Biopsychosocial predictors of drug dependence among Filipino drug users in community-based drug rehabilitation.

This study examines the biopsychosocial predictors of drug use and dependence among Filipino drug users enrolled in community-based drug rehabilitation. Data from 925 clients revealed that the severity of drug use, cigarette and alcohol use, recovery skills, and mental health problems predict drug dependence. Family support, life skills, and psychological well-being are indirect predictors of severity of use. Results also revealed differences in predictors by sex, level of use, and type of clients. These findings highlight the importance of a client-centered approach to treatment and suggest what might be critical elements in a community-based drug rehabilitation program in the Philippines.

Effects of health qigong exercise on sleep and life quality in patients with drug abuse.

Objective: The aim of this study was to investigate the effect of Health Qigong (HQ) exercise on the subjective and objective sleep quality and the quality of life in male patients with drug abuse who received treatment at a mandatory drug rehabilitation residential institution. Methods: Ninety male patients (mean age, 36.85 ± 8.72 y) were included and randomly divided into the Health Qigong (HQ) group, aerobic exercise (AE) group, or control group. The participants in the HQ and AE groups exercised four times a week for 1 hour per session for 12 weeks, while the control group maintained their original lifestyle. The following parameters were recorded before and after exercise: Pittsburgh Sleep Quality Index (PSQI); SF-36; and total sleep time, sleep efficiency, sleep latency, deep sleep time, deep sleep rate, light sleep time, and light sleep rate using actigraphy. Results: Health Qigong improved the subjective sleep quality, objective sleep quality, and quality of life after a 12-week intervention. Considering the subjective sleep quality, Health Qigong helped improve several aspects of the PSQI, including the overall sleep quality (p < 0.01), sleep latency (p < 0.01), sleep duration (p < 0.01), sleep latency (p < 0.01), sleep disturbance (p < 0.01), and day dysfunction (p < 0.01). In relation to the objective sleep quality, Health Qigong improved the total sleep time (p < 0.01), sleep efficiency (p < 0.01), sleep latency (p < 0.01), deep and light sleep rate (p < 0.01). Considering the quality of life, Health Qigong helped improve the role-physical (p < 0.01), general health (p < 0.01), bodily pain (p < 0.01), and mental health (p < 0.01) aspects of SF-36. Conclusion: Health Qigong may be an effective approach to improve the subjective and objective quality of sleep and life quality of patients with drug abuse.

Effects of social skills training for drug users under treatment / Efeitos do treinamento em habilidades sociais para usuários de substâncias em tratamento / Efectos del entrenamiento en habilidades sociales para usuarios de sustancias en tratamiento

The Social Skills Training (SST) presents satisfactory results in different clinical and non-clinical populations. The objective of this study is to evaluate the effects of SST on the perception of quality of life of drug users under treatment in post-intervention and follow-up conditions. It is a quasi-experimental study. The instruments used in the study were: CHASO, EMES-M, Extensive Interaction Semi-structured Test and WHOQOL. The study sample was composed of forty male drug users who participated in SST in a Therapeutic Community. The results indicate a statistically significant increase in the ability of defending rights, dealing with and keeping calm upon criticism, with medium effect size on the ability to refuse requests, refuse drugs and quality of life (psychological domain). SST was found to contribute to the development of specific social skills and as a complementary strategy in the Therapeutic Community. (AU)

O Treinamento em Habilidades Sociais (THS) apresenta resultados satisfatórios em populações clínicas e não clínicas. Objetiva-se avaliar os efeitos do THS na percepção de qualidade de vida e habilidades sociais de usuários de substâncias em tratamento nas condições de pós-intervenção e follow-up. Trata-se de um estudo quase-experimental. Os instrumentos utilizados foram: CHASO, EMES-M, Teste Semiestruturado de Interação Extensa e WHOQOL. Participaram 40 homens usuários de substâncias que participaram do THS em uma Comunidade Terapêutica. Os resultados apontam para um aumento estatisticamente significativo nas habilidades de defesa de direitos, enfrentar e manter a tranquilidade diante das críticas, com tamanho de efeito médio nas habilidades de negar pedidos, recusar a droga e qualidade de vida (domínio psicológico). Identifica-se que o THS contribui no desenvolvimento de habilidades sociais específicas, sendo uma estratégia complementar do tratamento na Comunidade Terapêutica. (AU)

