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Noroozi A, Danesh A. Prevalence of alcohol consumption among clients of opioid agonist treatment (OAT) centers in Golestan province, Iran. Front Psychiatry 2023; 14:1134683. [PMID: 37304429 PMCID: PMC10248063 DOI: 10.3389/fpsyt.2023.1134683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/04/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Opioid agonist treatments (OATs) with methadone and buprenorphine are known to be effective treatments for people with opioid use disorder (OUD). However, concomitant use of other substances such as alcohol can negatively affect OAT outcomes. This study aimed to determine the prevalence of alcohol use among clients of OAT centers in the Golestan province in the northern part of Iran. Materials and methods This is a secondary analysis of a sample of 706 clients who were receiving OATs from certified OAT centers in Golestan province in 2015. They had been on OATs for at least 1 month and were randomly selected for the study. Data were collected via interviews with selected OAT clients. The main indicators studied in the present study were lifetime history of alcohol consumption, alcohol consumption during last month, lifetime history of excessive alcohol use on one occasion, and years of regular alcohol consumption. Results The prevalence of lifetime history of alcohol consumption was estimated at 39.2%. Prevalence of alcohol consumption during last month and lifetime history of excessive alcohol use on one occasion was 6.9 and 18.8%, respectively. Conclusion Despite a total ban on alcohol consumption in Iran, a sub-sample of participants admitted past-month alcohol use concurrent with their OATs. The estimated past-month prevalence of alcohol use was lower than the reported prevalence in countries where the production, distribution, and consumption of alcohol are legal.
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Affiliation(s)
- Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Danesh
- Health Management and Social Development Research Center, School of Medicine, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
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Rezaei N, Ahmadi N, Shams Beyranvand M, Hasan M, Gohari K, Yoosefi M, Djalalinia S, Saeedi Moghaddam S, Modirian M, Pazhuheian F, Mahdavihezaveh A, Moradi G, Delavari F, Larijani B, Farzadfar F. Alcohol consumption and related disorders in Iran: Results from the National Surveillance of Non-Communicable Diseases' Survey (STEPs) 2016. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000107. [PMID: 36962484 PMCID: PMC10021244 DOI: 10.1371/journal.pgph.0000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/28/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Alcohol consumption is a public health concern which is illegal in Iran. Moreover, due to cultural and religious beliefs, the available population-based research findings on alcohol consumption are inadequate. We aimed to provide an estimate on alcohol consumption using a large-scale population-based survey in Iran. MATERIALS AND METHODS The National Surveillance of Non-Communicable Risk Factors in Iran was a population-based survey conducted in 2016. The epidemiologic distribution of alcohol consumption and its related disorders were assessed using weighted survey methods and multiple logistic regression models. Age standardized rates were calculated using Iran's national population census in 2016. RESULTS At the national level, the prevalence rates of lifetime and current alcohol consumption were 8.00% (95% CI: 7.67-8.32) and 4.04% (95% CI: 3.81-4.27), respectively. The highest prevalence was reported among 25 to 34 year-olds. Individuals of higher socioeconomic status consumed significantly greater levels of alcohol. At provincial level, the highest and lowest percentages of the current alcohol drinking rates in Iran's provinces were, 23.92% (95% CI: 17.56-30.28) and 0.4% (95% CI: 0-1.18) in males, 1.58% (95% CI: 0.22-2.94) and 0% in females, respectively. In urban regions, the highest alcohol consumption rate was more than 22 times greater than the lowest alcohol consumption rate. Current alcohol drinkers were 2 times more prone to injury as compared to nondrinkers (ORadj: 2.0, 95%CI: 1.7, 2.3). CONCLUSION In Iran, the prevalence of alcohol consumption is low, although there is a considerable variation of alcohol consumption at provincial level as well as in different gender groups. Therefore, preventive WHO-recommended measures should be adopted more seriously by vulnerable groups.
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Affiliation(s)
- Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Shams Beyranvand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Hasan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farnaz Delavari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Zuberi A, Waqas A, Naveed S, Hossain MM, Rahman A, Saeed K, Fuhr DC. Prevalence of Mental Disorders in the WHO Eastern Mediterranean Region: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:665019. [PMID: 34335323 PMCID: PMC8316754 DOI: 10.3389/fpsyt.2021.665019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022] Open
Abstract
Objectives: To synthesize the prevalence of mental and substance use disorders in countries of the Eastern Mediterranean Region (EMR) of the World Health Organization. Methods: The literature search was conducted across several databases in two phases. First, we searched for systematic reviews and/or meta-analyses published before 2014, reporting prevalence estimates for mental disorders in the EMR. Then, we identified new primary cross-sectional or longitudinal studies published between 2014 and 2020. Studies were included if they had a sample size of ≥ 450 and were conducted among the general adult population. Current, period and lifetime prevalence estimates for each disorder were pooled using random-effects meta-analyses, and subgroup analyses and meta-regressions were conducted. Findings: Prevalence estimates were extracted from 54 cross-sectional studies across 15 countries within the EMR. Pooled analyses of current, period and lifetime prevalence showed the highest prevalence for depression (14.8%, 95% confidence interval, CI: 10.7-20.1%), followed by generalized anxiety disorder (GAD) (10.4%, 95% CI: 7.1-14.7%), post-traumatic stress disorder (7.2%, 95% CI: 2.9-16.6%), substance use (4.0%, 95% CI: 3.1-5.2%), obsessive compulsive disorder (2.8%, 95% CI: 1.6-4.9%), phobic disorders (1.8%, 95% CI: 1.1-2.8%), panic disorders (1.1%, 95% CI: 0.6-2.2%), bipolar disorders (0.7%, 95% CI: 0.3-1.6%), and psychosis (0.5%, 95% CI: 0.3-0.9%). Populations exposed to adverse events had higher prevalence of mental disorders than the general population. Period and lifetime prevalence showed little difference across mental disorders. More pronounced differences in prevalence were seen for depression and GAD, specifically between current and lifetime prevalence (depression: current prevalence 20.5% (95% CI: 14.9-27.4%), vs. lifetime prevalence: 4.2% (95%CI: 1.8-9.6%); GAD: current prevalence 10.3% (95% CI: 6.1-17.0), vs. lifetime prevalence: 4.5% (95% CI: 2.4-8.3%). Differences between current and lifetime prevalence of mental disorders may be due to the use of different screening instruments and thresholds being applied. Conclusion: The prevalence of mental and substance use disorders in the EMR is high. Despite substantial inter-survey heterogeneity, our estimates align with previous global and regional data on mental disorders. Our meta-review provides new evidence on the burden of mental health problems in the EMR. Systematic Review Registration: PROSPERO, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020187388.
