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The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countries, this paper compares national responses to substance use during the first wave of the COVID-19 pandemic. Field data was collected by the Substance Use x COVID-19 (SU x COVID) Data Collaborative, an international network of social scientists, public health scientists, and community health practitioners convened to identify and contextualise health service delivery models and social protections that influence the health and wellbeing of PWUD during COVID-19. Findings suggest that countries with stronger social welfare systems pre-COVID introduced durable interventions targeting structural drivers of health. Countries with fragmented social service infrastructures implemented temporary initiatives for PWUD led by non-governmental organisations. The paper summarises the most successful early pandemic responses seen across countries and ends by calling for greater systemic investments in social protections for PWUD, diversion away from criminal-legal systems toward health interventions, and integrated harm reduction, treatment and recovery supports for PWUD.

A novel nanocomposite of CoMnFe[O.sub.4]-MWCNT has been synthesized via green and simple hydrothermal method and the structure characterization has been done through FT-IR, X-ray diffraction, scanning electron microscopy, EDX, and highresolution transmission electron microscopy analysis in this research. Cyclic voltammetry and galvanostatic charge-discharge methods are picked as the strategies to compare their supercapacitor behavior. The specific capacitance of about 1310[Fg.sup.-1] (at 1A[g.sup.-1]) in 3mol[L.sup.-1] KOH has been recorded for CoMnFe[O.sub.4]-MWCNT nanocomposite when the working voltage is 1.2V. Moreover, this nanocomposite retains 89% of its initial capacitance after 10 000 charge-discharge cycles. Also, some initial mechanistic studies are performed to achieve a deeper insight into the electrochemical behavior of the nanocomposite implying that the oxidation-reduction process of CoMnFe[O.sub.4]-MWCNT nanocomposite is generally quasi-reversible and difusion-controlled. From the view of time, coat, and environment, the hydrothermal process is much more reliable and beneficial regarding higher performance. Key words: CoMnFe[O.sub.4], hydrothermal deposition, supercapacitor, carbon nanotube, nanocomposite, 1. Introduction Both ultracapacitors, and electrochemical capacitors are well-known terms to call supercapacitors (SCs). They are popular for their highly efficient and cost-effective type of electrochemical energy storage devices based [...]

ObjectivesOpium smoking is commonly practiced via traditional and novel routes in Iran. Both smoking methods are practiced in a non-ergonomic position. According to previous studies and our hypothesis, it can be potentially harmful to the cervical spine. Thus, the present study aimed to investigate the relationship between opium smoking and neck range of motion and neck muscle strength.MethodsIn this cross-sectional and correlational study, the range of motion and strength of the neck muscles of 120 men with drug use disorder were measured by a CROM goniometer and a hand-held dynamometer. Other data gathering was performed using a demographic questionnaire, the Maudsley Addiction Profile, and the Persian version of Leeds Dependence Questionnaire. The obtained data were analyzed by Shapiro–Wilks test, Pearson’s correlation coefficient and stepwise linear regression.ResultsThere was no significant correlation between the age of drug use onset and range of motion and muscle strength of the neck; however, the daily duration of opium smoking and the number of years of opium smoking were inversely and significantly correlated with the range of motion and muscle strength of the neck in some directions. Daily opium smoking time for decreasing in neck range of motion and total duration of opium smoking for reduction of neck muscles strength are stronger predictor variables.ConclusionOpium smoking by traditional routes causes non-ergonomic positions and has a moderate significant correlation with reduced range of motion and neck muscle strength, in Iran.Highlights– The harm of drug use disorder is not only AIDS and hepatitis, and harm reduction programs should go beyond the prevention of AIDS and hepatitis. According to more than 90% of smoking use of drug compared to other methods (oral and injectable, etc.) musculoskeletal disorders caused by the smoking use of drugs, have a greater cost burden in reducing the quality of life and the need for rehabilitation.– Drug abuse treatment and harm reduction programs should focus more seriously on replacing smoking use of drugs with oral medications assisted treatment.– Although in Iran and some countries in the region, a large number of people smoke opium for many years and sometimes all their lives, daily in a completely non-ergonomic position, but studying the deformation of the posture and musculoskeletal disorders related to the body position in them, is not a scientific concern and neither physical therapy researchers have paid attention to it nor addiction researchers.– Neck muscles strength and range of motion in opium addicts are correlated to the number of years of opium smoking and daily minutes of opium smoking, but not to its oral use.– There is no significant correlation between the onset age of continues and permanent opium smoking and substance dependence severity with neck range of motion and muscles strength.– People with drug use disorder (especially smoking users) as a large group of vulnerable people, should be the target population of musculoskeletal disorders researchers and addiction harm reduction researchers, and more experimental, comparative, cohort, etc. researches should be designed and implemented for them.

