Changes in the pattern of opium addiction in Bam after the earthquake

الموضوعات : Report of Health Care

Mohammad Reza Aflatoonian ¹ , Iraj Sharifi ² , Behnaz Aflatoonian ³ , Kouros Divsalar ⁴

1 - MPH, Head of Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
2 - Professor, Head of Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
3 - MSc, Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
4 - MSC, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

تاريخ الإرسال : 15 الجمعة , جمادى الأولى, 1436 تاريخ التأكيد : 15 الثلاثاء , شعبان, 1436 تاريخ الإصدار : 14 الإثنين , شعبان, 1436

الکلمات المفتاحية: Iran, Earthquake, Addiction, Opium, Epidemiology,

ملخص المقالة :

Introduction: Opium abuse is a serious public health threat of various magnitudes in Iran and neighboring countries. We conducted this study to explore the rate and intensity of opium addiction in Bam before the earthquake in comparison to the data collected after the earthquake.
Methods: This descriptive cross-sectional study was conducted in the city of Bam in 2010. We used cluster random sampling method to collect data. This was done through house-to-house visits by a team of trained indigenous health personnel and informants. The status of addiction was achieved through case informants and confirmed by an experienced physician.
Results: Opium addiction was significantly higher in men aged more than 50 (46%), illiterates (29.8%), labors/farmers (51.3%), private (50.7%) and jobless (21.6%) participants. Majority of the addicts (17.1%) were from the suburban areas (17.1%) as compared with those in urban areas (13.6%, P < 0.05). Of the addicts, those with a history of addiction for 3-8 years (P < 0.05), consumed 3-8 g (P < 0.01), two sessions/day (P < 0.05), used opium on a regular basis (P < 0.05) and smoked with Sikh-sang (P < 0.001) showed a significantly higher severity of addiction than the other groups. The mean scores of severity including duration, amount, session, regularity, and consumption device were 2.5, 2.2, 2.4, 1.9 and 2.6, respectively. The overall mean of severity was 2.3 for 226 addicts.
Conclusion: It seems that earthquake is a major traumatic risk factor for such an epidemic condition compared to the previous state of opium addiction. The present findings could be used for future prophylactic measures and therapeutic control strategies. These findings can be applied in clinical practice for active detection of opioid cases and subsequent treatment.

المصادر:

 

1. United Nations Office on Drugs and Crime: World Drug Report. United Nations; 2011. http://www.unodc.org/documents/data-and analysis/WDR2011/The_opium-heroin_market.pdf.

2. United Nations Office on Drugs and Crime: Drug use in Afghanistan: Survey. Vienna, Austria: United Nations; 2009. http://www.unodc.org/documents/data and-analysis/Studies/Afghanistan

3. United Nations: Global illicit drug trends. Pretoria: UNODC; 2003. p. 101-36.

4. Farnia M, Ebrahimi B, Shams A, Zamani S. Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran. Int J Drug Policy 2010; 21(5): 422-4.

5. Kalant H. Opium revisited: a brief review of its nature, composition, non-medical use and relative risks. Addiction 1997; 92(3): 267-77.

6. Alemi AA. the iceberg of opium addiction. An epidemiological survey of opium addiction in a rural community. Drug Alcohol Depend 1978; 3(2): 107-12.

7. Ahmadi J, Fallahzadeh H, Salimi A, Rahimian M, Salehi V, Khaghani M , et al. Analysis of opium use by students of medical sciences. Journal of Clinical Nursing 2006; 15(4): 379-86.

8. Ahmadi J, Pridmore S, Alimi A, Cheraghi A, Arad A, Parsaeyan H, et al. Epidemiology of opium use in the general population. Am J Drug Alcohol Abuse 2007; 33(3): 483-91.

9. Ray R. The extent, pattern and trends of drug abuse in India-national survey. Ministry of social justice and empowerment, government of India and United Nations Office on Drugs and Crime; 2004.

10. Tang YL1, Zhao D, Zhao C, Cubells JF. Opiate addiction in China: current situation and treatments. Addiction 2006; 101(5): 657-65.

11. Kerimi N. Opium use in Turkmenistan: a historical perspective. Addiction 2000; 95(9):1319-33.

12. Seyedin SH, Aflatoonian MR, Ryan J. Adverse impact of international NGOs during and after the Bam earthquake: health system’s consumers’ points of view. American Journal of Disaster Medicine 2009; 4(3): 173-9.

13. Gilrame E. Substance abuse in young people. J Child Psychol Psyc 2000; 41: 55-80.

14. Vuong C, Van Uum SH, O’Dell LE, Lutfy K, Friedman TC. the effects of opioids and opioid analogs on animal and human endocrine systems. Endocr Rev 2010; 31(1): 98-132.

15. Page GG. Immunologic effects of opioids in the presence or absence of pain. J Pain Symptom Manage 2005; 29(5 Suppl): S25-31.

16. Majdzadeh R, Feiz-Zadeh A, Rajabpour Z, Motevalian A, Hosseini M, Abdollahi M, et al. Opium consumption and the risk of traffic injuries in regular users: a case-crossover study in an emergency department. Traffic Inj Prev 2009; 10(4): 325-9.

17. Divsalar K, Haghpanah T, Afarinesh M, Mahmoudi Zarandi M. Opium and heroin alter biochemical parameters of human’s serum. Am J Drug Alcohol Abuse 2010; 36(3): 135-9.

18. Nemati MH, Astaneh B, Ardekani GS. Effects of opium addiction on bleeding after coronary artery bypass graft surgery: report from Iran. Gen Thorac Cardiovasc Surg 2010; 58(9): 456-60.

19. Wei G, Moss J, Yuan CS. Opioid-induced immunosuppression: is it centrally mediated or peripherally mediated? Biochem Pharmacol 2003; 65(11): 1761-6.

20. Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med 2003; 349(20): 1943-53.

21. McQuay H. Opioids in pain management. Lancet 1999; 353(9171): 2229-32.

22. Montazeri A, Baradaran H, Omidvari S, Azin SA, Ebadi M, Garmaroudi G, et al. Psychological distress among Bam earthquake survivors in Iran: a population-based study. BMC Public Health 2005; 5: 4.

23. Mousavi SS, Mahmoudi-Gharaei J, Bina M, Gholampoor E, Eisar S. Post traumatic stress disorder and general symptoms of anxiety in adolescent survivors of Bam earthquake. Iranian Journal of Psychiatry 2006; 1(2): 76-80.

24. Aflatoonian MR, Meymandi MS, Divsalar K, Mahmoudi M, Heravi G. Possible association between human blood types and opioid addiction. Am J Addict 2011; 20(6): 581-4.

25. Voukassovitch C. Drug addiction, anorexia: what is the connection? Ann Med Psychol (Paris) 1986; 144(7): 695-709. [In French].