Development of country-wide strategies to reduce the alcohol abuse

Evidence shows that in Iran alcohol abuse rate may be of concern, especially among the youth. The mental and social health and addiction Department of the Ministry of Health and Medical Education has designed a plan to prevent, treat, and rehabilitate the patients abusing alcohol in a time period of 2011-2015. In a 6-month period, three guiding committees of experts in the field of alcohol abuse reviewed the literature. The meetings of the steering committee were held in order to collect the comments of the policy-makers in recognition of the problem, orientation, and administration procedures for the suggested strategies. The first input was discussed in the committee meeting. In the orientation phase, intervention strategies were suggested whose base was the evaluation of the previous international guidelines. In the final phase, the suggested strategies and challenges and their possible solutions were criticized. Finally, using these strategies, appropriate interventions were defined. Preventing alcohol supply, school- and community-based prevention efforts, monitoring and vigilance were defined as primary prevention. While secondary and tertiary prevention are defined to be the treating and rehabilitating services for the alcohol abusers. We hope by using this strategy we will be able to control alcohol abuse in our country. The first step to reach this aim is done by breaking the taboo of giving alcohol-related information and news using media and educational programs especially to the young population

Social hidden groups size analyzing: application of count regression models for excess zeros

In the case of sensitive questions such as number of alcoholics known, majority of respondents might give an answer of zero. Poisson regression model [P] is the standard tool to analyze count data. However, P provides poor fit in the case of zero inflated counts, when over-dispersion exists. Therefore, the questions to be addressed are to compare performance of alternative count regression models; and to investigate whether characteristics of respondents affect their responses. A total of 700 participants were asked about number of people they know in hidden groups; alcoholics, methadone users, and Female Sex Workers [FSW]. Five regression models were fitted to these outcomes: Logistic, P, Negative Binomial [NB], Zero Inflated Poisson [ZIP], and Zero Inflated Negative Binomial [ZINB]. Models were compared in terms of Likelihood Ratio Test [LRT], Vuong, AIC and Sum Square of Error [SSE]. Percentages of zero were 35% for number of alcoholics, 50% for methadone users, and 65% for FSWs. ZINB provided the best fit for alcoholics, and NB provided the best fit for other outcomes. In addition, we noticed that young respondents, male and those with low education were more likely to know or reveal sensitive information. Although P is the first choice for modeling of count data in many cases, it seems because of over-dispersion of zero inflated counts in the case of sensitive questions, other models, specifying NB and ZINB, might have better goodness of fit

Descriptive aspects of injection drug users in Iran's national harm reduction program by methadone maintenance treatment

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