Introduction: Socio-cultural norms can either be encouraging or a barrier to addiction treatment. More, rigorous research is needed on nonindigenous models in addiction treatment, to better understand the role of socio-cultural differences. Methods: The present qualitative study is part of the project, “The Inclusive Assessment of the Barriers of Drug Addiction Treatment Services in Iran,” which was conducted in Tehran from 2018 to 2021. The participants consisted of eight people who used drugs, seven individual family members of the people who used drugs participants, seven service providers, and four policymakers. A purposeful sampling method was used for the selection of the participants, and the process continued until reaching the theoretical saturation of data. Analysis used the Graneheim and Lundman methods, classifying primary codes, the sub-themes, and themes were classified according to the similarities and differences between primary codes. Finding: The most important socio-cultural barriers to addiction treatment in Iran are: unrealistic expectations of the family and society from the people who use drugs, addiction stigma, mistrust between various components of the treatment system, perceptions that professional substance use disorder treatment is inefficient and low uptake of that treatment, the disturbed relational boundaries between the people who use drugs and their relatives, the interweaving of treatment and ethical and religious principles, low acceptance of maintenance treatments, treatment focusing on short-term outcomes, and presence of facilitating backgrounds of using drugs. Conclusions: The Iranian socio-cultural characteristics play an important role in the addiction treatment of the people who use drugs, so it is necessary for treatment interventions to be sensitive to these characteristics.

Abstract Background With increasing obese populations worldwide, developing interventions to modulate food-related brain processes and functions is particularly important. Evidence suggests that transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) may modulate the reward–control balance towards facilitation of cognitive control and possible suppression of reward-related mechanisms that drive food cue-induced craving. This protocol describes a clinical trial that investigates the neurocognitive mechanisms of action for tDCS to modulate food cue-reactivity and cravings in people with obesity. Method The NeuroStim-Obesity trial is a prospective, randomized, sham-controlled, double-blind single-session tDCS trial targeting food craving in those with obesity or overweighed. Once randomized, 64 adults with obesity or overweighed complete one session in which they receive either active or sham tDCS over the DLPFC (anode F4 and cathode F3, 2 mA intensity for 20 min). The primary outcome is change in neural response to the food cue-reactivity task in the ventral striatum after a single-session bilateral tDCS compared to sham stimulation. Secondary outcomes include changes in food craving evaluated by the Food Craving Questionnaire-State (FCQ-S). We will also explore the predictive role of brain structure and functional networks assessed by structural and functional magnetic resonance imaging (MRI) during both task performance and the resting-state that are acquired pre- and post-intervention to predict response to tDCS. Discussion The results will provide novel insight into neuroscience for the efficacy of tDCS and will advance the field towards precision medicine for obesity. Exploratory results will examine the potential predictive biomarkers for tDCS response and eventually provide personalized intervention for the treatment of obesity. Trial registration Iranian Registry of Clinical Trials (IRCT) IRCT20121020011172N4 . Retrospectively registered on 4 June 2020

Opium smoking has been a common practice in Iran for many years, with people often smoking for long hours. During the COVID-19 pandemic, there was an increase in opium smoking due to false beliefs about its protective effects against COVID-19 infection. In this study, we aimed to examine the association between the non-ergonomic positions associated with traditional opium smoking in Iran and the development of neck pain and disability, forward head posture (FHP), and hyperkyphosis (HK). In this cross-sectional, correlational study, a total of 120 individuals who smoked opium were selected based on the inclusion criteria. They were interviewed about their addiction profile using the Lite version of the Addiction Severity Index and the Leeds Dependence Questionnaire. The presence of neck pain and disability was also evaluated using the Visual Analog Scale and the Neck Disability Index. The participants were examined for FHP via side-view photography and for HK using a flexible ruler. Data were analyzed using correlation coefficient tests and stepwise linear regression analysis. Based on the results, homelessness, the lifetime duration of opium smoking (in months), the duration of daily opium smoking (in minutes), and the severity of drug dependence had significant relationships with the severity of neck pain, neck disability, FHP, and HK. Homelessness was the strongest predictor of neck pain and disability (R2 = 0.367, p < 0.001), FHP (R2 = 0.457, p < 0.001), and HK (R2 = 0.476, p < 0.001), followed by the lifetime duration of opium smoking and the duration of daily opium smoking, respectively, in which R2 increased to 0.505 (p = 0.011), 0.546 (p = 0.022), and 0.570 (p = 0.004) with the addition of two other variables. Overall, an increase in the duration of sitting in non-ergonomic positions could lead to neck pain and disability, FHP, and HK due to the non-neutral posture of opium smokers.

