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Iran J Psychiatry Behav Sci. The illegal use of amphetamine-type stimulants ATS is a global health concern with medical, psychiatric and social impacts. The use of ATS is a major health concern amongst the Persian population. The traditional pattern of illicit drug use in Iran is opium and the main route of drug use is smoking 1. However, in the recent years i. Although Iran has the only universal methadone treatment system in Western Asia 2 , ATS use is a health problem in Iran, which cannot be treated with methadone maintenance treatment 3 , 4. Amphetamine-Type Stimulants include a group of many drugs such as methamphetamine, ecstasy, and methylphenidate Ritalin tablets. Some ATS such as methylphenidate are prescribed for the treatment of medical and psychiatric problems such as attention deficit and hyperactivity disorder yet they can be misused with no medical prescription. This issue can result in dependence 2. Amphetamine-Type Stimulants dependence such as methamphetamine dependence is a relapsing condition with no approved pharmacotherapies 4 , 5. Furthermore, ATS-dependence is associated with high-risk behaviors such as violence, psychosis and suicide 1 - 5. Researches attempting to find an effective medication are ongoing and cognitive-behavioral treatments have remained as the main treatment options for ATS dependents 4. Amphetamine-Type Stimulants dependence has numerous reasons. For example, a recent study of males and females injecting methamphetamine users in Tehran indicated that methamphetamine dependence was associated with living with sexual partners, long duration of dependence, and lack of participation in step meetings and psychological sessions 6. Literature is not well documented on the prevalence of ATS dependence and the reasons associated with this problem in Iran. Furthermore, ATS treatment barriers have not been documented in Iran. To address this gap in the literature, this study aimed to investigate the prevalence of ATS dependence, the reasons associated with this problem and the treatment barriers in a group of general adult population in 22 districts of Tehran. Rapid situation assessment RSA was selected as the main study design in This was because of efficiency, cost-effectiveness and using a mixed quantitative-qualitative methodology 7. Furthermore, conducting a comprehensive survey in Tehran was time-consuming and expensive because the city is vast and populous. This guideline has been developed by the United Nations office for drug control and crime prevention as a standard method for conducting RSA 7. The study sites included 22 districts in Tehran; via the following official information resources, 22 districts with considerable rates of illegal use of ATS in the past two years were identified. After determining the study population, Open-Epi software was used to determine the sample size in each district. After determining the total required sample size using this software, convenience sampling was used as the main method of sample taking in each district of Tehran. Eligibility criteria included age of 18 - 65 years old, male or female gender, living in the same districs where the participants were recruited for at least three months prior to recruitment and taking any stimulant with no medical prescription. Dependence on ATS was defined as the daily use of any ATS within the past twelve months for a purpose not consistent with legal or medical purposes in Iran. This definition was based on the recent American diagnostic and statistical manual of mental disorders 8. Based on the study guideline 7 , to increase the chance of finding ATS dependents in each district, 10 to 12 former ATS users with good communication abilities were recruited and trained. This group facilitated finding eligible participants in each district. Overall, 35 well-trained interviewers were recruited to collect quantitative and qualitative data. They were general practitioners, social workers or registered psychologists with high qualifications in interview techniques. A checklist was designed with the collaboration of three senior drug researchers at the Substance Abuse and Dependence Research Centre in Tehran. The checklist included details of demographics, illegal use of ATS and qualitative questions about the reasons of ATS use and treatment barriers. The checklist was piloted on 30 ATS dependents before conducting the study. The validity of the checklist was considered with reviewing the relevant literature in the field of ATS use 5 , 6. The study was conducted between September and January Participation was confidential and voluntary. Consent forms were signed by participants. The study had one quantitative section, which included participants and one qualitative section, which included 60 interviews. All interviews were conducted in pre-allocated interview rooms in the districts. The FGDs consisted of six to ten people. Key informant interviewing was also conducted. Audio-taping was implemented with prior permission. Overall, ten key informants KIs were interviewed. Key Informants included health professionals, who worked with ATS dependents at drug treatment centers or other professionals such as the police. Quantitative data were analyzed using Chi-square test, independent samples t-test and logistic regression in SPSS version Qualitative data were analyzed using Atlas-ti qualitative software. Of the 22 districts, districts one and three were of high socio-economic status. Overall, seven districts 2, 4, 5, 8, 9, 13 and 22 were middle class and the remaining districts had low socio-economic status. Overall, participants were recruited from 22 districts. District 11 had the lowest reported prevalence rate of ATS use 1. More than half of the participants were males The age range and the mean age SD of all participants were 18 to 60 years and 32 SD 11 years, respectively. Overall, participants 