Background: Laser auricular acupuncture is a form of therapy that is non-invasive, aseptic, and painless, thus advantageous over the traditional form of acupuncture for tobacco cessation. The objective of the study is to evaluate and compare nicotine dependence, urinary cotinine level, physical effects, and quit rate among tobacco chewers before and one month after laser therapy and behavioral counseling, and to evaluate and compare extrinsic stains one month post-intervention.Methods: The present study was a randomized controlled trial, with laser therapy and behavioral counseling as the test and control interventions, respectively. The laser was focused on both ears once a week for four weeks. Counseling sessions were held once a week for four weeks. Nicotine dependence, urinary cotinine level, physical effects, as measured using the Visual Analog Scale, and quit rate were recorded before and after the intervention. Findings: The results showed significant reductions in nicotine dependence in both laser and counseling groups post-intervention (P<0.001). Urinary cotinine levels increased significantly in the counseling group post-intervention (P=0.010). Inter-group comparison revealed significant differences in pre- and post-intervention cotinine levels (P<0.05). Adjusted analysis confirmed significant post-intervention differences between the groups (P=0.048).Conclusion: This study demonstrates that combining laser auricular acupuncture therapy with behavioral counseling yields superior outcomes for smokeless tobacco cessation compared to behavioral counseling alone. The combined approach results in greater reductions in nicotine dependence, lower urinary cotinine levels, slightly higher quit rates, and significant improvements in various physical effects associated with tobacco use.

Background: Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity and survival. The BDNF gene Val66Met polymorphism is hypothesized to be linked with alcohol dependence syndrome (ADS). We studied the relationship between the BDNF Val66Met polymorphism and the clinical features of ADS, including severity, craving, and perceived stress among alcohol-dependent patients. Methods: In this cross-sectional study on treatment-seeking north Indian male ADS patients aged 18 to 60 years, alcohol dependence severity (Severity of Alcohol Dependence Questionnaire, SADQ), craving (obsessive compulsive drinking scale), and perceived stress (perceived stress scale-4) were measured. The genetic analysis for calculating the BDNF Val66Met allele frequency was carried out using TaqMan assays. Statistical analysis was done using SPSS Version 26. Findings: The participants’ mean age (SD) (n=80) was 37±8.52 years. Half of the participants had tobacco dependence, too. Almost half of the participants showed alcohol dependence with mild severity. The mean OCDS and PSS-4 scores were 26.08±9.34 and 9.08±2.4, respectively. The allelic frequency of the Val and Met alleles were 73.1% and 26.9%, respectively. Among the Met allele carriers, the OCDS (P=0.02) and PSS-4 scores (P=0.03) were significantly higher than observed in the Val group patients.Conclusion: The study concludes that BDNF gene Val66Met polymorphism could impact clinical variables such as craving and perceived stress in alcohol-dependent subjects. It merits the use of genetic analysis in determining the course of clinical maintenance of alcohol-dependent patients.

Background: Congress 60, as an NGO, provides services to people with substance use disorders (SUDs). Despite offering services and evaluating their effectiveness in several studies, the underlying theory of interventions and the impact process of these interventions have not been investigated within this organization. The purpose of this study is to obtain the underlying theory of changes in treatment outcomes in this organization. Methods: To achieve this theory, the grounded theory methodology was used. The data for this study consisted of the results of in-depth individual interviews with 26 individuals treated at Congress 60 branches, as well as documents. The analysis of these data was conducted using continuous comparison analysis to extract concepts, involving open, axial, and selective coding. Trustworthiness was evaluated according to the grounded theory principles. Findings: The core concept derived from this study was the "Theory of Transformations in the Psyche" as presented in Congress 60. Subcategories of the core concept included the psyche, the addictive psyche, and the healthy psyche.Conclusion: In Congress 60, psyche is defined as the expression that a person shows, which is the interaction of physical structures and worldview. A person with SUD has an addictive psyche that is demonstrated in daily behavior and, therefore, experiences adverse outcomes. The person treated at Congress 60 achieves a healthy psyche, as shown in daily behavior, and thus experiences positive outcomes. The theory obtained in this study can explain the process of change in the outcomes in Congress 60.

