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How can I buy cocaine online in Isfahan

Substance use disorders are among the most common health problems of people involved with the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge, especially in poorly resourced countries. We systematically reviewed the prevalence of substance use in prison populations in low- and middle-income countries. We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug, and injection drug use during imprisonment in unselected samples of imprisoned people in low- and middle-income countries. Data meta-analysis was conducted and sources of heterogeneity were examined by meta-regression. Lifetime substance use was investigated in secondary analyses. The high prevalence of smoking in prison suggests that policies regarding smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable, and available treatments for alcohol and illegal drug use by people involved with the criminal justice system. Prison populations in low- and middle-income countries LMICs have been increasing over the past few decades 1. The increase has been especially pronounced in the Americas and in Oceania. Little is known about major causes of morbidity in people involved with the criminal justice system in LMICs, and prison health services rely on evidence from high-income countries. In such settings, a major health problem is substance use disorders 3 , 4. These disorders increase the risk of a range of adverse outcomes, including infectious diseases 5 , other mental health problems 6 , and death 7 , 8 , and of reoffending on release 9. Although there is high-quality evidence from the general population and prison populations 10 for treatment, there appear to be substantial unmet treatment needs in people involved with the criminal justice system Bans and treatments in prisons may have continuing effects after release, in contrast to approaches only focusing on forced abstinence in the controlled prison environment 10 , Imprisonment in LMICs is characterized by low budgets that permit providing only basic services, and by overcrowding and human rights violations 11 , 13 , Human rights concerns have been raised particularly for people with substance use and other psychiatric disorders in prisons In addition to the lack of basic care, there has been little mental health research in prison populations in LMICs 16 ; such research could assist in providing an evidence base from which to develop services. Based on limited research, it has been suggested that there is a higher prevalence of mental disorders in imprisoned LMIC populations 17 ; to our knowledge, however, substance use disorders have not been systematically reviewed. This study aims to present a systematic review and meta-analysis of substance use problems in imprisoned people of LMICs while they are in custody and, secondarily, to determine lifetime substance abuse rates. This systematic review followed the Meta-analysis of Observational Studies in Epidemiology guidelines 18 and data are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses A systematic search of the literature was conducted covering the time from , when the distinction betweenanalytical classification of countries in low-, middle-, and high-income economies was introduced by the World Bank as a development indicator www. The search included 1 online databases i. Non-English articles were translated. Prevalence and random-effects meta-analyses of nicotine use during imprisonment in low- and middle-income countries by regions as defined by the World Health Organization, — The dashed line indicates the overall pooled random-effects prevalence. We identified studies in which prevalence rates were reported of substance use in the general prison population. The following exclusion criteria were applied: 1 studies in which a particular age group was selected, such as adolescents or a particular offender type; 2 publications reporting data from the same samples as other publications the most comprehensive publication was retained ; 3 convenience sampling; 4 studies only reporting the prevalence of substance use, applying the disorder criteria and not the prevalence of substance use without necessarily fulfilling disorder criteria ; and 5 studies reporting data collected before Web Figure 1. Two reviewers G. The following data were extracted: sex, mean age, year and country of data collection, sample size, nonresponse rate, type of substance use, and number of people with any specific type of substance use. The periods covered by the reported prevalence estimates were extracted and coded as during imprisonment i. When data were missing or clarification was needed, authors of primary studies were contacted. We included people on remand i. If the prevalence of heroin use was reported in addition to the prevalence of other opiate use, rates were added to infer the overall prevalence of opiate use. If the prevalence of heroin use was reported as being part of the group of opiate use or vice versa, the higher rate was extracted as the overall prevalence of opiate use. For countries in Europe, Asia, and Africa that did not report opiate use but did report injection drug use, the latter was taken as a proxy for opiate use as well. If publications reported prevalence estimates separately for men and women or for samples from different countries, they were included in the statistical analyses as different samples. As a consequence, the number of samples is higher than the number of studies. Separate meta-analyses were conducted for the rates before and during imprisonment. To account for high heterogeneity between the samples, we used random-effects models to balance the weighting of studies for data syntheses To allow comparison between random- and fixed-effects models, fixed-effects meta-analyses also were calculated. Random-effects meta-regressions were conducted to assess the effects of prespecified sample characteristics on the prevalence of substance use. In additional secondary analyses, we included rates of substance use before imprisonment as variables in the regression analyses when assessing the heterogeneity of substance use during