Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan-Iran

AIM:Recent studies in Iran has shown that prevalence of hepatitis C virus (HCV) infection among Iranian prisoners is high, in spite of low HCV seroprevalence in general population. METHODS: This study was carried out in the central prison of Hamedan - Iran, in year 2002. Inmates were interviewed using a standard questionnaire including demographic, imprisonment history and HCV-related risk behaviors items. Thereafter, the sera drawn from the participants were tested for anti-HIV and anti-HCV antibodies. RESULTS: A total number of 427 drug abuser inmates participated in our study. Three hundred and ninety-seven (93%) were men and 30 (7%) were women. Total number of IV drug abusers (IDA) and non-IV drug abusers (NIDA) was 149 (34.9%) and 278 (65.1%), respectively. The overall rate of antibody positivity among inmates was 0.9% for HIV and 30% for HCV. Of all IDAs, 31.5% and of NIDAs, 29.1% had serological evidence of HCV infection. CONCLUSION: The seroprevalence of HCV infection among drug abuser prisoners in comparison with the general population in Iran, is very high (30% vs in italics 0.2%). Our results indicate the importance of policies to prevent transmission of HCV infection during and following incarceration.

Drug Use and Abuse among Orthopedic Ward Patients—A Revolving Cycle of Menace in Atbuth, Bauchi

Background: The use of drugs for purposes other than those for which they are meant to be used or in excess amounts. Psychoactive drugs are some of the drugs more commonly abused, also, antibiotics and other medications too can be misused. Drug abuse and misuse can lead to serious social, medical and emotional harm to the patients, and antibiotic resistance that makes treatment harder are also likely complications. Method: Patients in both male and female wards of the Orthoepaedics Department of ATBUTH, Bauchi were interviewed using a structured questionnaire and their responses were recorded and data were analyzed using the SPSS version 29. Results: A total of 112 patients were interviewed, 76 males and 36 females. Thirty-two (28.6%) patients had taken various kinds of unprescribed medications while on admission: 9 patients had taken unprescribed tramadol, 4 patients had taken codeine, 6 Ampiclox, 5 flagyl and about 8 patients had taken different kinds of traditional medications while on admission. Among the 32 patients, 23 (72%) are aged less than 30 years, 5 (16%) are aged between 30 and 50 years and 4 (12%) are aged above 50 years. Sixteen (50%) had such medications brought to them by relatives or friends, 10 (30%) were given by other patients on admission, 5 (15%) brought or bought the drugs by themselves while 1 (5%) were given by a non-clinical staff of the hospital. Conclusion: Drug misuse and abuse is a very serious, deleterious practice with destructive consequences in its wake, such consequences as drug dependency with all its antecedent effects, antibiotic resistance and difficulties in controlling/managing infections are but a few. So, it’s very important to both educate patients about these terrible practices and cope with the spread of them in our wards and hospitals.

Comparison of different approaches for direct coupling of solid-phase microextraction to mass spectrometry for drugs of abuse analysis in plasma

The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as blood and plasma.In recent years,our lab has developed three novel SPME-MS techniques:SPME-microfluidic open interface-MS(SPME-MOI-MS),coated blade spray-MS(CBS-MS),and SPME-probe electrospray ionization-MS(SPME-PESI-MS).The fast and high-throughput nature of these SPME-MS technologies makes them attractive options for point-of-care analysis and anti-doping testing.However,all these three techniques utilize different SPME geometries and were tested with different MS instruments.Lack of comparative data makes it difficult to determine which of these methodologies is the best option for any given application.This work fills this gap by making a comprehensive comparison of these three technologies with different SPME devices including SPME fibers,CBS blades,and SPME-PESI probes and SPME-liquid chromatography-MS(SPME-LC-MS)for the analysis of drugs of abuse using the same MS instrument.Furthermore,for the first time,we developed different desorption chambers for MOI-MS for coupling with SPME fibers,CBS blades,and SPME-PESI probes,thus illustrating the universality of this approach.In total,eight analytical methods were developed,with the experimental data showing that all the SPME-based methods provided good analytical performance with R^(2)of linearities larger than 0.9925,accuracies between 81%and 118%,and good precision with an RSD%≤13%.

Monitoring of regional drug abuse through wastewater-based epidemiology—A critical review

Wastewater-based epidemiology is a new approach to monitor drug abuse. It involves collecting wastewater, analysis of residues of drugs or its metabolites in wastewater, and back-calculation of drug consumption by taking into account wastewater flow, stability of drug target residues in wastewater, and excretion rates of drugs/metabolites. Wastewater-based epidemiology has the advantages of being inexpensive and yielding more consistent and near real-time results. It has the great potential to supplement the existing drug monitoring methods. It can be used to build large-scale(regional, national, or even continental) monitoring networks that would yield spatial patterns and temporal trends in drug abuse. This paper described in detail the principle and procedures of this wastewater-based approach. Application of this approach across the globe was also reviewed. The uncertainties involved in the approach and knowledge gaps were identified. Finally, necessity, benefits, and feasibility to set up nation or province-wide monitoring networks based on wastewater analysis in China were discussed.

