Substance Abuse Research Articles

Anxiety, depression and neurocognitive disorder among HIV-infected people in penitentiary institutions of Azerbaijan.

This study aims to assess neurocognitive impairment, depression and anxiety level in HIV-infected individuals in penitentiary institutions of Azerbaijan. A cross-sectional design was used to recruit incarcerated individuals in penitentiary institutions of Azerbaijan meeting the inclusion criteria (diagnosed with HIV). Participants completed standardized assessments to screen anxiety and depression symptoms, hospital anxiety and depression scale and neurocognitive functioning and mini mental status examination. Demographic and clinical data, including age, gender, HIV disease progression, antiretroviral therapy adherence, history of substance abuse and duration of incarceration, were also collected as covariates of interest. The study was approved by Azerbaijan Medical University Ethics Committee (P.23 / 19.05.2022). Data were analyzed using student-Bonferroni and H-Kruskal-Wallis tests. Variance analysis was conducted using the ANOVA test, while discriminant analyses involved the χ2-Pearson test, through SPSS software, version 26. Of the 88 HIV positive patients who agreed to participate, 99% were male, with a median age of 44 years (range: 30-62), median CD4 count 453.1 cells/µl (range: 153-1,290). The prevalence of HIV-associated neurocognitive disorder was 72.7%. Occurrence of comorbid depression and anxiety symptoms was found to be 72% and 67%, respectively. Most patients (59.1%) were HIV-positive for more than five years. Increased depression and anxiety levels were identified mostly in first two years after admission to prison (p < 0.05). HIV-associated neurocognitive disorder was most commonly found among depressed patients (p = 0.009). The findings of this study provide valuable insights into the cooccurrence and interrelationships between anxiety, depression and neurocognitive disorders in individuals with HIV in prisons. It highlights the unique intersection of HIV infection, mental health challenges and incarceration in a country where research on HIV-related issues in prisons is still developing. Ultimately, this study seeks to contribute to identify targeted interventions that address the mental health needs of incarcerated individuals living with HIV in Azerbaijan, promoting their overall well-being and quality of life.

Understanding the Relationship Between Empathy, Theory of Mind (ToM), and Parenting Styles Among Children With Disruptive Behaviour.

Disruptive behaviour has been recognized as one of the most common and persistent forms of childhood maladjustment, and predictive of a range of negative adolescent and adult outcomes including continuing aggression, failure in school and work settings, substance abuse, and late-onset psychopathology. As a child grows many factors influence the child's development like genetic factors, parenting styles, attachment patterns, environmental factors etc. These factors help in the development of empathy, theory of mind (ToM), emotional and behaviour regulation. We need to understand the relation between these factors among children with disruptive behaviours, inorder to develop targeted interventions and support strategies tailored to the unique needs of this population. A sample of 70 children and their mothers completed validated psychometric scales. Pearson correlation & regression analysis were conducted to determine the relation between variables. Results indicated that a significant negative correlation was observed between the permissive parenting style of the father and ToM among children with disruptive behaviour. Empathy was considered a significant inverse predictor of disruptive behaviour among children with disruptive behaviour. Another finding suggests that there is no significant difference in disruptive behaviour between boys and girls and no evident association between parenting styles and disruptive behaviours in children. While this could imply that inherent factors (nature) may have a more notable influence on disruptive behaviour in this sample, it is important to consider that this does not rule out the potential impact of environmental factors (nurture). The results should be viewed as part of a complex interplay between nature and nurture, and further investigation, particularly through longitudinal studies, is needed to clarify their respective contributions. This study builds upon existing research in providing a better understanding of contributors to disruptive behaviour among children, which may assist in the development of interventions to promote positive socio-emotional development and enhance the overall well-being of children.

OMB memo pausing federal grants causes chaos

Last week a memo from the federal Office of Management and Budget (OMB) released January 27 late in the day created chaos across the country. Although a judge stopped the order, which was due to take effect at 5:00 pm on January 28, temporarily, a full hearing will be held February 3. The White House is still defending its action, which would affect the SUPTRS block grant, research grantees, and all not for profits receiving grants. The news blackout from the federal Department of Health and Human Services (HHS) continued (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34392). We were not able to get comments from the Substance Abuse and Mental Health Services Administration (SAMHSA), which funds the SUPTRS block grant, or NIDA or NIAAA.