The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44-8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2-0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.

objective: This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm. methods: A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews. results: Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators. conclusions: The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.

BackgroundFew studies suggest that social network factors, including size of sexual network may associate with drug-related and sexual high-risk behaviors. The objective of this study is to investigate injecting and sexual networks and sociodemographic factors that might be associated with dual HIV risk (DHR) among people who inject drug (PWID).MethodsThe data from a cross-sectional study of 455 PWID that were recruited through peer-referral sampling were used in this study. The data were collected using a structured questionnaire consisted of modules on sociodemographic characteristics, sexual and injection-related risk behaviors during 12 months before the interview. DHR was defined as engaged in both using a syringe previously used by other PWIDs and unprotected sex during last 12 months. Data analysis was performed with descriptive and logistic regression. In final model, we considered variables with P < 0.500 as statistically significant. Finally, reported adjusted odds ratio (AOR) and confidence interval (95% CI) for variables that were significant in the final model.FindingsA total of 455 men who injected drugs participated in this study. The mean age ± standard deviation (SD) was 33.2 ± 7.3 (range 19-58) years. Overall, the prevalence of DHR In the last 12 months, 38% (95% CI: 18.3-51.2%). Multivariate model showed that regular visit to needle, syringe programs (NSPs) reduced odd of HDR to 50% when adjusted for other covariates, but still remained statistically significant (P < 0.050). The odds of reporting DHR was significantly higher in those ≥ 2 sex partners and injection partner (P < 0.010). Odds of DHR was higher (AOR: 2.3) among participants who had more than 2 injection per day but was not statistically significant (P > 0.050).ConclusionDHR was common in PWID in Kermanshah, Iran. Having multiple injecting and sexual partners increased the odds of engaging in dual risk behaviors, but regular visit of NSPs can reduce the DHR among PWID.

BackgroundIt is unclear whether knowing of current HIV status is associated with change in injecting behaviors among people who inject drugs (PWID) in Iran. The objective of the present study was to determine whether awareness of HIV positive status is associated with a reduction in injecting risk behaviors, after matching for socio-demographic characteristics.MethodsFive hundred male PWID were recruited in 2014 from two drop-in centers (DICs) in Kermanshah west of Iran. Trained interviewers collected data on socio-demographic characteristics, HIV testing and drug-related risk behaviors over the last month prior to interview using a structured questionnaire. Our primary exposure of interest was awareness of HIV status, used to group participants into three categories: positive, negative, unaware. We used coarsened exact matching to make the three groups statistically equivalent based on age, place of residence, education and income, and then compared them regarding the proportion of borrowing, lending and reuse of syringes.ResultsMatched sample (n=320) had a mean age ± standard deviation (SD) of 33.5 ±7.6 yr. Overall, 25% (95% CI: 14%, 32%) of participants reported "borrowing a syringe" in the past month and 15% (95% CI: 7%, 22%) of them reported "lending a used syringe" to others in the past month. In comparison to PWID who were unaware of their HIV status, those knew they were HIV positive (OR 1.68, CI95%1.32-2.81) or negative (OR 1.54; 95% CI: 1.28, 2.71) were both more likely to report borrowing syringes in past month.ConclusionsPWID WHO know they are positive for HIV are more likely to borrow another person's syringe, to report reuse of their own used syringes and less likely to report lending their syringes to others. Strategies to scale up HIV testing and counseling for PWID, which also increase awareness of HIV status, may decrease injecting related the risk behaviors.

