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1. A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic

Author

Farhoudian, A, Radfar, S, Ardabili, H, Rafei, P, Ebrahimi, M, Zonoozi, A, De Jong, C, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Hansen, H, Brady, K, Potenza, M, Baldacchino, A, Ekhtiari, H, Abagiu, A, Abouna, F, Ahmed, M, Al-Ansari, B, Al-Khair, F, Almaqbali, M, Ambekar, A, Arya, S, Asebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Busse, A, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Deilamizade, A, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Isra, T, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Kurniasanti, K, Lev, R, Lee, H, Lengvenyte, A, Lev-Ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Massah, O, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon, T, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Quiros, R, Qurishi, R, Rafiq, N, Raghavendra Rao, R, Ratta-Apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Wee Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Farhoudian A., Radfar S. R., Ardabili H. M., Rafei P., Ebrahimi M., Zonoozi A. K., De Jong C. A. J., Vahidi M., Yunesian M., Kouimtsidis C., Arunogiri S., Hansen H., Brady K. T., Potenza M. N., Baldacchino A. M., Ekhtiari H., Abagiu A. O., Abouna F. D. N., Ahmed M. H., Al-Ansari B., Al-Khair F. M. A., Almaqbali M. H., Ambekar A., Arya S., Asebikan V. O., Ayasreh M. A., Basu D., Benmebarek Z., Bhad R., Blaise M., Bonnet N., Brasch J., Broers B., Busse A., Butner J. L., Camilleri M., Campello G., Carra G., Celic I., Chalabianloo F., Chaturvedi A., Cherpitel J. J. E. N., Clark K. J., Cyders M. A., de Bernardis E., Deilamizade A., Derry J. E., Dhagudu N. K., Dolezalova P., Dom G., Dunlop A. J., Elhabiby M. M., Elkholy H., Essien N. F., Farah G. I., Ferri M., Floros G. D., Friedman C., Fuderanan C. H., Gerra G., Ghosh A., Gogia M., Grammatikopoulos I. A., Grandinetti P., Guirguis A., Gutnisky D., Haber P. S., Hassani-Abharian P., Hooshyari Z., Ibrahim I. I. M., Ieong H. F. -H., Indradewi R. N., Iskandar S., Isra T. N., Jain S., James S., Javadi S. M. H., Joe K. H., Jokubonis D., Jovanova A. T., Kamal R. M., Kantchelov A. I., Kathiresan P., Katzman G., Kawale P., Kern A. M., Kessler F. H. P., Kim S. -G. S., Kimball A. M., Kljucevic Z., Kurniasanti K. S., Lev R., Lee H. K., Lengvenyte A., Lev-Ran S., Mabelya G. S., Mahi M. A. E., Maphisa J. M., Maremmani I., Masferrer L., Massah O., McCambridge O., McGovern G. G., Min A. K., Moghanibashi-Mansourieh A., Mora-Rios J., Mudalige I. U. K., Mukherjee D., Munira P. M., Myers B., Menon T. N. J., Narasimha V. L., Ndionuka N., Nejatisafa A. -A., Niaz K., Nizami A. T., Nuijens J. H., Orsolini L., Oum V., Oyemade A. A., Palavra I. R., Pant S. B., Paredes J., Peyron E., Quiros R. A., Qurishi R., Rafiq N. U. Z., Raghavendra Rao R., Ratta-Apha W., Raymond K. -L., Reimer J., Renaldo E., Rezapour T., Robertson J. R., Roncero C., Roub F., Rubenstein E. J., Rupp C. I., Saenz E., Salehi M., Samartzis L., Sarubbo L. B., Segrec N., Shah B., Shen H., Shirasaka T., Shoptaw S., Sintango F. M., Sosa V. A., Subata E., Sztycberg N., Taghizadeh F., Wee Teck J. B. T., Tjagvad C., Torrens M., Twala J. M., Vadivel R., Volpicelli J. R., Weijs J., Wintoniw S. M., Wittayanookulluk A., Wojnar M., Yasir S., Yitayih Y., Zhao M., Farhoudian, A, Radfar, S, Ardabili, H, Rafei, P, Ebrahimi, M, Zonoozi, A, De Jong, C, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Hansen, H, Brady, K, Potenza, M, Baldacchino, A, Ekhtiari, H, Abagiu, A, Abouna, F, Ahmed, M, Al-Ansari, B, Al-Khair, F, Almaqbali, M, Ambekar, A, Arya, S, Asebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Busse, A, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Deilamizade, A, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Isra, T, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Kurniasanti, K, Lev, R, Lee, H, Lengvenyte, A, Lev-Ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Massah, O, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon, T, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Quiros, R, Qurishi, R, Rafiq, N, Raghavendra Rao, R, Ratta-Apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Wee Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Farhoudian A., Radfar S. R., Ardabili H. M., Rafei P., Ebrahimi M., Zonoozi A. K., De Jong C. A. J., Vahidi M., Yunesian M., Kouimtsidis C., Arunogiri S., Hansen H., Brady K. T., Potenza M. N., Baldacchino A. M., Ekhtiari H., Abagiu A. O., Abouna F. D. N., Ahmed M. H., Al-Ansari B., Al-Khair F. M. A., Almaqbali M. H., Ambekar A., Arya S., Asebikan V. O., Ayasreh M. A., Basu D., Benmebarek Z., Bhad R., Blaise M., Bonnet N., Brasch J., Broers B., Busse A., Butner J. L., Camilleri M., Campello G., Carra G., Celic I., Chalabianloo F., Chaturvedi A., Cherpitel J. J. E. N., Clark K. J., Cyders M. A., de Bernardis E., Deilamizade A., Derry J. E., Dhagudu N. K., Dolezalova P., Dom G., Dunlop A. J., Elhabiby M. M., Elkholy H., Essien N. F., Farah G. I., Ferri M., Floros G. D., Friedman C., Fuderanan C. H., Gerra G., Ghosh A., Gogia M., Grammatikopoulos I. A., Grandinetti P., Guirguis A., Gutnisky D., Haber P. S., Hassani-Abharian P., Hooshyari Z., Ibrahim I. I. M., Ieong H. F. -H., Indradewi R. N., Iskandar S., Isra T. N., Jain S., James S., Javadi S. M. H., Joe K. H., Jokubonis D., Jovanova A. T., Kamal R. M., Kantchelov A. I., Kathiresan P., Katzman G., Kawale P., Kern A. M., Kessler F. H. P., Kim S. -G. S., Kimball A. M., Kljucevic Z., Kurniasanti K. S., Lev R., Lee H. K., Lengvenyte A., Lev-Ran S., Mabelya G. S., Mahi M. A. E., Maphisa J. M., Maremmani I., Masferrer L., Massah O., McCambridge O., McGovern G. G., Min A. K., Moghanibashi-Mansourieh A., Mora-Rios J., Mudalige I. U. K., Mukherjee D., Munira P. M., Myers B., Menon T. N. J., Narasimha V. L., Ndionuka N., Nejatisafa A. -A., Niaz K., Nizami A. T., Nuijens J. H., Orsolini L., Oum V., Oyemade A. A., Palavra I. R., Pant S. B., Paredes J., Peyron E., Quiros R. A., Qurishi R., Rafiq N. U. Z., Raghavendra Rao R., Ratta-Apha W., Raymond K. -L., Reimer J., Renaldo E., Rezapour T., Robertson J. R., Roncero C., Roub F., Rubenstein E. J., Rupp C. I., Saenz E., Salehi M., Samartzis L., Sarubbo L. B., Segrec N., Shah B., Shen H., Shirasaka T., Shoptaw S., Sintango F. M., Sosa V. A., Subata E., Sztycberg N., Taghizadeh F., Wee Teck J. B. T., Tjagvad C., Torrens M., Twala J. M., Vadivel R., Volpicelli J. R., Weijs J., Wintoniw S. M., Wittayanookulluk A., Wojnar M., Yasir S., Yitayih Y., and Zhao M.

