Group ACT caused a significant decrease in emotion regulation scores (P<0.001) and its following dimensions, including non-acceptance (P=0.03), difficulties engaging in goal directed behavior (P=0.002), impulse control difficulties (P=0.027), and limited access to emotion regulation strategies (P=0.038). However, it could not significantly decrease the lack of emotional awareness and clarity dimensions.Conclusions: Group acceptance and commitment therapy improved emotion regulation in methamphetamine-dependent individuals and enabled them to regulate experiences and express emotions that are very effective in controlling cravings and retention in treatment and prevention of recurrence.

Background: There is a dearth of epidemiologic studies that provide important information to understand the incidence, prevalence and severity of oral lesions in patients with tuberculosis (TB).Objectives: This study aimed to determine the prevalence of oral mucosal lesions and adverse habits among hospitalized TB patients.Patients and Methods: The study was conducted on all the TB patients (n=118) admitted to the Tuberculosis and chest diseases Sanitarium in Udaipur City, Rajasthan, India, during April-May 2014. Oral mucosal lesions along with adverse habits were assessed according to world health organization, 1980. Demographic characteristics of the subjects were recorded. Data were analyzed using the chi-square.Results: The prevalence of oral mucosal lesions and adverse habits among study population accounted for 58.4% and 95% respectively.Among all the habits, bidi smoking was most prevalent (30.5%), followed by habits in combination (23.7%). Oral lesions were found to be significantly highest among those who were on combination of habits and also among those who were suffering from the habit for more than 10 years duration.Conclusions: The findings of the current study indicate a high prevalence of oral mucosal lesions and adverse habits among the patients with TB disease. Hence, there is an urgent need of probing this public health problem by the health authorities.

Background: Suicide ideation is one of the strongest risk factors for completed suicide. There have been many reports of significant increases in suicide and suicide attempts in university students.Objectives: This study was performed to determine the relationship of self-compassion and anger control dimensions with suicide ideation.Patients and Methods: The method of this study was descriptive and correlation. The statistical population comprised students of Mohaghegh Ardabili university in the second semester of the 2012 - 2013 school year. One hundred and fifty subjects were selected from this population by random multistage clustering. They were asked to answer questionnaires about suicide ideation, self-compassion, and multidimensional anger. The collected data were analyzed by Pearson correlation coefficient and multiple regression tests.Results: The results of the Pearson correlation coefficient tests showed that suicide ideation was negatively correlated with self-compassion (r=-0.19; P<0.05) and mindfulness components (r=-0.20; P<0.05), but it was positively correlated with self-judgment (r=0.39; P<0.001), isolation (r =0.28; P<0.004), over-identification (r=0.49; P<0.001), anger arousal (r=0.39; P<0.001), anger-provoking situations (r=0.24; P<0.001), hostile outlook (r=0.32; P<0.001) and anger (r=0.45; P<0.001). The regression analysis results also showed that 24% of the variance of suicide ideation can be explained by self-compassion and 24% by anger-control dimensions.Conclusions: Based on the results, improving self-compassion and anger-control skills are suggested as ways to decrease suicide ideation.

Background: In addition to the direct effect on health, high-risk behaviors expose people to a variety of disorders and affect their activities. Despite the importance of investigating the prevalence of high-risk behaviors among municipal workers, no comprehensive study has yet been conducted in this area.Objectives: The aim of the present study was to assess the predictors of high-risk behaviors among municipal workers in Zahedan city, Iran.Patients and Methods: This cross-sectional study was carried out on a total of 671 municipal workers and staff from different parts of Zahedan city in 2013. Information was collected through face to face interviews and registering answers in data forms. Data were analyzed in stata.12 software using chi-square and multivariate regression analysis at a significant level of 0.05.Results: Fifty-seven participants (8.5%) reported previous high-risk behaviors. According to the logistic regression test, only ethnicity and education variables were significantly related to the prevalence of high-risk behavior (P<0.05). Although those with a longer work history had greater odds of high-risk behaviors than newly employed workers, this variable had no significant relationship with high-risk behaviors, and only improved the fitness and remained in the final model.Conclusions: High-risk behaviors are not highly prevalent among municipal workers and staff, and have no relationship with the occupation type. Given the higher prevalence of high-risk behaviors among more educated workers, there should be no concern about high-risk behaviors in less-educated ones. In conclusion, the ethnicity and educational level revealed as important predictors of high-risk behaviors among municipal workers.