Background: Smokeless tobacco (SLT) use constitutes a considerable public health concern, especially in India, where there are more than 300 million users. This study seeks to assess the influence of graphic health warning labels (GHWLs) on smokeless tobacco (SLT) packaging on encouraging cessation among users.Methods: A cross-sectional study was conducted at the Faculty of Dental Sciences, BHU, Varanasi outpatient department, from December 2023 to April 2024. The study involved 387 participants, selected via simple random sampling, who were current smokeless tobacco users. Data was collected through structured interviews using a validated questionnaire. Statistical analysis was performed using SPSS version 21.0, with a significance level set at P<0.05. Findings: Awareness of GHWLs was high, with 91.7% of participants recognizing the labels. Among these, 66% considered quitting or reducing smokeless tobacco use due to the labels. Increased health awareness and serious consideration to quit were reported by 50.1% of participants, while 28.9% reported no impact. Awareness of tobacco cessation clinics was moderate at 48.1%, and 66.1% expressed willingness to seek help, primarily due to health concerns. Positive correlations were found between education level and awareness (r=0.387) and education and attitude towards quitting (r=0.227). Younger participants and those with shorter durations of smokeless tobacco use exhibited higher health awareness and a greater likelihood of considering cessation.Conclusion: GHWLs are a potent tool in tobacco control, significantly influencing smokeless tobacco users’ intentions to quit. A multifaceted approach involving GHWLs and comprehensive support systems can substantially reduce smokeless tobacco use and its associated health risks.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is a common liver disorder associated with metabolic abnormalities. This study aimed to evaluate the effectiveness of N-acetylcysteine (NAC) in improving liver function and metabolic profile in patients with MASLD.Methods: In this randomized controlled trial (RCT), 69 patients with MASLD were randomly assigned to either the NAC group (600 mg, administered three times daily, n=34) or the placebo group (n=35) for eight weeks. The severity of hepatic steatosis, liver enzymes, and metabolic profile were measured at baseline and the final trial. Data were analyzed using SPSS.Findings: Following eight weeks of NAC administration in patients with MASLD, no significant changes were observed compared to the placebo in hepatic steatosis grade (P=0.215), serum aspartate aminotransferase (AST) (P=0.21), alanine transaminase (ALT) (P=0.28), malondialdehyde (MDA) (P=0.79), total antioxidant capacity (TAC) (P=0.56), triglycerides (P=0.15), total cholesterol (P=0.28), low-density lipoprotein cholesterol (P=0.32), and high-density lipoprotein cholesterol (P=0.16). However, NAC administration resulted in significant reductions in fasting blood glucose (FBG) (P=0.01), fasting insulin levels (P<0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (P<0.001), and C-reactive protein (CRP) (P<0.001), along with a significant increase in total glutathione levels (P=0.003), compared to the placebo group.Conclusion: NAC administration in patients with MASLD does not significantly impact hepatic steatosis, liver enzymes, or lipid profiles; however, it improves oxidative, glycemic, and inflammatory markers. Therefore, NAC may be a beneficial adjunct therapy for managing metabolic parameters and reducing inflammation and oxidative stress in MASLD patients.Trial Registration: The trial was registered with the Iranian Registry of Clinical Trials (IRCT20201220049772N1) on February 20, 2021.

Background: Electronic cigarettes (e-cigarettes) have become significantly popular, especially among young people. E-cigarettes are a form of tobacco use in which the smoke produced by the vaporization of nicotine is inhaled. The increase in the consumption of these cigarettes causes many concerns about their long-term and unknown adverse effects on general and oral health. The present study was conducted to determine the level of awareness of dentists participating in the 15th Annual Scientific Congress of the Iranian General Dentists Association about e-cigarettes. Methods: In this cross-sectional study, the dentists selected by convenience sampling were given a questionnaire including 14 awareness questions. After the participants completed it, the data were statistically analyzed using Pearson’s correlation coefficient and an independent samples t-test.Findings: A total of 347 dentists participated in the present study, and 36.9% stated that they had no familiarity with e-cigarettes. The answers of more than half of the participants to questions regarding the relative risk of using this type of smoking as a suitable method to quit other types of tobacco, long-term adverse effects on health, and the risk of explosion of these cigarettes were incorrect. The average score of awareness was 7.88±3.25 out of a total of 14, indicating an overall moderate level of knowledge.Conclusion: The average knowledge score related to the subject under investigation was moderate, and the knowledge in some aspects was not satisfactory.

Background: This study aimed to investigate the impact of opium on liver function and the biliary tract in patients with bile duct stones, comparing outcomes with non-addicted individuals.Methods: This case-control study was conducted in Iran from 2016 to 2017. A total of 86 patients with bile duct stones were divided into two groups: opium-addicted (n=40) and non-opium-addicted (n=46). The patient’s hepatobiliary system was evaluated using liver function tests (LFTs) and endoscopic ultrasound (EUS). Data were collected and analyzed using SPSS software.Findings: LFTs showed significantly elevated levels of aspartate aminotransferase (AST) (90.67±46.99 vs 55.28±45.53 U/L, P=0.036) and aspartate aminotransferase (ALT) (120.47±90.15 vs 51.83±35.21 U/L, P=0.005) in the opium-addicted group compared to controls, and higher direct (4.05±2.84 vs 2.30±1.66 mg/dL, P=0.002) and total bilirubin levels (5.02±3.94 vs 2.93±2.35 mg/dL, P=0.007). Furthermore, the common bile duct (CBD) diameter was significantly larger in the opium-addicted group (12.21±3.42 vs 7.80±2.62 mm, P=0.007). In contrast, pancreatic duct diameters (P=0.289) and alanine aminotransferase (ALP) levels (P=0.842) showed no significant differences.Conclusion: The study revealed that opium addiction is associated with significantly elevated levels of liver enzymes (AST and ALT), higher bilirubin levels, and an increased common bile duct diameter in patients with bile duct stones, while the pancreatic duct diameter and ALP levels remained unaffected. These findings highlight the potential impact of opium use on the hepatobiliary system and underscore the importance of further research to understand its long-term effects and improve clinical management.

