Is Opioid Dependency Related to Coping Strategies (original) (raw)
Related papers
2019
Background: Providing population-based data on awareness, attitude and practice of drug and stimulant use has policy implications. A national study was conducted among Iranian general population to explore life time prevalence, awareness and attitudes toward opioids and stimulant use. Methods: We recruited subjects from 5 provinces with heterogenic pattern of drug use. Participants were selected using stratified multistage cluster sampling. Data were collected using a validated self-administered questionnaire. Logistic regression model was applied to identify the variables that are associated with drug and stimulant use. Results: In total 2065 respondents including 1155 men (33.96 ± 10.40 years old) and 910 women (35.45 ± 12.21 years old) were recruited. Two-third of respondents had good awareness about adverse effects of opioid use. Corresponding figure in terms of stimulants was 81.4%. Almost 95% of participants reported a negative attitude towards either opioid or stimulant use. The lifetime prevalence of opioid use and stimulant use were 12.9% (men: 21.5%, women: 4.0%) and 7.3% (men: 9.6%, women: 4.9%), respectively. Gender (adjusted odds ratio [AOR] M/W = 6.92; 95% CI: 2.92, 16.42), education (AOR undergraduate/diploma or less = 0.49; 95% CI: 0.26, 0.90), and marital status (AOR others/single = 2.13; 95% CI: 1.36, 3.33) were significantly related with opioid use. With respect to stimulant use, age was negatively associated with the outcome (AOR 60+/20-29 years = 0.08: 95% CI; 0.01, 0.98) and men were 2 times more likely than women to use stimulants (OR M/W =2.15: 95% CI: 0.83, 5.56). In addition, marital status (AOR Others/singles = 3.45; 95% CI: 1.09, 10.93), and awareness (AOR Weak and moderate/good = 0.40; 95% CI: 0.25, 0.61) were independently correlated with stimulants use. Conclusion: While the attitude of Iranian adults toward opioid and stimulant use was negative, their awareness was not that adequate to prevent the drug use. Men and those with lower socioeconomic status (SES) should be the focus of health promotion programs regarding opioid use. However, regarding stimulants use, promotion programs should target younger age groups and those with higher SES status. Implications for policy makers • The life time prevalence of opioids and stimulants were 12.9% (men: 21.5%, women: 4.0%) and 7.3% (men: 9.6%, women: 4.9%) respectively. • In terms of opioid use, health promotion programs should target men and populations with lower socioeconomic status (SES) status. • Regarding stimulants use, promotion programs should target the younger age groups and those with high SES status. Implications for the public The life time prevalence of opioid and stimulants use among men was 5 and 2 times higher than that of women. Although most Iranians were aware of adverse effects of opioid and stimulants use, the life time prevalence of these outcomes were high. Appropriate health promotion programs should be designed to decrease use of these drugs.
Prevalence of Mood and Anxiety Disorders in a Sample of Iranian Outpatient Opioid Addicts
This study assessed the rate of current mood disorders and anxiety disorders in outpatient opioid addicts. The data were collected from five hundred unpaid opioid-dependent patients who were seeking treatment and referred to private and government clinics. The Research version of structured clinical interview for DSM-IV Axis I Disorders (SCID-I) was used. The mean age of the subjects (487 men and 13 women) was 33.4 yr., ranging from 16 to 67. The majority (68.2%) had private sector job and 13.4% were unemployed. Most of them (59.8%) had education at the level of primary, guidance or high school and only 3.8% were illiterate. Three hundred and thirty-six (67.2%) subjects were diagnosed as having mood disorders, of those 274 (54.8%) had substance induced depression, 37 (7.4%) major depression, 14 (2.8%) dysthymia, 5 (1%) depression due to general medical condition, 3 (0.6%) cyclothymia, 3 (0.6%) bipolar mood disorder, type I, and none was diagnosed as having bipolar mood disorder, type II. One hundred and five (21%) subjects were diagnosed as having substance-induced anxiety disorders, and 11 (2.2%) as generalized anxiety disorders. Of the participants 319 (63.8%) reported more than 5 years use of opioid abuse. Of the subjects only 16 (3.2%) reported no episode of abstinence and the majority 484 (96.8%) reported one or more episodes of abstinences. About 4.2% (21) reported less than 1 gm per day and the majority 86.4% (432) reported between 1 to 5 gm per day current use of opioid. Due to high rates of mood disorders in opioid-dependent subjects, psychiatric services should be open and accessible to the patients, especially those who voluntarily seek help and treatment (German J Psychiatry 2005;8(1):5-7).
