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Backgrounds and aims: Iran has 2.1 and 1.8% of its 15–64‐year‐old population living with illicit substance and opioid use disorders, respectively. To address these problems, Iran has been developing a large and multi‐modality addiction treatment system, spanning the time before and after the Islamic Revolution. Methods: Iran's current drug treatment scene is a combination of services, ranging from medical/harm reduction services to punitive/criminal justice programs. Included in this array of services are drop‐in centers providing low‐threshold harm reduction services, such as distribution of sterile needles and syringes; opioid maintenance treatment clinics providing methadone, buprenorphine and opium tincture; and abstinence‐based residential centers. We will review the evolution of this system in four phases. Results: In 1980, Iran's revolutionary government shut down all voluntary treatment programs and replaced them with residential correctional programs. The first shift in the addiction treatment policies came 15 years later after facing the negative consequences. Addiction is viewed as a disease, and new voluntary treatment centers offering non‐agonist medications and psychosocial services were established. With an increased number of people who inject drugs and HIV/AIDS epidemics, in the second shift an extensive move towards harm reduction strategies and opioid‐maintenance programs has been implemented to reduce HIV‐related high‐risk behavior. The emergence of a methamphetamine use crisis creating an increased number of socially marginalized addicted people resulted in public and political demands for stricter policies and ended in the third shift starting in 2010, with extended compulsory court‐based residential programs. Currently, there is a new shift towards reducing the severity of criminal penalties for drug use/sales and promoting proposals for opium legalization. Conclusion: Iran's evolutionary experience in developing a large addiction treatment program in a complex combination of medical/harm reduction and punitive/criminal justice addiction treatment can be examined in its political, clinical and pragmatic context. [ABSTRACT FROM AUTHOR]

Introduction and Aims: There is a paucity of data on volume of alcohol use from Muslim majority countries. We aimed to present estimation methods for alcohol consumption with the use of survey data for these societies and provide an estimation for age 15+ per capita consumption of pure alcohol for Iran.Design and Methods: The Iranian Mental Health Survey was a nationally representative household survey on individuals aged 15-64 years, with a multistage, cluster sampling design. We used the 'Last Week' method and 'Quantity-Frequency' methods for gathering data on alcohol consumption and combined these to provide more complete estimates.Results: The response rate was 85.7%. From the total of 7840 respondents, 5.7% and 1% reported past 12 months and past week alcohol use, respectively. The highest estimation for age 15+ per capita consumption of pure alcohol was yielded by the 'combination method' (0.108 L ethanol/person/year) followed by the Quantity-Frequency method (0.079 L). The 'Last Week' method provided the lowest estimate (0.059 L).Discussion and Conclusions: Unlike in surveys of non-Muslim countries, frequency of drinking from recent recall (last week) was much lower than from recall of usual drinking in the last year. We conclude that 0.108 L (SE = 0.03) is the best survey-based estimate of age 15+ per capita consumption, which translates to about 5 750 000 L of national consumption per year in Iran. However, this method is still likely to under-estimate per capita consumption due to evidence of under-reporting in the survey. [ABSTRACT FROM AUTHOR]

Background: To assess the clinical course and outcome of patients with methamphetamine‐induced psychosis in comparison with patients with primary psychotic disorders. Methods: This prospective study was conducted on patients with methamphetamine‐induced psychosis, and 2 groups of primary psychotic disorders: affective psychosis and non‐affective psychosis admitted to 2 psychiatric hospitals in Tehran, Iran, with a first episode of a psychotic illness. A total of 165 subjects (55 in each group) were selected using convenience sampling. They were assessed at the time of admission, discharge and 6 and 12 months after discharge using the Positive and Negative Syndrome Scale, the Young Mania Rating Scale and the Global Assessment of Functioning Scale. The frequency of readmissions and suicide attempts were also assessed. Results: Significant differences were found in the trend of changes of symptoms and functioning among the 3 groups. At all‐time points, the severity of negative psychotic symptoms and dysfunction in the non‐affective psychosis group were greater than those in affective or methamphetamine‐induced psychosis groups, with latter 2 having similar profiles. However, the course of positive symptoms in methamphetamine‐induced psychosis was more similar to non‐affective psychosis. Number of suicide attempts and readmissions were non‐significantly higher in methamphetamine‐induced psychosis than in the other groups. Conclusion: Methamphetamine‐induced psychosis does not have a satisfactory course and in some cases symptoms may remain even after many months of follow‐up. Rate of certain outcomes such as re‐hospitalization is also considerably high. It is a challenge for the health‐care system that requires evidence‐based interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The aims of the study were to translate into Persian and culturally adapt the Kessler Psychological Distress Scales, K10 and K6, and to assess their reliability and validity. Method: The sample was recruited from primary health care (PHC) settings by quota nonprobability sampling, stratified by sex and age. Validity was assessed against the Composite International Diagnostic Interview (v2.1). The psychometric properties of K6 and K10 were also compared with the 12‐item General Health Questionnaire (GHQ‐12). Results: A total of 818 participants completed the questionnaire. Cronbach's alpha were 0.92 and 0.87 for K6 and K10, respectively. Optimal cutoff scores for detecting any mood or anxiety disorder in the past 30 days were 15 for K10 and 10 for K6. At these cutoff points, the measures had sensitivities of 0.77 and 0.73, specificities of 0.74 and 0.78, and positive predictive values of 0.48 and 0.52, respectively. Psychometric properties of K10 and K6 were similar to GHQ‐12. Conclusion: Persian K10 and K6 have acceptable psychometric properties as screening instruments for common mental health conditions. Given its brevity and similar psychometric properties to the longer instruments, the Persian K6 appears to be a suitable scale for use in PHC settings and, possibly, epidemiologic studies in Iran. [ABSTRACT FROM AUTHOR]

Background and aims Drug abuse is a significant social and public health problem in Iran. The present study aimed to provide prevalence estimates and information on correlates of illicit drug use disorder and opioid dependence, as well as service use for these disorders in Iran. Design, setting and participants This report is based on the Iranian household Mental Health Survey (IranMHS) conducted in 2011. A three-stage probability sampling was employed. Face-to-face interviews by trained psychologists were carried out with a nationally representative sample of 7841 individuals (3366 men and 4475 women) aged 15-64 years. Measurements The Composite International Diagnostic Interview and questionnaires for socio-demographic correlates and service use. Findings The prevalence of 12-month use disorders for any illicit drug according to DSM-IV and DSM-5 criteria were 2.09% [95% confidence interval (CI) = 1.70-2.47%] and 2.44% (95% CI = 2.03-2.85%), respectively. Opioid use disorders, and opium in particular, were the most common use disorder. The odds of drug use disorders were greater in men than in women, in previously married participants than in currently or never married participants, and in participants with lower socio-economic status than in those with higher socio-economic status (all P-values <0.05). Approximately half of those with drug use disorders and 40% with opioid dependence had a 12-month unmet need for treatment. Self-help groups were the most common type of service used, followed by obtaining medication from pharmacies directly and outpatient treatment services. Conclusions Opioid use disorders are the most common type of drug use disorders in Iran, setting Iran apart from many other countries. Patterns of service use suggest a large unmet need for drug use disorder treatment in Iran. [ABSTRACT FROM AUTHOR]