Background: Staying in Juvenile Correctional and Rehabilitation Centers (JCRCs) exposes adolescents to high levels of stress, potentially increasing the risk of substance use cravings and drug-seeking behaviors. Preventive programs should prioritize enhancing protective factors and mitigating risk factors. This research aimed to identify the risk and protective factors related to substance use among adolescents in JCRCs in Iran.Methods: This study was a content analysis based on individual semi-structured, in-depth interviews with volunteer adolescents (aged 12–18 years) who had experienced JCRCs in Iran within the past 12 months. Snowball sampling was used to identify the participants. Open coding was initially conducted by reading transcripts. Then, similar codes were grouped and placed into categories. We ensured the utmost trustworthiness using constant comparison, member checks, peer debriefing, and revisiting the data multiple times.Findings: Twenty-three eligible adolescents participated in the study. There was no substance use treatment protocol to treat adolescent substance users. Buprenorphine was the most accessed substance in JCRCs. Risk factors included peer substance use, substance offers during high-stress situations, stress, depression, hopelessness, slow passage of time, positive past substance use experiences, curiosity, poverty, financial problems, and myths about quitting. Protective factors included establishing rapport, providing counseling and social work services, engaging the adolescents in daily recreational activities, and assigning them responsibilities.Conclusion: Shifting from punitive to supportive and preventive approaches within JCRCs by addressing peer influence, training staff in adolescent substance use treatment, and facilitating meaningful leisure activities could promote healthier behaviors among adolescents in these facilities.

Background: Despite considerable advances in comprehending the neurobiology of drug addiction, available treatment options remain limited in terms of effectiveness and are often accompanied by adverse side effects that contribute to relapse. Notably, oxytocin administration has demonstrated potential in influencing neurobehavioral changes related to drug abuse. Furthermore, the effect of zinc on male fertility has been established. This study aimed to assess the impact of combining oxytocin with zinc sulfate on reproductive parameters in men addicted to opioids who are undergoing methadone maintenance therapy.Methods: This research followed a double-masked randomized controlled clinical trial design and involved 40 men with opioid dependence receiving methadone treatment. Patients were randomly assigned to one of two groups: a control group receiving a saline nasal spray and a zinc sulfate placebo, and an intervention group receiving 40 international units of oxytocin nasal spray in combination with 220 mg zinc sulfate capsules, daily. Baseline evaluations of testosterone, oxytocin, sperm characteristics, and zinc levels were conducted three days after a 5–10 mg reduction in methadone dosage. Subsequently, a two-week treatment regimen was administered, followed by post-intervention assessments. Findings: The age of participants was comparable in the control and intervention groups. Zinc levels in the control and treatment groups showed no significant difference before the intervention, while a significant increase was seen after the intervention in the treatment group (P=0.023). A significant increase was reported in testosterone levels (P=0.002) and the active motility of sperm (P=0.015) in the treatment group after the intervention. The intervention led to a significant reduction in the total abnormality of sperm (P<0.001). Prescription of nasal oxytocin spray with zinc supplementation can be an effective remedy in improving reproductive indices in opiate-addicted men and could be considered in addiction management guidelines. The present study is one of the first studies evaluating the effects of combined oxytocin and zinc supplementation on improving the reproductive indices in opiate-addicted men.Conclusion: According to the results, the combination of oxytocin and zinc supplementation had a positive and significant effect on sperm parameters in opioid-dependent men undergoing methadone treatment.

Background: Morphine dependence is a significant concern because of its potential for inducing addiction and adverse withdrawal symptoms. Naringin, a flavonoid compound found in citrus fruits, has shown promise in various pharmacological activities, including analgesic and anti-inflammatory effects. However, its potential role in inhibiting or reducing morphine dependence has not been extensively investigated yet. This study aimed to determine whether naringin can inhibit or reduce physical morphine dependence in rats. Methods: Morphine dependence was induced in rats through chronic injection of the drug for 7 days. Also, different doses of naringin (10, 25, and 50 mg/kg) were administered 15 minutes prior to morphine injection in three experimental groups. The effect of naringin pretreatment on drug withdrawal-associated symptoms, including body weight, jumping, abdominal contraction, grooming, ptosis, diarrhea, and teeth chattering, was evaluated.Findings: The animals experiencing morphine dependence exhibited significant body weight loss. However, administration of naringin before morphine injection prevented this loss by 50%. Also, drug withdrawal symptoms such as jumping, abdominal contraction, grooming, diarrhea, and teeth chattering were significantly increased in the rats. Interestingly, the prescription of naringin significantly reduced these symptoms. Ptosis was observed in all rats receiving morphine, while naringin did not significantly affect this symptom. Furthermore, the inhibitory effect of naringin on morphine physical dependence was found to be dose-dependent.Conclusion: Naringin pretreatment demonstrated potential in inhibiting or reducing physical morphine dependence in rats. These findings suggest that naringin may have therapeutic potential in managing morphine dependence and associated withdrawal symptoms.