4. Overall, A considerable number of participants reported that they experienced low mood The qualitative analyses of the interviews showed multiple reasons associated with the illicit use of ATS and different treatment barriers as follows:. A theme that repeatedly emerged from the narratives was a desire to increase a performance. Participants repeatedly described the roles of physical energy, concentration, and job-related performances as their reasons associated with current ATS use. Some guys use ecstasy for energy and sex. Furthermore, participants repeatedly explained how their misconceptions of ATS as non-addictive drugs resulted in self-treatment for psychiatric problems. I have some clients, who misuse ATS for low mood or anxiety at this clinic. Participant accounts indicated how beauty-related issues resulted in current ATS use. In addition, further data analysis highlighted that some beauty salons had recommended ATS as a way to improve quality of skin. Some people think Shisheh is good for skin. Participant narratives underscored how some ATS users used opiates before initial ATS use and believed that only opiates such as opium, opium residues and heroin were addictive. Further qualitative analyses of narratives indicated that most participants did not have an adequate amount of information about the addictive effects of ATS. As a result, some of them used ATS to substitute them with opiate use. Among participants, who were dependent on illicit ATS use, narratives described how poor knowledge of illicit ATS treatment services in the community prevented them from treatment entry. Further qualitative analyses of the narratives demonstrated that although, ATS treatment was a necessity for some participants, poor information about ATS treatment centers hampered treatment entry. I know I need treatment but who can help me? Among participants, who were dependent on ATS use, their narratives described how poor knowledge of the side effects of ATS use prevented them from treatment entry. Further qualitative analyses of the narratives indicated that although ATS treatment was a necessity for some of them, poor information of the addictive nature of ATS use and ignoring treatment primarily hampered treatment entry. I can quit any time I want. Participant narratives suggested that stigma prevented treatment entry for ATS use. The study findings demonstrated that some participants perceived the necessity of treatment but social stigma prevented them from treatment entry. I want treatment but what will happen to me if I go for treatment. The study indicated that ATS dependence was present in the study regions in Tehran. This was a new trend of illicit drug use at the time of conducting the study 2. The study results indicated that ATS dependents were more likely to be younger, single, educated, unemployed and with more unstable living conditions compared with non-ATS users. Such characteristics were likely to predispose this group to misuse of ATS. A research study indicated that participants with ATS dependence were more likely to be single and jobless than recreational ATS users 3. These demographic characteristics should be considered in designing and implementing prevention and educational programs for this group in Iran. Studies have indicated that cognitive-behavioral interventions are effective in the treatment of ATS users 9 , Such treatment interventions should be provided for this group in Iran. In fact, it was likely that most of them had no actual knowledge of the side effects of ATS use. Their misconceptions were likely to originate from lack of knowledge or poor ATS education. Poor knowledge of the side effects of ATS can be a strong motivation to self-treatment with ATS use or its common use in the community 11 - Therefore, the provision of educational programs is suggested for this group. Key Informants repeatedly emphasized the roles of mass-media in ATS education and prevention. Health policy makers should consider ATS education as a health priority. Studies have shown that drug education is necessary to prevent the epidemic of any type of drug 17 - Furthermore, law enforcement and police efforts should target ceasing ATS production and distribution in the Persian community on a large scale. Poor knowledge of available ATS treatment services was frequently reported as an important barrier to treatment entry. A study on Puerto Rican injecting drug users found that perceived barriers to drug treatment played strong roles to treatment entry Opiate use treatment is available in Iran but ATS use was a new health concern at the time of conducting the study. Therefore, participants were likely to not know about the availability of ATS treatment in the community. On the basis of the study findings, we suggest policy recommendations for increasing access to treatment for ATS users in the community. It is important for people to have access to appropriate ATS treatment facilities in the Persian community. The role of mass-media, especially television in informing people about the treatment facilities for ATS use treatment in the community, is emphasized. Schools, universities, educational centers and hospitals should also contribute to informing people about the side effects of ATS use and available treatments in the community. Poor knowledge of the side effects of ATS use and considering ATS as non-addictive drugs were strong barriers to treatment entry. A study indicated that poor knowledge of the side effects of illicit drug use was associated with its easy use Participants were likely to traditionally consider opiate use as a health problem only while ATS use was a new concern in Iran at the time of conducting the study. To improve service delivery, treatment services should re-orient their services to better address the needs of ATS users in Iran. People should be informed that ATS use could be as addictive as opiate