Conciencia psico-pedagógica comunicativa en la prevención del consumo de psicotrópicos y de las violencias / More awareness psycho-pedagogical for the prevention of psychotropic consumption and violence's

En este artículo se presentan los resultados de una investigación cualitativa hermenéutica cuyo objetivo fue explorar la relación del consumo de psicotrópicos y las variables psicosociales entre 1998-2019 en campus universitarios en una ciudad colombiana, un problema crítico exponencial global de salud pública que poco se afronta desde la prevención real de los factores de riesgo. Se encontró que prevalece el diagnóstico y no se evidencia una intervención preventiva que ayude a la evolución de las causas que inducen a la decisión de consumir o no. El análisis sugiere que: 1) persiste el desafío de ir más allá de las acciones punitivas o permisibles; 2) se requiere incrementar la intervención psicoeducativa que concientice al adicto sobre los riesgos del consumo de psicotrópicos; 3) resulta prioritario, para trascender el diagnóstico, indagar sobre las causas estructurales; y 4) las políticas públicas educativas deben fortalecerse con enfoques psicopedagógicos que estimulen el proceso complejo de la expresividad e impulsen la trazabilidad de la educación y la formación basada en la comunicación bidireccional en familia.

Qualitative research hermeneutical. The objective was to explore relationship of consumption of psychotropics and psychosocial variables, between 1998-2019 at campus and in a Colombian city. It is a critical global public health exponential problem that is little addressed from the risks. It was found that: the diagnosis prevails and there is no evidence of a preventive intervention that helps the evolution of the causes that induces the decision to consume or not. The analysis suggests that: 1) the challenge of going beyond punitive or permissible actions persists; 2) it is need more psychoeducational intervention to make the addict mindful for following other ways; 3) it is urgent to investigate the structural causes beyond making a diagnosis; and 4) build together other psicopedagogical educational public policy that stimulates the complex process of education-training; theses based on two-way expressiveness, optimism, kindness, and promotes the traceability communication in the family and within the curricular plan. For to reduce the multidimensional impact caused by the consumption of psychotropic drugs by human, academic, professional, sociocultural, and economic destabilization

Disfunción sexual y uso de drogas en mujeres: una relación etiológica recíproca / Sexual dysfunction and drug use in women: A reciprocal etiologic relationship

Resumen Objetivo: Realizar una reflexión sobre la relación etiológica recíproca entre la disfunción sexual femenina y la drogodependencia, y sus implicaciones prácticas e investigativas. Materiales y métodos: Se presenta una descripción de los efectos y las consecuencias a corto y a largo plazo del uso de drogas en mujeres y se analiza si el uso de drogas es la causa de la disfunción sexual o si, por el contrario, la disfunción sexual conduce al uso de drogas. Asimismo, se discute la necesidad de ahondar en la investigación que relaciona estas dos variables y sus implicaciones clínicas. Conclusión: El consumo de drogas afecta la función sexual femenina, por lo que es pertinente un diagnóstico inicial y la rehabilitación sexual tras el uso crónico de sustancias psicoactivas; asimismo, se hace indispensable implementar medidas profilácticas para disminuir el uso de drogas en la actividad sexual y sus consecuencias asociadas, y ampliar la investigación de esta área del conocimiento médico y psicológico.

Abstract Objective: To reflect on the reciprocal etiologic relationship between female sexual dysfunction and drug abuse, and its implications for practice and research. Materials and Methods: A description of the effects and short-term and long-term consequences of drug use in women is presented together with an analysis of whether drug use is the cause of sexual dysfunction or on the contrary, if sexual dysfunction leads to drug abuse. The need to conduct further research into the relationship between these two variables and their clinical implications is also discussed. Conclusion: Drug use affects female sexual function, hence the importance of initial diagnosis and sexual rehabilitation following chronic use of psychoactive substances; Implementing prophylactic measures in order to reduce drug use during sexual activity and its associated consequences; and expanding research in this area of medical and psychological knowledge.

A single-case quasi-experimental design of functional analytic psychotherapy for substance abuse / Um delineamento quase-experimental de caso único da psicoterapia analítica funcional para abuso de substâncias / Un diseño de caso único cuasi experimental de psicoterapia analítica funcional para abuso de sustancias

This study evaluated the effectiveness of Functional Analytic Psychotherapy (FAP) on clinically relevant behaviors (CRBs) in the context of substance abuse/chemical de pendence and identifying the therapeutic components of change. The Functional Analytic Psychotherapy Rating Scale (FAPRS) was used to categorize therapist and client behaviors, and Timeline Followback was used to record drug abuse. Two participants were treated in a single case A/A + B quasi-experimental design, in which A = analytical-behavioral therapy and A + B = FAP. The results showed that with the introduction of FAP, specifically the therapist's contingent responding to the participant's progress, there was a decrease in the use of substances after three months for both participants. The participant who spent more time in psychotherapy experienced greater benefits at follow-up and a larger reduction in drug use. We concluded that FAP altered CRBs by positively reinforcing progress in-session and was significantly correlated with improvement out-of-session.