El Entrenamiento en Habilidades Sociales (EHS) proporciona resultados satisfactorios en poblaciones clínicas y no clínicas. El objetivo de este estudio fue evaluar los efectos del EHS en la percepción de la calidad de vida y las habilidades sociales de los usuarios de drogas bajo tratamiento en condiciones de post-intervención y seguimiento. Se trata de un estudio cuasi-experimental Los instrumentos utilizados fueron: CHASO, EMES-M, Test Semiestructurado de Interacción Extensiva y WHOQOL. La muestra del estudio se compuso por cuarenta varones usuarios de drogas que participaron en el EHS en una Comunidad Terapéutica. Los resultados apuntan a un aumento estadísticamente significativo en la capacidad de defensa de derechos, afrontar, mantener la tranquilidad frente a las críticas, con un tamaño de efecto promedio en la denegación de peticiones, rechazo de drogas y calidad de vida (dominio psicológico). Se comprueba que el EHS contribuye al desarrollo de habilidades sociales específicas como una estrategia complementaria de tratamiento en la Comunidad Terapéutica. (AU)

A Quasi-Experimental Study on the Effectiveness of Compulsory and Voluntary Treatment Settings for 1,299 Drug Abusers in Hunan, China.

Background: Although the type and structure of substance abuse treatment have changed, the overall approaches of drug rehabilitation in China has remained largely unchanged. Evidence of effectiveness for compulsory drug rehabilitation centers (CRCs) and voluntary drug rehabilitation centers (VRCs) remains mixed. The main objective of our study is to reveal the outcomes of CRCs and VRCs and examine the factors associated with relapse in these two centers. Methods: In this cross-sectional study, we recruited a total of 1,299 drug abusers in Hunan Province, 709 from CRCs and 590 from VRC, respectively. We used Pearson chi-squared test and t-test to examine the differences in demographics and drug-related characteristics. Binary logic regression was used to examine the relationship between important factors and relapse in CRCs and VRC. Results: Patients from CRCs and VRC significantly differed in age, sex, types of drug used, medical illness, education, occupation, mental illness, and marital status. After drug rehabilitation, both groups both had improved in occupation, family support, and social function (p < 0.05). In addition, employment and family support were significantly associated with a decreased risk of relapse (p < 0.05). Conclusion: This study revealed that compulsory rehabilitation is as effective as voluntary rehabilitation in (1) getting jobs and increasing monthly income, (2) having a good relationship with family, and (3) becoming more satisfied with their spared time. The components of these two settings were very different and may imply the necessity of these two approaches in China. In addition, employment and family support may prevent relapse.

Major and trace elements changes of female methamphetamine addicts during six months' compulsory treatment: Biomarkers discovery.

BACKGROUND: The concentration levels of major and trace elements are significantly correlated with human health. However, studies profiling major and trace elements among female using methamphetamine are rare. This study aims to investigate the major and trace elements changes and discover elemental biomarkers in plasma of female methamphetamine (METH) addicts in six months' compulsory treatment. METHODS: A total of 60 female METH addicts selected from drug rehabilitation center were randomly divided into three equal groups: (1) Detoxification for one month; (2) Detoxification for three months; (3) Detoxification for six months. Twenty healthy women, without drug abuse history were selected as control group. Four major elements including Na, Mg, K, Ca and twelve trace elements including V, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Mo, Sn, Pb were determined using inductively coupled plasma mass spectrometry (ICP-MS). The results were analyzed using One-way Analysis of Variance (ANOVA) and Student-Newman-Keuls (SNK test). Elemental biomarkers were discovered based on orthogonal partial least squares discriminant analysis (OPLS-DA). RESULTS: The four groups used in the study were divided into four significant sections according to scatter plots. The total elemental concentrations of three METH withdrawal groups were increased compared to the control group. Over six months, element contents of the withdrawal groups gradually equaled element contents of the control group in compulsory treatment. The variable importance in the projection values (VIP > 1) of OPLS-DA model and SNK test (p < 0.05) revealed Fe, Cu, Cr and Se as elemental biomarkers. CONCLUSION: Major and trace elements demonstrated significant differences between control group and three METH withdrawal groups. Fe, Cu, Cr and Se are potential elemental biomarkers among METH-abused female groups. Metabolic disorders of major and trace elements exist in the female methamphetamine addicts.