Background: The aim of this study was to assess the prevalence of sexual dysfunction and to investigate whether there is a change in sexual dysfunction after six months of methadone maintenance therapy (MMT) compared with baseline.Patients and Methods: We recruited 150 male Iranian patients from several centers offering methadone maintenance therapy (MMT). Patients underwent structured interview that consisted of socio-demographic characteristics, drug use, and sexual behavior, the patients completed the International Index of Erectile Function -15 (IIEF-15) and Sexual Self-efficacy Scale - Erectile Functioning (SSES-E) tests to assess sexual dysfunction. The statistical method used for analyzing data was the Mann-Whitney U test.Results: Among men on MMT, 65% had erectile dysfunction (ED). The baseline mean score on the IIEF was 15.55 and, after taking methadone, that positively increased to 18.12 in the post-assessment. Analysis indicated significant improvement in erectile function, sexual desire, overall satisfaction, and orgasmic function after methadone maintenance treatment. Also, the baseline means score on the SSES-E was 86.71, which increased moderately to 94.34 in the post-assessment.Conclusions: Results showed that sexual dysfunction is a prevalent disorder in opioid-dependent males. Addiction withdrawal centers should be warned about the dysfunction caused by opioids and, from a clinical perspective, it is imperative that patients misusing opiates and those treated with methadone are routinely asked about their sexual functioning so that, if indicated, appropriate investigations and treatment can be planned. Further, the findings of this study revealed an improvement in some aspects of sexual dysfunction in patients after six months of methadone maintenance treatment. Thus, explaining to addicts that methadone causes fewer complications than using illegal drugs can help prevent premature exit from MMT.

Background: Many studies have established an association between cigarette smoking and Hearing Loss (HL) mostly in subjects working in noisy places. However, few studies are devoted to the relationship between environmental noise and smoking through nicotine addiction.Objectives: The present study aimed to examine the effect of nicotine dependence on hearing loss and its association with environmental (non-occupational) noise among young subjects in Beirut.Patients and Methods: The study recruited smokers (100) and non-smokers as a reference group (100) aged 21 to 50 years living in noisy or quiet areas of Beirut [70 to 90 A-weighted decibels (dBA)]. After filling out a questionnaire related to medical history and lifestyle risk factors, including smoking and exposure to noise, each volunteer was subject to a hearing assessment including otoscopy and screening pure-tone air. The incidence of hearing loss was defined as a pure-tone average of thresholds at 2000, 4000 and 8000 Hz greater than 25-dB hearing level in either ear. Smokers were referred to perform the Fagerstrom test for nicotine dependence.A saliva sample was also collected from all subjects for cotinine determination, a biomarker of exposure to tobacco smoke.Results: The obtained results showed that smoking is associated with hearing loss at 8000Hz after age 40. Current smokers are 1.73 times as likely to have hearing loss as nonsmokers (P<0.05). Saliva cotinine levels were divided into three categories: group 1 (<15 ng/mL), group 2 (16 - 75 ng/mL) and group 3 (76 - 125 ng/mL). The incidence of hearing loss in each group was, respectively, 13 %, 16% and 23% (P<0.05).Conclusions: The significant difference between groups 1 and 3 permits to establish a correlation between degree of nicotine addiction and hearing loss. However, further studies are needed to identify the mechanisms leading to hearing loss.