Determinants of drug use: A test of the coping hypothesis
Social Science & Medicine, 1984
This paper uses a national probability sample to examine major correlates of drug use among American adults. Demographic correlates of alcohol, cigarette, marijuana, tranquilizer, sleeping pill and stimulant use are explained in terms of a self medication or coping perspective of drug use. Two analysis procedures are used. In the first, respondents were asked to list strategies they use when they have problems. These responses are 'broken down' by drug use categories or 'taking pills'. In the second procedure, attempts are made to interpret the correlations between age, sex, marital status. education and drug use by introducing variables which measure how respondents were experiencing fundamental aspects of their lives (role stress items) and mental health variables. A substantial portion of the variance in drug use that is explained by demographic variables appears to operate through social role and mental health variables, that is, these latter variables interpret the demographic/drug use relationships in a way that is consistent with a coping perspective. The authors conclude that these data and this analysis provided cautious support for a coping perspective. 503
Substance Abuse Treatment, Prevention, and Policy
Background: Opioid use remains a significant cause of harm to individual health. Perceived motives are of the main factors that help lead a patient into seeking treatment voluntarily to obviate that harm. The current study expands on the literature by exploring when and how male users of opioids become motivated to voluntarily seek treatment services. Methods: In a qualitative study in Isfahan city from January 2018 to March 2019, 55 male participants who had already started a variety of treatment services to withdraw their dependence on opioids were recruited. Selection of participants was based on a maximum variation purposive sampling strategy. Each participant took part in a unstructured interview to identify his motives for seeking opioid use treatment. Interviews were undertaken in eight different treatment centers. An inductive thematic analysis method was used to analyze the interviews. Results: The findings highlight that Iranian male opioid users have different motivations to seek treatment. To be precise, the findings illuminate three global themes and six themes as treatment-seeking motives among the participants including; motives related to family (reason for family and reason of family), quality of life (adverse effects on personal lifestyle and health) and economic motives (financial failure and job failure). Conclusions: The findings can improve our understanding of the motives for seeking treatment from the perspective of opioid patients who entered themselves into treatment. Particularly, these findings could help policymakers and treatment providers to better understand opioid-use patient's perceived concerns and fears as motives for treatment-seeking.
Global Journal of Health Science, 2014
Background and Aim: Addiction leads to many problems which may adversely affect addicted people, their families and impose health care agencies with many challenges. This study aimed to examined quality of life (QoL), social desirability and their relationship among opium addicted persons in southeast of Iran. Material and Methods: In a cross-sectional study conducted from September 2012 to January 2013, 123 addicted people were studied. Date collection tools were; checklist of demographic data, Iranian version of the 36-item short form QoL (SF-36) and Marlowe-Crowne Social Desirability Scale (MC-SDS). Results: While mean score of QoL was 60.4±29.5, mean score of social desirability were 14.2±3.7. Low, moderate and high levels of social desirability were observed in 4.9%, 90.2% and 4.9% of participants, respectively. Pearson's correlation were not significant between mean score of social desirability and mean score of QoL (p=0.969, r=0.004). Conclusion: Addicted participants of present study showed a moderate level of QoL and social desirability, without any significant relationship between QoL and social desirability. Further research is suggested in addicts with social and cultural differences.