Comparison of Hair Fatty Alcohols by N-Alkylpyridinium Isotope Quaternization and Matrix-assisted Laser Desorptionl ionization Mass Spectrometry for Drug Abuse Monitoring

Based on our previous report on N-alkylpyridinium isotope quaternization （NAPIQ） for the analysis of alcoholic and α,β-unsaturated ketone compounds, we have further applied NAPIQ method in the screening of hair lipids in drug abusers. Relative isotopic quantification was used for comparison of fatty alcohols between normal and drug abuse group, The NAPIQ strategy was proven to be a high-throughput method in the metabolic comparison studies of different group samples. The attached N-cationic pyridinium significantly improved the detection sensitivity for these fatty alcohols in matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometric （MALDI-FTMS） analysis. The experimental results showed that the levels of fatty alcohols in the hair of heroin abuse group decreased significantly compared with the normal groups, which may be the results of the inducing of peroxidation enzyme. NAPIQ was proven to be an effective and alternative method in the research of fatty alcoholic metabolism for drug abuse monitoring.

Endogenous Klebsiellapneumoniae endophthalmitis associated with intravenous drug abuse

Enndogenous endophthalmitis （EE） accounts for 2%- 15% of endophthalmitis cases;j EE may occur when microorganisms from remote infection site enter into the eye by crossing the blood-ocular barrier and reproduce in the eye. It is well known that EE often occurs secondary to systemic underlying condition, such as diabetes mellitus,

Ionic Liquid-salt Aqueous Two-phase System, a Novel System for theExtraction of Abused Drugs

A 1-butyl-3-methylimidazolium chloride-salt aqueous two-phase system was studied on extraction of abused drugs. The effects of sorts of salts, temperature, concentration of salt and drugs on system were investigated systematically. A satisfactory extraction efficiency of 93% was obtained for papaverine while that of morphine was 65%. The extraction mechanism was primarily discussed.

Analyzing the risk of drug abuse for morphine-containing Chinese patent medicines in China

Chinese patent medicines（CPMs） are widely used across China, and they are differently administrated from chemical drugs. For traditional reasons, CPMs may contain opium-derived compounds, such as morphine, which may pose the issues of drug abuse and addiction. In the present study, we aimed to evaluate the present risk of morphine-containing CPMs in causing drug abuse and addiction, based on a questionnaire-based approach and from a medicinal administrative perspective. We chose 76 CPMs containing morphine from government document and set them as the study group, and 10 chemical drugs containing morphine were set as the control group. Because there is no ready-made method, we created an evaluation sheet consisting of five questions to evaluate each drug and generate a risk-value score. Crosstabs analysis using SPSS 15.0 was conducted to obtain the influencing factors. We found that the study group obtained a mean score of 2.04 for the risk value, which was five times of that of the control group. Specifically, no maximum limit of morphine or codeine was set in product quality standards for more than four-fifth of the drugs. Moreover, 46.0% of package inserts failed to show any warning about addiction or prohibition over the long-term use of the drugs. The number of ingredients, as well as the functions of the drugs, was found to correlate with the risk value. Our findings suggested that CPMs were more risky in causing drug abuse and addiction than chemical drugs. Approaches, such as i） controlling the number of ingredients, ii） setting up maximum limit of morphine or codeine in quality standard, iii） providing more information on the package insert of drugs and iv） monitoring the drug containing both morphine and ephedrine, will be effective in reducing the risk of drug abuse and addiction.

Distinguishing of Abuse Drugs in Urine and Blood Samples of Abusers in Iran

In this study, one hundred urine samples and one hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples referred who addicts in clinics of Welfare Organization, during of detoxification treatment or maintenance treatment were screened for abuse drugs presence. Age ranges of female patients were 35 ± 15 and age range of males patients were 42 ± 18. All patients filled questionnaire and satisfy forms too. All data were analyzed by t-test and were Anowa one way, and P 〈 0.05 was considered significant. The P value of this study was P = 0.000. In this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis and TLC （thin-layer chromatography） is appropriate confirmation method to drug abuse distinguishing. Also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse.

