Table 2.
Studies related to the development of women-only services, drug treatment entry and outcomes
| Study citation | Year | Sample | Study site | Main drugs | Study outcomes |
|---|---|---|---|---|---|
| Ministry of Health and Medical Education. 2014 [5] | 2007–2014 | All women (i.e., 10 % of illicit drug users) | Main cities | Any type of illicit drug especially opiates | Women-only residential centers and drop in centers such as Chitgar center and Khaneye khorshid were established for female drug users and at-risk women such as female sex workers and female injecting drug users. |
| Dolan et al. 2011a [8] | 2007 | 78 | The first women-only methadone clinic, Tehran | Opiates and poly use of opiates and methamphetamine | The first methadone clinic was established for women. |
| Dolan et al. 2011b [9] | 2007–2008 | 78 | The first women-only methadone clinic, Tehran | Opiates and poly use of opiates and methamphetamine | Only 20 % of women reported lifetime drug treatment. Women reported poor social functioning, depression, poor general health and stigma. |
| Dolan et al. 2012 [10] | 2007–2008 | 78 | The first women-only methadone clinic, Tehran | Opiates and poly use of opiates and methamphetamine | Women who had attended the clinic between 2007 and 2008 were followed in 2009–2010. Of the 78 women recruited, 40 women were followed seven months later. There was a significant reduction in heroin use at follow-up. Women needed continued methadone treatment. |
| Radfar. 2013 [21] | 2007 | 15 | The first two centers for health promotion among at-risk women, Shiraz and Esfahan, The Persian Gulf region | Opiates and poly use of opiates and methamphetamine | Women needed women-only medical, psychiatric, social and psychological services for drug treatment. |
| Fahimfar et al. 2013 -[14] | 2007–2008 | 442 | The first five harm reduction centers, five provinces | Opiates and poly use of opiates and methamphetamine | Women received drug treatment and harm reduction services at the centers. |
| Fahimfar et al. 2014 [15] | 2007–2014 | 6,000 | Five provinces | Opiates and poly use of opiates and methamphetamine | Women received free drug treatment and harm reduction services such as methadone, sterile syringes and condoms. |
| Treatment motivations | |||||
| Babakhanian et al. 2013 [7] | 2010 | 69 | Sixteen methadone clinics, Tehran | Opiates | Receiving information from informant sources in the community such as mass-media, treatment success of relatives and friends, the encouragement of healthy family members, the need for keeping family and children, an individual need to take methadone to relieve the side effects of opiate use and poor satisfaction with other drug treatments such as therapeutic community program increased treatment entry. |
| Ahmadan-Panah et al. 2014 [22] | 2012 | 59 | Ten drug treatment centers, Hamadan, western Iran | Opiates, illicit methadone and hashish | Drug withdrawal, depression, anxiety, familial problems and headaches increased treatment entry. |
| Alam-mehrjerdi et al. 2013b [23] | 2008–2009 | 62 | Ten methadone clinics, Tehran | Opiates | Adequate methadone dose to substitute with opiate use, counseling sessions, group therapy, individual psychological sessions, family therapy and drug education on methadone program increased positive treatment outcomes such as treatment retention, relapse prevention and the improvement of general health. |
| Ghasemi-Arganeh et al. 2014 [24] | 2012 | 32 | A women-only therapeutic community center, Isfahan | Opiates | Group motivational interviewing and life skills training increased positive treatment outcomes including the reduction of drug relapse, anxiety, depression and increased mental health. |
| Daneshmand et al. 2014a [25] | 2011–2012 | 500 | Chitgar women-only therapeutic community center, Tehran | Methamphetamine | Family support, employment, counseling and psychological services, having an ongoing program for daily activities, learning motivations to change, strategies to cope with craving, dealing with lapse, refusal skills and relapse prevention increased treatment outcomes including the improvement of general health and the provision of drug-free urine specimens. |
| Tafaoli-Masooleh. 2010 [26] | 2009 | 70 | Chitgar women-only therapeutic community center, Tehran | Methamphetamine | Cognitive-behavioral therapy (CBT) increased treatment outcomes including treatment retention and the provision of drug-free urine specimens in treatment. |
| Dehghani-Firooz-Abadi et al. 2013 [27] | 2012 | 30 | Ayandenh- Roshan women-only therapeutic community center, Esfahan | Opiates | CBT increased positive treatment outcomes including the provision of drug-free urine specimens and the improvement of general health. |
| Hadadi et al. 2014 [28] | 2013 | 43 | Four drug treatment centers and clinics, Tehran | Methamphetamine | The Matrix Model of Intensive Outpatient Treatment (CBT) increased positive treatment outcomes including treatment retention, the provision of drug-free urine specimens and the improvement of general health and psychiatric comorbidities (i.e., depression and anxiety). |
| Treatment barriers | |||||
| Ebrahimi et al. 2014 [29] | 2012 | 409 | Eight districts, Esfahan, central Iran | Opium | Poor treatment motivations, insufficient information and misconceptions about drug use treatment were strong barriers to treatment entry. |
| Shaditalab et al. 2014 [30] | 2011 | 48 | Khaneye Khorshid women drop in center, Chitgar and Congress 60 1 centers, Tehran | Poly use of opiates and methamphetamine | Unemployment, low income, unstable accommodation and poor vocational training, poor physical and psychological health and poor education were barriers to achieving positive treatment outcomes. Service providers emphasized the necessity of providing social and financial supports and health insurance for increasing positive treatment outcomes such as relapse prevention. |
| Rahimi-Movaghar et al. 2011 [31] | 2011 | 62 | Chitgar center and Khaneye khorshid center, Tehran | Opiates and poly use of opiates and methamphetamine | Social stigma, poor family acceptance and low economic status were barriers to achieving treatment retention. Insufficient numbers of female medical doctors and a paucity of health counseling and educational services, living in drug-using environments and inadequate medical and social work services were barriers to achieving positive treatment outcomes such as treatment retention, relapse prevention and reduced psychiatric comorbidities. |
| Daneshmand et al. 2014b [32] | 2010–2011 | 150 | A central women-only drop in center, Tehran | Poly use of opiates and methamphetamine | Long duration of poly use of opiates and methamphetamine, poor family support, poor motivations to change methamphetamine use, poor participation in psychological and counseling sessions, depression, an inability to cope with everyday life pressures and inadequate skills to cope with methamphetamine craving and relapse were barriers to achieving positive treatment outcomes such as treatment compliance and the improved general health. |
1Congress 60: a chain non-governmental organization that officially provides drug treatment and harm reduction services