Abstract

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Design: Cross-sectional survey. Setting: Worldwide. Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries. Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic. Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

Published
2021

2. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Author

Radfar, S, De Jong, C, Farhoudian, A, Ebrahimi, M, Rafei, P, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Massah, O, Deylamizadeh, A, Brady, K, Busse, A, Potenza, M, Ekhtiari, H, Baldacchino, A, Abagiu, A, Abouna, F, Ahmed, M, Al-ansari, B, Mahmmoud Abu Al-khair, F, Almaqbali, M, Ambekar, A, Ardabili, H, Arya, S, Lasebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, de Jesus Eduardo Noyola Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Siste, K, Lev, R, Lee, H, Lengvenyte, A, Lev-ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon T N, J, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Alberto Quiros, R, Qurishi, R, Rafiq, N, Rao, R, Ratta-apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Zonoozi, A, Radfar S. R., De Jong C. A. J., Farhoudian A., Ebrahimi M., Rafei P., Vahidi M., Yunesian M., Kouimtsidis C., Arunogiri S., Massah O., Deylamizadeh A., Brady K. T., Busse A., Potenza M. N., Ekhtiari H., Baldacchino A. M., Abagiu A. O., Abouna F. D. N., Ahmed M. H., Al-ansari B., Mahmmoud Abu Al-khair F., Almaqbali M. H., Ambekar A., Ardabili H. M., Arya S., Lasebikan V. O., Ayasreh M. A., Basu D., Benmebarek Z., Bhad R., Blaise M., Bonnet N., Brasch J., Broers B., Butner J. L., Camilleri M., Campello G., Carra G., Celic I., Chalabianloo F., Chaturvedi A., de Jesus Eduardo Noyola Cherpitel J., Clark K. J., Cyders M. A., de Bernardis E., Derry J. E., Dhagudu N. K., Dolezalova P., Dom G., Dunlop A. J., Elhabiby M. M., Elkholy H., Essien N. F., Farah G. I., Ferri M., Floros G. D., Friedman C., Fuderanan C. H., Gerra G., Ghosh A., Gogia M., Grammatikopoulos I. A., Grandinetti P., Guirguis A., Gutnisky D., Haber P. S., Hassani-Abharian P., Hooshyari Z., Ibrahim I. I. M., Ieong H., Indradewi R. N., Iskandar S., Jain S., James S., Javadi S. M. H., Joe K. H., Jokubonis D., Jovanova A. T., Kamal R. M., Kantchelov A. I., Kathiresan P., Katzman G., Kawale P., Kern A. M., Kessler F. H. P., Kim S., Kimball A. M., Kljucevic Z., Siste K., Lev R., Lee H. K., Lengvenyte A., Lev-ran S., Mabelya G. S., Mahi M. A. E., Maphisa J., Maremmani I., Masferrer L., McCambridge O., McGovern G. G., Min A. K., Moghanibashi-Mansourieh A., Mora-Rios J., Mudalige I. U. K., Mukherjee D., Munira P. M., Myers B., Menon T N J., Narasimha V. L., Ndionuka N., Nejatisafa A., Niaz K., Nizami A. T., Nuijens J. H., Orsolini L., Oum V., Oyemade A. A., Palavra I. R., Pant S. B., Paredes J., Peyron E., Alberto Quiros R., Qurishi R., Rafiq N. U. Z., Rao R. R., Ratta-apha W., Raymond K., Reimer J., Renaldo E., Rezapour T., Robertson J. R., Roncero C., Roub F., Rubenstein E. J., Rupp C. I., Saenz E., Salehi M., Samartzis L., Sarubbo L. B., Segrec N., Shah B., Shen H., Shirasaka T., Shoptaw S., Sintango F. M., Sosa V. A., Subata E., Sztycberg N., Taghizadeh F., Teck J., Tjagvad C., Torrens M., Twala J. M., Vadivel R., Volpicelli J. R., Weijs J., Wintoniw S. M., Wittayanookulluk A., Wojnar M., Yasir S., Yitayih Y., Zhao M., Zonoozi A. K., Radfar, S, De Jong, C, Farhoudian, A, Ebrahimi, M, Rafei, P, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Massah, O, Deylamizadeh, A, Brady, K, Busse, A, Potenza, M, Ekhtiari, H, Baldacchino, A, Abagiu, A, Abouna, F, Ahmed, M, Al-ansari, B, Mahmmoud Abu Al-khair, F, Almaqbali, M, Ambekar, A, Ardabili, H, Arya, S, Lasebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, de Jesus Eduardo Noyola Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Siste, K, Lev, R, Lee, H, Lengvenyte, A, Lev-ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon T N, J, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Alberto Quiros, R, Qurishi, R, Rafiq, N, Rao, R, Ratta-apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Zonoozi, A, Radfar S. R., De Jong C. A. J., Farhoudian A., Ebrahimi M., Rafei P., Vahidi M., Yunesian M., Kouimtsidis C., Arunogiri S., Massah O., Deylamizadeh A., Brady K. T., Busse A., Potenza M. N., Ekhtiari H., Baldacchino A. M., Abagiu A. O., Abouna F. D. N., Ahmed M. H., Al-ansari B., Mahmmoud Abu Al-khair F., Almaqbali M. H., Ambekar A., Ardabili H. M., Arya S., Lasebikan V. O., Ayasreh M. A., Basu D., Benmebarek Z., Bhad R., Blaise M., Bonnet N., Brasch J., Broers B., Butner J. L., Camilleri M., Campello G., Carra G., Celic I., Chalabianloo F., Chaturvedi A., de Jesus Eduardo Noyola Cherpitel J., Clark K. J., Cyders M. A., de Bernardis E., Derry J. E., Dhagudu N. K., Dolezalova P., Dom G., Dunlop A. J., Elhabiby M. M., Elkholy H., Essien N. F., Farah G. I., Ferri M., Floros G. D., Friedman C., Fuderanan C. H., Gerra G., Ghosh A., Gogia M., Grammatikopoulos I. A., Grandinetti P., Guirguis A., Gutnisky D., Haber P. S., Hassani-Abharian P., Hooshyari Z., Ibrahim I. I. M., Ieong H., Indradewi R. N., Iskandar S., Jain S., James S., Javadi S. M. H., Joe K. H., Jokubonis D., Jovanova A. T., Kamal R. M., Kantchelov A. I., Kathiresan P., Katzman G., Kawale P., Kern A. M., Kessler F. H. P., Kim S., Kimball A. M., Kljucevic Z., Siste K., Lev R., Lee H. K., Lengvenyte A., Lev-ran S., Mabelya G. S., Mahi M. A. E., Maphisa J., Maremmani I., Masferrer L., McCambridge O., McGovern G. G., Min A. K., Moghanibashi-Mansourieh A., Mora-Rios J., Mudalige I. U. K., Mukherjee D., Munira P. M., Myers B., Menon T N J., Narasimha V. L., Ndionuka N., Nejatisafa A., Niaz K., Nizami A. T., Nuijens J. H., Orsolini L., Oum V., Oyemade A. A., Palavra I. R., Pant S. B., Paredes J., Peyron E., Alberto Quiros R., Qurishi R., Rafiq N. U. Z., Rao R. R., Ratta-apha W., Raymond K., Reimer J., Renaldo E., Rezapour T., Robertson J. R., Roncero C., Roub F., Rubenstein E. J., Rupp C. I., Saenz E., Salehi M., Samartzis L., Sarubbo L. B., Segrec N., Shah B., Shen H., Shirasaka T., Shoptaw S., Sintango F. M., Sosa V. A., Subata E., Sztycberg N., Taghizadeh F., Teck J., Tjagvad C., Torrens M., Twala J. M., Vadivel R., Volpicelli J. R., Weijs J., Wintoniw S. M., Wittayanookulluk A., Wojnar M., Yasir S., Yitayih Y., Zhao M., and Zonoozi A. K.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups. Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted. Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Published
2021

3. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Author

Radfar, SR, De Jong, CAJ, Farhoudian, A, Ebrahimi, M, Rafei, P, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Massah, O, Deylamizadeh, A, Brady, KT, Busse, A, Potenza, MN, Ekhtiari, H, Baldacchino, AM, Abagiu, AO, Abouna, FDN, Ahmed, MH, Al-ansari, B, Abu Al-khair, F Mahmmoud, Almaqbali, MH, Ambekar, A, Ardabili, HM, Arya, S, Lasebikan, VO, Ayasreh, MA, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Butner, JL, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, de Jesús Eduardo Noyola Cherpitel, J, Clark, KJ, Cyders, MA, de Bernardis, E, Derry, JE, Dhagudu, NK, Dolezalova, P, Dom, G, Dunlop, AJ, Elhabiby, MM, Elkholy, H, Essien, NF, Farah, GI, Ferri, M, Floros, GD, Friedman, C, Fuderanan, CH, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, IA, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, PS, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, IIM, Ieong, HFH, Indradewi, RN, Iskandar, S, Jain, S, James, Sandi, Javadi, SMH, Joe, KH, Jokubonis, D, Jovanova, AT, Kamal, RM, Kantchelov, AI, Kathiresan, P, Katzman, G, Kawale, P, Kern, AM, Kessler, FHP, Kim, SGS, Kimball, AM, Kljucevic, Z, Siste, K, Lev, R, Lee, HK, Lengvenyte, A, Lev-ran, S, Mabelya, GS, Mahi, MAE, Maphisa, JM, Maremmani, I, Masferrer, L, McCambridge, O, and McGovern, GG

Subjects
Uncategorized
Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups. Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted. Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Published
2021
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4. The 'glass ceiling' and empowerment of Qatari women for employment in Qatar

Author

Al-Ansari, B

Abstract

Qatar is rapidly transforming from a traditional conservative and modest society to a more open, modern and technologically advanced society. Qatar has made significant strides over the recent years in increasing the participation of women in higher education and in the Qatari workforce (Scott-Jackson, 2015). Women comprise 24% of the Qatari population and 18% of the workforce (MDPS, 2015), however, they remain concentrated in entry-level administrative jobs (Al Ansari, 2012) and mostly in the public sector. Is this inequality of participation of women in higher levels of Qatari organizations, a Glass Ceiling phenomenon that has been noticed in other countries and global organizations? The answer from similar previous research is “Yes” and this dissertation is an endeavor to further build on these reasons and highlight how this problem has sprouted in Qatar. Using an employment effectiveness route, to make employees both men and women, express their views of their current work experiences and their likelihood to continue or leave employment and complete their career objectives in the current organization, this dissertation will help understand whether the Glass Ceiling has external reasons or is it self-inflicted. Self-infliction can be a reason from the lack of enthusiasm to progress into senior roles by women themselves due to the Islamic and patriarchal society values and the influence that this has had on women in Qatar and the entire middle east region in general (Ermis-Mert, A., 2018). The objective of this research is to find not only the reasons for the Glass Ceiling but also the solutions of how to use public policies and driving cultural changes to overcome this problem and to see Qatar fulfilling its vision 2030 in its entirety.