Evaluation of Abuse Drugs and Clinical Laboratory Tests Variations in Whole Blood ＆ Urine Samples of Abusers

In this study, five hundred urine samples and five hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples of addicts in clinics of welfare organization, during detoxification treatment or maintenance treatment were screened for abuse drugs presence. The all of samples were tested through as a view of clinical laboratory methods. Age ranges of female patients were 35 ~ 15 and age range of males patients were 45 ~ 15. All patients filled questionnaire and satisfy forms too. First, all fresh urine and blood samples were examined to confirm presence drugs abuses, depend on their addiction and treatment, so all samples were confirmed by two tests. Then they were examined to other clinical laboratory tests. All data were analyzed by t-test and were Anova one way and two ways of Anova Turkey, and p 〈 0.05 was considered significant. The p-value of this study was p = 0.0001. The results of this study were showed that 4% of abusers had mild increase in hematocrite level and 2% of narcotic drugs abusers had mild lower level of blood sugars than normal range and 4% of participants had increase liver enzymes such ALT （alanine transferase）, AST （aspartat transferase）, ALP （alkaline phosphatease） and 1% of them had renal failure. Although blood level BUN （blood urea nitrogen） and creatinin were examined to evaluation of their renal failure .The results in Tabriz/Iran undrevision of welfare organization clinics were approximately showed that positive results of addiction are in each of urine and blood samples. Because some of abusers directly consumed full long time agonist or partial agonists＇ drugs such as methadone and buprenorphine for their maintenance therapy in clinics. Also doing test on blood samples has high importance in distinguishing and confirmation of drugs abuse in samples. Also in this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis, also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse, and serum levels of some other parameters showed all abusers patients situation such as liver and renal dysfimction through clinical laboratory tests.

Problem-Based Learning of Drug Use and Abuse during COVID-19 Contingency

Introduction: Nursing students’ experiences during the pandemic provoked social isolation, the way to learn and every context increasing their stress and anxiety leading to drug use and abuse, among others. Problem-based learning (PBL) is a pedagogic strategy to strengthen significant learning;then the objective was to establish PBL influence in nursing students’ experiences on drug use and abuse during COVID-19 contingency. Methods: Qualitative, phenomenological and descriptive paradigm, 12 female and male nursing students aged 20 - 24 years old from the 5th and 6th semesters participated. Information collection was through semi-structured interview and a deep one in four cases. A guide of questions about: How the pandemic impacted your life? How did you face it? And what did you learn during this process? Those questions were used. Qualitative data analysis was based on De Souza Minayo, and signed informed consent was obtained from participants. Results: Students’ experiences allowed four categories to emerge, with six sub-categories. Category I. Students’ experiences on drug use and abuse facing the sanitary contingency;Category II. Students’ skills development to identify a problem and design of appropriate solutions;Category III. Developing skills to favor interpersonal relationships;Category IV. Influence of PBL in nursing students’ experiences on drug use and abuse during the COVID-19 contingency. Conclusion: PBL favored analysis and thoughts in nursing students’ experiences on drug use and abuse during the COVID-19 contingency, they worked collaboratively, developed resilience to daily life situations, and implemented stress coping strategies with their significant learning, which diminished their risk behavior.

Studies on Different Hydrolysis Procedures for Drugs of Abuse in Hair

Different hydrolysis and extraction procedures have been studied for the determination of drugs of abuse in hair samples. The results showed that acid and enzymatic hydrolysis gave high extraction recoveries for 6-monoacetylmorphine, morphine, codeine and heroin. Enzymatic hydrolysis was more expensive. After alkaline hydrolysis, 6-monoacetylmorphine, a unique proof of heroin abuse, could not be detected and after methanolic extraction, the extract was dirty and the obtained chromatogram showed an interfering background. It is concluded that acid hydrolysis is the extraction method of choice.

3,4-Methylenedioxymethamphetamine(MDMA)Abuse Markedly Inhibits Acetylcholinesterase Activity and Induces Severe Oxidative Damage and Liperoxidative Damage

Objective To investigate whether 3,4-methylenedioxymethamphetamine (MDMA) abuse produces another neurotoxicity which may significantly inhibit the acetylcholinesterase activity and result in severe oxidative damage and liperoxidative damage to MDMA abusers. Methods 120 MDMA abusers (MA) and 120 healthy volunteers (HV) were enrolled in an independent sample control design, in which the levels of lipoperoxide (LPO) in plasma and erythrocytes as well as the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and acetylcholinesterase (AChE) in erythrocytes were determined by spectrophotometric methods. Results Compared with the average values of biochemical parameters in the HV group, those of LPO in plasma and erythrocytes in the MA group were significantly increased (P<0.0001), while those of SOD, CAT, GPX and AChE in erythrocytes in the MA group were significantly decreased (P<0.0001). The Pearson product-moment correlation analysis between the values of AChE and biochemical parameters in 120 MDMA abusers showed that significant linear negative correlation was present between the activity of AChE and the levels of LPO in plasma and erythrocytes (P<0.0005-0.0001), while significant linear positive correlation was observed between the activity of AchE and the activities of SOD, CAT and GPX (P<0.0001). The reliability analysis for the above biochemical parameters reflecting oxidative and lipoperoxidative damages in MDMA abusers suggested that the reliability coefficient (alpha) was 0.8124, and that the standardized item alpha was 0.9453. Conclusion The findings in the present study suggest that MDMA abuse can induce another neurotoxicity that significantly inhibits acetylcholinesterase activity and aggravates a series of free radical chain reactions and oxidative stress in the bodies of MDMA abusers, thereby resulting in severe neural, oxidative and lipoperoxidative damages in MDMA abusers.