Objective: Executive functions and impulse control ability are severely impaired in people with amphetamine use disorders. In this regard the study aims to decrease impulsivity in patients with Methamphetamine use disorder by using Acceptance and Commitment Therapy (ACT). Materials & Methods: The study is a quasi-experimental study with a pretest-posttest control group design. The study population included all men under treatment with Methamphetamine use disorder in 2019 in Yazd city. The sampling method was purposive sampling. Among those who scored higher than the cut-point according to Bart's Impulsivity Questionnaire (1994), 12 were randomly assigned to the experimental group and 12 randomly assigned to the control group. Descriptive and inferential statistical methods including covariance analysis were used to analyze the data. Results: The results showed that the value of the parameter (F) belonging to the pretest variable was 4.9 and it was significant. Therefore, there was a significant difference between the mean scores of impulsivity of the control and experimental groups in the posttest after the pretest effect was gone in patients with treated methamphetamine use disorder. Conclusion: Finally based on the results of this study, it can be concluded that the ACT as a new and emerging treatment of the third wave of behavioral therapy is a useful intervention for patients with methamphetamine use disorder to reduce their impulsive behaviors.

Coronavirus disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).

Introduction: As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic. Methods: This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened. Ethics and Dissemination: The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.

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.

BACKGROUND: Stress management is the ability of individuals to reduce stress and adapt to stressful situations. The objective in the present study was to investigate the effectiveness of stress management training on mental health of addicts quitting substance abuse referred to Raha addiction treatment clinic in Babol, Iran. METHODS: In this quasi-experimental study, available sampling method with pre-test and post-test design was used along with the control and intervention groups. A sample of 36 members of the community (drug quitting clinic) were selected and randomly assigned into the two test and control groups, then a pre-test was performed on them through the General Health Questionnaire (GHQ) with a reliability of 78%. For the test group, the stress management skill group intervention was trained in 10 sessions per week with each session lasting 90 minutes. At the end of the session, the post-test was executed on both the test and control groups. The t-test and chi-square tests were employed to compare the quantitative variables between the two groups and the qualitative variables using the SPSS software, respectively. RESULTS: The results of the study showed that group intervention has been effective on the mental health of addicts quitting substance abuse; as a result, participation in the therapy group and cognitive interventions leads to increasing the mental health of patients quitting substance abuse. CONCLUSION: According to the results of this study, it can be declared that stress management training has been effective on all mental health scales such as symptoms of somatization, anxiety, disorder in social actions, and depression and leads to a decrease in mental symptoms and mental health improvement in addicts quitting substance.

Objectives: The follow-up treatment or rehabilitation and monitoring of patients with drug abuse disorders require an efficient tool with a convenient and short-time implementation to measure psychological aspects of dependence. The Leeds Dependence Questionnaire (LDQ) has such features; thus, the present study aimed at evaluating the validity and reliability of its Persian version. Methods: The current validation study explored the data obtained from 142 substance dependent patients selected from drug addiction treatment centers in Tehran City, Iran. The criterion-related validity of the Persian version of the LDQ was evaluated by measuring its correlation with the Substance Dependence Severity Scale (SDSS). The construct validity of the Persian version of the LDQ was evaluated using the General Health Questionnaire (GHQ). Moreover, the internal consistency and reliability of this scale were calculated by Cronbach’s alpha coefficient and test-retest reliability methods, respectively. Results: The correlation coefficients between the LDQ and SDSS and GHQ were 0.773 and 0.780, respectively; the correlations were statistically significant (P

Objectives: The present review study aimed at investigating the vocational rehabilitation of individuals with drug dependence disorders. Methods: Based on the research method, a comprehensive search was conducted in the following databases: PubMed, Scopus, Web of Science, Science Direct, EBSCO, ProQuest and Google Scholar. All keywords synonymous with vocational rehabilitation and substance abuse were considered in search. Then related studies with vocation rehabilitation were selected and included in the study. Results: Job is a protective and major factor in effective treatment, and ignoring vocational counseling and rehabilitation leads to a significant defect in addiction treatment. Discussion: Individuals receiving vocational services along with drug abuse treatment would experience reduced drug abuse and a more productive life.