use. Finally, the study results indicated that stigma had a detrimental impact on ATS treatment entry. This issue was due to the new nature of ATS use at the time of conducting the study in Iran. A study in the USA indicated that stigma among people with substance use disorders hampered treatment entry These study results highlight the need for more work on stigma due to its important role in preventing treatment entry for the ATS use problem. The results of this RSA highlight the importance of understanding the reasons associated with ATS dependence and treatment barriers. As the first report from Western Asia, especially the Persian Gulf region, the findings of this study highlight the necessity of the provision of effective laws against ATS producers and vendors, as well as ATS education, prevention and treatment programs for the population of Tehran. The use of ATS without medical prescription was a hidden activity in Iran during years and As a result, it was difficult to conduct a household survey. Therefore, the study was limited to a RSA. Conducting household surveys is suggested. Drug use treatment and harm reduction programs in Iran: A unique model of health in the most populated Persian Gulf country. Asian J Psychiatr. Methamphetamine use and treatment in Iran: A systematic review from the most populated Persian Gulf country. Methamphetamine use among Iranian heroin kerack-dependent women: implications for treatment. Alam Mehrjerdi Z. Crystal in Iran: methamphetamine or heroin kerack. Djamshidian A. Neurobehavioral Sequelae of Psychostimulant Abuse. Int Rev Neurobiol. Correlates of shared methamphetamine injection among methamphetamine-injecting treatment seekers: the first report from Iran. The guidelines for the development and implementation of drug abuse rapid situation assessments and responses. Diagnostic and statistical manual of mental disorders. Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Methamphetamine use and methadone maintenance treatment: an emerging problem in the drug addiction treatment network in Iran. Int J Drug Policy. Quality of life among treatment seeking methamphetamine-dependent individuals. Am J Addict. Lashkaripour K, Torbati E. Methamphetamine dependency. Current research on methamphetamine: epidemiology, medical and psychiatric effects, treatment and harm reduction efforts. Addict Health. Methamphetamine use among patients undergoing methadone maintenance treatment in iran; a threat for harm reduction and treatment strategies: A qualitative study. Prevalence and complications of drug-induced seizures in Baharloo hospital, Tehran, Iran. Iran J Toxicol. The methamphetamine problem in the United States. Annu Rev Public Health. Will the methamphetamine problem go away? J Addict Dis. Methamphetamine dependence and human immunodeficiency virus risk behavior. J Subst Abuse Treat. Porter J. Subst Use Misuse. Treatment utilization and barriers to treatment: results of a survey of dependent methamphetamine users. Subst Abuse Treat Prev Policy. J Addict Behav Ther Rehabil. 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. However, there are no literature reports on ATS dependence in the community. Objectives: The current study aimed to investigate the prevalence of ATS-dependence, the reasons associated with this problem and the treatment barriers among a group of adults in 22 districts of Tehran. Materials and Methods: A rapid situation assessment was conducted. A mixed quantitative-qualitative methodology was applied. A researcher-made checklist was designed to collect data. Results: In total, individuals were randomly recruited and interviewed. Among them, participants were ATS-dependent. A desire to increase performance and reduce psychiatric problems, beauty-related issues and a desire to stop opiate use were the main reasons for the illegal use of ATS. Poor knowledge of ATS treatment services in the community, poor knowledge of the side effects of the illegal use of ATS and stigma were the main current treatment barriers. Conclusions: The study results indicated that ATS-dependence was present among the study participants. This issue necessitates treatment, which should be considered by health policy makers. Prevention programs should be provided on the large scale in the Persian community to prevent ATS use and dependence. Background The illegal use of amphetamine-type stimulants ATS is a global health concern with medical, psychiatric and social impacts. Objectives Literature is not well documented on the prevalence of ATS dependence and the reasons associated with this problem in Iran. Materials and Methods 3. Study Site and Sample Collection The study sites included 22 districts in Tehran; via the following official information resources, 22 districts with considerable rates of illegal use of ATS in the past two years were identified. Hospitals especially emergency rooms, 2. Drug treatment and harm reduction canters, 3. Courts, 4. Prisons, 5. Police reports of arrest figures and ATS confiscation, 6. Official reports of ATS-related deaths, 7. Crime-related reports, 8. Police reports of ATS use and vending and 9. Interview Team Based on the study guideline 7 , to increase the chance of finding ATS dependents in each district, 10 to 12 former ATS users with good communication abilities were recruited and trained. Study Measures A checklist was designed with the collaboration of three senior drug researchers at the Substance Abuse and Dependence Research Centre in Tehran. Study Procedure The study was conducted between September and January Data Analysis Quantitative data were analyzed using Chi-square test, independent samples t-test and logistic regression in SPSS version Results 4. Participants in Each Study Site Of the 22 districts, districts one and three were of high socio-economic status. Table 1. Table 2. Table 3. Variables Characteristics No. 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.