imprisonment. Ratios of pooled random-effects prevalence estimates before and during imprisonment were calculated. Statistical analyses were conducted with Stata, version 13 StataCorp LP, College Station, Texas , using the commands metaprop for meta-analyses, metareg for meta-regressions, and metan for the prevalence ratios. We identified 24 samples from 17 LMICs reporting prevalence data on nicotine use during imprisonment 23 — Alcohol use during imprisonment was reported in 19 samples from 15 LMICs 23 , 24 , 29 , 30 , 32 — 34 , 40 , 41 , 44 — Meta-regression analyses did not show any associations between predetermined study characteristics and alcohol use during imprisonment Web Table 4. Prevalence and random-effects meta-analyses of alcohol use during imprisonment in low- and middle-income countries by regions as defined by the World Health Organization, — There were 26 samples from 14 LMICs reporting prevalence estimates for any illicit drug use during imprisonment 30 , 31 , 34 , 35 , 38 , 45 , 47 — 49 , 51 — No significant associations between study characteristics were found on meta-regression analysis Web Table 5. Prevalence and random-effects meta-analyses of illicit drug use during imprisonment in low- and middle-income countries by regions as defined by the World Health Organization, — Prevalence estimates of cocaine use during imprisonment were reported for 20 samples in 8 LMICs 23 , 27 , 31 , 32 , 34 , 41 , 44 , 46 — 48 , 51 , 53 , 56 , 60 — On meta-regression, no study characteristics were associated with the prevalence of cocaine use during imprisonment Web Table 7. No associations were found on meta-regression Web Table 8. The pooled random-effects prevalence was 1. Prevalence and random-effects meta-analyses of injection drug use during imprisonment in low- and middle-income countries by regions as defined by the World Health Organization, — Prevalence rates of substance use before imprisonment are reported in the Web Appendices 2—8 and in the Web Figures 6—12 24 — 27 , 29 , 32 — 35 , 38 , 40 — 42 , 44 — 52 , 54 , 55 , 57 — There was clear geographical heterogeneity for nicotine use, alcohol use, cocaine use, opiate use, and injection drug use before imprisonment Web Tables 3—9. Web Table 10 lists all included studies reporting the prevalence of substance use in prison populations during or before imprisonment. We assessed whether substance use before imprisonment explained part of the heterogeneity of substance use during imprisonment. For nicotine, alcohol, any illicit drug use, and injection drug use, the prevalence before imprisonment was not associated with heterogeneity. Ratios of pooled random-effects prevalence rates before compared with during imprisonment were 1. Ratios were consistently higher than 1, indicating higher rates for substance use before than during imprisonment. Fixed-effects models for all analyses are presented in Web Table We estimated prevalence ratios for nicotine use, which were prevalence rates among prison populations compared with sex-matched estimates in the general population from the countries where those prisons were located. For nicotine, prevalence ratios were all higher than 1 and ranged from 1. Prevalence ratios of nicotine use during imprisonment to nicotine use in the general population by regions as defined by the World Health Organization, — We have provided estimates of nicotine, alcohol, and illicit drug use during imprisonment from a systematic review and meta-analysis of 94 samples in 83 studies and nearly 90, people imprisoned in LMICs. There were 3 main findings. To our knowledge, this is the first systematic review of substance use problems in prison populations of LMICs worldwide. We provide a sufficient body of evidence from data synthesis and have conducted meta-regression analyses examining sources of heterogeneity. The pooled prevalence estimates have to be interpreted with caution because of the high between-study heterogeneity of the data, which would be expected, considering the differences in criminal justice systems and prisons around the world. As a consequence, in addition to a random-effects prevalence that assumes heterogeneity, we have provided prevalence ranges and fixed-effects models. The latter weigh studies more by sample size and may be informative when small study effects are considered strong. An additional limitation of this study is the variability of the policy contexts with respect to partial smoking bans and the implementation of drug and alcohol bans. In contrast to the other substances reviewed here, nicotine use is legal in prisons in LMICs, to our knowledge. A principal implication of this review is the need to review smoking policies inside prisons in LMICs. Policy initiatives in this regard are relatively new in high-income countries, where tobacco control generally has been more effective Several high-income countries have introduced smoking bans in prisons and jails — , which should reduce morbidity and death among people involved in the criminal justice system Smoking bans during imprisonment combined with psychological interventions before release can be successful in prolonging abstinence from smoking after release In the current meta-analysis, we report more than half of the people imprisoned in LMICs smoked during imprisonment, and thus, the potential for addressing this is considerable. We also have shown that these rates of nicotine use are substantially higher than in the general population of the specific countries of the primary studies included in the review. Therefore, policies to ban smoking in prisons and treatments to reduce nicotine addiction should be considered in LMICs, especially in the Americas and in Europe, where the rates are particularly high. A second implication is the importance of ensuring that alcohol treatments are available in prisons in LMICs. There has been considerable interest in addressing drug use, particularly as it is associated with infectious diseases, but in this review, we found that approximately 1 in 6 imprisoned people consumes alcohol inside prison. Many of these individuals may not have alcohol use disorders, but many do and will continue to on release. Because