O objetivo da pesquisa foi avaliar o efeito da Psicoterapia Analítica Funcional (FAP) sobre os comportamentos clinicamente relevantes (CRBs) e abuso de substâncias de dependentes químicos e identificar os componentes terapêuticos de mudança. Foram utilizados os instrumentos Functional Analytic Psychotherapy Rating Scale para categorização de comportamentos do terapeuta e cliente e Timeline Followback para registrar o abuso de drogas. Dois participantes foram atendidos em um delineamento quase-experimental de caso único A/A+B, onde A = Terapia Analítico-Comportamental e A+B = FAP. Os resultados indicaram que a introdução da FAP, em especial o responder contingente do terapeuta, acompanhou os progressos e houve melhora no consumo de substâncias após 3 meses para ambos. O participante que se manteve mais tempo em psicoterapia obteve maior benefício no follow-up e no consumo de drogas. Concluiu-se que a FAP alterou CRBs reforçando positivamente progressos em sessão e que isto provavelmente se correlacionou com melhoras extrassessão.

El objetivo fue evaluar el efecto de la Psicoterapia Analítica Funcional (FAP) en los comportamientos clínicamente relevantes (clinically relevant behaviors - CRBs) e el abuso de sustancias de dependientes químicos, e identificar los componentes terapéuticos de cambio. Se utilizaron Functional Analytic Psychotherapy Rating Scale, para clasificar los comportamientos del terapeuta y del cliente, y timeline followback, para registrar el abuso. Dos participantes fueron evaluados a través de un diseño cuasiexperimental de caso único A/A + B, donde A = terapia analítico-comportamental y A + B = FAP. Los resultados indicaron que la implementación de la respuesta contingente del terapeuta llevó a cambios en las CRBs y mejorías en el consumo de sustancias en los dos participantes después de tres meses de intervención. El participante que se mantuvo más tiempo en psicoterapia obtuvo mayor beneficio durante el seguimiento. Se concluye que FAP modificó las CRBs a través del reforzamiento positivo en sesión, lo que se relacionó con las mejoras fuera de sesión.

Estratégias utilizadas no tratamento de famílias com usuários de substâncias / Strategies for treating families affected by substance abuse users

Este estudo teve por objetivo descrever as estratégias cognitivo-comportamentais mais utilizadas por pacientes usuários de substâncias (n=52) e seus familiares (n=75) para lidar com as situações de risco durante o tratamento. A intervenção baseou-se na psicoterapia cognitivo-comportamental, e foram analisadas estratégias de fuga e enfrentamento. A análise de conteúdo destacou o suporte familiar para auxiliar o paciente no redirecionamento de novos hábitos envolvidos com o uso de drogas. A inclusão de estratégias direcionadas aos familiares dos dependentes foi importante para o treino de habilidades de mudança de comportamentos desadaptativos envolvidos no consumo de substâncias. Esses achados também ajudam na elaboração de futuras intervenções destinadas aos dependentes de drogas e seus familiares como forma de aumentar a efetividade da intervenção.

This study aimed to describe some cognitive behavioral strategies used by substance users (n=52), as well as their familiars (n=75), to handle with risky situation during the treatment. The intervention was based on the behavioral cognitive therapy, and we analyzed escape and coping strategies. The content analysis showed that the familiar support is important to help the users to change their habits linked with the substance use. The inclusion of some strategies directed to the familiars was important to change their social skills in order to handle with risk situations. These fidings also can support the development of new approaches to substance misuse users and their familiars in order to improve the quality of the interventions.

Social distance toward people with substance dependence: a survey among health professionals / La distancia social de las personas con dependencia de sustancias: una encuesta entre los profesionales de la salud

The aim of this study was to investigate factors associated with social distance toward people with substance dependence among health professionals. A hundred and eighty-three health professionals from Juiz de Fora, Minas Gerais, Brasil, were interviewed using structured questionnaires with vignettes. The vignettes assessed emotional reactions generated by alcohol, marijuana, and cocaine dependents. Belief in recovery and perception of dangerousness were significantly associated with social distance toward people with cocaine and marijuana dependence. Only belief in recovery was significant with alcohol dependence. This study provides preliminary data on factors related to the desire for social distance among health professionals, improving the understanding of stigmatization, and the development of research and training in the area.