Dataset relating self-control and hope among participants in Malaysian rehabilitation centers.

Current research trends are moving towards acknowledging the significance and contributions of positive psychology in understanding the potential of individuals coping with problems. The shared data were used to explore the relations between self-control and hope among drug addicts in drug rehabilitation centers in Malaysia. Self-control was conceptualized by six dimensions: impulsivity, simple tasks, risk seeking, physical activities, self-centeredness, and temper. The measurement of hope included three dimensions: cognitive-temporal, affiliative-contextual, and affective-behavioral. A total of 244 clients from drug rehabilitation centers in Peninsular Malaysia were randomly selected to participate in the data collection. Significant correlations were observed between the self-control dimensions of impulsivity, simple tasks, self-centeredness and temper with hope. No significant correlation was observed between risk seeking or physical activities with hope. The data are useful in providing information towards developing treatment and rehabilitation programs for drug addicts. In general, the data showed the importance of incorporating self-control in rehabilitation modules to increase hope among drug addicts in their effort to combat drug addiction. The data can be used by researchers and practitioners to further understand the role of positive psychology variables in developing and advancing current empirical understanding and knowledge about drug addiction.

How to Enhance the Motivation for Drug Detoxification: Consciousness Guidance and Behaviour Restriction of Family Intergenerational Ethics.

Assisting substance users to recover from the behaviour of drug addiction and maintain long-term rehabilitation is a long and complicated process, in which the motivation to undergo drug rehabilitation plays a decisive role. So far, the cultural connotation of family and its mechanism of promoting behavioural change of substance users have not been fully explored. Through in-depth interviews with 15 drug rehabilitants, among which there were 7 women and 8 men, it is found that the motivation for drug rehabilitation is stimulated under the guidance and restriction of family ethics based on obligation and responsibility, which is mainly reflected in the longitudinal intergenerational responsibility. On the one hand, negative consequences such as intergenerational liability deficit and reputation damage lead substance users to reflect on ethical values. On the other hand, disciplines such as intergenerational responsibility and obligation and mutual assistance can correct the actual behaviour of substance users in ethical practice. In contrast to Western countries, which focus on external environmental factors such as family function, family relationships and family support, the motivation for drug rehabilitation in China places more emphasis on their identity and role as family members and corresponding responsibilities, which provides inspiration for developing social work services for substance users from family cultural norms.

Concretizing occupational justice principles in Philippine community-based drug rehabilitation practice settings

Background@#The substance addiction and rehabilitation situation in the Philippines is a complex health and social crisis that has plagued individuals, groups, and communities in the past decades. While pluralistic and critical approaches to address the drug demand reduction issue are available, hegemonic practices continue to eclipse evidenceinformed approaches underpinned by resiliency and occupational justice perspectives. @*Methodology@#This case study utilized a qualitative and interpretive approach to describe the practice processes of localized community-based drug rehabilitation programs in selected Filipino communities and to propose concrete practice processes to improve the development and implementation of the local community-based drug rehabilitation. Two independent focus group discussions were conducted. Participants were health care professionals, community workers, and citizens who have an affinity to the substance addiction rehabilitation setting. Framed by the Participatory Occupational Justice Framework, specifically the practice process “engage collaboratively with partners,” qualitative data extracted from the focus group discussions were thematically analyzed. @*Results@#Three themes emerged: (1) Changing perspective: starting from the community; (2) Better together: collaboration and coordination in substance addiction and rehabilitation; and (3) “Juan for All, All for Juan”: contextualized strategies in substance addiction and rehabilitation. The findings in the case study reaffirm the value of shifting from an individualistic (symptom-eradication) to populational (social and systemic interventions) perspectives in developing community-based drug rehabilitation programs. @*Conclusion@#To reify occupational justice and resiliency approaches, proposed strategies include understanding drug use from critical and occupational perspectives, enacting social modeling and mentorship, promoting inter-agency and inter-professional collaborative practices, and infusing culturally appropriate strategies in the development and implementation of local community-based drug rehabilitation programs.

