Background: Drug dependency based on the substance type brings undesirable effects for individuals. The aim of current study was to compare the executive functions among heroin dependents and normal individuals.Methods: The method of current research was causative-comparative carried out on two groups of heroin dependents and normal individuals. Substance consumer group included 30 patients with heroin dependence selected via a convenience method among those referred to addiction treatment centers of Gonabad city. The comparison group consisted of 30 normal individuals that were matched in terms of age, gender and education with group of heroin dependence. To collect data Wisconsin Card Sorting Test was used. Data analyzed through SPSS v.16 software using multivariate analysis.Results: The results of multivariate analysis revealed a significant difference between heroin dependents and normal individuals in executive function. Heroin dependents had lower performance on the Wisconsin card sorting test compared with the normal group.Conclusion: Considering the results, it can be inferred that heroin dependence has damaging effects on the brain executive functions.

Introduction: Genes often have multiple polymorphisms that interact with each other and the environment in different individuals. Variability in the opioid receptors can influence opiate withdrawal and dependence. In humans, A118G Single Nucleotide Polymorphisms (SNP) on m-Opioid Receptor (MOR), 36 G>T in κ-Opioid Receptor (KOR), and T921C in the  d-Opioid Receptor (DOR) have been found to associate with substance dependence.Methods: To investigate the association between opioid receptors gene polymorphism and heroin addiction, 100 control subjects with no history of opioid use, and 100 heroin addicts (50% males and 50% females) in Tehran (capital of Iran), were evaluated. A118G, 36 G>T, and T921C SNPs on the MOR, KOR, DOR genes, respectively, were genotyped by sequencing.Results: We found no differences in either allele or genotype frequency for MOR, KOR and DOR genes SNPs between controls and subjects addicted to heroin.Conclusion: The relationships among polymorphisms may be important in determining the risk profile for complex diseases such as addiction, but opioid addiction is a multifactorial syndrome which is partially hereditary and partially affected by the environment.

Background: QTc prolongation and Torsade de Ppointes have been reported in patients on methadone maintenance.Objectives: In this study, QTc was compared before and after the veteran (n=49) was on a stable dosage of methadone for 8.72 ± 4.50 years to treat heroin dependence. Risk factors were correlated with the QTc once the veteran was on a stable dose of methadone. Differences in the clinical risk factors in subgroups of veterans with below and above mean QTc change was compared.Patients and Methods: ECG data was obtained from a 12-lead electrocardiogram (pre-methadone and on methadone) on 49 veterans. Data and risk factors were retrospectively collected from the medical records.Results: The mean QTc at baseline (pre-methadone) was 426 ± 34 msec and after being on methadone for an average of 8.72 ± 4.50 years was significantly higher at 450 ± 35 msec. No significant relationships were found between QTc prolongation and risk factors except for calcium. The methadone dosage was significantly higher in veterans with a QTc change above the mean change of ≥ 24 msec (88.48 ± 27.20 mg v.s 68.96 ± 19.84 mg). None of the veterans experienced cardiac arrhythmias.Conclusions: The low complexity of medical co-morbidities may explain the lack of a significant correlation between any risk factor with the QTc except calcium and methadone dosage. The absence of TdP may be explained by the low prevalence of QTc values>500 msec as well as the retrospective design of the study. During long-term methadone treatment, there was a slight increase in the QTc interval but we did not find evidence of increased cardiac toxicity as a reason for treatment termination.

Introduction: Opium dependence is one of important health problems in our country. Several researches showed many of patients with opium dependence have psychiatric disorders. The aim of this study was evaluation of psychiatric disorders in opium dependent patients and comparing psychiatric disorders between opium and heroin dependent patients. Method & Material: In this descriptive study, 192 male opium dependent patients who were admitted in dual-diagnosis ward of Beheshti hospital, Kerman, Iran for detoxification, were enrolled randomly. After evaluation of their demographic data, they were assessed by means of SCL-90-R standard test. Analysis of variance and chi-square tests were used for statistical analysis and P<0.05 was considered as significant. Results: The mean± SD of age of subjects was 33.92±7/67 years. All scales of SCL-90-R were evaluated as borderline or sick. Scores of obsession and compulsion, anxiety, phobia, psychosis, PST and GSI were significantly higher in patients with heroin dependence than patients with opium dependence. Conclusion: It is recommended that all of patients with opium dependence should be evaluated for comorbid psychiatric disorders, that may improve outcome of their dependence treatment. Heroin dependent patients have more psychopathology than opium dependent patients and need more attention.

Objective: The aim of current study was to compare the visual memory functions among heroin dependents and normal individuals.Method: The method of current research was causative-comparative carried out on two groups of heroin dependents and normal individuals. Statistical population of the research was people with heroin dependents that from March 2013 to September 2013 that referred to Drug Addiction Treatment Centers of Gonabad city. Finally, 30 patients with heroin dependents selected with convenience sampling. The comparison group consisted of 30 normal individuals who were selected from among the relatives of patients with heroin dependents and were matched in terms of age, gender and education with group of patients with heroin dependence. To collect data was used from Rey-Sterrieth Complex Figure. Data analyzed through SPSS v.16 software using multivariate analysis.Results: The results of the current study showed individuals with heroin dependents had more difficulties in visual memory and gained lower scores in all three stages performances compared to the normal group.Conclusion: Chronic use of heroin is associated with cognitive defects and damage on visual memory. Therefore, rehabilitation programs that are considered to improve the conditions and treatment of addicts, it is necessary to be noted to these types of deficits and to formulate programs for reduce it.