Background: In Western and Southwest Asia, literature is not documented on human immunodeficiency virus (HIV) programs in Iran, Iraq and Saudi Arabia. The present study is the first brief review that describes HIV programs in these three neighboring countries.Methods: Data regarding the evidence of HIV programs were gathered through a systematic literature searching. English publications were retrieved through searching online scientific databases. Grey literature was also searched online. The review was based on the studies related to the last decade.Findings: Systematic searching resulted in retrieving 21,948 studies but only 21 studies were relevant to the study aim. The review findings indicated that Iran has provided a nationwide sero-surveillance data system and has identified its key populations. Detecting HIV prevalence has been limited to case-finding in Iraq and Saudi Arabia. However, strategic plans for HIV have been provided in the three countries. HIV education, knowledge and support have been provided but still needs consideration in the three countries especially in Iraq. The low coverage of antiretroviral therapy (ART) has remained a critical gap in the provision of comprehensive HIV programs in these three countries. This issue has been followed by the lack of opiate substitution therapies for drug dependents and injecting drug users in Iraq and Saudi Arabia. Condom promotion and voluntary HIV counselling and testing have been provided for at-risk groups in the three countries but need more nationwide coverages. However, needle and syringe programs (NSPs) have been only provided in Iran.Conclusion: The review concluded that the provision of effective HIV programs should address training human resources and infrastructural development. This issue should be facilitated by international collaborations and governmental supports.

Objectives: This study aimed to compare the ratio of suicide attempts between female opium and Methamphetamine (MA) users to determine the relationship between the increased prevalence of MA and suicide risk. Methods: In this cross-sectional study, 136 drug dependent females were randomly selected from Tehran. Data gathering was performed by a demographic questionnaire and Beck Scale for Suicidal Ideation. Data were analyzed by Chi-squared test and Independent Samples t-test. Results: There was no significant different in suicidal ideation between the two groups; however, the suicide attempt was significantly higher in the MA users compared to opium users (P

Hydrogen as an energy carrier is a promising alternative to fossil fuels, and it becomes more and more popular in developed countries as a carbon-free fuel. The low boiling temperature of hydrogen (20 K or −253.15 °C) provides a unique opportunity to implement superconductors with a critical temperature above 20 K such as MgB2 or high-temperature superconductors. Superconductors increase efficiency and reduce the loss of energy, which could compensate for the high price of LH2 to some extent. Norway is one of the pioneer countries with adequate infrastructure for using liquid hydrogen in the industry, especially in marine technology where a superconducting propulsion system can make a remarkable impact on its economy. Using superconductors in the motor of a propulsion system can increase its efficiency from 95% to 98% when the motor operates at full power. The difference in efficiency is even greater when the motor does not work at full power. Here, we survey the applications of liquid hydrogen and superconductors and propose a realistic roadmap for their synergy, specifically for the Norwegian economy in the marine industry.

Millions of children are left to survive on the streets around the world. Investigations on drug use disorders among street children reveal that they not only abuse all types of drugs higher than their peers who live at home or in shelters, but also they abuse more harmful drugs such as injection drugs or methamphetamines. This guideline provides a comprehensive approach to the treatment and management of substance use disorders among children of 3 to 18 years of age for the staff of substance use disorder clinics. It highlights examples of how to perceive and approach the management and issues of substance abuse among street children at an early stage of development through various medical, psycho-social, and other interventions. It also defines the characteristics of the street children with a focus on prevention. These provisions consist of addressing the applicability matters in this area and necessity of a decision model in our country.

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.

Objectives: High prevalence of stimulants use –especially crystalline methamphetamine (crystal meth)-, which required extensive medical and rehabilitation interventions is a major problem in Iran; health care system. Main objective of the current study was to compare social, economic and cultural factors associated with female tendency toward use of two main types of drugs including opium and crystal methamphetamine. Methods: The present cross-sectional and comparative study was performed on female opium and Methamphetamine (MA) dependents of Tehran in 2015. 136 women (82 crystal meth consumers and 54 opium consumers) were selected by simple random sampling method whom filled a researcher-developed questionnaire. Data was analyzed by Pearson Correlation Coefficient and Chi-square test using SPSS software V. 19. Results: There were significant differences between two groups in terms of marital status (P=0.012), the believe in better fitness with drug use (P=0.011), and the believe in improved working and studying efficacy (P=0.039). Discussion: It seems that misconceptions of beneficial impact of crystal methamphetamine use on fitness and improved working and studying efficacy could be recognized as a prominent factor for women tendency toward crystal methamphetamine use. Also, being single and avoiding a stable marital life was a strong factor associated with such tendency. This was whilst opium use was more prevalent among married women, and especially those influenced by their addicted spouse.