alcohol is usually banned in prisons and difficult to smuggle, it is often produced inside prisons and, consequently, tends to be of low quality and high toxicity 33 , Prison services need to have available appropriate alcohol detoxification treatments on entry and to consider other interventions, including group therapies and other psychosocial treatments that are scalable In addition, the heterogeneity of prevalence estimates for alcohol use during imprisonment indicates the need for local surveys to best inform service development. Such local surveys may not be feasible owing to financial pressures in some countries; therefore, the estimates presented here could be of assistance. A third implication is that the findings underscore the importance of addressing illicit drug use during imprisonment. High-income countries have high rates and persistence of illicit drug use during imprisonment, especially heroin use We found that approximately one-quarter of the prison population uses illicit drugs during imprisonment. There is good evidence for the effectiveness of opioid-substitution treatment in prison populations However, apart from initiatives in a few countries , treatment interventions are mostly unavailable in LMICs. In addition, we report important regional differences in the prevalence of cannabis and possibly of opiate and cocaine use. This would suggest that rather than 1 treatment model for all countries, interventions may need to be tailored at regional or national levels for specific types of drug use problems. There remains a paucity of data available from LMICs , with data from 32 countries and considerable heterogeneity in the findings. More research on the changing dynamics of injection drug use in LMICs is required. Individual prevalence rates of specific types of illicit drugs used before imprisonment, including cannabis, opiates, and cocaine, explained part of the heterogeneity in illicit drug use prevalence during imprisonment. We also found that prevalence rates of substance use before imprisonment were consistently higher than those during imprisonment for all substances. This difference was more pronounced for alcohol than for illicit drugs, suggesting that prison systems more effectively limit alcohol than illicit drugs. Overall, this suggests that people import their substance use problems into prison and further underscores the need for intervention programs to be integrated between the community and prison. We report estimates of smoking, alcohol, and illicit drug use during imprisonment in LMICs. Approximately 1 in 2 prisoners smokes, 1 in 6 drinks alcohol, and 1 in 4 uses illicit drugs. From a public health perspective, these high rates represent an opportunity for intervention, particularly because interventions that are effective in other settings can be transferred to prisons. Smoking bans in prisons, and scalable and available detoxification and addiction services have the potential to address the large burdens of smoking and substance use in LMICs. We thank Vanise Cleto Murta for participation in the screening of the studies. Walmsley R. World Prison Population List. Psychiatric hospital beds and prison populations in South America since does the Penrose hypothesis apply? JAMA Psychiatry. Google Scholar. Substance abuse and dependence in prisoners: a systematic review. Substance use disorders in prisoners: an updated systematic review and meta-regression analysis in recently incarcerated men and women. HIV, prisoners, and human rights. Treating substance abuse is not enough: comorbidities in consecutively admitted female prisoners. Addict Behav. Substance use disorders, psychiatric disorders, and mortality after release from prison: a nationwide longitudinal cohort study. Lancet Psychiatry. Zlodre J , Fazel S. All-cause and external mortality in released prisoners: systematic review and meta-analysis. Am J Public Health. Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden. Forced smoking abstinence: not enough for smoking cessation. Treatment of mentally ill offenders in nine developing Latin American countries. J Am Acad Psychiatry Law. Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons. Tob Control. Garcia-Guerrero J , Marco A. Overcrowding in prisons and its impact on health. Rev Esp Sanid Penit. Human rights and Nigerian prisoners — are prisoners not humans? Med Law. Health and human rights concerns of drug users in detention in Guangxi Province, China. PLoS Med. Fazel S , Baillargeon J. The health of prisoners. Fazel S , Seewald K. Severe mental illness in 33, prisoners worldwide: systematic review and meta-regression analysis. Br J Psychiatry. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Int J Surg. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health. Measuring inconsistency in meta-analyses. Factors associated with psychoactive substance use among a sample of prison inmates in Ilesa, Nigeria. Niger Postgrad Med J. Kinyanjui DW , Atwoli L. Substance use among inmates at the Eldoret prison in Western Kenya. BMC Psychiatry. Asian Pac J Cancer Prev. Prevalence, risk factors and social context of active pulmonary tuberculosis among prison inmates in Tajikistan. PLoS One. A cross-sectional study of prisoners in Mexico City comparing prevalence of transmissible infections and chronic diseases with that in the general population. Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan. Int J Epidemiol. Mental health and substance use problems in prisons. The Bangalore prison mental health study: Local lessons for national action. Prison health in transitional Albania. Med Arch. Posttraumatic stress disorder and illicit drug use among incarcerated women in Rio de Janeiro. Rev Psiquiatr Clin. Incidence of substance abuse among inmate at Peshawar Prison, Pakistan. Gould CA. Dunedin, New Zealand: University of Otago; Sexual behavior and drug abuse in homosexuals, prostitutes, and prisoners in Tijuana, Mexico. Rev Latinoam Psicol. The prevalence of psychotropic substance use and its influencing factors in Lithuanian penitentiaries. Med Sci Monit. Turan O. Smoking status and the presence of chronic obstructive pulmonary disease in prison. J Addict Med. Assessment of effectiveness of smoking cessation intervention among male prisoners in India: a randomized controlled trial. HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa. BMC Infect Dis. Elekes Z , Paksi B. BMC Public Health. Health status and imprisonment profile of jail inmates of district jail Rahim Yar Khan, Pakistan. Expl Animal Med Res. Psychoactive substance abuse among inmates of a Nigerian prison population. Drug Alcohol Depend. Prevalence of risk factors for transmission of HIV and blood-borne viruses in a prison population. Afr J Micro Res. Profile of prisoners in the Rio de Janeiro prison system: specifities of gender in the social exclusion process. Cien Saude Colet. Anonymous survey on infectious diseases and related risk behaviour among Armenian prisoners and prison staff. Int J Prison Health. Riga, Latvia: Veselibas ekonomikas centrs, Sociologisko petijumu instituts; Psychiatr Danub. Socioeconomic factors associated with drug consumption in prison population in Mexico. Characteristics, depressive symptoms, and associated factors in incarcerated women in the State of Rio Grande do Sul, Brazil. Cad Saude Publica. The prevalence of violence and relation to depression and illicit drug use among incarcerated women in Recife, Brazil. Int J Law Psychiatry. Prevalence and risk factors associated with infection by human immunodeficiency virus, hepatitis B virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso. Med Trop Mars. Drug Use Survey Sarpoza Prison, Kandahar, Afghanistan. Patterns of drug use and HIV-related risk behaviors among incarcerated people in a prison in Iran. J Urban Health. Sieroslawski J. Warsaw, Poland: Institute of Psychiatry and Neurology; Survey of prison inmates. Drug Abuse Prevalence in Latvia. Accessed November 7, Google Preview. Drug use in prisons in Kyrgyzstan: a study about the effect of health promotion among prisoners. Heroin consumption patterns in a northern Mexican border prison: obstacles to treatment access. Salud Publica Mex. HIV prevalence and related risk behaviours among prisoners in Iran: results of the national biobehavioural survey, Sex Transm Infect. Intravenous drugs abuse as the main risk factor of increasing hepatitis C infection prevalence in prisoners in Zenica, Bosnia and Herzegovina. Med Glas Zenica. Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali, Indonesia. Indonesian national inmate bio-behavioral survey for HIV and syphilis prevalence and risk behaviors in prisons and detention centers, SAGE Open. Prevalence, genotypes and factors associated with HCV infection among prisoners in Northeastern Brazil. World J Gastroenterol. HIV infection and associated risk behaviours in a prison in Montevideo, Uruguay. Human immunonodeficiency virus, hepatitis B virus and hepatitis C virus: sero-prevalence, co-infection and risk factors among prison inmates in Nasarawa State, Nigeria. J Infect Dev Ctries. Intersecting epidemics of HIV, HCV, and syphilis among soon-to-be released prisoners in Kyrgyzstan: implications for prevention and treatment. Int J Drug Policy. Sexually transmitted diseases among female prisoners in Brazil: prevalence and risk factors. Sex Transm Dis. Assessment of the mental health of convicted prisoners and those under temporary arrest. Arch Psychiatry Psychother. Prevalence of psychiatric disorders among prisoners in Konya prison. Anadolu Psikiyatri Dergisi. Olubodun J. Prison life and the blood pressure of the inmates of a developing community prison. J Hum Hypertens. Hepatitis C in prisoners and non-prisoners in Colatina, Espirito santo, Brazil. Braz J Pharm Sci. Hepat Mon. Risk factors and prevalence of tuberculosis, human immunodeficiency virus, syphilis, hepatitis B virus, and hepatitis C virus among prisoners in Pakistan. Int J Infect Dis. Prevalence of latent Mycobacterium tuberculosis infection in prisoners. J Bras Pneumol. Mycobacterium tuberculosis prevalence in the prison complex in the city of Itaperuna, RJ. Acta Biomed Brasiliensia. Prevalence and incidence rates of latent tuberculous infection in a large prison in Iran. Int J Tuberc Lung Dis. Prevalence of previously undetected tuberculosis and underlying risk factors for transmission in a prison setting in Ibadan, south-western Nigeria. Afr J Med Med Sci. Rev Soc Bras Med Trop. AIDS Behav. Predictive markers for hepatitis C virus infection among Brazilian inmates. Iran J Public Health. Epidemiol Infect. Burden of substance use disorders, mental illness, and correlates of infectious diseases among soon-to-be released prisoners in Azerbaijan. Prevalence of borderline personality disorder and its risk factors in female prison inmates in China. Psychiatry Res. The vulnerability of Brazilian female prisoners to HIV infection. Braz J Med Biol Res. Seroprevalence and factors associated with human immunodeficiency virus HIV and syphilis in inmates in the state of Pernambuco, Brazil. Hepatitis C, hepatitis B and HIV infection among Egyptian prisoners: seroprevalence, risk factors and related chronic liver diseases. J Infect Public Health. Hepatitis B and C prevalence among the high risk groups of Pakistani population. A cross sectional study. Burden of infectious diseases, substance use disorders, and mental illness among Ukrainian prisoners transitioning to the community. Prevalence of hepatitis B and hepatitis C infections and their relationship to injectable drug use in a cohort of Sri Lankan prison inmates. Ceylon Med J. Eur J Epidemiol. Zhang X. Analysis on HIV infection status of new prisoners in detention places of Xinyang area from — Occup Health. GBD Tobacco Collaborators. Smoking prevalence and attributable disease burden in countries and territories, — a systematic analysis from the Global Burden of Disease Study Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis. Extending smoking abstinence after release from smoke-free prisons: protocol for a randomised controlled trial. Health Justice. Smokefree prisons in New Zealand: maximising the health gain. Implementing an indoor smoking ban in prison: enforcement issues and effects on tobacco use, exposure to second-hand smoke and health of inmates. Can J Public Health. Outbreak of botulism after consumption of illicit prison-brewed alcohol in a maximum security prison-Arizona, J Correct Health Care. Outcomes of psychological therapies for prisoners with mental health problems: a systematic review and meta-analysis. J Consult Clin Psychol. Persistence of drug use during imprisonment: relationship of drug type, recency of use and severity of dependence to use of heroin, cocaine and amphetamine in prison. Mental health of prisoners: prevalence, adverse outcomes, and interventions. Scaling up methadone maintenance treatment for opioid-dependent prisoners in Iran. HIV in prison in low-income and middle-income countries. Lancet Infect Dis. Interventions to reduce HIV transmission related to injecting drug use in prison. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign in through your institution. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Journal Article. Oxford Academic. Caroline Gabrysch. Seena Fazel. Revision received:. Select Format Select format. Permissions Icon Permissions. Abstract Substance use disorders are among the most common health problems of people involved with the criminal justice system. Figure 1. Open in new tab Download slide. Figure 2. Figure 3. Figure 4. Figure 5. Google Scholar Crossref. Search ADS. Google Scholar PubMed. Issue Section:. Download all slides. Supplementary data. Supplementary Data - pdf file. Views 11, More metrics information. Total Views 11, Email alerts Article activity alert. Advance article alerts. New issue alert. In progress issue alert. Receive exclusive offers and updates from Oxford Academic. Citing articles via Web of Science Latest Most Read Most Cited The effect of post-traumatic chondropathy on the functional state of knee joints in athletes during the basketball game. 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How can I buy cocaine online in Isfahan

Addiction is a chronic relapsing disorder, during which drug consumption is continued, despite its catastrophic outcomes 2. Substance abuse and dependence is one of the major sanitary, mental, and social problems of the current era and is on top of the most important issues in healthcare services, worldwide, directly effecting individuals 3. Every year, tens of thousands of people are victims of drug-related issues and billions of dollars are spent to mend the irreparable harms of drugs, causing personal, familial, and social problems 4. In addition, drug users experience different individual issues, such as receiving diagnosis of infectious diseases, undergoing mental abnormalities, having behavioral disorders, vocational, financial, juridical, and legal problems 5. Although drugs are socially undesirable, people from different social levels are engaged with its plight, as the disastrous outcomes can bring down whatever moral values there are 6. Hence, the number of substance users has grown three folds more than that of the population 4. Furthermore, in the recent years, the tendency to drug use has shifted from traditional drugs, such as opium and bang, to industrial drugs, such as heroin 7. Drug use is increasing nowadays and there are various reasons as to why this is the case. Some people take drugs to become socially accepted while others do so to feel grown up and show their independence, whereas some others do drugs to soothe their pain 8. The general understanding of addiction is that it is mainly a phenomenon involving males, whereas it can be as serious a harm to females, as it is for males. It is an accepted general fact that females tend to take drugs less than males. Recent studies, however, reported that the number of female addicts is increasing Hence, as the phenomenon of addiction is spreading among males and females, it is essential to determine factors affecting the first experience of drug use so that preventive programs are planned accordingly. The reason is many individuals continue taking drugs after its first use for one reason or another, and consequently end up in devastating outcomes of addiction. The aim of the present study was to examine the effective factors in the first experience of drug use from the perspective of male and female addicts, who are in recovery. Due to the unique feature of qualitative studies in exploring and expressing human behavior as well as the immense information, which is acquired from a few people 18 , it was chosen as the method of the present study. Since qualitative research provides rich findings, it seems that the phenomenological qualitative methodology was an appropriate method for the present study. In this study, the researchers focused on finding details of experiences in the life of individuals and attempted to determine reasons for first drug experience of males and females. The researchers chose phenomenological qualitative methodology, among various types of qualitative methods, for the present study. The aim of the study was to determine factors affecting the first experience of drug use among males and females, through their own reports. Data were collected through semi-structured interviews. This kind of interview enables participants to share the story of their life and their experiences, and it helps observe the world through their perspectives Interviews were done with 40 individuals 20 females and 20 male , who were receiving treatment at addiction treatment centers across the city of Kerman one center specialized for treating females and one specialized in treating males. Following qualitative research standards, criterion sampling was chosen to select the participants, who met the conditions of interest of the study. In addition to speaking Farsi, willingness to participate in the study, and tendency to answer the questions were the main criteria. Individuals diagnosed with psychotic disorders were excluded. Once sampling was done, interviews were performed individually inside a counseling room at the addiction treatment center and the session was recorded for later analysis. The researchers told the participants that the interviews were voice-recorded because it was impossible for the researchers to remember all their answers, hence the voice records would be used for later analysis 18 and accordingly, interviews were