Drug trends: Stimulant‐related overdoses increasing

Last month, the National Drug Early Warning System (NDEWS), funded by the National Institute on Drug Abuse, released an interactive “heatmap” illustrating the distribution of nonfatal stimulant‐related overdoses by time of day and day of the week. Charts below provide demographic breakdowns, including age, sex, and racial/ethnic groups.

Evaluation of acute substance abuse patients admitted to the ICU by different scoring system.

Drug abuse poisoning is a significant public health problem in many countries all over the world. The recent study aimed to assess the applicability of NEWS II and APACHE II scores as predictors of the ICU admission of acute intoxication by substance abuse. The study enrolled 98 patients admitted to the Alexandria Poison Center of the Main University Hospital (APC-AMUH) with a history of acute intoxication with substance abuse. Collected data included socio-demographic data, circumstances of exposure, and clinical and laboratory data. These data were employed to calculate NEWS II and APACHE II scores. A total of 98 substance abuse patients were admitted. Morphine constituted the highest percentage of substance intoxication (33.7%), followed by methanol (23.5%) and tramadol (17.3%). About one-third of the patients needed the ICU admission (32.7%). The median of NEWS and APACHE II was 7. The mean values of NEWS II and APACHE II in patients who entered the ICU were significantly higher than in patients who did not enter the ICU. The cut-off value of the ROC curve of NEWS II and APACHE II scores for admission to the ICU was 8 for both. These findings suggest that NEWS II and APACHE II scores are good predictors for the evaluation of patients intoxicated by substance abuse who need ICU admission.

An analysis of ambulance re-contacts after non-conveyance: a retrospective cohort study in the Netherlands

BackgroundNon-conveyance is an increasing part of ambulance care and has to be safe. One of the indicators to measure safety is an ambulance re-contact within 72 h. However, solely measuring the percentage of re-contacts has limited validity as it lacks insight in actual reasons of an ambulance re-contact. Therefore, the aim of our study was to analyze the incidence, reasons and outcomes of ambulance re-contacts within 72 h after non-conveyance.MethodsWe conducted a one year (2022) retrospective study in one EMS region in the Netherlands. Medical records of all non-conveyance runs with a re-contact were analyzed using a framework to categorize re-contact reasons in illness-related, patient-related, professional-related, and unrelated. Re-contact outcomes were measured in terms of (non-)conveyance and mortality.Results585/13.879 (4.2%) non-conveyance runs had a re-contact within 72 h. 547/585 (93.5%) re-contacts could be categorized with the framework. Re-contacts were related to the illness (n = 267, 48.8%), the patient (n = 130, 23.8%), the professional (n = 106, 19.4%) and unrelated (n = 44, 8.0%). Four subreasons accounted for 68.5% of reasons for re-contacts: progression of disease (19.4%), recurrent disease process/exacerbation (18.6%), reassessment and ambulance request by another medical professional (15.9%), and psychiatric disorder and/or substance abuse (14.6%). 403/547 (73.7%) patients with a re-contact were conveyed to the hospital. Mortality rate for patients with a re-contact was 0.5%.ConclusionsRe-contact incidence after non-conveyance is relatively low, with a very small part of re-contacts related to ambulance care professionals making errors in diagnosis or treatment. Combined with low re-contact mortality, this indicates safe non-conveyance decisions. Re-contacts as quality indicator cover a variety of reasons, with almost half of the re-contacts being related to illness. Four subcategories accounted for the majority of all reasons for re-contacts: progression of disease, recurrent disease process/exacerbation, reassessment and ambulance request by another medical professional, and psychiatric disorder and/or substance abuse. Three-quarters of the patients were conveyed, although more re-contacts due to patient related reasons ended in non-conveyance again.