Background: To self-medicate substance dependence, many substance users consume herbal medicines delivered in herbal medicine shops which are prepared through non-standard methods using a variety of different materials. Hence, the present study was carried out aiming to investigate and analyze the content of such herbal medicines.Methods: Four herbal medicine shops were selected from each of the 22 zones of Tehran City, Iran, and a total of 95 samples were purchased. A package containing 6 types of medication that was advertised by a satellite TV channel, was also purchased. Using high-performance liquid chromatography (HPLC) method, the samples were analyzed in the laboratory to detect different types of materials.Findings: Among the samples, 23 and 72 samples were uncovered compressed pills (Dragon pills) and capsules filled with colored powders (handmade drug-quitting capsules), respectively. The package advertised in the satellite TV was prepared in 6 various forms. The most common substances present in all the samples were as follows: diphenoxylate, tramadol, opioids, acetaminophen, and codeine with values of 90%, 86%, 78%, 69%, and 68%, respectively. On average, 5 of the above mentioned substances were present in each sample; moreover, 63% of the samples contained 5 or more substances. In addition, 42 (41%) of the samples contained all the 5 main substances including opioids, codeine, tramadol, diphenoxylate, and acetaminophen.Conclusion: The findings of this study showed that handmade capsules and pills used for quitting addiction and also medicines advertised in the satellite TV channels contain different amounts of opioids, amphetamine, benzodiazepines, tramadol, codeine, and other substances that cause problems for substance users who are going to abandon substance abuse.

Background: Untreated Hepatitis C Virus (HCV) has been reported among many Iranian female methadone patients. However, few of them report receiving HCV treatment. The present study is the first research from western Asia that explored the barriers to receiving HCV treatment among a group of Iranian female HCV-infected methadone patients.Methods: This qualitative study was conducted in four main methadone treatment clinics in Tehran, Iran, in November 2016. Overall, fifty-six untreated HCV-infected women and eight clinicians from HCV and methadone treatment services were interviewed. Women either had not received HCV treatment or received HCV treatment but left it. Data were analyzed using NVivo software. This was based on the grounded theory of Strauss and Corbin.Findings: Barriers to receiving HCV treatment included factors related to individuals and factors related to the system. Individual factors included the perception that untreated HCV infection was not a serious health concern, family responsibilities, and self-perceived discrimination against HCV-infected women. System-related factors included the lack of referral from methadone treatment staff, and a long distance between HCV treatment centers and methadone treatment centers. Interviews with the health professionals also confirmed the women’ self-reports.Conclusion: The results of this research confirm the necessity of providing HCV education and the delivery of comprehensive care for this group in methadone treatment clinics. Other services such as staff education and HCV treatment services at methadone treatment centers are suggested.

Background: There are different street substance users' communities (SSUCs). Typology of SSUCs in Tehran, Iran was approached in this qualitative study.Methods: Using content analysis and saturation principles, 22 street-outreach workers were recruited and interviewed. Data were analyzed using open, axial, and selective coding.Findings: Three types of SSUCs were identified. SSUCs were different in geographic location, the community hierarchy, roles of residents and its function during a 24-hour period. Type 1: surrounded naturally by trees, mountains etc. or located in places like canals that make them not simply reachable, a nonresident smuggler (or a small group of smugglers) has the most power in its hierarchy, works 24 hours with at least two shifts, structured with special roles (nonresident smuggler, the Balancer, sex-worker, seller, armed guard, resident substance users and nonresident costumers). Type 2: mostly located in the city gardens, several nonresident smugglers with limited power, works 16 hours or less in a day, semi-structured with roles of nonresident drug dealer, sex-worker, resident substance users and nonresident costumers. Type 3: houses that their landlords are the resident drug dealers and let the costumers to use drug in the house. The substance users have to leave the house after using drug. The house is open less than 24 hours a day.Conclusion: Strategies for delivering harm reduction services in different types of SSUCs should be modified according to characteristics of these communities.