Published
2020

5. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Author

Seyed Ramin Radfar, Cornelis A. J. De Jong, Ali Farhoudian, Mohsen Ebrahimi, Parnian Rafei, Mehrnoosh Vahidi, Masud Yunesian, Christos Kouimtsidis, Shalini Arunogiri, Omid Massah, Abbas Deylamizadeh, Kathleen T. Brady, Anja Busse, ISAM-PPIG Global Survey Consortium, Marc N. Potenza, Hamed Ekhtiari, Alexander Mario Baldacchino, Adrian Octavian Abagiu, Franck David Noel Abouna, Mohamed Hassan Ahmed, Basma Al-ansari, Feda Mahmmoud Abu Al-khair, Mandhar Humaid Almaqbali, Atul Ambekar, Hossein Mohaddes Ardabili, Sidharth Arya, Victor Olufolahan Lasebikan, Murad Ali Ayasreh, Debasish Basu, Zoubir Benmebarek, Roshan Bhad, Mario Blaise, Nicolas Bonnet, Jennifer Brasch, Barbara Broers, Jenna L. Butner, Moses Camilleri, Giovanna Campello, Giuseppe Carra, Ivan Celic, Fatemeh Chalabianloo, Abhishek Chaturvedi, José de Jesús Eduardo Noyola Cherpitel, Kelly J. Clark, Melissa Anne Cyders, Ernesto de Bernardis, John Edward Derry, Naveen Kumar Dhagudu, Pavla Dolezalova, Geert Dom, Adrian John Dunlop, Mahmoud Mamdouh Elhabiby, Hussien Elkholy, Nsidibe Francis Essien, Ghandi Ilias Farah, Marica Ferri, Georgios D Floros, Catherine Friedman, Clara Hidalgo Fuderanan, Gilberto Gerra, Abhishek Ghosh, Maka Gogia, Ilias A. Grammatikopoulos, Paolo Grandinetti, Amira Guirguis, David Gutnisky, Paul Steven Haber, Peyman Hassani-Abharian, Zahra Hooshyari, Islam Ibrahim Mokhtar Ibrahim, Hada Fong-ha Ieong, Regina Nova Indradewi, Shelly Iskandar, Shobhit Jain, Sandi James, Seyyed Mohammad hossein Javadi, Keun Ho Joe, Darius Jokubonis, Acka Tushevska Jovanova, Rama Mohamed Kamal, Alexander Ivanov Kantchelov, Preethy Kathiresan, Gary Katzman, Paul Kawale, Audrey Margaret Kern, Felix Henrique Paim Kessler, Sung-Gon Sue Kim, Ann Marie Kimball, Zeljko Kljucevic, Kristiana Siste, Roneet Lev, Hae Kook Lee, Aiste Lengvenyte, Shaul Lev-ran, Geni Seseja Mabelya, Mohamed Ali El Mahi, J. Maphisa Maphisa, Icro Maremmani, Laura Masferrer, Orlagh McCambridge, Garrett Gregory McGovern, Aung Kyi Min, Amir Moghanibashi-Mansourieh, Jazman Mora-Rios, Indika Udaya Kumara Mudalige, Diptadhi Mukherjee, Pejic Munira Munira, Bronwyn Myers, Jayakrishnan Menon T N, Venkata Lakshmi Narasimha, Nkemakolam Ndionuka, Ali-Akbar Nejatisafa, Kamran Niaz, Asad Tamizuddin Nizami, Jan H. Nuijens, Laura Orsolini, Vantheara Oum, Adegboyega Adekunle Oyemade, Irena Rojnia Palavra, Sagun Ballav Pant, Joselyn Paredes, Eric Peyron, Randall Alberto Quirós, Rouhollah Qurishi, Noor ul Zaman Rafiq, Ranjini Raghavendra Rao, Woraphat Ratta-apha, Karren-Lee Raymond, Jens Reimer, Eduardo Renaldo, Tara Rezapour, James Roy Robertson, Carlos Roncero, Fazle Roub, Elizabeth Jane Rubenstein, Claudia Ines Rupp, Elizabeth