Comparing the life concerns of prescription opioid and heroin users
Journal of substance abuse treatment, 2015
This study explored life concerns of prescription opioid (PO) and heroin users. Persons entering opioid detoxification rated their level of concern about 43 health and welfare items. Using exploratory factor analysis and conceptual rationale, we identified ten areas of concern. Participants (N=529) were 69.9% male, 87.5% non-Hispanic Caucasian, and 24.2% PO users. Concern about drug problems was perceived as the most serious concern, followed by money problems, relationship problems, mental health, and cigarette smoking. PO users expressed significantly lower concern about drug problems (p=.017) and transmissible diseases (p<.001), but were more concerned about alcohol use (p<.001) than heroin users. There were no significant differences with regard to the other 7 areas of concern. Recognition of the daily worries of opioid dependent persons could allow providers to better tailor their services to the context of their patients' lives.
American Journal of Drug and Alcohol Abuse, 2020
Background: Severity of substance use disorder (SUD) is typically evaluated by tabulating the number of symptoms. The resulting estimate of disorder severity is, however, biased due to intercorrelations among symptoms and their unequal salience. Objective. Employing item response theory (IRT) methodology, opioid use disorder symptoms were calibrated to derive the Opioid Use Disorder Severity Scale (OUDSS) and assess its predictive ability in men and women separately. Methods: A two-parameter IRT model was utilized to derive the OUDSS from DSM-IV symptoms recorded on the Structured Clinical Interview for DSM-IV (SCID) in 438 men and 429 women who reported at least one lifetime opioid consumption event. The predictive ability of the OUDSS was evaluated using the 10 health, psychological, and social adjustment domains of the revised Drug Use Screening Inventory (DUSI-R) assessed 2 years later. Results: The OUDSS score predicted the severity of problems in all 10 DUSI-R domains in men and women. The OUDSS also predicted the DUSI-R diagnostic cutoff score of overall problem density score in men and women (OR = 2.21 and OR = 4.83, respectively). Withdrawal was the most frequently endorsed symptom in this sample of opioid users. The other symptoms' frequencies, while somewhat lower than withdrawal's, did not differ from it substantially, indicating a similar severity threshold. Conclusions: OUDSS enables dimensional measurement of opioid use severity on an interval scale. The OUDSS and DUSI-R together can identify problem areas requiring prevention or treatment.
2020
Background Opioid substitution treatment (OST) uptake has been associated with multiple positive health outcomes among people who inject drugs (PWID). This study evaluated the pattern of OST uptake among PWID in two consecutive national bio-behavioral surveillance surveys (2010 and 2014) in Iran. Methods Data were obtained from two national bio-behavioral surveillance surveys (N2010 = 1,783 and N2014 = 2,166) implemented using convenience sampling at the harm reduction facilities and street venues in 10 geographically diverse urban centers across Iran. Multivariable logistic regression model was used to determine the correlates of OST uptake for 2014 survey and adjusted odds ratios (AORs) and 95% confidence intervals (CI) were reported. Results The prevalence of OST uptake decreased from 49.2% in 2010 to 45.8% in 2014 (P-value = 0.033). OST uptake varied across the studied cities ranging from 0.0%-69.3% in the 2010 survey and 3.2%-75.5% in the 2014 survey. Ever being married (AOR = ...
The experience of opioid abstinence: the relevance of motivation and history
British journal of …, 1989
Questionnaire measures relating to a recent episode of unmodified heroin withdrawal (the target episode) were obtained from 70 subjects. The duration of the target episode, but not reported distress during the episode, correlated with the amount of heroin consumed in the previous 3 months. Data from scales measuring motivation during the target episode were factor analysed and two factors emerged, one relating to motivation concerning private affairs and the other relating to motivation derived from public sources. High scores for private affairs motivation were correlated with success in the target episode whilst there was a trend for public affairs based motivation to be associated with failure. Private affairs motivation was negatively correlated with length of heroin use but positively correlated with the number of coping strategies employed in withdrawal. The implications of these findings for the treatment of heroin users are discussed.