done with those, who agreed for their voice to be recorded. Data collection took five months April to September and each interview lasted between 40 and 60 minutes. Interviewers were members of the research team, including a PhD associate professor specializing in family counseling male and an MA student in clinical psychology female. All interviews were conducted by the research team, who were familiar with interviewing techniques. During data collection, saturation was achieved, meaning the size of the sample was adequate for the present study In both groups of females and males after the fifteenth interview, the researchers realized the gradual decrease of data to a point where the law of diminishing returns was occurring with the data. Open coding was used to analyze the data 21 and the researchers did not have any pre-conceived constructs. In some instances, codes were merged or removed because there was too much similarity in the viewpoints of the participants. In other cases, those codes with little or no support to represent the whole sample were removed. Themes were derived from the codes, and those were the constructs reflected from the viewpoint of most participants. All the reported findings of the study represent the consensus of the participants. Demographic characteristics of female and male participants are shown in Tables 1 and 2 , respectively. The present study and its procedures were approved by Shahid Bahonar University of Kerman. Preliminary codes were derived during data analysis, and at the end four major factors were found. These factors were as follows:. The majority of the participants considered the role of family as the most important factor in triggering their first drug use experience. In fact, I was 16 when I took drugs for the first time. I was home and decided to eat some of the opium that my father had. I used to swallow a pellet of opium every day and then it increased to 1. I might have never touched drugs if my father had not been a drug addict. This powerful quote stresses the key role of family. However, the importance of family is more obvious when the family, while taking drugs, has a positive attitude towards drugs and implies this positive attitude to the children. She says:. I did it, felt well and it was the start to my taking drugs. This kind of family attitude towards drugs was stated by most participants, both males and females. Other participants stated that the addiction of their siblings was an important factor in triggering their first drug use experience. He said:. My brother was taking heroin and he offered me to try it. I took heroin and indeed I felt better. In addition, some participants said that apart from using drugs, their family members were selling drugs, which in turn made access to drugs easy for them, paving the way for their first drug use experience and continuance. A participant described his first drug use experience as:. I had never tried any drugs before, neither cigarette, nor opium, nor bang or any other drugs. I took heroin for the first time and I got addicted to it. It is self-evident from these lines that easy access to drugs can precipitate the potential of addiction for individuals. Some of these participants had been offered drugs earlier by friends, for example yet they had never taken drugs before. They had only started taking drugs once their family members were selling drugs at home and therefore they had ample access to them. A participant said:. Although, my school friends were taking drugs and offered me to take drugs too, yet I never did drugs. However, since my mother was selling drugs, I got curious and tried some of the drugs she was selling. After that, whenever I wanted to take drugs, I would use some of what my mother was selling. Hence, selling of drugs within the family contributes considerably to addiction and its continuance, the reason being that individuals had easy access to drugs with the least price or often for free. According to some participants, the role of family was so influential that although they were married and lived independently from their parents, their occasional interactions with their families made it easier for their first drug use experience and consequently they, as well as their spouses, became addicted. A participant had the following to say here:. When I got married, my brother and sister came to my house and occasionally took heroin. My husband and I tried it once and that was enough to become addicted to it. Many of the participants believed their friends were the reason for their first drug use experience and addiction. That day, I took a pellet with them and I was dizzy for three days. After that, I would go and take drugs with them regularly. A participant explained his drug use in this way:. They said it would be ok to take a puff of the opium and it would refresh me, and I can carry the loads easier. They insisted that I have a puff but I resisted. I said no, I cannot, I have just got married. And finally, with an occasional puff or two, I got addicted. These comments indicate that lack of information and unawareness of the consequences of drug use will make individuals more prone to addiction to drugs. Other participants took drugs with friends during military service and their addiction progressed considerably during their term two years and they had tried and became addicted to different drugs. During the military service, I started smoking and tried drugs for the first time. I was missing my family and wanted to abscond from the military base to visit my family. My friends offered me cigarettes and said to me it would soothe my pain. I smoked cigarettes for three months but after a while I developed tolerance to cigarettes, therefore, I started taking the black substance opium. When I was home on furlough, I would take methadone pills to hide my addiction from the family. Making friends during married life, however, is an important factor, which has to be taken into consideration. Interacting with addicted friends can make the couple prone to addiction. Participants believed it is essential that individuals be careful in selecting friends, as they have seen unwelcome