Brief cognitive-behavioural therapy for methamphetamine use among methadone-maintained women in Iran
This paper describes a unique randomised controlled trial of behavioral therapy for the treatment of regular methamphetamine use and dependence among female clients in Tehran, Iran.
Co-existing methamphetamine (MA) use disorder among methadone clients is a global health concern. Amphetamine-Type Stimulants (ATS), including MA, are the major illicit drugs used by over 20 per cent of those in drug treatment in Asian countries, 12 per cent in the North American region and nine per cent in the European region.
MA use disorder is common as an important health problem among methadone-maintained women in Iran. Among female methadone-maintained clients, MA use is associated with greater depression and dependence as well as lower treatment retention than men.
To date, there is not any approved pharmacotherapy for MA regular use and dependence. In recent years, brief cognitive-behavioral therapy (BCBT) has been suggested as a new treatment for ATS use disorder.
A multicentre randomised controlled trial (RCT) was conducted in Tehran, Iran in 2014-2015. 120 women in methadone treatment who reported methamphetamine use of weekly or more were randomly assigned to BCBT or control.
For both groups, days, frequency and dependence were almost the same at baseline. At week four there were significant reductions in the mean number of days of methamphetamine use per week in the BCBT group, while the control group showed no significant reduction. This result remained significant at week 12.
The severity of dependence also declined significantly in the BCBT group at week four. There were also significant improvements in readiness to change MA use (psychological well-being and social functioning in the BCBT group at week four). These results remained significant in the BCBT group at week 12. However, the control group showed no significant changes over the same time.
There were no differences in criminality or risky sexual behaviour between the two groups.
Zahra Alammehrjerdi is an international doctoral student at NDARC, supervised by Professor Kate Dolan. This work was presented as a poster and a five-minute presentation at the 2016 NDARC Annual Symposium. It was the joint winner of the People’s Choice Poster Award.