Shiraz E-Medical Journal

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Efficacy of a Cognitive-Behavioral Relapse Prevention Model in the Treatment of Opioid Dependence in Iran: A Randomized Clinical Trial

Leili Salehi 1 , 2 and Leila Alizadeh 3 , *
Authors Information
1 Research Center for Health, Safety and Environment and Health Education and Promotion Department, Alborz University of Medical Sciences, Karaj, IR Iran
2 Community Based Participatory Research center, Iranian Institue for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran
3 Department of Maternal and Child Health, Ardabil Branch, Islamic Azad University, Ardabil, IR Iran
Article information
  • Shiraz E-Medical Journal: May 2018, 19 (5); e14170
  • Published Online: April 17, 2018
  • Article Type: Research Article
  • Received: September 27, 2017
  • Revised: February 24, 2018
  • Accepted: March 6, 2018
  • DOI: 10.5812/semj.14170

To Cite: Salehi L, Alizadeh L. Efficacy of a Cognitive-Behavioral Relapse Prevention Model in the Treatment of Opioid Dependence in Iran: A Randomized Clinical Trial, Shiraz E-Med J. 2018 ; 19(5):e14170. doi: 10.5812/semj.14170.

Copyright © 2018, Shiraz E-Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Kelly JF, Hoeppner BB, Urbanoski KA, Slaymaker V. Predicting relapse among young adults: psychometric validation of the Advanced WArning of RElapse (AWARE) scale. Addict Behav. 2011;36(10):987-93. doi: 10.1016/j.addbeh.2011.05.013. [PubMed: 21700396].
  • 2. Brandon TH, Vidrine JI, Litvin EB. Relapse and relapse prevention. Annu Rev Clin Psychol. 2007;3:257-84. doi: 10.1146/annurev.clinpsy.3.022806.091455. [PubMed: 17716056].
  • 3. Nielsen DA, Ho A, Bahl A, Varma P, Kellogg S, Borg L, et al. Former heroin addicts with or without a history of cocaine dependence are more impulsive than controls. Drug Alcohol Depend. 2012;124(1-2):113-20. doi: 10.1016/j.drugalcdep.2011.12.022. [PubMed: 22265192].
  • 4. Marlatt GA, Donovan DM. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press; 2005.
  • 5. Heather N, Stockwell T. The essential handbook of treatment and prevention of alcohol problems. John Wiley & Sons; 2004.
  • 6. Parks GA, Marlatt GA, Anderson BK. Cognitive-behavioral alcohol treatment. The essential handbook of treatment and prevention of alcohol problems. 2004.
  • 7. G. Alan Marlatt PD, George AP, Katie Witkiewitz P. Clinical guidelines for implementing relapse prevention therapy. USA: University of Washington Seattle; 2002. Available from:
  • 8. Irvin JE, Bowers CA, Dunn ME, Wang MC. Efficacy of relapse prevention: a meta-analytic review. J Consult Clin Psychol. 1999;67(4):563-70. [PubMed: 10450627].
  • 9. Momtazi S, Rawson R. Substance abuse among Iranian high school students. Curr Opin Psychiatry. 2010;23(3):221-6. doi: 10.1097/YCO.0b013e328338630d. [PubMed: 20308905].
  • 10. World drug report 2010. ed. United Nations Publications; 2010.Drugs UNOo Crime.
  • 11. Larimer ME, Palmer RS, Marlatt GA. Relapse prevention. An overview of Marlatt's cognitive-behavioral model. Alcohol Res Health. 1999;23(2):151-60. [PubMed: 10890810].
  • 12. Annis HM, Turner NE, Sklar SM. IDTS, inventory of drug-taking situations: User's guide. Addiction Research Foundation; 1997.
  • 13. Martin GW, Wilkinson DA, Poulos CX. The Drug Avoidance Self-Efficacy Scale. J Subst Abuse. 1995;7(2):151-63. [PubMed: 7580226].
