Objective (s): The rising of risky injections has caused HIV infections epidemics among Intravenous DRUG USERS (IDUs). So, high costs of HIV/AIDS care and low financial resources necessitate economic evaluation to choose the best decision to control HIV/AIDS. This study was conducted to determine cost-effectiveness of METHADONE MAINTENANCE Treatment (MMT) CENTERS to prevent HIV infections among IDUs.Methods: In this study, we selected all seven MMT CENTERS and their IDUs (n=259). We calculated all costs from government perspective. Mathematical models were used to estimate number of HIV cases averted from risky injecting behaviors changes.Results: Total cost of MMT CENTERS was $204297.7 and cost of HIV/AIDS care in no intervention scenario, was estimated $13942756.8. ICER was $109035.3 per HIV case averted based on an estimated 126 HIV case averted. The results of the sensitivity analysis indicated that MMT intervention is cost-effective even in worst scenario and ICER varies from $39149.42 to $290004.1 per HIV case averted.Conclusion: Considering to high effectiveness and cost-effectiveness of MMT CENTERS, it is necessary to develop these CENTERS in regional and national levels to cover the high risk people more.

Objective: METHADONE MAINTENANCE treatment is one of the most common methods of substance abuse treatment. There is conflicting evidence of the effect of METHADONE on behavior and cognition. The aim of this study was to evaluate the effect of METHADONE MAINTENANCE treatment on executive functions. Method: A quasi-experimental research design along with pretest and posttest stages was used for the conduct of this study. A variety of neurological tests, such as Stroop Test, Wisconsin Test, Continuous Performance Test, Verbal Fluency Test, Digit Span Test, and Go/No-Go Test were used to evaluate executive functions. Results: The results showed that METHADONE MAINTENANCE treatment did not lead to a significant difference in Wisconsin test, Continuous Performance Test, Verbal Fluency Test, Digit Span Test, and Go/No-Go Test (P>.05). However, it brought about a significant difference in the indexes of Stroop test (P<.05). Discussion and Conclusion: Although METHADONE treatment does not lead to the improvement of cognitive functions, it exerts no detrimental effect on cognitive functions, as well. METHADONE treatment can be used when it is not aimed to improve substance USERS’ cognitive functions.

DRUG abuse seems to be a major problem in all contemporary societies; it has destroyed millions of lives and fighting it has consumed a substantial percentage of national budgets around the world (UN DRUG Report, 2011: 8).Iran has one of the most serious DRUG problems in the world and the latest Rapid Situation Assessment (RSA), which was conducted in 2010 by the authorities in the country, estimated the number of DRUG USERS - both DRUG abUSERS and recreational DRUG USERS – to be 2.1 million people.

Background: Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. Procrastination is a self-regulatory failure, defined as the voluntary delay of an intended course of action despite expecting to be worse off for the delay. Behavioral procrastination is a self-sabotage strategy that allows people to shift blame and avoid action; the decisional procrastination strategy is to put off making a decision when dealing with conflicts or choices. Procrastination has a great role in quitting DRUG addiction. Objectives: The aim of this study was to determine the relationship between procrastination and self-efficacy and other factors among intravenous DRUG USERS. Patients and Methods: This cross-sectional study was conducted on 178 intravenous DRUG USERS in the behavioral disease counseling, health center in Sari city, Mazandaran province, Iran, in 2013. The samples were selected through census sampling, descriptive and inferential statistics were used to measure the properties of distribution that depicts a set of data shown as frequency distribution tables, while for the mean and standard deviation, chi-square, Fisher and Spearman-Brown coefficients were used to analyze the data. Results: The mean age of the participants was 43 years. Seventy-two percent of them were married and opium was the first DRUG used. The first substance used in them was 54% of opium, 33% cannabis and 5% alcohol and 79% smoking. The reason of the first DRUG use in 32% of the subjects was temptation and in 10% a friend’ s influence. The mean age of the first DRUG use was 23 years, and the frequency was 2 times per day. All of them had relapse at least once. Seven percent of them currently use other materials (2% crystal, 5% alcohol and opium and crack) both in METHADONE treatment. Behavioral procrastination in 60. 5% of them and decisional procrastination in 62% is from low to average range. There was a significant relationship between relapse and self-efficacy as well as between self-efficacy and the age of the first DRUG use, DRUG dose, and procrastination for treatment, marriage, employment and job. Also, the relationship between behavioral procrastination and self-efficacy was significant and inverse. Conclusions: This study found a significant difference between procrastination and self-efficacy as well as other related factors. It is important to include DRUG USERS and the society organizations representing them in every stage of the governmental policy and program development process to make them responsive to the needs of the community.