Background: Periodontitis is a multi-factorial disease related to the formation of dental plaque. Saliva composition plays a role in plaque formation and in the development of periodontal disease.Objectives: This study was designed to compare the salivary concentrations of calcium and phosphate between patients with chronic periodontitis (CP) and healthy individuals and to assess the effect of smoking status in this regard.Patients and Methods: This case control study was conducted on 50 healthy subjects and 56 patients with CP. The two groups were matched in terms of age, sex, and smoking status. After obtaining written informed consents from the subjects, periodontal parameters such as calculus index (CI), plaque index (PI), bleeding index (BI) and clinical attachment loss (CAL) as well as body mass index (BMI) were calculated and recorded. Non-stimulated saliva was collected by the spitting method, and the concentration of calcium and phosphate was measured by spectrophotometry. Data were analyzed using independent t-test. Pearson correlation was utilized to correlate the periodontal parameters with the salivary concentrations of calcium and phosphate in the CP group. Confidence interval and P value were set to 95% and0.05, respectively.Results: The mean concentration of phosphate in the saliva of CP patients was significantly higher than that in healthy individuals (P=0.008). No significant difference was found between the two groups in the mean concentration of calcium in the saliva (P=0.145). The mean concentrations of calcium and phosphate were not significantly different between non-smoker CP patients and healthy subjects. However, the concentrations of calcium and phosphate in the saliva of smoker CP patients were significantly lower and higher, respectively, than the corresponding values in the healthy smoker group (P=0.016 and P=0.037, respectively). In subjects with BMI<25, the mean concentration of salivary phosphate in CP patients was significantly higher than that in healthy individuals (P=0.005). Among the periodontal parameters, only CI had a significant correlation with the concentration of phosphate in the saliva of patients with CP (P=0.029).Conclusions: Cigarette smoking and BMI are two main confounding factors affecting the correlation of calcium and phosphate concentrations in the saliva and periodontal status.

Background: Although a correlation between anxiety states, stress, and the occurrence of periodontal disorders has been reported, more research on other psychological symptoms seems to be necessary.Objectives: To evaluate the association between psychological disorders and periodontitis.Patients and Methods: In a case-control study, 40 patients with chronic periodontitis and 40 healthy individuals, all between 20 to 40 years old and able to read and write, participated. Clinical examinations were performed by a single examiner. Psychological assessment was done using the SCL-90-R questionnaire. This study was performed in 2011 in Zahedan, Iran. The comparison between groups was performed using the Mann-Whitney U test.Results: There was a significant difference between the study groups in the mean scores on 9 psychological disorders. The mean score of the global severity index in periodontitis patients was higher than in healthy people, and this difference was significant. After grouping the individuals into four age groups (20 - 25, 26 - 30, 31 - 35, and 36 - 40 years old), the results showed that the mean scores of psychological disorders were significantly different between the study groups and three of these age groups (20 - 25, 31 -35, and 36 - 40).Conclusions: This study can be used as a guide for further studies, especially longitudinal studies. It would also be worthwhile to do more studies in different age groups, because research in this area is limited.

Background: There are many risky behaviors that threat adolescents and must receive specific attention. Research has shown that personality pattern behaviors have a significant relationship with risky behaviors.Objectives: The objective of this study was to clarify the role of personality pattern behaviors in risky behaviors of high school students in Chabahar city.Patients and Methods: Three hundred high school students from Chabahar city were selected at random for this study and filled Type A and B pattern behavior profile and Type D personality and sensation seeking (Type T Personality) questionnaires.Results: To analyze the data, Pearson correlation coefficient and multiple stepwise regression were applied. Results revealed that type of sensation seeking (Type T personality) and Type A behavior pattern were significantly correlated with risky behaviors. Type D personality had a significant negative correlation with risky behaviors. Type B behavior pattern was not significantly correlated with risky behaviors. The results of multiple stepwise regressions demonstrated that type A behavior pattern, type D, and type T personality explained 11.4% of the variance in risky behaviors, respectively. Type T and type A personality was a positive and type D personality was a negative predictor of risky behaviors.Conclusions: In conclusion personality pattern behaviors had a unique role in risky behaviors of high school students in Chabahar city and the training and education organization should identify their personality patterns to prevent risky behaviors among them.