Este estudio tuvo como objetivo investigar los factores asociados con la distancia social hacia las personas con dependencia de sustancias entre los profesionales de la salud . Ciento ochenta y tres profesionales de la salud de Juiz de Fora, Minas Gerais - Brasil fueron entrevistados mediante un cuestionario estructurado con viñetas . Las viñetas evaluaron las reacciones emocionales generados por el alcohol, marihuana y cocaína dependientes . La creencia en la recuperación y la percepción de peligrosidad fueron significativos asociados con la distancia social hacia las personas con dependencia de la cocaína y la marihuana . Sólo la fe en la recuperación fue significativa con la dependencia del alcohol . Este estudio muestra los datos preliminares sobre los factores relacionados con el deseo de distancia social entre los profesionales de la salud , la mejora de la comprensión de la estigmatización y el desarrollo de la investigación y la formación en el área.

Oficinas terapêuticas em um Centro de Atenção Psicossocial: álcool e drogas / Therapeutic workshops in a Psychosocial Care Center: alcohol and other drugs

São descritas Oficinas Terapêuticas conduzidas por psicólogos em um Centro de Atenção Psicossocial - álcool e drogas, direcionadas a adultos de ambos os sexos, usuários de álcool e/ou outras drogas. Seus objetivos principais eram proporcionar espaços de expressão, construção e transformação subjetiva. Aborda-se especialmente um encontro de uma "Oficina de Poesia". Como metodologia, a Oficina incluiu: leitura de uma poesia junto com os usuários, apreensão de seus significados, abertura de espaços de expressão nos quais os usuários, indagados pelos psicólogos, relacionavam as palavras e versos lidos a suas experiências de vida. Sete usuários participaram do encontro relatado. Falaram sobre experiências diversas: usar droga para poder se expressar; sentir-se solitário; sentir-se insatisfeito consigo mesmo; sentir a necessidade do apoio da família e dos profissionais do CAPSad. As falas dos usuários foram pontuadas por intervenções dos psicólogos. A discussão ressalta que as Oficinas são condizentes com diretrizes clínicas e políticas da Reforma Psiquiátrica.

This paper describes workshops conducted by psychologists towards drug dependent patients in a Brazilian Psychosocial Care Center. The workshops had the main objectives of fostering patients' expression, subjective construction and subjective change. We specially describe one session of a "Poetry Workshop". In this session, patients and psychologists read a poem together. The psychologists asked the patients to speak about the images and meanings of the poem and to link these images and meanings to their experiences of life. Seven patients participated in the session. They talked about various experiences: the need to use drugs to allow expression; the feelings of being lonely and of having low self-esteem; the need to search for support from the family and from the professionals of the Center. These participations allowed the psychologists to perform insight-oriented interventions. The discussion highlights that the workshops embody important political and clinical guidelines of the Brazilian Psychiatric Reform.

Afrontamiento familiar a la drogodependencia en adolescentes / The family facing up to drug dependency in adolescents

Objetivo Describir el afrontamiento familiar a la drogodependencia en adolescentes atendidos en el Centro de Deshabituación de Adolescentes en La Habana, 2009. Métodos Investigación descriptiva de corte transversal realizada en el 2009 en el contexto de la mencionada institución, sitio donde se ofrece un servicio multidisciplinario e integral dirigido a tratar la drogodependencia y sus complicaciones en adolescentes y jóvenes. La exploración del afrontamiento familiar a la enfermedad se realizó mediante entrevistas en profundidad. La unidad de análisis en la investigación fue el grupo familiar de convivencia de los pacientes drogodependientes. La fuente de información fue primaria a partir de la selección de un informante clave de la familia. El amplio volumen de datos recolectados fue procesado siguiendo el algoritmo propuesto por Taylor-Bogdan. Resultados Emergieron categorías de análisis, conceptos y proposiciones a través de los cuales se perfiló la descripción de un afrontamiento familiar a la drogodependencia desde antes de ser confirmada la enfermedad, hasta el momento del estudio. Sobresalió la figura materna, como moderadora de la relación de los familiares con el hijo enfermo en diferentes momentos de la vida de este, comportamientos familiares de justificación y encubrimiento de conductas relacionadas con el consumo de drogas de los adolescentes, percepción familiar de pérdida de control así como comportamientos de negación de responsabilidad familiar con la enfermedad del paciente y su tratamiento. Conclusiones Se identificó un estilo de Afrontamiento Familiar Evasivo a la drogodependencia, comportamiento grupal predominante, manifiesto ante las situaciones relacionadas con la historia del consumo de sustancias en los adolescentes, en el tránsito de la salud a la enfermedad