Substance Abuse among Iranian High School Students

Tehran buying Ecstasy

Official websites use. Share sensitive information only on official, secure websites. There is cultural support for opium in Iran, and also there is cultural tolerance for tobacco smoking, especially as water pipe smoking, in Iranian families. Alcohol, opium, and cannabis are the most frequently used illicit drugs, but there are new emerging problems with anabolic steroids, ecstasy, and stimulant substances, such as crystal methamphetamine. There is serious drug abuse problem among Iranian high school students. It could be due to role-modeling by parents — mainly fathers — and also cultural tolerance of some substances. Early onset of tobacco smoking, with a daily use rate between 4. Use of all types of drugs, except prescription drugs, is more prevalent among boys. Alcohol is the most frequently abused substance, with a lifetime rate of at least 9. Lifetime rates of opiate use — mostly opium — were between 1. As drug abuse is a frequent problem among Iranian high school students, it is necessary to design and implement drug prevention programs to protect them. Such programs, including life skills training and drug education, have been operating in recent years for Iranian students from kindergarten to the university level. There is a long history of opium use in Iran. Opium use as a recreational substance has been recorded for more than four centuries. One of the first scientific descriptions of opium use in Iran was written by Dr. Jacob Eduard Polak — , a Jewish Austrian physician who worked in Iran between and 1 among teachers of the first Iranian medical school. It is not forbidden and every Iranian who can afford its cost uses it daily. Adolescence is a particularly vulnerable period for initiation of drug use 2 , and younger age at first drug use significantly increases the likelihood of more serious drug problems 3. Iran has the highest rate of abuse of opiates in the world 6 , 7. In recent years, there has been increased use of heroin, crystal methamphetamine, and ecstasy. There is no direct standard survey for finding the prevalence of drug abuse in Iran. But there are surveys that help in estimating the drug use situation. The last nationwide survey of drug use in Iran, carried out in , was a rapid situational assessment RSA This study is based on interviews with drug abusers in treatment centers, the justice department system and prisons, as well as interviews with key informants. It is not a household survey and, therefore, interpretation of the data should consider their limitations. Unpublished data from this survey 8 showed that there are 1. Although traditional drugs of abuse in Iran are opium and cannabis, in recent years there has been more use of heroin, crystal methamphetamine, and ecstasy. In RSA , it is shown that The use of drugs by parents is a particular concern, as parental drug use is a risk factor for offspring Evidence has shown that family environment and mental health are inter-related in opiate addicts Spousal 13 and child abuse 14 are more frequent in drug abusers than the general population. Regarding age in this study, Main substances of use were opium all forms in Comparing these results with a previous RSA in , which found that the main substance was opium at This is the first time in the history of drug use in Iran that heroin use is more prevalent than opium use. Heroin is usually smoked, sniffed, or injected. In RSA , the usual way of drug use for Although the average Iranian drug-dependent person is likely to be married and employed, the average Iranian injection drug user is more likely to be unemployed and single or divorced RSA has shown that, compared with previous reports, there has been a decrease in cannabis use and an increase in crystal methamphetamine use as the main substance used among the total population of drug abusers. Crystal methamphetamine was the main substance in 3. In this article, we review published papers in international and domestic journals as well as existing unpublished data describing substance use by young people in Iran. There are four main studies on drug abuse in high school students in different parts of the country. Drug abuse in these studies is considered to be the use of any illicit substances, including alcohol, cannabis, opiates opium and heroin , ecstasy, and methamphetamine. Information about tobacco use is also included in these studies. In , Ziaaddini et al. This city is near the eastern border with Pakistan and Afghanistan and has a traditionally high rate of drug abuse. In this study Kerman Study , the rate for lifetime use of drugs in high school students was Also In another study, conducted in in Zanjan, a city in the northwest of the country Zanjan study , lifetime prevalence of drug abuse in high school students was The rate was significantly higher among boys than girls In this study, poor school performance, depression, and cigarette-smoking parents were associated with higher rates of drug abuse. Ahamdi and Hasani 21 in Shiraz — a large city located in the southern part of the country Shiraz study — have found