Saenz, Mohammad Salehi, Lampros Samartzis, Laura Beatriz Sarubbo, Nusa Segrec, Bigya Shah, Hongxian Shen, Tomohiro Shirasaka, Steve Shoptaw, Fransiskus Muronga Sintango, Veronica Andrea Sosa, Emilis Subata, Norberto Sztycberg, Fatemeh Taghizadeh, Joseph Brian Tay Wee Teck, Christian Tjagvad, Marta Torrens, Judith Meme Twala, Ramyadarshni Vadivel, Joseph Robert Volpicelli, Jelmer Weijs, Steven Michael Wintoniw, Apisak Wittayanookulluk, Marcin Wojnar, Sadia Yasir, Yimenu Yitayih, Min Zhao, Arash Khojasteh Zonoozi, ISAM-PPIG Global Survey Consortium, Radfar, S, De Jong, C, Farhoudian, A, Ebrahimi, M, Rafei, P, Vahidi, M, Yunesian, M, Kouimtsidis, C, Arunogiri, S, Massah, O, Deylamizadeh, A, Brady, K, Busse, A, Potenza, M, Ekhtiari, H, Baldacchino, A, Abagiu, A, Abouna, F, Ahmed, M, Al-ansari, B, Mahmmoud Abu Al-khair, F, Almaqbali, M, Ambekar, A, Ardabili, H, Arya, S, Lasebikan, V, Ayasreh, M, Basu, D, Benmebarek, Z, Bhad, R, Blaise, M, Bonnet, N, Brasch, J, Broers, B, Butner, J, Camilleri, M, Campello, G, Carra, G, Celic, I, Chalabianloo, F, Chaturvedi, A, de Jesus Eduardo Noyola Cherpitel, J, Clark, K, Cyders, M, de Bernardis, E, Derry, J, Dhagudu, N, Dolezalova, P, Dom, G, Dunlop, A, Elhabiby, M, Elkholy, H, Essien, N, Farah, G, Ferri, M, Floros, G, Friedman, C, Fuderanan, C, Gerra, G, Ghosh, A, Gogia, M, Grammatikopoulos, I, Grandinetti, P, Guirguis, A, Gutnisky, D, Haber, P, Hassani-Abharian, P, Hooshyari, Z, Ibrahim, I, Ieong, H, Indradewi, R, Iskandar, S, Jain, S, James, S, Javadi, S, Joe, K, Jokubonis, D, Jovanova, A, Kamal, R, Kantchelov, A, Kathiresan, P, Katzman, G, Kawale, P, Kern, A, Kessler, F, Kim, S, Kimball, A, Kljucevic, Z, Siste, K, Lev, R, Lee, H, Lengvenyte, A, Lev-ran, S, Mabelya, G, Mahi, M, Maphisa, J, Maremmani, I, Masferrer, L, Mccambridge, O, Mcgovern, G, Min, A, Moghanibashi-Mansourieh, A, Mora-Rios, J, Mudalige, I, Mukherjee, D, Munira, P, Myers, B, Menon T N, J, Narasimha, V, Ndionuka, N, Nejatisafa, A, Niaz, K, Nizami, A, Nuijens, J, Orsolini, L, Oum, V, Oyemade, A, Palavra, I, Pant, S, Paredes, J, Peyron, E, Alberto Quiros, R, Qurishi, R, Rafiq, N, Rao, R, Ratta-apha, W, Raymond, K, Reimer, J, Renaldo, E, Rezapour, T, Robertson, J, Roncero, C, Roub, F, Rubenstein, E, Rupp, C, Saenz, E, Salehi, M, Samartzis, L, Sarubbo, L, Segrec, N, Shah, B, Shen, H, Shirasaka, T, Shoptaw, S, Sintango, F, Sosa, V, Subata, E, Sztycberg, N, Taghizadeh, F, Teck, J, Tjagvad, C, Torrens, M, Twala, J, Vadivel, R, Volpicelli, J, Weijs, J, Wintoniw, S, Wittayanookulluk, A, Wojnar, M, Yasir, S, Yitayih, Y, Zhao, M, Zonoozi, A, University of St Andrews. School of Medicine, University of St Andrews. Centre for Minorities Research (CMR), and University of St Andrews. Population and Behavioural Science Division