Objective To describe the various ways in which the family faces up to drug dependency in teenagers seen at the Havana's Center for Treatment of Drug Dependency in Adolescents. Methods Cross-sectional descriptive research study conducted in this institution in 2009, a place where a comprehensive multidisciplinary service is offered to treat drug dependency and its complications in adolescents and young people. The exploration of the various ways in which the family faced up to this problem was based on in-depth interviews. The analytical unit was the group of relatives living with the drug-dependent patients. The primary source of information was the chosen family key informant. The wide range of data was processed by the Taylor-Bogdanïs algorithm. Results Several analysis categories, concepts and proposals emerged, which helped to make a description of the ways the family faced up to drug dependency before the confirmation of the disease up to the moment of the study. It could be observed that the mother prevailed as the regulator of the family relationships with the sick son/daughter at different times of his/her life; there were some family behaviours in favour of justifying and covering up actions associated to drug consumption by adolescents, the family perception of loss of control over them as well as the denial of family responsibility over the patient's disease and treatment. Conclusions This research identified a sort of evasive way of family facing up to drug dependency as well as predominant group behaviour before the situations linked to the history of substance consumption by adolescents in the process of transition from health to disease

Grupos psicoterapêuticos de mulheres dependentes químicas: questões de gênero implicadas no tratamento / Drug-dependent women psychotherapeutic groups: gender issues involved in treatment / Grupos psicoterapéuticos de mujeres dependientes químicas: cuestiones de género implicadas en el tratamiento

O presente trabalho tem como principal objetivo contribuir com a discussão a respeito do tratamento de mulheres dependentes químicas em um dos dispositivos considerados mais importantes para a sua terapêutica: o grupo psicoterapêutico - psicanaliticamente orientado. Entende-se que pesquisar como se dá a transferência nesses grupos homogêneos quanto ao gênero e ao sintoma - dependência - a partir da experiência clínica contribui para abrir perspectivas de manejo neste campo. Neste texto, nota-se na experiência clínica a escolha destas mulheres em falar sobre as condições de ser mulher em suas associações livres. A dependência química aparece como secundária aos conflitos que vivenciam como mulheres. Finalmente, conclui-se que a reflexão e ampliação das possibilidades de conceber o que é “ser mulher” por estas pacientes podem interferir no vínculo simbiótico entre a paciente e a droga, potencializando, portanto, o processo psicoterapêutico.

The main objective of this work is to contribute with the discussion concerning treatment for drug-dependent women. The purpose is to approach this theme from the author’s experience. It’s based on the idea that researching about the transference in these groups called homogenous in relation to gender and symptom (dependence) can widen the perspectives of handling in this area. From the clinical experience of the author, it is noticeable the women’s preference on talking about the subject of what or how it is “to be a woman” in their free association. The drug dependence appears as a secondary issue in relation to that. In the end, it points that the possibility of widening the ways of “being a woman” by each of them, as it seemed possible in a psychoanalysis-guided group therapy, interfere in the symbiotic bonds between the patient and the drug, bringing advantages, therefore, to the psychotherapeutic effects.

El presente trabajo tiene como principal objetivo contribuir con la discusión a respecto del tratamiento de mujeres con dependencia química en uno de los dispositivos considerados más importantes para su terapia: el grupo psicoterapéutico (psicoanalíticamente orientado). Se entiende que pesquisar como sucede en la transferéncia de esos grupos homogêneos, en cuanto al género y al síntoma (dependéncia). Esta experiéncia clínica, contribuye para abrir perspectivas de manejo en este campo. En este texto, se percibe a través de la experiéncia clínica, la opción de esas mujeres en hablar sobre las condiciones de ser mujer en sus asociaciones libres. La dependéncia química surgue como secundaria a los conflitos que vivencían como mujeres. Se concluye que la reflexión y la ampliación de las posibilidades de concebir lo que es “ser mujer” por estas pacientes puede interferir en el vínculo simbiótico entre la paciente y la droga, potencializando, por consiguiente, el proceso psicoterapéutico.

HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment.

Background & Objectives: HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. Results: No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). Interpretation & conclusions: HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.