rates of lifetime use and current use of drugs to be significantly higher among boys than among girls. In this study, pleasure seeking, modeling, and tension release were the most common reasons for drug use. In a study in Tabriz — another city in the northeast Tabriz study — among male high school students, There are two usual ways of using tobacco among Iranian adolescents: cigarette smoking and a water pipe. The latter has been a common practice for centuries, mostly in the Middle East, but its use appears to be widespread among high school students even in the United States 23 and European countries In the Zanjan study 20 , a history of water pipe tobacco smoking in high school students was twice that of cigarette smoking In Iran, like in most of the Middle Eastern and Islamic countries, there are traditional taboos and social behavioral limitations for girls. For example, in the Zanjan study 20 , lifetime history of cigarette smoking was more than three times higher for boys than for girls, but the sex difference for water pipe smoking was less see Table 1. It seems that smoking a water pipe is more tolerable in families compared with cigarettes, and its use does not bring the same degree of negative stigma for girls. One study in Lebanon has also shown a sex difference in cigarette smoking but not for water pipe smoking Smoking a water pipe is a socially acceptable practice for adolescents in Iran 20 , other Middle East countries 25 — 28 , and in western countries, even for athletes, who are traditionally considered at low risk for tobacco use 29 , and it appears acceptable for both boys and girls. Regular daily cigarette smoking was more prevalent than water pipe smoking The prevalence of daily smoking ranged from 4. There is also a study of middle school students grade 7 , with a mean age of 13 years, which shows 7. Although the purchasing of cigarettes is not allowed in Iran for people under the age of 18, clearly for many youth, the age of smoking onset is much younger. Age of smoking onset was Also there are studies that have shown an association between smoking and mental 35 and physical disorders In Iran, alcohol is considered an illicit drug and its use is banned for all age groups. Unfortunately this situation does not prevent its use among adolescents, and, in fact, alcohol is the most common illicit substance among Iranian high school students, especially among boys 20 — Two studies in Kerman have shown lifetime prevalences for alcohol between In RSA , in a cross-country study, the mean age of first alcohol use was In a study among high-risk grade 11students in Tehran, The rate of alcohol use was similar to the rate for tobacco smoking and much more than the rate for any other substance. In the Zanjan study, the lifetime history of alcohol use was 9. The rate was significantly lower in girls 3. In this study, 16 boys out of 6. Although alcohol consumption is illegal in Iran it is banned by Islam and unlike many other countries there is no alcohol advertising 39 to promote use by youth , it is customary to have alcohol at various parties and ceremonies. In the Kerman study, It seems that there is a tolerant atmosphere in these situations even for adolescents regarding alcohol use. In the Kerman study, among those students with lifetime experience of alcohol use, Whereas there is no comparative study between Muslims and other religious groups in Iran, some studies in Iran have shown that there is more tolerance for alcohol consumption among Christians than among Muslims Iran has a long border with Afghanistan, the biggest producer of opium in the world, and opium use has a centuries-old tradition in Iran Although there is negative stigma for heroin use, there is a traditional supporting culture for opium. In a household survey of people aged 15 and over, As Agahi and Spencer reported nearly three decades ago, the problem for Iranian adolescents is exposure to role models of drug abuse; such models are more likely to be an adult family member than an adolescent peer, a reversal of what is usually found in western countries Modeling is the second most common reason for drug use in the offspring of opium dependents Lifetime prevalence of opium and heroin use was 1. In this study, none of the high school students were current opiate users Ahmadi et al. In Kerman study, one fourth to one third of high school students who had lifetime experience of opiate use — opium or heroin — were daily users of it Although there is no cross-country study of youth drug use, it seems that the southeastern parts of the country, which border Pakistan and Afghanistan, show larger numbers of opioid users. In all studies, the rate of heroin use was far lower than the rate of opium use Table 2. Studies on the epidemiology of drug use in Iran show that all drugs are used more often by males than females 19 — 22 , The situation is the same for high school students. The Zanjan study reported that the lifetime prevalences of opium and heroin use in male students were 3. None of female students had a lifetime history of opium or heroin use. In the Kerman study, among high school students, lifetime