consequences of ignoring this fact. A participant described his friends as:. Another influential factor, claimed by some of the female participants, however, was the addiction of their partner. Once husbands took drugs, their wives put them under pressure to quit. Therefore, the husbands offered drugs to their wives to minimize this pressure. After the wedding, my husband and I moved from Kerman to Isfahan. After a while, he started taking drugs at home. It was too difficult for me and he kept sassing me disrespectfully. I wanted to move back to Kerman and be near my family, but my husband offered me drugs and wanted to make me feel well. In some cases, husbands forced their wives to take drugs and embroiled them in addiction to prevent them from applying for divorce. But he forced me to take heroin and I got addicted. I was reluctant to take heroin but he told me to try it just once. That one time was enough for me to get addicted to heroin. The problem doubles, however, when the individual has taken the drug, ironically, by force but gets addicted to it and continues taking it. The following participant was a prime example:. Participants who had the experience of remarriage, after divorcing their first spouse, had married addicted people and unfortunately, they had started taking other drugs as well. One participant said:. These quotes stress the important role of spouses in the addiction of individuals. Accordingly, participants believed that it is essential to get to know their spouse before marrying them. Some of the participants pointed that stressful events triggered their first drug use experience. One stressful event, according to some participants, was the bereavement of parents and they had chosen to take drugs in order to soothe their pain. She said:. When my mother died I suffered a mental breakdown and at the same time my husband was taking crack. One day, he was taking drugs and I asked if I could try it also to see what it tastes like that is keeping him so dependent on it. It was me, who insisted and finally I took a puff and felt relieved. Imprisonment of husband was yet another stressful event in the life of some participants and in order to ameliorate their troubles, they had started taking drugs. A participant said in this regard:. My brother was reluctant in allowing me to take drugs but I was too adamant and wanted to see how it tasted. I was curious and desperate to make myself feel better. When we broke up, I started taking opium with my friends. I did it because I wanted to feel better. These comments demonstrate that some participants volunteered to take drugs to cope with and overcome the stressful events of their lives, and not only had they not resolved their problem, but also another, bigger trouble, namely addiction, had emerged. I tried solving my problem by another problem. It never helped, but I kept telling myself that it does. Finally, some participants referred to their physical pain and claimed that instead of visiting a doctor or taking painkillers, they had started taking drugs to alleviate their pain. For instance, one of the participants commented:. Whenever I felt pain, I would start searching for drugs. I took drugs instead of going to a doctor. The present study was carried out to examine influential factors on first drug use experience of females and males in recovery. Findings demonstrate that four factors family, friends, spouse, and stressful events were among the most important variables leading to the first drug use experience, which in turn, can end in the addiction of individuals. If parents or other family members sell drugs, it can leave individuals with easy access to drugs, which in turn, can lead to drug use among individuals. These are risk factors within the family, which can push individuals, consciously or unconsciously, towards addiction. However, parental monitoring and positive relationship with children can function as a shield, lowering or stopping drug use among individuals 27 , Friends, along with family, play a key role in the first drug use experience. This is supported by studies, which highlight that dependence on drug user friends predicts own concurrent and future substance use 29 , When parental monitoring rules are weak and friends mainly spend their time together in unstructured contexts, substance co-use with friends and individual substance use is more likely Also, unsupervised time with peers at high schools and having delinquent friends outside school can potentiality provide a dangerous setting for addiction 32 , Another factor triggering first drug use experience, which was mentioned by female participants of the study, was the addiction of husbands. These participants claimed that their husbands played a key role in their first drug use experience and progression of addiction. Some of them had started taking drugs under the pressure of their intimate partners. Therefore, females are greatly subjected to different forms of risks as they have started taking drugs because of dependence upon an intimate male partner In other cases, individuals took drugs to alleviate grief, relieve negative emotions, reduce stress, and ameliorate physical pain. They have in fact tried to manage their negative feelings and better their mental and physical state through drugs 24 , 37 - Findings of the present study indicate that males and females try drugs for the first time because of four major reasons. Family, friends, and stress are common among males and females, with the potential of leading to addiction in individuals. There were some limitations to the present study. Since the population of the study and the sample size was small, generalizations of the findings need to be done with discretion. Finally, limiting the sample to females and males of the city of Kerman was another limitation of the study. Studying other populations from other cities of Iran may lead to different and more profound findings. Finally, it is essential to focus on the role of family in preventing addiction. Parents have to be educated and they need to know that their access to drugs and drug trafficking will ease the access to drugs for their children and exposes them