A single-case quasi-experimental design of functional analytic psychotherapy for substance abuse / Um delineamento quase-experimental de caso único da psicoterapia analítica funcional para abuso de substâncias / Un diseño de caso único cuasi experimental de psicoterapia analítica funcional para abuso de sustancias

This study evaluated the effectiveness of Functional Analytic Psychotherapy (FAP) on clinically relevant behaviors (CRBs) in the context of substance abuse/chemical de pendence and identifying the therapeutic components of change. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to categorize therapist and client behaviors, and Timeline Followback was used to record drug abuse. Two participants were treated in a single case A/A + B quasi-experimental design, in which A = analytical-behavioral therapy and A + B = FAP. The results showed that with the introduction of FAP, specifically the therapist's contingent responding to the participant's progress, there was a decrease in the use of substances after three months for both participants. The participant who spent more time in psychotherapy experienced greater benefits at follow-up and a larger reduction in drug use. We concluded that FAP altered CRBs by positively reinforcing progress in-session and was significantly correlated with improvement out-of-session.

O objetivo da pesquisa foi avaliar o efeito da Psicoterapia Analítica Funcional (FAP) sobre os comportamentos clinicamente relevantes (CRBs) e abuso de substâncias de dependentes químicos e identificar os componentes terapêuticos de mudança. Foram utilizados os instrumentos Functional Analytic Psychotherapy Rating Scale para categorização de comportamentos do terapeuta e cliente e Timeline Followback para registrar o abuso de drogas. Dois participantes foram atendidos em um delineamento quase-experimental de caso único A/A+B, onde A = Terapia Analítico-Comportamental e A+B = FAP. Os resultados indicaram que a introdução da FAP, em especial o responder contingente do terapeuta, acompanhou os progressos e houve melhora no consumo de substâncias após 3 meses para ambos. O participante que se manteve mais tempo em psicoterapia obteve maior benefício no follow-up e no consumo de drogas. Concluiu-se que a FAP alterou CRBs reforçando positivamente progressos em sessão e que isto provavelmente se correlacionou com melhoras extrassessão.

El objetivo fue evaluar el efecto de la Psicoterapia Analítica Funcional (FAP) en los comportamientos clínicamente relevantes (clinically relevant behaviors - CRBs) e el abuso de sustancias de dependientes químicos, e identificar los componentes terapéuticos de cambio. Se utilizaron Functional Analytic Psychotherapy Rating Scale, para clasificar los comportamientos del terapeuta y del cliente, y timeline followback, para registrar el abuso. Dos participantes fueron evaluados a través de un diseño cuasiexperimental de caso único A/A + B, donde A = terapia analítico-comportamental y A + B = FAP. Los resultados indicaron que la implementación de la respuesta contingente del terapeuta llevó a cambios en las CRBs y mejorías en el consumo de sustancias en los dos participantes después de tres meses de intervención. El participante que se mantuvo más tiempo en psicoterapia obtuvo mayor beneficio durante el seguimiento. Se concluye que FAP modificó las CRBs a través del reforzamiento positivo en sesión, lo que se relacionó con las mejoras fuera de sesión.

Investigating the Associations among Drug Dependents' Family Function and Exercise Attitudes: Marital Status Differences.

This paper examines: (1) The demographic characteristics of different marital statuses of drug dependents; (2) differences in exercise attitudes and family function by marital status; and (3) if family function factors correlated with exercise attitudes and if exercise attitude factors correlated with family function. Multivariate analyses of variance (MANOVAs) revealed significant differences in drug dependents' exercise attitudes between married and single groups (p < 0.05) and the married and "other" groups (p < 0.01). Furthermore, we observed significant differences in drug dependents' family function between married and single groups (p < 0.01) and married and other groups (p < 0.05). Regression analyses indicated that communication [Fchange(1,1791) = 137.819; p < 0.001] was a significant positive predictor for drug dependents' exercise attitude, accounting for 7.1% of the observed variance. Moreover, 50% of the variance was explained by willingness [Fchange(1,1791) = 850.49, p < 0.001] and control [Fchange(1,1790) = 141.415, p < 0.001], which were two significant predictors of drug dependents' family function. Findings of this study were: (1) Exercise attitude and family function of married drug dependents were better than single drug dependents and other marital status addicts; (2) communication was observed as a factor of family function that correlated with exercise attitude; and (3) willingness was related with family function.

