The Effect of Krocina™ on Decreasing Substance User Withdrawal Syndrome, Craving, Depression and Stress: A Double-Blind Randomized Parallel Clinical Trial.

INTRODUCTION: Due to the association between substance use abstinence with some psychological syndromes, the use of herbal medicines such as Crocus sativus L. have been considered as a proper approach to controlling withdrawal syndrome. The present study aimed to identify the effect of Krocina™ in reducing withdrawal symptoms, craving, depression, stress, anxiety and durability of treatment in the detoxification period and abstinence phase. METHODS: In a double-blind randomized parallel clinical trial, 72 opioid users passing the detoxification period who were referred to the Soroush Center during 2020, randomly categorized into the two groups. Motivational interviewing sessions and 15 mg of Krocina™ twice a day were provided for six weeks for the cases. The placebo group received pills with the same coating and motivational interviewing. Withdrawal symptoms, craving, depression, stress and anxiety were assessed at the start of the study and then weekly using the Clinical Opiate Withdrawal Scale, Obsessive-Compulsive Drug Use Scale, and the Depression Anxiety Stress Scales-21, respectively. SPSS-v16 was used for statistical analyses. RESULTS: Drug withdrawal symptoms and craving did not indicate a significant difference by Krocina™ intervention during the time (p > 0.05). Furthermore, depression, stress and anxiety were statistically similar between Krocina™ and placebo groups (p > 0.05). Moreover, we found similar findings between the two groups when analyzing only patients with negative urinary test (F = 0.03;p = 0.86). CONCLUSION: Our finding rejected the effectiveness of 30 mg/day of Krocina™ for six weeks as an effective substance for decreasing withdrawal symptoms, craving, depression, anxiety and stress at the detoxification period and abstinence phase.

Comparison of Psychopathologic Characteristics between Individuals Undergoing Methadone Maintenance Treatment, Opioid Dependents, and Control Group.

Background: Methadone maintenance treatment (MMT) can theoretically reduce the psychosocial harms of opioid dependency. The increasing number of MMT clinics in Iran during the last two decades was not accompanied by a reduction in addiction rates. Therefore, this study was conducted to compare the psychopathological characteristics of individuals on MMT, opioid dependents, and a control group in the Iranian population. Methods: This cross-sectional study was conducted in Mashhad to evaluate the psychopathological profile of 99 participants (33 opioid-dependent individuals [ODI], 33 MMT clients, and 33 controls) using the Symptom Checklist-90-Revised (SCL-90-R) questionnaire and demographic form. Parametric and non-parametric tests were used to compare the mean score of symptoms between the three groups. The Spearman correlation test was used to test the correlation of psychological features with age and dependency duration. Findings: There was no significant difference between MMT clients and ODI regarding the Global Severity Index (GSI) and nine items of the SCL-90-R questionnaire. However, a significant difference was found between the controls and two other groups (P<0.001). Paranoid ideation in the ODI was more frequent compared to MMT clients significantly (P=0.015). Psychological characteristics had a direct correlation with dependency duration and an inverse correlation with age (P<0.05). Conclusion: Psychopathologic features observed in the dependent patients and MMT clients were significantly higher than in the control group. It seems that the psychopathology profile in MMT clients was not better than dependent individuals in Iran.

Gastric Obstruction by Opium Packets: A Case Report.

Background: We reported a case of gastric obstruction in a body packer who swallowed a large number of opium packets. Case Report: A 36-year-old man opium addict visited the emergency department with epigastric pain for three days. He swallowed nearly 90 packets of opium for smuggling purposes four days earlier. He self-administered laxatives. In contrast, many times vomiting, he defecated only four packets and vomited one packet. The abdominal X-rays showed some amounts of fluid-air levels and multiple cylindrical opacities with the double-condom sign, corresponding to the distended stomach. Due to the worsening of his abdominal symptoms, he underwent an urgent laparotomy and 84 packets (4-6 cm in size and 8-10 g/ packet of opium) with a total weight of 870 g. They were wrapped in some layers of plastic and tied at the ends. He was discharged in stable condition. Conclusion: A large number of ingested drug packets can induce gastrointestinal obstruction.