Subjects
opioid agonist treatment, RC435-571, Psychological intervention, addiction services, Health administration, Experimental Psychopathology and Treatment, 0302 clinical medicine, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Pandemic, Severe acute respiratory syndrome coronavirus 2, Drug addiction, 030212 general & internal medicine, harm reduction, Original Research, Psychiatry, Public health, Addiction medicine, substance use disorder, public health, 3rd-DAS, Opiate agonist treatment, Addiction services, Outreach, Substance abuse, Psychiatry and Mental health, RM, COVID-19 pandemic, drug policy, medicine.medical_specialty, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Drug policy, medicine, Substance use disorders, Harm reduction, business.industry, SDG 16 - Peace, Justice and Strong Institutions, COVID-19, medicine.disease, addiction service, RM Therapeutics. Pharmacology, Coronavirus, Family medicine, Human medicine, business, 030217 neurology & neurosurgery
Abstract

Background:The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods:One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results:Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions:Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Published
2021

6. Managing risk of infectious disease transmission at religious mass gatherings: Insights from survey, COVID-19 PCR, and antibody tests from Arbaeen walkers in 2020.

Author

Al-Ansari F, Al-Ansari B, Abdulzahra MS, Rashid H, Hill-Cawthorne GA, Al-Ansari MB, Al-Fatlaw SM, Mawash M, Al Ansari M, and Conigrave KM

Abstract

Background: Arbaeen in Iraq has been one of the largest mass gatherings during the COVID-19 pandemic with 14.5 million attendees in 2020. We set out to assess the prevalence of current or past COVID-19 among 2020 Arbaeen participants, and establish associations between COVID-19 test results, symptoms, and known recent exposure., Methods: This was a cross-sectional study involving participants who joined Arbaeen walk in Iraq in October 2020. COVID-19 PCR and/or rapid antibody test were conducted among consented participants. A short questionnaire was administered. Rapid antibody testing was done onsite. Nasal and throat swab samples were transferred to the laboratory for PCR testing., Results: A total of 835 (88.3% male; 11.7% female) participants were recruited. The most common symptom overall was cough (9.6%) followed by sore throat, fever, and loss of taste/smell (6.6%, 5.5%, and 5.0%, respectively). One in five (20.3%) participants reported close contact with a confirmed COVID-19 case in the past 14 days. Of the 237 participants with a PCR test, 18 (7.6%) were positive. Of the 765 participants with rapid antibody test, 19.3% tested positive for IgM, 39.3% for IgG, and 16.4% for both. Approximately 40% of the participants had evidence of current or past COVID-19 infection based on antibody and PCR., Conclusions: The almost 1 in 10 COVID-19 cases within such a multimillion person gathering, illustrates the difficulty in limiting the participation of infectious individuals in religious mass gatherings. There is a pressing need to explore measures to reduce the risk of transmission of infectious diseases at major mass gathering events., (Copyright © 2024 Copyright: © 2024 Indian Chest Society.)

Published
2024
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7. Approach to the Management of Hypertriglyceridemia Complicated With Acute Pancreatitis in Pregnancy: A Case Report.

Author

Saif HS, Al-Ansari B, Raza G, and Ghorabah M

Abstract

This is a case of a 32-year-old woman, Gravida 3 para 2, previous two cesarean sections, who presented to our emergency department at 24+3 weeks of gestation complaining of severe epigastric pain radiating to the back. She was diagnosed with severe hypertriglyceridemia complicated with acute pancreatitis and was managed by a multi-disciplinary team, which included obstetrics, gastroenterology, endocrinology, hematology, nutrition, and ICU team. Initially, conservative treatment was employed for her management. She was placed on nil per oral status and initiated on a normal saline infusion at a rate of 150 ml/hour, along with insulin infusion at 0.1 unit/kg/hour and dextrose (D5) at 80 ml/hour. Additionally, she received omeprazole, meropenem, clexane (40 mg once daily subcutaneous injection), iron, vitamin supplements, and analgesics as required. Subsequently, due to the failure of the initial conservative medical management, the patient was admitted to the ICU. Plasmapheresis was performed after the insertion of a vascath, using 3000 ml of albumin 5% as replacement fluid and oral calcium. Following this, she was prescribed Omacor (Omega 3) at a dosage of 2 grams orally twice daily, along with a low carbohydrate and fat diet, to manage her triglyceride levels. After the removal of the central line, her triglycerides increased to 14.3 mmol/L, leading to the initiation of fenofibrate at a daily dose of one tablet. With persistent elevation to 16.4 mmol/L, Lipitor at 40 mg once daily was introduced. Following this intervention, her triglyceride levels stabilized, and her overall condition improved. She was discharged at 25+1 weeks with a prescribed regimen, and scheduled follow-ups were arranged in the endocrine and obstetrics clinics. At 36 weeks of gestation, she presented to the emergency room with abdominal, back, and leg pain. Fetal distress, indicated by fetal tachycardia (170-180 bpm) on cardiotocography, prompted an urgent category 1 cesarean section, which proceeded without complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Saif et al.)

Published
2024
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8. Tramadol, captagon and khat use in the Eastern Mediterranean Region: opening Pandora's box.

Author

Mohaddes Ardabili H, Akbari A, Rafei P, Butner JL, Khan R, Khazaal Y, Arab AZ, Qazizada MR, Al-Ansari B, and Baldacchino AM

Abstract

As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat., Competing Interests: None., (© The Author(s) 2021.)