Hepatitis C Virus Screening Among Adolescents Attending a Drug Rehabilitation Center.

BACKGROUND: Hepatitis C virus (HCV) infection has a strong association with intravenous drug use (IVDU). IVDU is a growing public health concern, even in the adolescent population. To our knowledge, there are no published HCV screening studies targeting high-risk adolescents who attend drug rehabilitation centers.This study was designed to determine the seroprevalence of HCV infection utilizing point-of-care (POC) testing at an adolescent drug rehabilitation center and gain a preliminary understanding of the acceptance rate for HCV screening in this high-risk population. METHODS: This single-center, observational study was conducted at a major drug rehabilitation center in northeast Ohio from July 2016 to June 2017. The consented adolescents who presented at the center were recruited to participate in HCV screening. The participants were administered a survey to assess their demographics and risk behavior profile followed by HCV testing utilizing a POC test. RESULTS: During the study period, 150 adolescents were admitted to the drug rehabilitation center, of whom 100 were approached and 85 agreed to participate. Forty percent of the participants (34/85) were females, and 78% (66/85) were white. HCV prevalence among participants was 5% (4/85), all of whom were females. History of heroin use was reported by 15% (13/85) and it was associated with HCV seropositivity; 100% (4/4) of all HCV-positive individuals reported the use of heroin vs only 11% (9/81) of HCV-negative individuals (P = .0004). CONCLUSIONS: Our study showed a high prevalence of HCV among adolescents attending a drug rehabilitation center with high acceptance of POC HCV testing.

Factors associated with the physical and mental health of drug users participating in community-based drug rehabilitation programmes in China.

Since the promulgation and implementation of a new anti-drug law in 2008, the Chinese central government has encouraged local governments to carry out community-based drug rehabilitation programmes. This study explores the association between community-based drug rehabilitation programmes and drug users' physical and mental health. This study collected data between October 2018 and February 2019 from a community-based rehabilitation programme in a community in Foshan Municipality in Guangdong Province of China. A total of 162 drug users participating in a community-based drug rehabilitation program were selected to complete a self-administered and anonymous questionnaire. A cover letter interpreting the purpose of the study and a self-administered questionnaire was provided to the drug users. Ethics approval for this study was obtained from the Academic Committee of School of Public Administration, JiNan University, Guangzhou, China. All participants gave verbal informed consent. Four multiple linear regression models were used to explain social services that influence drug users' physical and mental health. The findings show that the number of service items provided by the social service organization was significantly associated with physical and mental health among drug users. Particularly, the employment assistance service influenced the drug user's physical and mental health status significantly.

Tuberculosis in Selected Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in Luzon, Philippines

Background and Objectives@#Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015.@*Methods@#All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence.@*Results@#A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases.@*Conclusion@#The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.

Prison Addiction Program and the Role of Integrative Treatment and Program Completion on Recidivism.

This study examines whether there is variability between the effects of three different drug rehabilitation programs operating in the Israeli Prison Service (IPS) on completers' recidivism. By performing comparative analysis, this study attempts to address the problem of assessing the role of participants' motivation. The study uses a rich administrative data obtained from the IPS system to develop a propensity score matching (PSM) approach where the treatment groups consist of only those who completed the programs, and the comparison groups consist of drug-addicted prisoners who have not taken part in any drug rehabilitation program. After matching, prisoners in the treatment and comparison groups are found to be similar on all known characteristics. Findings show that the only rehabilitation program that promised significant and positive outcomes for its completers was the more comprehensive one operating at Hermon Prison. Prisoners who completed the treatment were incarcerated and arrested less than their comparison group. The "golden strategy" for rehabilitating drug-using prisoners, then, will be twofold. The program should be based on the promising components of rehabilitation, that is, cognitive behavioral therapy, therapeutic community, long duration, intensity, and positive social climate. The program should also succeed in retaining its participants through completion.