Evaluation of Effectiveness of Integrated Intervention Program in Improving Drug Addicts' Psychological Health

Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.

Investigation of Direct Causes of Drug Relapse and Abstainers’ Demands in a Compulsive Detoxification Center in Wuhan City of China

Objective To identify the direct causes of drug relapse and abstainers’ demand, and to develop programs for the prevention of drug relapse. Methods Abstainers in a Compulsive Detoxification Center in Wuhan City, capital of Hubei Province were randomly selected. An investigation on the direct causes of drug relapse and abstainers’ demands was conducted with multiple-choice questionnaires and face to face interviews. Data were analyzed with SPSS 12.0. Results The direct causes leading to drug relapse included： temptation to use drug again by themselves or by their drug mates, seeking pleasure and ecstasy from drug use, relatively well off living, mental stress, irritation, demoralization, family conflicts, unemployment, feeling distrusted by the family, lack of care and love from the family, and discrimination by others. abstainers’ demands after detoxification and returning to the society included： care and support from the family, employment assistance, changing living environment, understanding by others, support from the society, and keeping far away from drugs. Conclusions Environmental factors are the direct causes of drug relapse, and negative irritation is its predisposing causes. Leaving former residence, more care and help given by both the family and the society and raising their overall quality of life are the demands of abstainers.

Short-term Impact of Cognition-Motivation-Emotional IntelligenceResistance Skills Program on Drug Use Prevention for School Students in Wuhan,China

Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.

Fulminant Hepatitis Associated with Chronic Consumption of 3,4-Methylenedioxy-Methamphetamine;Case Report

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).

Drug-abusing Offenders with Co-morbid Mental Disorders:Gender Differences in Problem Severity,Treatment Participation,and Recidivism

Objective This study examined the gender differences in drug‐related problems and predictors of recidivism among a sample of 1444 offenders with co‐morbid drug abuse and mental disorders participating in California＇s Proposition 36 Program.Methods Background characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index,and drug treatment participation,mental health diagnoses and arrests were based on official records.Results Women demonstrated greater problem severity than men in family relationships,health,psychological health,and sexual and physical abuse history.Men on the other hand had greater criminal history,high rates of attention disorder,and psychotic disorder.More men than women were rearrested during the year after treatment admission.Logistic regression analyses showed that for the combined sample,male,young age,cocaine use（relative to methamphetamine）,drug abuse severity,methadone treatment,arrest history and fewer prior treatment history were associated with higher recidivism at 12‐month follow‐up;lower education,cocaine use,and arrest history were related to women＇s recidivism,while young age,outpatient treatment,and arrest history were predictors of men＇s recidivism.Conclusion Although the specific type of mental disorder did not seem to be predictive of recidivism,the high rates of mental health disorder and arrest of this population is problematic.Intervention strategies taking into consideration gender‐specific problems and needs can improve outcomes for both.

Evaluation of Perinatal and Developmental Outcomes in Neonates with Abstinence Syndrome Admitted to NICU

Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.

A Brief Review of the Relationship between Addiction and Memory Systems

This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of behavior that is learned and is associated with the development of drug addiction and drug relapse. Additional information reveals that when individuals make the transition from recreational drug or impulsive use to compulsive drug abuse, which may result in a neuroanatomical change in areas of the brain from cognitive control guided by the hippocampus/dorsomedial striatum towards conditioned control of behavior managed by the dorsolateral striatum (DLS) [1]. This review also looked at studies that involved experiments with humans and lower animals, which suggested that the hippocampus mediates a cognitive/spatial type of memory, while the dorsal striatum manages stimulus-response (S-R) habit memory, and the amygdala governs the classical conditioning form of learning and stimulus-affective-associative relationships [1]. Overall, these studies utilize the hypothesis of the memory systems view of addiction, and the involvement of learning and memory in the context of drug addiction, which was proposed by them [2]. This theory has been proposed in response to drug addiction research and includes alcohol, amphetamine, and cocaine [1]. The research also explains how stress and anxiety can play a role in how strong emotional excitement can lead to dependent habit memory in rodents and humans [1]. .