title: Methamphetamine use among Iranian heroin kerack-dependent women: implications for treatment.
abstract: BACKGROUND
  Co-use of heroin kerack with methamphetamine (MA) is a new epidemic health concern among Iranian female drug users. Yet, little is known about this issue because of stigma.
  
  
  OBJECTIVE
  The current study aimed to investigate the reasons associated with initial and continued co-use of heroin kerack with MA among two groups of regular and recreational female co-users, their motivations associated with treatment entry and to compare their general characteristics at a drop in center (DIC) in Tehran.
  
  
  METHODS
  82 clients were randomly recruited. A researcher-designed questionnaire was used to collect data. Data was analyzed by performing descriptive statistics, the Chi-square test and t-test.
  
  
  RESULTS
  The mean age of the participants were 31 (SD = 8) years. Reducing negative affect (55%), addicted family and social networks (50%), curiosity (48%), and the lack of knowledge on addictive effects of co-use of heroin kerack with MA (32%) were the most frequently reported reasons at initiation. Drug dependence (71%) and drug availability (56%) were reasons of continued co-use. Restoring health (61%), fear from becoming MA abuser only (33%), and fear from making a transition from heroin kerack and MA smoking to injection (15%) were important motivations for treatment entry. Regular co-users were more likely to be single (41.7% vs. 14.7%, P < 0.001), jobless (45.8% vs. 38.2, P < 0.05), homemaker (50% vs. 35.3%, P < 0.01), recently incarcerated (16.7% vs. 11.7%, P < 0.01), and were less likely to be enrolled in opioid replacement programs (33.5% vs. 41%, P < 0.01). Regular co-users were younger (30.6 vs. 32.1 years, P < 0.05), less educated (9.6 vs. 10.8 years, P < 0.05) and had a longer duration of drug dependence (9.6 vs. 8 years, P < 0.05).
  
  
  CONCLUSIONS
  Reasons associated with initial and continued co-use of heroin kerack with MA, factors associated with treatment entry and the differences between regular and recreational co-users should be specifically considered in designing and tailoring drug use treatment programs for this group.
authors: Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Zahra
authors: Z
authors: Alam Mehrjerdi
authors: Center of Psychological Counseling Services, Ferdowsi University, Mashhad, IR Iran.
authors: Zohreh
authors: Z
authors: Abarashi
authors: Division of Research on Drug Use and Dependence, Rebirth Society (NGO), Tehran, IR Iran.
authors: Sahar
authors: S
authors: Mansoori
authors: Division of Research on Drug Use and Dependence, Rebirth Society (NGO), Tehran, IR Iran.
authors: Abbas
authors: A
authors: Deylamizadeh
authors: Department of Psychology, Faculty of Psychology and Educational Sciences, Ferdowsi University, Mashhad, IR Iran.
authors: Javad
authors: J
authors: Salehi Fadardi
authors: School of Advanced Technologies in Medicine (SATM), Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Alireza
authors: A
authors: Noroozi
authors: Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran ; Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors: Mehran
authors: M
authors: Zarghami
keywords: Heroin kerack; Methamphetamine; Treatment; Women