Background: Injecting DRUG USERS (IDUs) are a major and most important risk factor for rising hepatitis C virus (HCV) prevalence in Iran.Objectives: The objective of this study was to determine the effectiveness of METHADONE MAINTENANCE treatment (MMT) in prevention of HCV infection transmission among IDUs.Patients and Methods: A mathematical modeling has been used to estimate number of HCV infections averted. The input parameters used in the model were collected by self-reported method from 259 IDUs before registering and one year after MMT. Nonparametric statistical tests have been used to compare risky injecting and sexual behaviors among IDUs before and after participating in MMT program. Deterministic sensitivity analyses were done to show the effects of parameters’ uncertainty on outcome.Results: Of the 259 participants, 98.4% (255) were men, the mean age ± SD was 33.1 ± 7.58 years and HCV prevalence was 50%. The studied IDUs reported lower rate of risky injecting and sexual behavior after participation in MMT program. The cumulative incidence of HCV per 100 IDUs due to sharing injection and unsafe sexual contact with MMT program were 13.84 (95% CI: 6.17 -21.51), 0.0003 (0.0001 - 0.0005) and without it 36.48 (25.84 - 47.11) and 0.0004 (0.0002-0.0006) respectively.Conclusions: The MMT program is an effective intervention to prevent HCV infection transmission, although it is essential to compare its effectiveness with other interventions before implementing it in nationwide.

Background: The Ministry of Health, Treatment and Medical Education of Iran has recently announced an estimated figure of 200, 000 injecting DRUG USERS (IDUs). The aim of this study was to pilot a national program using demographics, types of DRUG abuse and prevalence of blood-borne infections among IDUs.Methods: In order to elicit data on demographics, types of DRUG abuse and prevalence of blood-borne infections among IDUs, a questionnaire was designed in the Bureau of Mental-Social Health and Addiction in collaboration with Iran’s DRUG Control Headquarters of the Police Department. Therapeutical alliance of addiction in Shafagh Center was based on METHADONE MAINTENANCE Therapy (MMT).Results: Among 402 reported IDUs most of them were male, single and in age range of 20 to 39 years old with 72.7% history of imprisonment. Most of them had elementary and high school education and a history of addiction treatment. The majority were current USERS of opioid, heroin and crack. The prevalence of blood-borne infections was 65.9% and 18.8% for HCV and HIV/AIDS infections, respectively.Conclusion: Prevention programs about harm reduction, treatment and counseling should include young IDUs as a core focus of their intervention structure.

Objectives: METHADONE MAINTENANCE Therapy (MMT) is one of treatment choices for opiate USERS. Understanding opiate USERS experiences is important because it effects on continuing their treatments in METHADONE CENTERS. The aim of this study is describing the structure and essence of opiate USERS experiences with (MMT). Method: The qualitative phenomenological approach was used in this study and applied purposive sampling among opiate USERS who came to METHADONE CENTERS in Kerman city in 2008. Purposive sampling continued until data saturation was occurred when sample size became 32 participants. The data was collected by in-depth interviews. Researcher has used field note for completing data collection process. Colaize΄ s Method applied for data analysis. The rigor of present study was based a transferability and credibility. Results: Six themes was extracted from the research (structural components of experience), including: 1-encouragements, 2- barriers, 3-believes, 4- DRUG experiences, 5-center experiences and 6-habits. Conclusion: Physical, psychological, social and economic efficacy, easy availability and good saturation by DRUG were positive experiences. In the other hand, physical, psychological complications and stigma were negative experiences. Three components of participants' experiences including: "center, DRUG, believes" have important role in formation of the positive or negative experiences. Moreover, some habitual behaviors and dependencies were detected among participants. In addition to physical, mental and spiritual cares, psychotherapy and consultation provide meaningful and purposive treatment for opiate USERS.

Background: Clopidogrel is a proDRUG that converts in the liver to an active thiol metabolite, which irreversibly inhibits the platelet P2Y12 adenosine diphosphate receptor. It seems that METHADONE as CYP2C19 inhibitor affects ticlopidine activity i n vivo. This study aimed to test the ability of METHADONE in changing ticlopidine pharmacokinetics.Methods: We conducted a case–control study in 10 subjects. The cases (5 subjects) in our study were addicts who were receiving METHADONE MAINTENANCE treatment (MMT) for preventing opium withdrawal symptoms. The control group were opiate USERS before starting MMT. In both groups, the patients received clopidogrel (75mg/day) for 5 days. On the 6th day, the subjects returned to the clinic, blood samples were taken up to 12 hours following clopidogrel dosing in case and control groups. Plasma concentration of clopidogrel was measured by GC-MAS. Noncompartmental pharmacokinetic analysis was performed using Microsoft Excel software to estimate PK parameters.Results: In this study, METHADONE decreased clopidogrel clearance by 25% and increased the AUC0-inf nearly 1.3 fold during the coadministration of clopidogrel as an antiplatelet DRUG.Conclusion: A significant decrease in the clearance of clopidogrel during the coadministration of METHADONE consistent with a decrease in clopidogrel conversion to its active metabolite and this may decrease its efficacy and may have life-threatening consequences for the patients undergoing clopidogerel MAINTENANCE therapy.