Our findings provide evidence that adding CRT as an adjunct intervention to MMT can improve cognitive performance as well as abstinence from both opiates and stimulants.

BackgroundDifferent studies have suggested that antipsychotic medications of the first generation have better effectiveness for the treatment of psychotic symptoms compared with antipsychotic medications of the second generation.ObjectivesThe current study was the first pilot study in Iran that compared Haloperidol with Risperidone in the treatment of positive symptoms of psychosis among a group of methamphetamine-dependent patients.Materials and MethodsThis randomized clinical trial was designed and conducted in 2012. Overall, 44 patients who met the diagnostic and statistical manual of mental disorders, fourth edition-text revised (DSM.IV-TR) criteria for methamphetamine-associated psychosis (MAP) and were hospitalized at Razi psychiatric hospital in Tehran were selected. Patients (1: 1) were randomly divided to two groups. Overall, 22 subjects received Haloperidol (5 - 20 mg) and 22 subjects received Risperidone (2 - 8 mg). All subjects were assessed at baseline, during three consecutive weeks of treatment and one week after treatment (i.e., follow-up). Scale of assessment of positive symptoms (SAPS) was completed for each subject.ResultsThe study findings indicated that both Haloperidol (< 0.05) and Risperidone (< 0.05) were similarly applicable in the treatment of MAP but no differential effectiveness was found between the two medications. The treatment effects of both medications increased in the first two weeks of treatment and remained stable in the second two weeks.ConclusionsRisperidone and Haloperidol are two effective antipsychotic medications for the treatment of positive symptoms of MAP but other aspects of these two neuroleptic medications such as the long-term treatment effects should be studied. Further studies with more samples and longer follow-ups are suggested.

Background: Dependence on amphetamine-type stimulants (ATS) is a health concern in Iran (i.e. the most populated Persian Gulf country). However, there are no literature reports on ATS dependence in the community. Objectives: The current study aimed to investigate the prevalence of ATS-dependence, the reasons associated with this problem and the treatment barriers among a group of adults in 22 districts of Tehran. Materials and Methods: A rapid situation assessment was conducted. A mixed quantitative-qualitative methodology was applied. The study was conducted between September 2009 and January 2010. A researcher-made checklist was designed to collect data. The SPSS version 23 and Atlas-ti qualitative software were used for data analyses. Results: In total, 6027 individuals were randomly recruited and interviewed. Among them, 261 participants were ATS-dependent. A desire to increase performance and reduce psychiatric problems, beauty-related issues and a desire to stop opiate use were the main reasons for the illegal use of ATS. Poor knowledge of ATS treatment services in the community, poor knowledge of the side effects of the illegal use of ATS and stigma were the main current treatment barriers. Amphetamine-Type Stimulants dependence was associated with unemployment (adjusted OR = 3.1 CI 95% 1.0 -4.6), lack of leisure activities (OR = 2.9 CI 95% 1.0 -5.3), curiosity (OR = 3.2 CI 95% 2.1 -5.6) and increasing sexual performance (OR = 2.6 CI 95% 2.3 -5.4). Conclusions:The study results indicated that ATS-dependence was present among the study participants. This issue necessitates treatment, which should be considered by health policy makers. Prevention programs should be provided on the large scale in the Persian community to prevent ATS use and dependence.

BackgroundIran (Persia) has a women-only drug treatment system. However, literature is not documented. The current study aimed to review the development of women-only drug treatment and harm reduction services (WODTHRS) and the factors associated with treatment entry and outcomes in Iran. The review was based on a comprehensive search for all literature focusing on WODTHRS in Iran.MethodsData were collected by conducting systematic searching of scientific English and Persian databases and grey literature. This was done in line with Cochrane Guideline for conducting systematic reviews. Overall, 19,929 studies were found. But, only 19 original studies were included after excluding non-relevant studies.ResultsThe review findings indicate how WODTHRS have been developed in the past 15 years. The review findings underscore the roles of numerous factors in treatment entry such as the side effects of illicit drug use. In addition, cognitive-behavioral interventions, methadone treatment and some factors outside drug treatment such as family support increase positive treatment outcomes among women.In contrast, financial problems as well as other factors such as insufficient medical, psychiatric and social work services hamper treatment entry and positive treatment outcomes.ConclusionsThe review results highlight that eliminating barriers to treatment entry and positive treatment outcomes should be addressed. Conducting randomized controlled trials is needed to evaluate the effectiveness of WODTHRS. This issue should address the factors influencing service utilization to incorporate the best practice for women. The evaluation of the long-term efficacy of WODTHRS is a critical research gap which should be addressed in future studies.

BackgroundEmotion plays an important role in adapting to life changes and stressful events. Difficulty regulating emotions is one of the problems drug abusers often face, and teaching these individuals to express and manage their emotions can be effective on improving their difficult circumstances.ObjectivesThe present study aimed to determine the effectiveness of the Gross model-based emotion regulation strategies training on anger reduction in drug-dependent individuals.Patients and MethodsThe present study had a quasi-experimental design wherein pretest-posttest evaluations were applied using a control group. The population under study included addicts attending Marivan’s methadone maintenance therapy centers in 2012 - 2013. Convenience sampling was used to select 30 substance-dependent individuals undergoing maintenance treatment who were then randomly assigned to the experiment and control groups. The experiment group received its training in eight two-hour sessions. Data were analyzed using analysis of co-variance and paired t-test.ResultsThere was significant reduction in anger symptoms of drug-dependent individuals after gross model based emotion regulation training (ERT) (P < 0.001). Moreover, the effectiveness of the training on anger was persistent in the follow-up period.ConclusionsSymptoms of anger in drug-dependent individuals of this study were reduced by gross model-based emotion regulation strategies training. Based on the results of this study, we may conclude that the gross model based emotion regulation strategies training can be applied alongside other therapies to treat drug abusers undergoing rehabilitation.

Background: Opiate use on a stable methadone dose is a health concern in Iran (Persia). Cognitive-behavioral therapy (CBT) is a suggested treatment for this problem.

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ContextThere is no review of HIV responses in Arab states on the southern Persian Gulf border. This narrative review aimed to describe and synthesize HIV responses in Kuwait, Qatar, Bahrain and the United Arab Emirates (UAE).Evidence AcquisitionA review of scientific databases and grey literature was conducted based on an international guide. Overall, 16 original studies and reports were found.ResultsThe review indicates that HIV has been found present in each Arab state based on sporadic case finding. The prevalence of HIV is the result of heterosexual relationship and/or drug injection. Mandatory testing of the nationals and expatriate workers is the main route of HIV detection. In general, HIV knowledge and education are poor. Only Bahrain has some non-governmental organizations that provide HIV education. Lack of identifying key populations and high risk behaviors has been reported in all of the states. HIV responses are mainly for Arab and Arabic-speaking nationals. Effective strategic plans for HIV have not been developed in all of the states. The provision of antiretroviral therapy for the nationals is the main HIV response. Only Qatar has paid for the treatment of Qatari and non-Qatari HIV-infected patients. As a HIV response, drug treatment is based on short-term inpatient rehabilitation. Only Qatar has voluntary HIV counseling and testing. Lack of needle and syringe programs has been reported for people who inject drugs with HIV problem in all of the states.ConclusionsTo conclude, HIV problem needs a comprehensive policy response in each state. Providing effective strategic plans for HIV and sero-surveillance data systems is required. Empowering human resources and infrastructural development are suggested.