Services availability and readiness assessment of adolescent sexual and reproductive health in primary healthcare facilities: evidence from selected districts in Ghana

BackgroundGlobally, adolescent health remains a public health priority given that adolescents often face unique vulnerabilities to health issues like mental disorders, substance abuse, and sexual health risks. In developing countries like Ghana, primary healthcare facilities (PHCs) are often the first point of contact for addressing these issues. However, there is a lack of literature examining the capacity of PHCs to address adolescent sexual and reproductive health (ASRH) issues. This study aims to fill this gap in the literature by assessing the availability and readiness of ASRH services within Ghana’s PHCs.MethodsThe study utilized a multi-stage sampling approach to select 67 PHCs across four districts in the Greater Accra region, reflecting Ghana's broad demographic diversity. We employed the WHO's Services Availability and Readiness Assessment (SARA) tool to measure the availability and readiness of ASRH services. This framework focused on key domains including service availability and readiness, assessing aspects such as HIV testing, family planning, and availability of contraceptives and necessary staff training. Data analysis was conducted using Stata version 17.0, analysing frequencies and percentages to capture the extent of service provision across the selected facilities.ResultsThe study highlighted significant disparities in the availability and readiness of essential ASRH services (HIV services, family planning, contraceptive pills, IUCD provisions, and male condoms) across selected districts and facility types. In Shai Osudoku, 65% of facilities offered a full range of selected ASRH services, the highest among the districts, whereas Ningo Prampram had the lowest at just 16%. In terms of facility types, 57% of CHPS facilities, 59% of health centres, and 44% of clinics provided all the selected ASRH services. Urban areas reported a 51% provision rate of these services, slightly less than the 54% observed in rural areas. Additionally, readiness disparities were evident: only 21% of urban facilities had adequate service guidelines compared to 29% in rural areas, and a higher percentage of rural facilities (46%) had trained staff, compared to 23% in urban areas.ConclusionThis study examined the availability and readiness of ASRH services in PHCs across the Greater Accra region, revealing significant disparities by location and facility type. Particularly, rural and public facilities demonstrated a higher availability of ASRH services compared to urban and private facilities. These findings suggest an uneven distribution of resources and highlight a potential urban underutilization of public health services. Moreover, the study identified a critical lack of service guidelines and trained staff across many facilities, emphasizing the need for enhanced training and resource allocation to improve service readiness. Targeted interventions are necessary to elevate the quality and accessibility of ASRH services, ensuring equitable health care delivery across all regions. Future research should expand to other regions to validate these findings and inform nationwide health strategies.

'I Don't Know How to Live Real Life Sober'-Identifying Needed Supports Through the Voices of Pregnant and Parenting People Seeking Recovery.

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis was framed by the Substance Abuse and Mental Health Services Administration (SAMHSA) eight dimensions of wellness, which reflect wellness standards across life domains. Participants identified internal and external challenges including feelings of guilt and shame, treatment access issues, lack of recovery support, grief and loss and inadequate instrumental support. Needed supports were broadly categorised as parenting resources, childcare resources, housing supports, recovery supports, occupational training and assistance and spirituality resources, and then evaluated and sorted based on appropriate fit within the SAMHSA's eight dimensions of wellness. Highest perceived needs fit within Intellectual, Emotional, Spiritual and Environmental wellness dimensions, respectively. Healthcare providers promoting recovery for PPP should focus on support needs within SAMHSA's dimensions of wellness and develop strategies that address the full range of these critical wellness dimensions. Intellectual, emotional and tangible environmental supports including parenting and recovery skills training, accessible mental health care and residential housing with childcare availability are essential for long-term recovery and positive parenting.

Impact of Sociodemographic Factors on the Efficacy of Multidrug-resistant Tuberculosis Therapy in Russia: Retrospective Epidemiological Study

Abstract Background: Russia has the highest prevalence of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) in the world. This study aims to evaluate the impact of sociodemographic determinants on the effectiveness of therapy in patients with MDR/RR-TB in the Khabarovsk krai region of Russia. Methods: We conducted a retrospective cross-sectional epidemiological study. Using the centralized national database of TB patients, data was collected on 2661 patients diagnosed with TB from 2018 to 2019 in all medical facilities of the region. After applying exclusion criteria, the final sample consisted of 531 patients with determined MDR/RR and with a known chemotherapy outcome. The influence on the therapy outcome of the 13 variables was analyzed using a binary logistic regression. Results: 10 out 13 analyzed variables had no influence on a given therapy’s effectiveness. These variables were sex, age, residence, occupation, substance abuse, presence of disability, circumstance of TB diagnosis, TB localization, HIV coinfection, and history of imprisonment. Previous treatment with Isoniazid and Rifampicin (P = 0.036, AOR 1.987, CI 95% 1.097 to 3.601), cavities absence in the lungs (P = 0.009, AOR 1.720, CI 95% 1.142 to 2.590), and living in a separate apartment (P = 0.023, AOD -1.150, 95% CI -2.223 to -1.027) significantly influenced treatment efficacy. Conclusion: Our findings point to demographic restructuring of the core of MDR/RR-TB carriers in Russia. As a way to resolve this situation, we wish to emphasize shifting the focus from risk groups and facility-based therapy to home-based therapy, as well as focusing on combating the social stigma and further improving HIV care.

