An Epidemic Problem: A Commentary on Stimulant Use in Opioid Maintenance Treatment

authors:

avatar Saeed Nateghi 1 , * , avatar Hosein Effatpanah 2

School of Medicine, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran
Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
Iranian Journal of Psychiatry and Behavioral Sciences: Vol.13, issue 4; e97805
published online: December 7, 2019
article type: Letter
received: September 4, 2019
revised: September 21, 2019
accepted: November 8, 2019
DOI: https://doi.org/10.5812/ijpbs.97805

how to cite: Nateghi S, Effatpanah H. An Epidemic Problem: A Commentary on Stimulant Use in Opioid Maintenance Treatment. Iran J Psychiatry Behav Sci. 2019;13(4):e97805. https://doi.org/10.5812/ijpbs.97805.

Dear Editor,

A paper by Danesh and Noroozi entitled ‘‘Concurrent amphetamine and methamphetamine use among clients of opioid maintenance treatment programs in Golestan, Iran’’ has been recently published in your journal. In our view, the authors have highlighted the prevalence of the critical problem of amphetamine and methamphetamine use in OPIOID MAINTENANCE TREATMENT PROGRAMS (OMTPs) (1). The concurrent use of stimulants in OMTPs remains a challenging concern in Iran, associated with important health implications (2-4). This health concern is serious due to the effects of the stimulant use on OMTPs such as poor treatment outcomes, poor treatment retention, and compliance (1-4).

In their study of 750 patients, 8.1% had positive urine samples for amphetamine or methamphetamine. Overall, 41.8% of the participants had positive samples for morphine. Interestingly, the authors highlighted that positive urine specimens for morphine were significantly higher among those who had positive urine samples for amphetamines. Furthermore, lifetime alcohol use and imprisonment were associated with positive urine samples for amphetamines (1).

Recently, at the research level, psychological treatments such as motivational interviewing, the Matrix model, and cognitive-behavioral therapy have been evaluated for stimulant users in OMTPs (5-10). However, at the clinical level, these treatments need to be widely considered for stimulant use.

In our view, Danesh and Noroozi s’ research paper is a valuable and influential study that aimed to identify and investigate the prevalence of a new health problem. As a well-designed research study, the paper benefits the clinicians and researchers by providing a summary of the existing evidence, generating new hypotheses, and showing the research gaps. We suggest that the delivery of effective psychological treatments be considered for Persian stimulant users in OMTPs.

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