  • 14. Pashaei T, Shojaeizadeh D, Rahimi Foroushani A, Ghazitabatabae M, Moeeni M, Rajati F, et al. Effectiveness of Relapse Prevention Cognitive-Behavioral Model in Opioid-Dependent Patients Participating in the Methadone Maintenance Treatment in Iran. Iran J Public Health. 2013;42(8):896-902. [PubMed: 26056645].
  • 15. Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. Am Psychol. 2004;59(4):224-35. doi: 10.1037/0003-066X.59.4.224. [PubMed: 15149263].
  • 16. Adamson SJ, Sellman JD, Frampton CM. Patient predictors of alcohol treatment outcome: a systematic review. J Subst Abuse Treat. 2009;36(1):75-86. doi: 10.1016/j.jsat.2008.05.007. [PubMed: 18657940].
  • 17. Ibrahim F, Kumar N, Abu Samah B. Self Efficacy and Relapsed Addiction Tendency: An Empirical Study. Soc Sci. 2011;6(4):277-82. doi: 10.3923/sscience.2011.277.282.
  • 18. Dolan SL, Martin RA, Rohsenow DJ. Self-efficacy for cocaine abstinence: pretreatment correlates and relationship to outcomes. Addict Behav. 2008;33(5):675-88. doi: 10.1016/j.addbeh.2007.12.001. [PubMed: 18191329].
  • 19. Taghizadeh F, Yazdani Cherati J. Procrastination and Self-Efficacy Among Intravenous Drug Users on a Methadone Maintenance Program in Sari City, Iran, 2013. Iran J Psychiatry Behav Sci. 2015;9(4). e3738. doi: 10.17795/ijpbs-3738. [PubMed: 26834810].
  • 20. Abdollahi Z, Taghizadeh F, Hamzehgardeshi Z, Bahramzad O. Relationship between addiction relapse and self-efficacy rates in injection drug users referred to Maintenance Therapy Center of Sari, 1391. Glob J Health Sci. 2014;6(3):138-44. doi: 10.5539/gjhs.v6n3p138. [PubMed: 24762356].
  • 21. Nikmanesh Z, Baluchi MH, Pirasteh Motlagh AA. The Role of Self-Efficacy Beliefs and Social Support on Prediction of Addiction Relapse. Int J High Risk Behav Addict. 2016;6(1). doi: 10.5812/ijhrba.21209.
  • 22. Burling TA, Reilly PM, Moltzen JO, Ziff DC. Self-efficacy and relapse among inpatient drug and alcohol abusers: a predictor of outcome. J Stud Alcohol. 1989;50(4):354-60. [PubMed: 2787877].
  • 23. Gwaltney CJ, Metrik J, Kahler CW, Shiffman S. Self-efficacy and smoking cessation: a meta-analysis. Psychol Addict Behav. 2009;23(1):56-66. doi: 10.1037/a0013529. [PubMed: 19290690].
  • 24. Kelly TM, Daley DC, Douaihy AB. Treatment of substance abusing patients with comorbid psychiatric disorders. Addict Behav. 2012;37(1):11-24. doi: 10.1016/j.addbeh.2011.09.010. [PubMed: 21981788].
  • 25. Cucchia AT, Monnat M, Spagnoli J, Ferrero F, Bertschy G. Ultra-rapid opiate detoxification using deep sedation with oral midazolam: short and long-term results. Drug Alcohol Depend. 1998;52(3):243-50. [PubMed: 9839150].
  • 26. Maehira Y, Chowdhury EI, Reza M, Drahozal R, Gayen TK, Masud I, et al. Factors associated with relapse into drug use among male and female attendees of a three-month drug detoxification-rehabilitation programme in Dhaka, Bangladesh: a prospective cohort study. Harm Reduct J. 2013;10:14. doi: 10.1186/1477-7517-10-14. [PubMed: 24004685].
  • 27. Sau M, Mukherjee A, Manna N, Sanyal S. Sociodemographic and substance use correlates of repeated relapse among patients presenting for relapse treatment at an addiction treatment center in Kolkata, India. Afr Health Sci. 2013;13(3):791-9. doi: 10.4314/ahs.v13i3.39. [PubMed: 24250323].
  • 28. Dennhardt AA, Murphy JG. Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students. Psychol Addict Behav. 2011;25(4):595-604. doi: 10.1037/a0025807. [PubMed: 21988480].
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