The Efficacy of Matrix Model Treatment in the Reduction of Addiction Severity and Relapse Prevention among Amphetamine Abusers

Abstract

10.30699/jambs.30.142.407 Background & Objective: Procedural sedation and analgesia (PSA) includes the administration of sedative/dissociative medications with or without the concomitant delivery of analgesic agents. The bispectral index system (BIS) is a modern technology for neurophysiological monitoring that continuously analyzes the patient's electroencephalogram curve during sedation to assess the level of consciousness. This study aimed to compare various PSA protocols, including propofol/fentanyl, propofol/ketamine, and ketamine, based on the BIS and other critical items in adults with anterior shoulder dislocation (ASD) in the emergency department. Materials & Methods: This randomized three-group double-blinded clinical trial was conducted on 150 patients with ASD in Besat General Hospital in Tehran, Iran. The sample size was determined at 50 individuals in each group receiving propofol/fentanyl (group A), propofol/ketamine (ketofol; group B), and ketamine (group C). Before PSA, the sensor of the BIS monitor was attached to the patient, and several items were compared, including the side effects and duration of sedation, as well as BIS values before and 1-5 min after PSA.Results: Visual analogue scale scores before and after the intervention were obtained at 8.1±0.69 and 2.08±0.7, respectively. The BIS values at the 1 st , 2 nd , 3 rd , 4 th , and 5 th min after PSA were not different in the three groups. The comparison between the three groups regarding the patients' satisfaction showed that there was a significant difference between them (P=0.02), which was higher in the ketofol group. Conclusion:The investigation of PSA using propofol/ketamine, ketamine, and propofol/fentanyl showed similar frequencies of BIS values and adverse respiratory events. The use of propofol/fentanyl was associated with a slightly higher incidence of hypotension. Moreover, the frequency of patient satisfaction was higher among the subjects in group B, compared to those in the other groups.

Comparing the Effect of Transcranial Direct Current Stimulation (TDCS) and Cognitive-Behavioral Therapy on Substance Craving Control and Rumination in Methamphetamine-Dependent Patients

“…All narcotics, including psychoactive substances like methamphetamine, not only have direct consequences and side effects on users but also entail secondary social costs such as disturbances in family, work life, and the emergence of various types of violence (Mirza Nia & Firoozi, 2020). The greatest threat to a recovering patient and the primary cause of relapse is the craving for substance use, which can be very confusing and distressing if not accurately identified and controlled, potentially leading to resumed consumption (Ehteshami et al, 2018;Hamednia et al, 2017;Ruisoto & Contador, 2019). In clinical studies, craving has been reported as an important predictor of drug use and relapse.…”

“…In clinical studies, craving has been reported as an important predictor of drug use and relapse. Craving is an uncontrollable desire to consume drugs; a desire that, if unmet, can lead to psychological and physical suffering in drug-dependent individuals, including aggression, anxiety, depression, and weakness (Di Nicola et al, 2015;Ehteshami et al, 2018;Ameneh Oji et al, 2020;Rosenberg, 2009;Sadeghi & Karimi, 2019). One issue that significantly contributes to the continuation of substance use in addicts is rumination about substance use.…”