Estudio de politicas publicas para el tratamiento de jóvenes adictos a la droga en Ecuador / Study of public policies for the treatment of young people addicted to the drug in Ecuador / Studio delle politiche pubbliche per il trattamento di giovani dedo alla drogas no Equador

Resumen Introducción: El consumo de drogas, es un tema de gran importancia, y un grave problema social, que no sólo aqueja a nuestro país, Ecuador, sino que su afectación es a nivel mundial, tomando en consideración que llega incluso a ocasionar graves daños en la salud, en la convivencia social y la seguridad ciudadana. Objetivo: Proponer y difundir estrategias integrales para la rehabilitación y reinserción de los jóvenes adictos a las drogas. Materiales y métodos: Se implementó una encuesta a 40 jóvenes comprendidos entre los 18 a 25 años de edad, de diferentes clases sociales. Resultados: Se determinó que el consumo de drogas va en aumento, a causa de problemas familiares y la influencia de amistades y redes sociales; así como también, se determina que un alto porcentaje de los encuestados desconoce las normativas que regulan la adicción en el Ecuador y las Políticas de Estado, creadas para la debida rehabilitación y reinserción de los adictos a la sociedad. Conclusión: Se proyecta a través de los resultados obtenidos poner en conocimiento de la sociedad en general y en especial de los adictos, las normativas que regulan el problema de la adicción; así como, hacer conocer el tema de las Políticas Públicas que el Estado, ha creado en función de la prevención integral de esta problémica, con el fin de garantizar una vida digna.

Abstract Introduction: Drug use, is a subject of great importance, and a serious social problem, which not only afflicting our country, Ecuador, but that his involvement is at the global level, taking into consideration that even serious damage in health, social life and the citizen security. Objective: Propose and disseminate comprehensive strategies for the rehabilitation and reintegration of young people addicted to drugs. Materials and methods: A survey was implemented to 40 young people between 18 and 25 years of age, of different social classes. Results: It was determined that drug use is on the rise, because of family problems and the influence of friendships and social networks; as well as, it is determined that a high percentage of respondents unknown regulations governing the addiction in the Ecuador and State policies, created for the appropriate rehabilitation and reintegration of addicts into society. Conclusion: Is projected through the results bring to the attention of society in general and in particular of addicts, the norms that regulate the problem of addiction; as well as, make known the issue of public policy that the State has created based on comprehensive prevention of this problem, in order to ensure a dignified life.

Resumo Introdução: Uso de drogas, é um assunto de grande importância e um grave problema social, que não só que afligem nosso país, o Equador, mas o seu envolvimento é a nível global, levando em consideração que até mesmo sérios danos na saúde, vida social e a segurança dos cidadãos. Objetivo: Propor e divulgar estratégias globais para a reabilitação e a reintegração de jovens viciados em drogas. Materiais e métodos: Um levantamento foi implementado para 40 jovens entre 18 e 25 anos de idade, de diferentes classes sociais. Resultados: Determinou-se que o uso de drogas está em ascensão, por causa de problemas familiares e a influência de amizades e redes sociais; assim como, é determinado que uma elevada percentagem de inquiridos desconhecido regulamentos o vício nas políticas Equador e estado, criado para a adequada reabilitação e reinserção social de toxicodependentes. Conclusão: Projeta-se através dos resultados chamar a atenção da sociedade em geral e em particular dos viciados, as normas que regulam o problema da toxicodependência; bem como, dar a conhecer a questão das políticas públicas que o estado tem criado com base na prevenção abrangente deste problema, a fim de garantir uma vida digna.

The effect of educating the clients of rehab centers on the frequency of methadone poisoning among children: a study from Iran.