history of opium use rates were The numbers for heroin use were 5. Cannabis is used in Iran in both the form of grass marijuana and hashish. Studies have reported lifetime history of cannabis use at 0. The Zanjan study showed a 2. The rate was 5. In the Kerman study, lifetime history of cannabis use was 8. Prevalence of daily cannabis use in this study was reported as 3. There is a lack of studies on methamphetamine or cocaine. Although the four most common substances used by high school students in Iran are tobacco, alcohol, cannabis and opium 19 — 22 , there have been some studies in recent years about other substances. Rates of lifetime and daily use of prescription sedatives mostly benzodiazepines were 2. In the Zanjan study, lifetime use rates for prescription narcotic drugs, including codeine and tramadol, were 9. Codeine is usually supplied and consumed as codeine-containing pain-killer tablets that mostly also contain acetaminophen. Both acetaminophen-codeine tablets and tramadol tablets are prescription drugs, but some pharmacies sell them without a prescription. Actually there are reports that acetaminophen-codeine tablets are one of the best selling drugs in Iran. Significant rates of use of prescription drugs by girls, who report very low rates of illicit drug use, suggest that prescription drug use is less stigmatized than illicit drug use. It is also an important concern that, like in other countries 47 , many users of these tablets are also abusing other substances. In the Zanjan study, the rate of lifetime and daily use of anabolic steroids was 6. Lifetime anabolic use was Shakeri et al. Sepehri et al. The prevalence of ecstasy use among 15—year-old people in Tehran was In another study on ecstasy use among high school students in Lahijan in the north of Iran, 2. The rate in boys 3. There is also one study that has shown that a large number of ecstasy users were high school or university students There are a large number of studies that have shown that various mental health disorders can be concordant with drug abuse problems. Zanganeh 53 stated that social isolation and lower socio-economic status can be associated with psychiatric disorders, including drug abuse. Emami et al. The frequency of such problems was higher in girls than in boys. Alcohol and drug use can be associated with high risk sexual behavior 55 and other risk-taking behaviors in Iranian adolescents 56 and can be a risk factor for HIV transmission. There is evidence that substance-using adolescents in Iran 19 and other countries 57 have greater psychological dysfunction. Childhood and family adverse events are also associated with more drug abuse problems in Iran and other countries 58 — Drug abuse is also reported in association with impulsivity 30 and delinquent antisocial behaviors in Iran 22 as well as other countries 61 — Adolescent drug use in Iran shows co-morbidity with mental disorders, especially depression and anxiety disorders. The Zanjan study, using the Beck depression inventory, found that Pathological anxiety was also more prevalent in high school students with a history of drug abuse, but it did not reach the significance threshold. Drug abuse also has been shown to be associated with academic problems There are very important drug problems among youth in Iran. As drug abuse and addiction are biopsychosocial problems, we should keep in mind relevant cultural factors and co-morbidities. It seems that parents and schools fail to play a significant role in primary prevention in Iran, and families in which the father is a drug user pose a very significant risk factor. Nearly half of drug-using university students in one study had been familiar with drugs since their adolescence Considering this fact and also the rule that earlier first drug use leads to more drug problems later in life, it is necessary to initiate preventive programs as early as possible. Adaptive motivational structure is important 67 , and it has been shown that behavioral control can help Iranian adolescents to resist drugs There are youth and family counseling programs in Iran that can be effective for behavior problems and, as DeJong et al. Although in Iran there are not yet comprehensive family-based or school-based drug prevention programs as in developed countries, some recent programs appear promising. Such programs include drug related life-skills training in kindergartens and primary schools, life skills training and drug education packages in high schools and universities, and parenting skills training programs promoting family bonding. Papers of particular interest, published within the annual period of review, have been highlighted as:. As a library, NLM provides access to scientific literature. Curr Opin Psychiatry. Published in final edited form as: Curr Opin Psychiatry. Find articles by Saeed Momtazi. Find articles by Richard A Rawson. PMC Copyright notice. The publisher's version of this article is available at Curr Opin Psychiatry. Cigarette Water pipe Girls Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Ziaaddini et al. Mohammadpoorasl et al. Nakhaee et al. Momtazi et al.

Tehran buying Ecstasy