Modular Maximization Theory: A functional account of economic behavior in laboratory animal models with applications to drug-seeking behavior.

Substance abuse research depends on precise and sensitive assessments of reinforcer efficacy in animal models. However, conventional methods often lack theoretical rigor and specificity to support these assessments. To address these gaps, the Modular Maximization Theory (MMT) is introduced as a comprehensive framework for understanding instrumental behavior. Like earlier maximization theories, MMT posits that behavior is distributed across alternatives to maximize utility over time. This concept is structured through five foundational postulates that define alternative actions and rules for choosing between them as budget constraints and utility functions. A key innovation of MMT is its incorporation of reinforcer utilization-encompassing both consummatory and post-consummatory activities-into the budget-constraint function. A model of ratio-schedule performance is developed under the assumption that utilization is proportional to demand, with utility represented as an additive power function of reinforcer magnitude. This model, termed PURSPU (Proportional Utilization, Ratio Schedule, Power Utility), effectively explains how reinforcer magnitude, response effort, non-contingent reinforcement, and income influence demand curves, behavior-output functions, dose-response relationships, and progressive-ratio breakpoints, while accounting for rate-dependent effects. The model also offers novel insights into choice behavior, including concurrent-schedule performance, income dependency, and delay discounting, as well as post-reinforcement pauses and run rates. Variations in budget constraints and utility functions are proposed as alternative models. Potential theoretical advancements, more targeted assessments of drug abuse liability, and the broader role of MMT in understanding human drug abuse are explored.

Ultra Processed Food Addiction among People: A Mini-Review of the Evidence

Background: According to the availability of various types of processed food products worldwide, the demand for their consumption has increased. Ultra-processed foods (UPFs) containing high amounts of sodium, hydrogenated oils, and refined carbohydrates are triggers for activating the same neural pathways and act like drug abuse. On the other hand, changing the food environment is a key factor in obesity prevalence and its related outcomes. It may be attributed to addiction to foods that has also been called “eating dependence” which emphasizes the behavior, not the food itself. Food addiction is important for a better understanding of psychiatric and medical problems such as eating disorders, obesity, and metabolic syndrome. Methods: In this mini-review, we will examine food addiction and the appropriate strategies for its management. Conclusion: Because food addiction has negative health consequences, strategies for reducing the accessibility of UPFs should be warranted. Also, high fiber intake and consumption of probiotic products should be considered. Further interventional studies are needed to manage this problem.

Decarceration and COVID-19 infections in U.S. Immigration and Customs Enforcement detention facilities: a simulation modeling study.

U.S. Immigration and Customs Enforcement (ICE) facilities had high rates of COVID-19 infections and mortality during the global pandemic. We sought to quantify how many COVID-19 infections could have been averted through different decarceration strategies. We developed a set of stochastic simulation models of SARS-CoV-2 transmission in ICE facilities. Employing incremental mixture importance sampling (IMIS), we calibrated them to empirical targets derived from publicly available case time series for ICE facilities, and publicly available facility population censuses prior to vaccine availability (May 6, 2020 to December 31, 2020). The models included infection importation from extra-facility sources. We evaluated reduction of the incarcerated population by 10-90%. People who were decarcerated faced background cumulative risks of infection and detection based on a weighted average of county-level estimates from the covidestim model, which is a Bayesian evidence synthesis model. Without decarceration, the infection rate was 5.05 per 1000 person-days (95% CrI 3.40-6.81) and case rate was 1.53 per 1000 person-days (95% CrI 1.04-2.02). Rates declined linearly when decarceration did not reduce contacts of people remaining in facilities and faster than linearly when it did reduce contacts. At all decarceration levels, rates were substantially higher when contacts were not reduced. Even with 90% decarceration, infection rates for people remaining in facilities were higher than or comparable to otherwise similar free-living people. The decline in COVID-19 infection rates with decarceration was linear or faster than linear depending on how decarceration was implemented. Our findings highlight infection risks associated with incarceration, which compound other health harms of incarceration. Stanford's COVID-19 Emergency Response Fund; the National Institute on Drug Abuse; and the National Institute of Mental Health.

