{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:46:35Z","timestamp":1783529195092,"version":"3.55.0"},"reference-count":63,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic disrupted healthcare delivery and posed challenges for addiction treatment, particularly methadone maintenance therapy (MMT). This study examined changes in methadone use, behavioral patterns, and psychological well\u2010being among MMT patients in Tehran, Iran, to assess how public health crises can influence addiction care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cross\u2010sectional study with within\u2010subject pre\u2013post comparisons was conducted among 180 MMT patients from four randomly selected treatment centers. Methadone intake and behavioral outcomes (smoking, physical activity, technology use, and anxiety) were assessed for the periods immediately before and during the pandemic. Multivariable logistic regression identified predictors of dose escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Paired analyses (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009179) showed a modest overall increase in mean methadone dose from 54.16\u2009\u00b1\u200937.28\u2009mg to 62.09\u2009\u00b1\u200949.77\u2009mg (mean change +7.93\u2009mg; 95% CI, 2.49\u201313.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Subgroup analyses revealed heterogeneity: patients who increased intake (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200957) rose by 35.79\u2009mg (95% CI, 17.38\u201354.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while those who decreased intake (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914) reduced by 37.15\u2009mg (95% CI, \u201365.73 to \u20138.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Regression analysis identified living with family (aOR\u2009=\u20092.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) as a risk factor, while pre\u2010existing illness (aOR\u2009=\u20090.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and age 40\u201350 years (aOR\u2009=\u20090.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) were protective. Methadone formulation, timing, and frequency remained stable. Behaviorally, 21.1% reported stronger drug cravings, 14.4% reported slippage to other substances (most often methamphetamine), 94.4% were smokers with high nicotine dependence, 10% reported reduced physical activity, 44.4% increased mobile phone use, 39.4% increased internet use, and 28.3% experienced high anxiety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pandemic was associated with increased methadone use and maladaptive behavioral changes among MMT patients, while dispensing practices remained resilient. Strengthening telehealth capacity, flexible dosing, integrated mental health services, and family\u2010sensitive counseling will be essential to protect continuity of care during future disruptive events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71580","type":"journal-article","created":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T12:41:03Z","timestamp":1764506463000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impacts of Disruptive Events on Addictive Behavioral Patterns: A Cross\u2010Sectional Study of Methadone Maintenance Therapy During the COVID\u201019 Pandemic in Iran"],"prefix":"10.1002","volume":"8","author":[{"given":"Zahra","family":"Toreyhi","sequence":"first","affiliation":[{"name":"School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Mohammad","family":"Rezai\u2010Mersagh","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3704-9233","authenticated-orcid":false,"given":"Ali","family":"Kheradmand","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Taleghani Hospital Clinical Research Development Unit, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7356-311X","authenticated-orcid":false,"given":"Reyhaneh","family":"Mehrvar","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Societal Disruption as a Disaster: Exploring Suicide, Drug Addiction, and Domestic Violence in Australia Through a Disaster Risk Reduction Lens","volume":"13","author":"Cuthbertson J.","year":"2022","journal-title":"Progress in Disaster Science"},{"key":"e_1_2_11_3_1","unstructured":"Government of Ontario. \u201cSubstance Use\u2013Related Harms and Risk Factors During Periods of Disruption.\u201d Queen's Printer for Ontario; (2020) https:\/\/www.publichealthontario.ca."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.209160"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-3107"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2012.729845"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-8-17"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1141"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-5562-1_2"},{"key":"e_1_2_11_10_1","unstructured":"R. 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