Background Poisoning with methadone is considered dangerous and fatal, which can lead to decreased consciousness, coma, apnea and eventually death. Aims The present study was conducted to evaluate the effect of educating the clients of rehabilitation (rehab) centers on the frequency of methadone poisoning among children. Methods In the present semi-experimental study, the study population included all of the clients referred to the rehab centers in an urban area of Iran who received treatment with methadone. Samples were selected using the census method. The data gathering tool was a researcher-made questionnaire of which the content validity has been approved. To perform the educational program, educational brochures were distributed among all the rehab centers (33 centers) and one face-to-face educational session was conducted at each center. Six months after the intervention, the number of under 12 year-old children who were referred to hospital with methadone poisoning was calculated and compared to the same number from the 6 months prior to the study. Data were analyzed using SPSS 18. Results According to the results, the number of methadone poisonings during the 6-month period prior to the study was 29, while the same number during the 6-month period after the intervention was 9. Fisher's exact test showed a significant difference between the number of methadone poisonings before and after the intervention (p < 0.001). Conclusion The increased level of knowledge among the parents referred to rehab centers could decrease the rate of poisoning among their children. Therefore, performing this educational program is recommended for all the rehab centers.

Medical and Ethical Concerns Regarding Pacemaker Implantation in a Patient with Substance Use Disorder.

Medical and ethical dilemmas surrounding endocarditis and cardiac valve replacements related to intravenous drug use have been described often. Less well-described are dilemmas associated with pacemaker implantation in such patients. We describe a patient with a substance use disorder for whom a pacemaker was medically indicated.

Craving Responses to Methamphetamine and Sexual Visual Cues in Individuals With Methamphetamine Use Disorder After Long-Term Drug Rehabilitation.

Studies utilizing functional magnetic resonance imaging (fMRI) cue-reactivity paradigms have demonstrated that short-term abstinent or current methamphetamine (MA) users have increased brain activity in the ventral striatum, caudate nucleus and medial frontal cortex, when exposed to MA-related visual cues. However, patterns of brain activity following cue-reactivity in subjects with long-term MA abstinence, especially long-term compulsory drug rehabilitation, have not been well studied. To enrich knowledge in this field, functional brain imaging was conducted during a cue-reactivity paradigm task in 28 individuals with MA use disorder following long-term compulsory drug rehabilitation, and 27 healthy control subjects. The results showed that, when compared with controls, individuals with MA use disorder displayed elevated activity in the bilateral medial prefrontal cortex (mPFC) and right lateral posterior cingulate cortex in response to MA-related images. Additionally, the anterior cingulate region of mPFC activation during the MA-related cue-reactivity paradigm was positively correlated with craving alterations and previous frequency of drug use. No significant differences in brain activity in response to pornographic images were found between the two groups. Compared to MA cues, individuals with MA use disorder had increased activation in the occipital lobe when exposed to pornographic cues. In conclusion, the present study indicates that, even after long-term drug rehabilitation, individuals with MA use disorder have unique brain activity when exposed to MA-related cues. Additionally, our results illustrate that the libido brain response might be restored, and that sexual demand might be more robust than drug demand, in individuals with MA use disorder following long-term drug rehabilitation.

Case report: surgical removal of a migrated needle in right ventricle of an intravenous drug user.

BACKGROUND: Illicit drug use has become an increasing public health and social concern in the past decades worldwide. Intravenous injection has an elevated risk of infection. Needle embolism is a rare complication of intravenous drug users, Retained broken needles can lead to local complications, such as infection, but they also have the potential to embolize to heart or lung, and lead to serious complications. METHOD: We reported a rare case of an intravenous drug user which a retained broken needle fragments in the inferior wall of the right ventricle. RESULTS: We performed a successful surgery and give our comments and recommendations for illicit drug use worldwide and in China. CONCLUSIONS: Illicit Drug use becomes a global problem because of its health and social harmfulness. To help drug addicts and provide prevention and treatment services are the obligations and responsibilities of all medical workers.

Methadone maintenance-lessons from two systems in China.

In Hong Kong, methadone maintenance treatment (MMT) was launched in the 1970s, almost 30 years before the counterpart programme's inauguration in Mainland China. Both were established in response to perceived public crises-addiction-related crime and HIV outbreak, respectively-and both are now regular services under two systems in the same country. Effectiveness of MMT in achieving the stated goals was evident in each case and provides useful lessons on strategies for dealing with the varied concerns related to illicit drug use. Today, with changing patterns of drug addiction, increasing competition for resources, and changing attitudes towards addiction and its treatment, the two MMT systems are confronted with similar challenges to achieve sustainability.