Background: This research sought to determine how well the causes of addiction, addiction harms, and prevention of addiction have been noticed in high school textbooks.Methods: We used descriptive method to select the main related components of the addiction concept and content analysis method for analyzing the content of textbooks. The study population comprised 61 secondary school curriculum textbooks and study sample consisted of 14 secondary school textbooks selected by purposeful sampling method. The tools for collecting data were “content analysis inventory” which its validity was confirmed by educational and social sciences experts and its reliability has been found to be 91%. About 67 components were prepared for content analysis and were divided to 3 categories of causes, harms, and prevention of addiction. The analysis units in this study comprised phrases, topics, examples, course topics, words, poems, images, questions, tables, and exercises.Findings: Results of the study showed that the components of the addiction concept have presented with 212 remarks in the textbooks. Also, the degree of attention given to any of the 3 main components of the addiction concept were presented as follows: causes with 52 (24.52%) remarks, harm with 89 (41.98%) remarks, and prevention with 71 (33.49%) remarks.Conclusion: In high school textbooks, little attention has been paid to the concept of addiction and mostly its biological dimension were addressed while social, personal, familial, and religious dimensions of addiction have been neglected.

In this review, we examine the greenest nanoparticles of zero-valent metals, metal oxides and metal salts, with emphasis on recent developments routes. Products from nature or those derived from natural products, such as extracts of several plants or parts of plants, tea, coffee, banana, simple amino acids, as well as wine, table sugar and glucose, have been used as reductants and as capping agents during the present synthesis method. Polyphenols found in plant material often play a key role in the processes mentioned here. The techniques involved are generally one-pot processes, environmentally friendly and simple. Green synthesis of gold nanoparticles using several extracts and spices extracts was conducted, in which aqueous extracts HAuCl4.3H2O reduce to Au° has establishing themselves in specific crystal phase. Synthesized nanoparticles were confirmed by the color change of auric chloride which is yellow. The growth of nanoparticles was monitored by the behavior of surface Plasmon using UV-Vis spectroscopy; also the pH was determined meanwhile. Moreover, this approach is not only of a green rapid synthesis kind and considered as a better alternative to chemical synthesis, but also found to be effective for large scale synthesis of gold nanoparticles.

Background: The awareness of sexual experiences could be an effective factor in preventing high-risk sexual behavior pertaining to relapse during the recovery period of substances. This research explored the role of sexual behaviors among Iranian methamphetamine (MA) users in relapse process.Methods: The study was conducted with a qualitative approach using content analysis method. 28 participants were selected through purposeful and theoretical sampling. Data were collected based on face-to-face, in-depth, semi-structured interviews based on open-ended questions. Interviews continued until the data saturation had occurred. All interviews were examined in four stages of codes, sub-categories, categories and themes according to the content analysis of explanations and descriptions of sexual behaviors.Findings: Two main themes were emerged from the analysis of interviews, including extreme pleasure seeking (including the main categories of sexual tunnel vision and sexual totalitarianism) and comprehended threat (including the main categories of internal conflict and external disorganization) as well as 10 subcategories.Conclusion: The results indicated that sexual behaviors played an important role in relapse process among Iranian MA users and needed to be considered and managed properly in the planning of prevention, treatment, and rehabilitation.

Background: Few studies suggest that social network factors, including size of sexual network may associate with drug-related and sexual high-risk behaviors. The objective of this study is to investigate injecting and sexual networks and sociodemographic factors that might be associated with dual HIV risk (DHR) among people who inject drug (PWID).Methods: The data from a cross-sectional study of 455 PWID that were recruited through peer-referral sampling were used in this study. The data were collected using a structured questionnaire consisted of modules on sociodemographic characteristics, sexual and injection-related risk behaviors during 12 months before the interview. DHR was defined as engaged in both using a syringe previously used by other PWIDs and unprotected sex during last 12 months. Data analysis was performed with descriptive and logistic regression. In final model, we considered variables with P < 0.500 as statistically significant. Finally, reported adjusted odds ratio (AOR) and confidence interval (95% CI) for variables that were significant in the final model.Findings: A total of 455 men who injected drugs participated in this study. The mean age ± standard deviation was 33.2 ± 7.3 (range 19-58) years. Overall, the prevalence of DHR In the last 12 months, 38% (95% CI: 18.3-51.2%). Multivariate model showed that regular visit to needle, syringe programs (NSPs) reduced odd of HDR to 50% when adjusted for other covariates, but still remained statistically significant (P < 0.050). The odds of reporting DHR was significantly higher in those ≥ 2 sex partners and injection partner (P < 0.010). Odds of DHR was higher (AOR: 2.3) among participants who had more than 2 injection per day but was not statistically significant (P > 0.050).Conclusion: DHR was common in PWID in Kermanshah. Having multiple injecting and sexual partners increased the odds of engaging in dual risk behaviors, but regular visit of NSPs can reduce the DHR among PWID.