The effect of intracerebroventricular injection of melatonin on the period of acquisition, expression, extinction, and reinstatement of morphine conditioned place preference in the male rat: A behavioral and biochemical study.

Behavior in both humans and animals is significantly influenced by the brain's reward system. Many studies have shown that this dopaminergic system is the root of drug addiction and abuse. Melatonin, an indoleamine neurohormone, has been studied for its potential negative effects on addictive drugs such as morphine. This study evaluates the effect of intraventricular melatonin injection during different phases of morphine conditioning. Rats were conditioned with morphine [5 mg/kg; subcutaneously (SC)] for three days. The changes in conditioned place preference (CPP) scores following the injection of different doses of melatonin [25, 50, and 100 μg/kg; intracerebroventricular (ICV)] were investigated during the acquisition, expression, extinction, and reinstatement phases of morphine conditioning. After completing these steps, the c-Fos level in the nucleus accumbens (NAc) was measured using the ELISA technique. The results indicated that daily injections of 50 and 100 μg/kg melatonin during the acquisition and expression phases caused a dose-dependent decrease in the conditioning score. During the extinction phase, melatonin administration reduced its duration incrementally. Notably, only the 100 μg/kg dose significantly decreased morphine reinstatement. In terms of c-Fos levels, which were elevated after morphine consumption, melatonin administration led to a significant reduction across all phases. This study demonstrates the neural interaction between melatonin and the opioid system. The evidence suggests that melatonin may be effective at decreasing drug-related rewards and has potential utility in preventing addiction.

How useful was a paediatric physical abuse screening project in a rural Australian emergency department?

Children with non-accidental injuries have increased risk of future death. There is insufficient evidence for widespread physical abuse screening tool use in the ED. This study assesses the utility of a physical abuse project that includes the implementation of a screening tool with case-matching from multiple sources. It aims to confirm whether risk-screening in a medium-sized rural Australian ED is reliable and will improve outcomes. This is a 16-month ED retrospective pre-/post-implementation study of all injury, burn or poisoning cases 16 years and under during a paediatric physical abuse safety project which included a screening tool. Presentations with potential physical abuse were filtered by ICD-10 codes and reviewed. Multivariable logistic regression models compared pre- and post-implementation cases. Analyses examined outcomes, trends and interrogated the screening tool which formed a Clinical Pathway Algorithm (CPA). A total of 1469 presentations underwent investigation: 747 pre-implementation and 722 post-implementation. Pearson's χ2 test showed statistically insignificant differences. If tool used, documentation improved (odds ratio [OR] 7.73; 95% confidence interval [CI] 4.91-12.18), child protection service referrals increased (OR 5.50; 95% CI 1.82-16.61) and hospital admissions decreased (OR 0.42; 95% CI 0.22-0.79). Re-presentation rates stayed the same. Increased physical abuse was associated with screening factors including carer behavioural concerns, inadequate supervision, delayed presentation, repeat and unexplained injuries (ORs/CIs in an accompanying Table 4). Screening tool sensitivity was 62.3% and specificity 79.7%. Implementing this ED paediatric physical abuse project improved safety behaviours and best-practice documentation. The tool improved medical decision making without increased re-presentations. ED clinicians may use similar CPAs to help review safety concerns and facilitate discharge; however, resources are needed to investigate referrals flagged due to false-positive rates.