to the risk of substance addiction especially with teenagers. In addition, according to the findings of the study, friends also play an important role in the first substance use experience of individuals. Families, as well as school and social media, need to educate young children on social skills, such as making friends and problem solving skills, in order to minimize the risk of being affected by their friends. North Khorasan Med J. Jiloha RC. Biological basis of tobacco addiction: Implications for smoking-cessation treatment. Indian J Psychiatry. IlbeigiGhalenei R, Rostami M. Role of parenting styles, perfectionism, and quality of friendship in predicting the drug craving in addicted people. Res on Addict. Safarzadeh S, Sabahi P. J Sabzevar Uni Med Sci. Adolescent individuation and alcohol use in multi-ethnic youth. J Stud Alcohol. The influence of peers on young adult substance use. Health Psychol. The effect of adverse childhood experience on clinical diagnosis of a substance use disorder: Results of a nationally representative study. Subst Use Misuse. Parental divorce and initiation of alcohol use in early adolescence. Psychol Addict Behav. Risks for early substance involvement associated with parental alcoholism and parental separation in an adolescent female cohort. Drug Alcohol Depend. Neurobiological mechanisms of addiction: focus on corticotropin-releasing factor. Curr Opin Investig Drugs. Explaining the relationship between religiousness and substance use: Self-control matters. J Pers Soc Psychol. Unlu A, Sahin I. Religiosity and youth substance use in a Muslim context. J Ethn Subst Abuse. Sex differences in drug addiction and response to exercise intervention: From human to animal studies. Front Neuroendocrinol. Qualitative research methods within the addictions. Potter J, Hepburn A. Qualitative interviews in psychology: Problems and possibilities. Qual Res Psychol. Bernard HR. Research methods in anthropology: Qualitative and quantitative approaches. Rowman and Littlefield; Maxwell JA. Qualitative research design: An interactive approach. Sage Publications; Patterns of alcohol and drug use in adolescents can be predicted by parental substance use disorders. Rowe CL. Multidimensional family therapy: addressing co-occurring substance abuse and other problems among adolescents with comprehensive family-based treatment. Dope sniffers in New York city: An ethnography of heroin markets and patterns of use. J Drug Issues. BMC Public Health. Growth in alcohol use in at-risk adolescent boys: Two-part random effects prediction models. Moderators of the association between peer and target adolescent substance use. Addict Behav. Comparing the influence of parents and peers on the choice to use drugs. Crim Justice Behav. The influence of parents and friends on adolescent substance use: A multidimensional approach. J Subst Use. Adolescent substance use with friends: Moderating and mediating effects of parental monitoring and peer activity contexts. Out-of-school time and adolescent substance use. J Adolesc Health. Peer relations across contexts: Individual-network homophily and network inclusion in and after school. Child Dev. Narrating the social relations of initiating injecting drug use: Transitions in self and society. Int J Drug Policy. The experience of initiating injection drug use and its social context: A qualitative systematic review and thematic synthesis. Is peer injecting a form of intimate partner abuse? A qualitative study of the experiences of women drug users. Health Soc Care Community. Parenting and addiction: Neurobiological insights. Curr Opin Psychol. A qualitative study on the initiation into injection drug use: Necessary and background processes. The first injection event: Differences among heroin, methamphetamine, cocaine, and ketamine initiates. We use cookies to provide you with the best possible experience. They also allow us to analyze user behavior in order to constantly improve the website for you. Abstract Background: Addiction is a chronic relapsing disorder and there are several factors influencing its commencement and continuance. Objectives: The aim of the present study was to examine the effective factors in first drug use experience among male and female addicts in recovery. Methods: Interviews were performed with 40 individuals 20 females and 20 males at addiction treatment centers across the city of Kerman, using criterion sampling. Transcripts were analyzed for themes, which represented the shared consensus of the research participants and the utilization of MAXQDA12 software helped in the analysis of data. Conclusions: The findings of the present study stress the need to focus on the role of family in preventive addiction programs, as well as educating individuals to learn better partner-seeking and friendship skills, and stress management. Methods 2. Design The researchers chose phenomenological qualitative methodology, among various types of qualitative methods, for the present study. Participants and Data Collection Interviews were done with 40 individuals 20 females and 20 male , who were receiving treatment at addiction treatment centers across the city of Kerman one center specialized for treating females and one specialized in treating males. Data Analysis Open coding was used to analyze the data 21 and the researchers did not have any pre-conceived constructs. Table 1. Demographic Characteristics of Female Participants. Table 2. Demographic Characteristics of Males Participants. Participant Age Duration of Abuse First Used Substance 1 26 12 years Opium 2 32 20 years Cigarette 3 40 21 years Cigarette 4 27 7 years Opium 5 38 5 years Opium 6 32 12 years Heroin 7 38 15 years Opium 8 27 3 years Crack 9 21 2 years Opium 10 31 9 years Opium 11 24 4 years Opium 12 29 13 years Opium 13 24 12 years Opium 14 36 6 years Heroin 15 22 4 years Cigarette 16 24 8 years Opium 17 36 8 years Opium 18 39 14 years Opium 19 44 26 years Opium 20 37 10 years Opium. References 1. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4. Leave a comment here:. Cookie Setting We use cookies to provide you with the best possible experience.

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