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Affiliation(s)
- Alina Zuberi
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ahmed Waqas
- Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sadiq Naveed
- Department of Child Psychiatry, Institute of Living, Hartford, CT, United States
| | - Md Mahbub Hossain
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Atif Rahman
- Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Khalid Saeed
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Daniela C. Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Beyraghi N, Sadeghipour Meybodi S, Noorani Yazdi SS, Janani M, Banihashem SS, Bahri R, Noroozi A. Results from the first inpatient alcohol withdrawal management program in Iran: An observational study. Alcohol 2020; 88:43-47. [PMID: 32698051 DOI: 10.1016/j.alcohol.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS The consumption of alcohol is prohibited in Iran; however, concerns regarding alcohol-related harm have led to the development of national policies supporting the establishment of officially endorsed alcohol treatment settings. As a part of these policies, the Iranian Ministry of Health supported the establishment of the first alcohol withdrawal management unit in the psychosomatic unit of Taleghani Hospital in 2015. The purpose of this study is to report on this pilot project. METHODS This was an observational and descriptive study, conducted on 83 patients with alcohol use disorder based on DSM 5 who were consecutively admitted to the unit for alcohol withdrawal management, from March 2017 to March 2018. The demographic data, alcohol use history, comorbid physical and psychiatric conditions, completion of inpatient treatment, length of hospital stay, and adverse events were extracted from the patients' records using a checklist developed by the authors. RESULTS 95.2% of the patients were male. The mean age was 45.3 (±12.2) years. Study participants reported using 38.7 (±29.6) standard drinks in a drinking day during the last year. Mean length of stay was 9.01 (±6.8) days. 81.7% of patients completed the inpatient treatment episode. Six patients (7.2%) had a complicated withdrawal (delirium), and no incidents of a withdrawal seizure were reported during the period of this study. CONCLUSIONS This is the first study providing preliminary results on the safety and effectiveness of symptom-triggered alcohol withdrawal management in Iran. The clinical and policy level implications of these findings have been discussed.
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Chegeni M, Kamel Khodabandeh A, Karamouzian M, Shokoohi M, Abedi L, Khalili M, Rajaei L, Ardalan G, Sharifi H. Alcohol consumption in Iran: A systematic review and meta-analysis of the literature. Drug Alcohol Rev 2020; 39:525-538. [PMID: 32441436 DOI: 10.1111/dar.13093] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 12/13/2022]
Abstract
ISSUES Alcohol production, marketing and consumption are illegal in Iran. This systematic review examines the lifetime and last 12-month prevalence of alcohol consumption among the general and young population in Iran. APPROACH We searched Web of Science, PubMed, Embase, Scopus and Iranian scientific databases (i.e. Scientific Information Database and Magiran) for relevant publications in English and Persian from inception to 12 May 2019. Following a random-effects meta-analysis, we estimated the pooled prevalence of alcohol consumption among the general population and young people (<30 years old). Meta-regression was used to identify potential sources of heterogeneity. KEY FINDINGS Of the 2400 identified records, 62 met the inclusion criteria. The overall pooled prevalence of lifetime alcohol consumption among the general population and young people was 13.0% [95% confidence intervals (CI) 10.0, 16.0]. The overall pooled prevalence of last 12-month alcohol consumption was 12.0% (95% CI 7.0, 18.0) for the general population and 15.0% (95% CI 9.0, 22.0) for young people. The prevalence of alcohol consumption varied from 0.03% to 68.0% in different regions, 0.3% to 66.6% among males and 0.2% to 21.0% among females. IMPLICATIONS Our findings highlight the need for public health surveillance of alcohol use in Iran. CONCLUSION These estimates show that, on average, one in eight people in the general population have ever consumed alcohol in Iran, indicating that alcohol consumption is not an uncommon practice in the country.
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Affiliation(s)
- Maryam Chegeni
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Atiyeh Kamel Khodabandeh
- Department of Biostatistics and Epidemiology, School of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,British Columbia Centre on Substance Use, Vancouver, Canada
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.,Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Leili Abedi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Rajaei
- Adolescent and Youth Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Gelayol Ardalan
- Adolescent and Youth Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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