In vitro hydrolysis of areca nut xenobiotics in human liver

Areca nut (AN) is a substance of abuse consumed by millions worldwide, in spite of established oral and systemic toxicities associated with its use. Previous research demonstrates methyl ester alkaloids in the AN, such as arecoline and guvacoline, exhibit mood-altering and toxicological effects. Nonetheless, their metabolism has not been fully elucidated in humans. In the present study, an HPLC-UV bioanalytical method was developed to evaluate the hydrolytic kinetics and clearance rates of arecoline and guvacoline in human liver microsomes (HLM) and cytosol (HLC). The bioassay was capable of quantifying arecoline and guvacoline (and carboxylate metabolites arecaidine and guvacine, respectively) with good sensitivity, accuracy, and precision. Kinetics of arecoline and guvacoline hydrolysis best followed the Michaelis-Menten model. Apparent intrinsic clearance (Clint.in vivo) of arecoline was 57.8ml/min/kg in HLM and 11.6mL/min/kg in HLC, a 5-fold difference. Unexpectedly, guvacoline was dramatically less hydrolyzed than arecoline in both HLM and HLC, with Clint.in vivo estimates of 0.654ml/min/kg and 0.466ml/min/kg, respectively. These results demonstrate, for the first time, arecoline undergoes significant hydrolysis with high clearance rates in the liver. Furthermore, differential tissue metabolic rates and utilization of specific esterase inhibitors unequivocally demonstrated arecoline is a substrate for CES1 and not CES2.

Identification of Epigenetic Biomarkers Associated With Prenatal Exposure to Substances of Abuse

Identification of Epigenetic Biomarkers Associated With Prenatal Exposure to Substances of Abuse

Pharmacotherapy of Psychological Disorders Using Psychedelic Drugs: A Treatise for Psychiatrists

: Psychedelics are currently being examined once more as potential remedies for untreatable biological illnesses after decades of research problems. They are frequently regarded to be physically safe and do not frequently lead to dependency or addiction. The use of psychedelic substances in the treatment of mental illness and the adoption of the Substance Act of 1970 has classified psychedelic drugs as Schedule I. The major objective of this review is to highlight the prospective use of specific psychedelic medicines, such as psilocybin, LSD, MDMA, and ayahuasca, in the treatment of various psychiatric conditions, such as treatment-resistant depression, post-traumatic traumatic stress, end-of-life anxiety, and substance misuse disorders. As documented from both animal and human studies, in addition, there will be a study of the effectiveness and safety. The body of research suggests that psychedelics may one day offer revolutionary treatments for mental diseases, contrary to conventional therapy. However, given their distinctive histories and a high potential for abuse with widespread distribution, more care and effort must be given to protect their use as efficient medical treatments instead of drugs of abuse.

Provision of Recovery Support Services in Opioid Use Disorder (OUD) Treatment Settings: A Secondary Data Analysis of the National Survey of Substance Abuse Treatment Services (N-SSATS) Data

Provision of Recovery Support Services in Opioid Use Disorder (OUD) Treatment Settings: A Secondary Data Analysis of the National Survey of Substance Abuse Treatment Services (N-SSATS) Data

Assessing Tobacco Product Abuse Liability in the Context of the Appropriate for the Protection of Public Health (APPH) Regulatory Standard

Assessing Tobacco Product Abuse Liability in the Context of the Appropriate for the Protection of Public Health (APPH) Regulatory Standard

Psychometric Properties of the Persian Version of PID5BF + M in Iranian Drug Users.

This study aimed to adapt and evaluate the psychometric properties of the PID5BF + M as a brief measure for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users. The sample consisted of 380 participants, including both clinical (28.68%) and nonclinical (71.32%) groups, with 43.7% female participants. All participants completed the Personality Inventory for DSM-5 and ICD-11 Brief Form-Modified (PID5BF + M), the Symptom Checklist-25 (SCL-25), the Brief Five-Factor Inventory (BFI-10), the Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0), and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). The findings revealed that the PID5BF + M demonstrates strong psychometric properties, with a six-factor structure that is culturally appropriate for the Iranian population. Significant associations were found between the ICD-11/DSM-5 traits and both internalizing and externalizing symptoms, as well as with normal personality factors. The PID5BF + M appears to be a valid and reliable tool for assessing DSM-5 and ICD-11 personality disorder traits in Iranian drug users, showing promising potential for use in clinical and research settings within this cultural context.