Introduction: Substance abuse is a major problem in many societies as well as our country. This leads too many socioeconomic problems for societies, so it is important to achieve an effective program to improve this problem. Many treatment protocols such as therapeutic community (T.C) have been suggested for substance abusers. Psychological problem and co-morbidity in substance abuse leads to poor therapeutic response and high rate of recurrence. T.C can improve mental status of substance abusers. Therefore we studied the effect of residence in T.C on their mental status. Methods: In an experimental pretest – posttest survey, 30 substance abusers were evaluated for mental status, before and after residence in T.C using ScL-90-R scale. The results evaluated with SPSS program and T - paired Test. Results: In this study, there was a significant difference in mental status of addict patients before and after residence in T.C (P,0.005), except in phobia (P=0.018). Conclusion: Our results show that therapeutic community is an effective program and improve mental status of substance abuser and addict patients and probably can decrease the tendency of patients to come back to dependency.

Background: The most common drug, illegally used in Iran is opium. The treatment of people with substance use disorder is one of the most important strategies in reducing its burden. The aim of this study was to investigate the effect of different increasing and decreasing opium treatment coverage on the patterns of abstinence, transition to heroin dependence and mortality, over 30 years. Methods: This study was a dynamic compartmental modeling conducted in three stages: 1) presenting a conceptual model of opium dependence treatment in Iran, 2) estimating model’ s parameters value, and 3) modeling of opium dependence treatment and examining the outcomes for different treatment coverage scenarios. The input parameters of the model were extracted from the literature, and secondary data analysis, which were finalized in expert panels. Results: The number of opium dependence will increase from 1 180 550 to 1 522 063 [28. 93% (95% CI: 28. 6 to 29. 2)] over 30 years. With a 25% decrease in coverage compared to the status quo, the number of deaths will increase by 459 cases [3. 28% (95% CI: 0. 91 to 5. 7)] in the first year, and this trend will continue to be 2989 cases [15. 63% (95% CI: 13. 4 to 17. 9)] in the 30th year. A 25% increase in treatment coverage causes a cumulative decrease of heroin dependence by 14 451 cases [10. 1% (95% CI: 9. 5 to 10. 8)] in the first decade. Conclusion: The modeling showed that the treatment coverage level reduction has a greater impact than the coverage level increase in the country and any amount of reduction in the coverage level, even to a small extent, may have a large negative impact in the long run.

Introduction: Heroin dependence is a chronic relapsing disorder caused by a combination of genetic, epigenetic, and environmental factors. The genetic contribution in the vulnerability to heroin dependence is 40%-60%. Alterations in dopamine transport in the CNS are implicated in drug and alcohol dependence, and according to linkage studies, the HTR2A rs6313 single nucleotide polymorphism plays an important role in drug dependence and abuse. This casecontrol study aimed to investigate the association between HTR2A rs6313 and heroin dependence among a population from Northwest Iran. Material & Methods: The study included a sample of 100 heroin-dependent patients and 102 control subjects. After DNA extraction from blood samples, the genotype of HTR2A rs6313 polymorphism was investigated among patients and controls using the PCR-RFLP method. The obtained data were analyzed in SPSS software to explore a significant association. (Ethic code: 5/4/12152) Findings: Frequencies of CC, CT, and TT genotypes were 23%, 50%, and 27% in the patient group and 32. 35%, 44. 12%, and 23. 53% in the control group. According to statistical analysis, there were no significant differences between case and control groups in this regard (P>0. 05). Discussion & Conclusion: The results of the study could not support a significant association between HTR2A rs6313 polymorphism and heroin dependence in the Azeri population of Northwest Iran. This indicates the need to investigate other candidate genetic polymorphisms in the study population.

Introduction & Objectives: The goal of our study was to elucidate the time and factors influencing the transition from non-injection to injection among male heroin users.Materials & Methods: In this retrospective cohort study conducted in Iran from April to August 2007, the data was obtained from the subjects who had never injected heroin at study entry. The total population included 7743 (402 women and 7341 men) substance dependents in Iran. In this study we enrolled 1641 non-injecting male heroin users. The data was collected through Inventory Rapid Situation Assessment (RSA).Results: The results revealed that among the 1641 never injectors, 591 had initiated injection (The incidence of initiation into injection was 36% after 6.5 years). Independent predictors of transition into injection among non-injecting heroin users were being single, unemployment, attending injecting friends' gatherings, age at first heroin use (early adolescent drug use).Conclusion: The study suggests that several factors increase the risk of injecting drugs among heroin users. Interventions to prevent injecting should identify risk factors associated with the transition from heroin sniffing to heroin injection.