Published
2022
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9. Health Risks, Preventive Behaviours and Respiratory Illnesses at the 2019 Arbaeen: Implications for COVID-19 and Other Pandemics.

Author

Al-Ansari F, Mirzaei M, Al-Ansari B, Al-Ansari MB, Abdulzahra MS, Rashid H, Hill-Cawthorne GA, Al Ansari M, Negin J, and Conigrave K

Subjects
Female, Hand Disinfection, Humans, Iraq, Male, Masks, SARS-CoV-2, COVID-19, Pandemics
Abstract

COVID-19 poses grave challenges for mass gatherings. One of the world's largest annual gatherings, Arbaeen, occurs in Iraq. We studied respiratory symptoms and risk and protective factors using representative sampling of Arbaeen pilgrims in 2019 to inform prevention of COVID-19 transmission. Structured sampling was used to recruit walking pilgrims. A questionnaire asked about respiratory symptoms, risk, and preventive factors, including hygiene-related resources of toilet facilities. The commonest symptom reported by the 1842 participants (63.3% male, 36.7% female) was cough (25.6%). Eating in mawkibs (rest areas) with indoor kitchens and drinking only packaged water were associated with lower risk of cough (AOR = 0.72, CI = 0.56-0.94; AOR = 0.60; CI = 0.45-0.78, p < 0.05). Facemask use was associated with increased risk of cough (AOR = 2.71, CI = 2.08-3.53, p < 0.05). Handwashing was not protective against cough, or against (one or more of) cough, fever, or breathlessness in multivariate analysis. Toilet facilities often lacked running water (32.1%) and soap (26.1%), and had shared hand towels (17%). To reduce risk of respiratory infections including COVID-19 during Arbaeen or other mass gatherings, needs include running water, soap, and hygienic hand drying options or hand sanitiser. Education on proper handwashing and facemask approaches and monitoring around food preparation and eating spaces are needed.

Published
2021
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10. Alcohol treatment systems in Muslim majority countries: Case study of alcohol treatment policy in Iran.

Author

Al-Ansari B, Noroozi A, Thow AM, Day CA, Mirzaie M, and Conigrave KM

Subjects
Health Policy, Humans, Iran epidemiology, Pilot Projects, Public Policy, Alcoholism epidemiology, Islam
Abstract

Background: Alcohol is a leading risk factor for death and disability globally. Due to the Islamic prohibition of alcohol consumption, alcohol policy is an under-studied and sensitive topic in Muslim majority countries (MMCs). In addition, drinkers in these countries may face barriers to treatment access due to stigma or the legal status of alcohol. Using Iran as a case study this paper explores how alcohol treatment is planned and delivered in the complex environment of an MMC., Method: We searched academic and grey literature, clinical manuals, guidelines and policy documents for information on the development and implementation of alcohol treatment policy in Iran. The search was conducted in English, Persian and Arabic. We conducted 6 consultations to verify information obtained. We analysed information based on the Walt & Gilson health policy analysis triangle, which identifies context, process, actors and content as key factors for understanding policy., Results: Iran initiated an alcohol-specific national strategy in 2011-2012 that aims to prevent, reduce and treat alcohol use disorders. This strategy has been designed to be implemented on a multi-sectoral level. Screening and prevention are mainly initiated in primary health care and cases are referred accordingly. Alcohol treatment is provided in specialised outpatient and inpatient settings. Due to contextual factors such as stigma, feasibility and affordability, alcohol outpatient units are planned to be integrated into existing public/ private drug addiction treatment facilities. However, the Ministry of Health has faced many challenges in implementing this pilot project. To date only small numbers of outpatient and inpatient units have formally commenced offering alcohol treatment., Conclusion: Implementing alcohol treatment has been challenging for Iran. Approval of new treatment programs may not be seen as a priority because of the low prevalence of alcohol use disorders in the country. Also, policy makers are implementing treatment services with caution due to the existing alcohol prohibition for the country's Muslim majority population. Barriers to treatment seeking need to be addressed at the micro and macro levels. Support from international agencies such as the WHO could assist MMCs to develop appropriate services that are feasible for their unique alcohol policy environment., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Published
2020
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11. Arbaeen public health concerns: A pilot cross-sectional survey.

Author

Al-Ansari F, Al Ansari M, Hill-Cawthorne GA, Abdulzahra MS, Al-Ansari MB, Al-Ansari B, Rashid H, Negin J, and Conigrave KM

Subjects
Adolescent, Adult, Aged, Cough, Cross-Sectional Studies, Diarrhea, Female, Food standards, Humans, Iraq epidemiology, Islam, Male, Middle Aged, Pilot Projects, Rhinorrhea, Risk Factors, Surveys and Questionnaires, Communicable Diseases epidemiology
Abstract

Background: Arbaeen is an annual religious procession in Iraq with an estimated 17-20 million participants. Public health risks associated with such a mass gathering can be serious at both local and global levels. This is the first quantitative examination of risk factors for, and symptoms of, infectious disease among Arbaeen participants., Methods: A cross-sectional survey was conducted of a convenience sample of 191 Arbaeen participants in 2017. Interviewers administered a structured questionnaire. Questions included food sources, preventive measures used and symptoms of infectious diseases during the procession., Results: Data were collected for 191 participants (143 males, 58 females). The most prevalent symptoms were respiratory (runny nose: 22.6%, cough: 22.5%). Diarrhoea was reported by 12.6% of participants, with a strong association with high-income country origin and eating (commercial) street food (odds ratios 6.1 and 4.1, respectively, p < 0.05). All symptoms investigated, except breathlessness, were more prevalent in high-income country participants (p < 0.05)., Conclusion: Street food and high-income country origin were independent risk factors for respiratory or gastrointestinal infection symptoms in this sample of Arbaeen participants. However, these results cannot be generalised due to possible selection bias. Further studies are required to inform policy development and health system preparedness to reduce Arbaeen-associated health risks., Competing Interests: Declaration of competing interest There are no conflicts of interest to declare., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Published
2020
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12. Alcohol policy in Iran: Policy content analysis.