Background: Previous studies provided inconsistent associations of smoking, stroke, and serious psychological distress (SPD) with epilepsy while urban-rural differences in the associations of risk factors with epilepsy are not well documented.Objectives: This study aimed to evaluate the associations of lifestyle, health conditions, and SPD with epilepsy and to examine whether the associations differ between urban and rural areas.Patients and Methods: A total of 604 adults with epilepsy and 42416 controls were selected from the 2005 California Health Interview Survey. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors (behavioral factors, SPD, social factors and health conditions) with epilepsy. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.Results: The overall prevalence of epilepsy was 1.3% and the prevalence was higher in urban area than rural area (1.4 vs.1.1%). The prevalence of SPD was 11% in cases and 4% in controls, respectively. The percentage of stroke was higher in cases than in controls (9% vs.2%). After adjusting for other factors using multiple logistic regression, current smoking, stroke, cancer, SPD and living in urban were positively significantly associated with epilepsy (OR=1.74, 95% CI=1.28-2.38; OR=4.81, 95% CI=3.13-7.41; OR=1.52, 95% CI=1.12-2.06; OR=2.02, 95% CI=1.39-2.92, and OR=1.4, 95% CI=1.08 - 1.81, respectively); while binge drinking was negatively associated with epilepsy (OR=0.65, 95% CI=0.43-0.99). Stratified by residence, in the urban area, current smoking and race were only associated with epilepsy. Stroke and SPD showed stronger association with epilepsy in the rural area (OR=7.63, 95% CI=3.68-15.8, and OR=3.14, 95% CI=1.52-6.47, respectively) comparing with urban region (OR=4.51, 95% CI=2.79-7.28 and OR=1.9, 95% CI=1.27-2.86, respectively).Conclusions: Smoking, stroke, and SPD were associated with epilepsy; while the associations differed between urban and rural areas.

Background: Opium addiction is a major issue amongst burn-patients in Iran. A few studies have addressed interactions between burn and addiction.Objectives: The aim of the present study was to compare mortality and morbidity between addicted and non-addicted patients with burn injuries.Patients and Methods: This research was a prospective paired matched-cohort study that was conducted from October 2012 to July 2013 at the Burn Unit of Mashhad University of Medical Sciences. Onehundred and fifty-two burn patients (64% of 237) were matched in pairs based on age, gender, total body surface area and burn thickness. Mortality and morbidity was compared between the two groups using the McNemar test, the conditional logistic regression model and the Kaplan-Meier method.Results: Fourteen (9.2%) patients died at the Burn unit. McNemartest found statistically significant differences in mortality between the two groups. Survival analysis using the Kaplan-Meier method revealed that the estimated mean survival time was 59.02 (CI 95%: 41.83 - 76.21) for non-addicted patients and 118.78 (CI 95%: 106.52 - 131.04) for addicted patients. The odds ratio for mortality was 0.524 (CI 95%: 0.167 - 1.64) times greater for addicted patients compared with non-addicted patients.Conclusions: Addiction in burn patients could be considered as a factor against mortality that deserves further studies. Besides, addicted patients didn‘t show significantly higher morbidity than non-addicted patients.