Author

Al-Ansari B, Thow AM, Mirzaie M, Day CA, and Conigrave KM

Subjects
Alcohol Drinking prevention & control, Alcohol-Related Disorders prevention & control, Alcoholic Beverages legislation & jurisprudence, Humans, Internationality, Iran, Policy Making, Alcohol Drinking legislation & jurisprudence, Islam, Public Policy
Abstract

Background: Muslim majority countries (MMCs) typically have limited alcohol policy development due to Islamic prohibition of alcohol consumption. In response to recent increases in alcohol consumption and related harms, MMCs have introduced civil alcohol policies, ranging from total prohibition to European-style regulations. Using Iran as a case study, we describe how alcohol prohibition is translated into policy in the face of influences from globalisation., Methods: We collected information from publicly available literature and policy documents, because of the sensitivity of the topic of alcohol in Iran. The search was conducted in English and Persian. We verified information through consultations with policy actors. We also reviewed newspapers over periods just before the 1979 Islamic revolution, and before and after the 2011 alcohol policy (2008-2010; 2014-2016) was introduced. We analysed policy content based on WHO policy recommendations and used the Walt & Gilson health framework to identify policy content, context, actors and process., Results: Despite its broad approach of civil prohibition with concessions for the non-Muslim population, Iran has developed approaches to reduce the harmful impacts of alcohol and adopted nine of ten policy interventions recommended by WHO. Pricing policy was the only intervention not used. We identified contextual challenges, such as resources, stigma and cultural offence that influence policy development., Conclusion: MMCs face challenges in creating civil alcohol policies. Iran has taken steps, including a national alcohol strategy, to reduce alcohol-related harms. The socio-cultural, governance and historical context have shaped Iran's adaptation of policy interventions recommended by WHO., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Published
2019
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13. Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization.

Author

Al-Ansari B, Thow AM, Day CA, and Conigrave KM

Subjects
Alcohol Drinking prevention & control, Alcoholic Beverages supply & distribution, Humans, Law Enforcement, Policy Making, Alcohol Drinking legislation & jurisprudence, Internationality, Islam, Public Policy legislation & jurisprudence
Abstract

Background and Aims: Many policies have been introduced to reduce alcohol harm in different countries. However, Muslim majority countries (MMCs), where the major religion (Islam) prohibits alcohol consumption, have less well-developed civil alcohol policies. Overall, MMCs have low prevalence of alcohol consumption, although recently most MMCs have been undergoing transition, which has sometimes increased pressure for alcohol availability and impacted on social practices, alcohol policies and broader public health. Globalization, the influence of the global alcohol industry, recent governmental transition or political instability and the presence of immigrants from non-Muslim countries can all affect civil alcohol policy. In this context, consumption overall has increased compared with two decades ago. This paper presents an overview of current civil alcohol policy, with regard to the presence or absence of alcohol prohibition, and provides an insight into the legal availability of alcohol in MMCs and the challenges facing policymakers., Methods: English, Arabic and Persian language sources were examined, using PubMed, government websites for each country and the World Health Organization (WHO). Some of the challenges MMCs may face in developing alcohol policies are explored, including the need to interact with the global economy and the potential influence of the alcohol industry., Conclusion: Muslim majority countries have adopted a range of civil alcohol policies in recent decades. There is a pressing need for better data and to support Muslim majority countries in alcohol policy development. Lessons from Muslim majority countries can help to inform other parts of the world., (© 2015 Society for the Study of Addiction.)

Published
2016
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15. Placement of dental implants without flap surgery: a clinical report.

Author

al-Ansari BH and Morris RR

Subjects
Adult, Dental Abutments, Dental Prosthesis Retention, Follow-Up Studies, Humans, Male, Mandible diagnostic imaging, Mandible surgery, Maxilla diagnostic imaging, Maxilla surgery, Middle Aged, Necrosis, Osseointegration, Pain, Postoperative prevention & control, Periodontium pathology, Periosteum surgery, Radiography, Surgical Flaps, Surgical Wound Infection prevention & control, Treatment Outcome, Wound Healing, Dental Implantation, Endosseous methods, Dental Implants
Abstract

Traditionally, the procedure of implant placement requires a surgical periosteal flap to be raised. In a percentage of implant cases, there is no need for flap surgery for implant placement, or for a follow-up surgical procedure for abutment connection. In this clinical investigation, 20 maxillary and mandibular implants were placed in seven adult male patients. The sites for implant placement were prepared according to an alternative surgical technique without raising a surgical flap. Patients were recalled periodically for 2 years to evaluate healing and clinical integration of implants. The results showed normal clinical healing at the first week of reexamination in all implant sites; periodontal probing of less than 2 mm circumferentially around all healing caps at 3 months and later at subsequent recall periods; no radiolucency observed in the peri-implant zone; no sign of clinical mobility during recall examination; and no persistent or irreversible sign or symptoms of pain, infection, or necrosis. This alternative surgical technique can provide several advantages over the traditional 2-step procedure.

Published
1998

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