Background: Type 2 diabetes (T2D) is an inflammatory disease that may cause inflammatory responses if it is not controlled; and mayalso lead to clinical manifestations such as retinopathy, nephropathy, and neuropathy. Interleukin 6 (IL6) is an important proinflammatory cytokine that controls the influence of systemic inflammation on acute phase responses. To work effectively, IL6 must bind with its IL6 receptor (IL6R).Objectives: The current study aimed to investigate the possible associations between two IL6R polymorphisms, namely, rs2229238 and rs4845625, and their susceptibility to T2D.Patients and Methods: This case-control study was done on 250 T2D patients and 250 healthy individuals. The polymorphisms were genotyped using an amplification refractory mutation system-polymerase chain reaction (ARMS-PCR).Results: Our findings showed that either the rs2229238 or the rs4845625 variant was associated with T2D in a sample of the Iranian population. The rs2229238 C/T polymorphism showed a strong significant difference in the CT genotype (OR=0.38, %95 CI=0.23 -0.65, P=0.000), as well as in the TT genotype (OR=0.18, %95 CI=0.05 - 0.63, P=0.007) as a protective factor against T2D in both the patient and the control group. In contrast, the rs4845625 C/T polymorphism showed a significant difference in the CT genotype (OR=1.92, %95 CI=1.15 - 3.23, P=0.031) and in the TT genotype (OR=1.59, %95 CI=1.08 - 2.38, P=0.021) as a risk factor for T2D in both the patient and the control group. An investigation of the alleles relating to these single nucleotide polymorphisms (SNPs) showed that the T allele of rs2229238 (OR=0.34, %95 CI=0.22 - 0.52, P=0.000) and the T allele of rs4845625 (OR=1.43, % 95 CI=1.11 - 1.84, P= 0.006) were significantly different between the subject and control groups, and that these two polymorphisms play a protective and a risk factor role in T2D, respectively. A statistical analysis of the demographic and clinical data showed no significant association between the CC genotype and the CT+TT genotype: in the patient group, with the exception of body mass index (BMI) (P=0.023) in the rs4845625 polymorphism and in the control group, with the exception of HDL (P=0.025) in the rs2229238 SNP.Conclusions: We identified a strong association between the T allele of IL6R gene polymorphisms (rs2229238, rs4845625) and the risk of T2D in a protective role and as a risk factor, respectively. We also found different BMI and HDL values between the patient group and the control group, respectively in compare genotypes (CT+TT vs. CC). Further studies on various ethnicities are necessary to verify our findings.

Background: Opiates are the most commonly reported substances of abuse in Iran. Over two thirds (68%) of all newly identified HIV cases in Iran are among people who inject drugs. On the heels of the HIV epidemic, methamphetamine use has grown. Public health officials are concerned that methamphetamine use has gained popularity among individuals who use opioid substitution therapy, such as methadone maintenance therapy.Objectives: The purpose of this qualitative study is to inform stakeholders of the motivations and experiences of MMT patients who use methamphetamine.Patients and Methods: To gain a better understanding of patients’ motivations and experiences with MMT and methamphetamine, the authors conducted 7 focus groups with 45 participants in drop-in centers, public outpatient clinics, and a private outpatient clinic in Isfahan, Iran.Results: Patients reported that their use of meth amphetamine was motivated by methadone’s side effects and encouraged by family and friends who promoted methamphetamine use to assuage the side effects of methadone in the early stages of treatment before the appearance of methadone maintenance therapy’s effects on their life.Conclusions: Findings suggest that there is a need for evidence-based practices in methadone maintenance therapy programs in Iran to reduce methamphetamine use among methadone maintenance therapy patients. Methamphetamine use among methadone maintenance therapy patients in Iran can reduce the efficacy of these services in reducing risky behaviors as well as other desired outcomes of methadone maintenance therapy. Our findings suggest two strategies that may be of use (or our findings suggest that two strategies that may be of use are: 1) educate patients and their families about methadone’s side effects and the contraindications of methamphetamine use by treatment team and/or peer groups’ educators; 2) integrate routine amphetamine testing into methadone treatment. These findings may be useful to those designing and implementing strategies for reducing methamphetamine use in methadone maintenance therapy programs in Iran.